Originating in a man’s testicles, testicular cancer usually occurs earlier than life than most forms of cancer. The average diagnosis for testicular cancer is between the ages of 20 to 39. Usually, testicular cancer is very treatable. Most cases that haven’t spread can effectively be treated and then cured. Treatment usually involves surgery and then radiation therapy or chemotherapy.
There are two major kinds of testicular cancer, which are non-seminomas and seminomas. Non-seminomas metastasize to other body parts, as they are more aggressive and grow more quickly. Seminomas are slow-growing and stay localized in the lymph nodes and testicles. Seminomas are usually effectively treated with radiation treatments.
If testicular cancer has impacted your ability to work, you may be eligible to receive Social Security Disability Insurance (SSDI) benefits. In order to be eligible to receive benefits, you have had to work enough to earn enough credits to qualify for SSDI. You have had to pay in enough taxes to the SSA as well. You then must meet the requirements of the SSA in order to be determined permanently disabled and eligible to receive benefits.
You have to be disabled for at least a full year, and benefits are not payable for partial disability or short-term disability. The first six months you are disabled do not qualify for benefits. The SSA guidelines for disability vary from those set forth by insurance companies and other organizations.
Financial Expenses Related to Testicular Cancer
Of course, all cancer is expensive to treat and testicular cancer is no exception. According to the NCBI, the total treatment cost for an advanced-stage seminoma is expected to be about $48,877 while a non-seminoma treatment is expected to be about $51,592.
The treatment process involves 313-330 benign office visits, 180-190 office visits with a scrotal ultrasound, 79-83 office visits with serial scrotal ultrasounds and labs and other examinations and tests. Of course, there are costs that are involved with treating the cancer. Chemotherapy treatment is also expensive and is often required.
The Evaluation Conducted by the Social Security Administration and the Medical Qualifications
The SSA lists the criteria for qualifying for SSDI as a result of testicular cancer in the Blue Book under Section 13.25. Section 13 has the details regarding cancers and malignant neoplastic diseases in general.
Section 13.25 is specifically dealing with testicular cancer. In order to meet the requirements for SSDI approval per the Blue Book, you must have been diagnosed with testicular cancer and meet one of these conditions:
- Recurrent cancer after chemotherapy
- Progressive cancer with metastases, which means it has spread beyond the testicles
You may be granted automatic qualification if your cancer has been treated with a stem cell transplant as outlined in Section 13.28 of the Blue Book that deals with general cancers treated with a stem cell transplant. You may also qualify for SSDI if you have undergone treatment that has caused significant adverse effects on other bodily functions. In that case, the SSA will determine your eligibility based on the criteria for the affected system or body function.
Qualifying for Disability Using an RFC if the Blue Book Listing Is Not Met
Just because your testicular cancer diagnosis does not meet the Blue Book requirements for SSDI approval does not mean you are not eligible to receive SSDI benefits. You may still be able to meet the requirements to receive SSDI if you can prove that your diagnosis of testicular cancer and its treatment render you unable to be involved in substantial gainful activity.
If you can prove that you are not able to perform any work that you have performed in the past or any new work that you could be trained to do. You need to provide adequate medical evidence, such as three months of documentation that show your cancer is continuing to spread. The SSA needs to see documentation that your cancer is continuing to spread.
You will also have to provide documentation in regards to any other kinds of treatment that you have had and your response to those treatments. If any of the documents that are required are not available, the SSA may be willing to accept documentation from your medical providers that detail the pertinent conditions and treatments.
A residual functioning capacity (RFC)form should also be completed by your doctor. It provides detailed information about your condition, treatment and how it affects your functioning. As an example, if surgery has impacted your ability to lift or bend, that needs to be noted. If chemotherapy or treatment has left you fatigued and unable to stand long periods, that also should be indicated.
When the Disability Determination Services team has a complete understanding of your condition and how it impacts your functioning, they can make a better informed decision in regards to whether or not you are disabled per their guidelines.
The disability determination staff will also consider your education level, past work experience, transferable job skills and if you can transition to some other kind of work enabling you to earn substantial income.
Applying Specific Medical Tests
Several tests are effective in proving the diagnosis of testicular cancer. These can involve pathology reports, scans and lab work, and operative reports. Even with extensive documentation and medical records, the SSA can order a medical evaluation to verify your condition and how it impacts your ability to work.
The SSA will cover the cost of this medical evaluation and it will not be used for medical treatment, but rather for informational purposes. Using this approach can help them make the best decision for your particular case and situation. The evaluation can include basic tests such as x-rays or lab work as well.
Oftentimes, a mental evaluation may also be ordered. This will help the team determine if you have been impacted mentally by the condition and the treatment. Sometimes you can suffer from anxiety or depression after a cancer diagnosis, and that can play a role in your ability to work.
The process of getting approved for Social Security Disability benefits because of testicular cancer can be lengthy and complicated. You may have to go through several appeals and even appear before an administrative law judge to plead your case and present evidence.
With the right documentation and detailed records, you can be approved for SSDI benefits if you are indeed unable to work because of your condition and the treatment involved with it. The key to a successful claim is proving how your life has been impacted by keeping detailed records and accurate documentation.
Your Testicular Cancer Social Security Disability Case
If you are considering claiming Social Security disability based on testicular cancer, or have already made a disability claim and been denied, consider consulting with a Social Security disability lawyer. Most Social Security lawyers offer an initial consultation at no cost to you and they will only charge you if your claim is approved and you are awarded Social Security disability benefits.
Studies show that the chances of receiving an approval improve significantly at all stages of the claims and approval process when a claimant is represented by an attorney who regularly deals with Social Security disability claims.