Endometrial Cancer and Disability Benefits

The Social Security Disability Application Process for Endometrial Cancer

Endometrial cancer is the most common gynecological cancer in the United States. This particular cancer originates in the uterus’s inner lining. Almost all uterine cancers start in the uterus.

These are called endometrial carcinomas. This kind of cancer usually develops slowly, and more often than not, it occurs in women who are post-menopausal. According to the Ovarian Cancer Research Fund (OCRF), about 47,130 new cases of uterine cancer will be diagnosed and approximately 8,010 women died from uterine body cancers.

When this kind of cancer is caught early, it can often be cured. Even if endometrial cancer has metastasized to fallopian tubes, regional lymph nodes, or other areas of the body, there are treatment options available.

Surgery is required for endometrial cancer. Other therapies may be required, such as biological or chemical cancer treatments. Endometrial cancer and its treatments can have a major impact on an individual’s ability to work.

If you are unable to work because of endometrial cancer, you may be eligible to receive Social Security Disability benefits. In order to receive Social Security Disability Insurance (SSDI), you have to have worked enough to earn sufficient credits and to have paid enough taxes in to SSDI.

The application process can be lengthy and will involve a lot of medical records. These documents are used to determine if you are able to work or if you are completely disabled and unable to earn gainful employment.

Financial Expenses Related to Endometrial Cancer

Any kind of cancer is expensive to treat. According to the American Cancer Society, there are several expenses related to overcoming endometrial cancer.

There are doctor visits and prescriptions, both of which require copays and/or deductibles as set forth by your insurance plan.

Patients also require surgery, which involves copays and deductibles.

Endometrial Cancer Disabling Condition Social Security Benefits

If additional therapy is required, whether it is chemical or biological in nature, there are copays and deductibles involved with that as well. It's safe to say that the average cost of battling endometrial cancer may run well over $100,000.

Follow-up doctor visits after the treatment plan has been completed range from every 3 to every 6 months to ensure that the cancer has not returned and that you are recovering well.

Of course, the treatment is dependent upon the severity of the cancer and if it has spread, as well as how well you do following treatment.

Your care plan will involve physicians, oncologists, hematologists, anesthesiologists and other professionals to ensure the best plan of treatment is derived for your individual situation.


Medically Qualifying for Benefits

The Social Security Administration (SSA) maintains precise, stringent guidelines that they follow in order to determine whether an individual meets the requirements in order to receive disability benefits.

In order to receive SSDI benefits, you need to meet the guidelines for being permanently and totally disabled per the SSA guidelines per the Blue Book. There is a step-by-step disability determination process involves five detailed questions.

Going through your medical records is the most significant step in the determination process. Your medical records should include your diagnosis including any test results or labs that were used in the disability determination process.

Any medications or treatments involved in tackling your diagnosis should be specified along with their side effects and how they affect your ability to function normally.

The SSA Blue Book has a list of all of the body systems and what diseases and disorders qualify for disability. In the Blue Book, endometrial cancer is found under section 13.23, which pertains to cancer in the uterine cervix or uterine that:

  • Has spread to the pelvic wall, vagina, lymph nodes or nearby organs
  • Or
  • recurrences or persists after undergoing medical treatments.

If your endometrial cancer diagnosis does not meet these guidelines, it does not mean you cannot be approved for SSDI benefits.


Qualifying for Disability Using an RFC

Even if your cancer doesn’t meet the listing for disability, you may still be eligible for SSDI benefits with the help of a residual functional capacity (RFC) form.

This is a form completed in detail by your physician. It explains your symptoms and side effects and how they impact your ability to function.

During the RFC approval process, the SSA looks at several things including:

  • Your education level
  • Job skills and work experience
  • Your age
  • Your overall medical condition
  • How your illness impacts your everyday abilities
  • How your treatments and prescriptions impact your functioning

When the form is completed, your doctor will indicate how your treatments impact your ability to do normal activities, such as if chemotherapy makes you fatigued or weak.

Also, if that weakness impacts your ability to walk or stand for long periods. The form will also indicate if your medicine makes you feel nauseated or can require frequent bathroom trips.

The form indicates how long you can stand or sit without needing repositioning. It also indicates how much you can lift and at what frequency, your ability to bend and your ability to grasp or reach.

If these factors show your cancer diagnosis limits your abilities and the required medications and treatments impact your ability to work as well, then you can be granted benefits by the SSA through a “medical vocational allowance”.

Several tests may be required to confirm your diagnosis and to indicate how it has impacted your normal functioning. As an example, the determination team will look at biopsy and pathology reports, lab work, reporting abnormalities that are consistent with the cancer diagnosis, diagnostic test results that document any lesions or tumors and their locations and any surgical or post-operative reports that document any tumor removals and how any organs or tissue were impacted by the procedures or diagnosis. Any treatment protocols are also included in the documentation.


Applying Specific Medical Tests

It is not uncommon for the SSA to order an additional medical evaluation to determine whether the information supplied in other documents is accurate or needs to be updated.

During this process, you will be examined by a physician who is paid by the SSA.

The SSA uses this evaluation for informational purposes only and not for medical treatment. It is to confirm diagnosis and prognosis and to see how limited your functioning is after being diagnosed with this medical condition.

Sometimes a mental evaluation may also be ordered to see if the illness has impacted your mindset or caused depression or anxiety which can impact your functioning.

While the disability determination process can be long, you can be approved farther into the process depending upon the evidence and documentation provided to the SSA.

Some cases have to appear before an administrative law judge for final approval.

Additional Resources

Find Out If I Qualify for Benefits!