While many GIST patients are able to continue working throughout their treatment, there may be a time when cancer and its associated complications can progress to the point that work becomes difficult. Social Security Disability benefits can be helpful to those seeking to maintain an independent lifestyle, while being able to afford the treatment they need.
When this happens, it may be wise to apply for Social Security Disability benefits, though it’s important to note that the process can take several months, and many applicants may be denied initially and will need to appeal.
The United States Social Security Administration (SSA) pays disability benefits to people who cannot work because they have a medical condition that is expected to last at least one year or result in death. Federal law requires this very strict definition of disability. While some programs give money to people with partial disability or short-term disability, Social Security does not.
Specific disability claims are evaluated against the Social Security Administration’s guidebook of technical medical criteria, the blue book, in order to determine whether the case in question could be considered disabling.
The blue book contains sections for adults and children, and is divided according to body region. In general, cancers are evaluated under Section 13.00: Malignant Neoplastic Diseases.
Applicants whose medical conditions are so serious that they meet disability standards are considered Compassionate Allowances (CAL). CALs are a quick way for the SSA to identify disabled individuals who most obviously qualify for allowances based on objective medical information. CAL cases will receive expedited processing within the context of the existing disability determination process. These cases are similar to terminal illness claims, although not all CAL cases involve terminal illness. For example, a person with a spinal cord injury could qualify as Compassionate Allowance, even if he or she is expected to live for many years.
CAL conditions are developed as a result of:
- Information received from public outreach hearings,
- Comments received from the Social Security and Disability Determination Service communities,
- Counsel from medical and scientific experts, and
- SSA’s research with the National Institutes of Health (NIH)
Those applying for disability benefits with a cancer will have to show the origin of the cancer, how far it has spread throughout the body, and what treatments have been received and the results of each therapy.
Patients with Gastrointestinal Stromal Tumors that are inoperable, unresectable, extend to surrounding structures, are recurrent or have distant metastases are also available for immediate awarding of benefits through the CAL. This allows those with certain obvious and more severe health conditions that are clearly disabling to receive benefits quickly. People who apply for Social Security benefits and qualify under a compassionate allowance will typically receive their first benefit payment within three weeks. The compassionate allowance listing for GIST can be accessed here: secure.ssa.gov/apps10/poms.nsf/lnx/0423022963
Types of Benefits
In general, most applicants for Social Security Disability benefits will be applying for either Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI).
SSDI is a program for disabled workers who have paid Social Security taxes for a number of years. The Social Security Administration requires applicants to have earned enough work credits to qualify for SSDI. As such, a substantial work history is required for SSDI applications. The amount of work credits required varies depending on the age of the applicant, but the rule of thumb is that you must have worked any five of the past ten years.
SSI is a program for elderly and disabled people with low income. The program bases eligibility on meeting certain financial limits, such as on income and asset values. SSI does not require a work history, which makes it a suitable option for children and those who have not been able to hold a job. SSI requires that an individual applying for benefits does not own more than $2,000 in assets.
When applying for either program, it is wise to gather all documentation needed to prove disability eligibility. SSDI applicants will need employment information, while SSI applicants should prepare financial information.
GIST patients applying for SSD benefits will also need significant medical documentation, usually in the form of hospitalization records, diagnosis of condition, supporting laboratory results, doctor’s notes, and treatment history.
Adults may begin the application on the Social Security Administration’s website, www.ssa.gov/disabilityssi or in person at an SSA office. You may also call the toll-free number at 1-800-772-1213 to make an appointment at your local office. If you are deaf or hard of hearing, please call the toll-free TTY number, 1-800-325-0778, between 7am and & 7 pm on business days. If you schedule an appointment, you will be sent a Disability Starter Kit to help you get ready for your disability claims interview. The Disability Starter Kit is also available online.
The process may seem overwhelming, but with the support of your treatment team to provide documentation and the professionals at the Social Security Administration, it is possible for GIST patients to qualify and receive the Disability benefits that will provide assistance in their time of need.