Hodgkin’s Disease and Qualifying for Disability Benefits

Summary: Can I get disability benefits if I am suffering from the effects of Hodgkin’s disease?

Hodgkin’s disease, as well as non-Hodgkin’s lymphoma, is listed as a disability in Social Security’s Blue Book under Section 13.05. To be eligible for Social Security Disability with Hodgkin’s disease, you must prove that the cancer has not gone into complete remission, or that the cancer returns within one year of finishing chemotherapy or radiation.

---

A patient with Hodgkin’s lymphoma which is not cured, or reoccurs, a year after initial treatment is automatically eligible for benefits under the guidelines of the Social Security Administration’s Blue Book.

This year an estimated 8,480 people will be diagnosed with Hodgkin’s disease in the United States.

Also known as Hodgkin’s lymphoma, Hodgkin’s disease (or HD) is a type of blood cancer that begins in the lymphatic system. Hodgkin’s disease occurs most commonly in individuals aged 20 – 29 and over 55. If discovered early, Hodgkin’s disease responds well to treatment, and the survival rate has risen steadily since 1975.

The lymphatic system consists of a network of tiny filters called nodes which rids the body of waste, drains fluid from the body and protects it from infection.

Hodgkin’s disease begins when lymphocytes, the white blood cells in the lymphatic system, grow abnormally and out of control, spreading into other tissue. There are two types of lymphocytes, B cells and T cells. B lymphocytes make proteins called antibodies to protect the body from germs while T lymphocytes destroy germs or abnormal cells in the body. As the disease progresses, it becomes more difficult for the body to fight infection.

Can I get Disability Benefits for Hodgkin’s disease?

Hodgkin’s disease, as well as non-Hodgkin’s lymphoma, is listed as a disability in Social Security’s Blue Book under Section 13.05.Hodgkin’s disease, as well as non-Hodgkin’s lymphoma, is listed as a disability in Social Security’s Blue Book under Section 13.05.

To be eligible for Social Security Disability with Hodgkin’s disease, you must prove that the cancer has not gone into complete remission, or that the cancer returns within one year of finishing chemotherapy or radiation.

With the assistance of your doctor, you should provide Social Security with detailed medical records, including:

•   Medications you take;
•   Tissue and lab reports;
•    Results of blood tests and imaging tests;
•   Reports of chemotherapy and radiation treatments;
•   Reactions to and side effects of treatments;
•   Related medical complications, such as heart problems or intellectual problems;
•   Limitations to working, such as needing frequent breaks or time off; and
•   Impacts on your daily life and caring for personal needs.

But even if you don’t meet the requirements of Social Security’s listing, you may still be too sick to work.

Individuals with Hodgkin’s disease are at constant risk of infection and long-term complications associated with treatment can lead to cardiovascular disease, thyroid dysfunction and second cancers. If you can provide evidence that you’re still unable to work because of complications that persist for at least one year, you may still qualify for disability benefits.

Additionally, you may still be eligible for Social Security Disability benefits if you have another impairment; for example, a vascular disease or diabetes.

Applicants often have more than one illness or injury that prevents them from working full time. By itself one disorder may not meet the requirements of an impairment as stated in Social Security’s Blue Book. However, if an applicant has multiple medical conditions, Social Security must consider how those health issues, combined together, limit an applicant’s ability to hold a job and perform necessary daily tasks. Social Security will also evaluate how your limitations affect your ability to work (called a medical-vocational assessment), taking into account whether or not you are able to drive, your age, and level of education.

If you are 55 or older or have another medical condition you may get approval.

Social Security follows a set of rules to determine when the agency expects an applicant to learn a new job.

Applicants who are 55 or older often fall under a grid rule, which means they are not expected to learn a new job. For example, a 55-year-old applicant with no transferable skills might be found disabled. If you can’t go back to your old job, and you don’t have the skills to learn a new one, Social Security will likely grant you disability benefits.

You may also be eligible for Social Security Disability benefits if you have another medical condition; for example, diabetes or high blood pressure.

One disorder by itself may not match the requirements of an impairment as stated in Social Security’s Blue Book, but if you have more than one medical condition, Social Security must consider how those health issues combined limit your ability to hold a job and perform necessary daily tasks.

Social Security also has basic financial requirements.

Before you are eligible for Social Security disability benefits, you must satisfy some basic financial requirements.

You must: 1) have a disability that has lasted or is expected to last 12 months; and 2) you must have worked in a job where you paid Social Security taxes long enough and recently enough; and 3) you must not earn more than Substantial Gainful Activity (SGA), which is $1,550 per month in 2024 for nonblind applicants and $2,590 per month for blind applicants.

What if I don’t qualify for SSDI?

If you haven’t worked long enough to earn enough work credits, or if you earn too much income, you may be eligible for disability benefits through another Social Security program, such as Supplemental Security Income (SSI), or from a long-term disability insurance plan through your employer or a privately purchased policy.

SSI is a program that pays monthly benefits to people with limited income and resources who are disabled, blind, or age 65 or older. SSI is based on income instead of work credits, and is financed by general funds of the U.S. Treasury.

I have long-term disability insurance – should I file a claim?

Yes, you should file a claim as soon as you become disabled.

Long-term disability insurance (LTD) is coverage that protects your income if you are unable to work due to illness or injury and is purchased as part of a group employment plan or privately through an insurance company. Policies pay between 50-60% of your salary and benefits continue until you return to work or for the number of years stated in the policy. However, LTD coverage is good only as long as you are employed, so do not quit your job before you file a claim, and be sure to check your policy’s definition of “disabled” as each policy will state the definition of “disabled” which is in use. Additionally, be aware that long-term disability insurance companies can require a claimant to also apply for SSDI.

How do I file for Social Security Disability benefits?

You can apply for Social Security Disability benefits online, over the phone, or in person at your local Social Security Administration office.

If your initial application is denied, don’t be discouraged. Approximately 65% of initial applications are denied, but you will have the opportunity to appeal.

There are four steps to the Social Security appeal process:

1.    File a Request for Reconsideration with the Social Security Administration to completely review the case.
2.    If you don’t agree with SSA’s response to your Request for Reconsideration, you can request a hearing before an Administrative Law Judge (ALJ). ALJs are attorneys who work for the Social Security Administration; they review SSDI cases and either uphold or overturn decisions to deny SSDI benefits. If you are not represented by an attorney at this point, now is the time to obtain legal counsel. This is a critical point in the process and will raise your chance for success.
3.    If an ALJ does not grant your claim, you can request that the Appeals Council review your case.
4.    Federal Court review. The final step in the appeal process is filing suit in U.S. District Court.

Do I need a disability attorney for SSDI?

Qualifying for Social Security Disability benefits is problematic because the requirements of Social Security’s impairment listing are very difficult to decipher.

Your chances for approval are increased significantly if you have an experienced disability attorney who can gather your necessary medical evidence and even write a brief explaining why you qualify. At each potential stage of the process, from the initial application stage, the reconsideration stage and the ALJ hearing stage, an attorney can assist you in completing the detailed forms and questionnaires required by Social Security, collecting and submitting relevant medical evidence, and preparing questionnaires for your doctors. At the ALJ hearing phase an attorney will not only continue to assure that the evidence is complete, but prepare you for questioning by the ALJ, prepare an argument on your behalf and question any doctors or vocational experts selected by the ALJ to testify at the hearing. At the Appeals Council and federal court level, a lawyer can present legal arguments to show your case was wrongfully denied. Fees charged by disability attorneys are regulated by federal law and are usually 25% of disability backpay you are owed. There are no out-of-pocket costs, and if you don’t win your case, you won’t be charged anything.

Do I need a disability attorney for a long-term disability insurance claim?

Whether you have a long-term disability insurance policy purchased through a private insurance broker or a group policy purchased with your employer, filing a claim for long-term insurance is a complex process.

The wording of LTD policies can be confusing and the laws and regulations which affect the two types of LTD insurance differ in their procedures for filing claims and appeals. An experienced LTD attorney with thorough knowledge of ERISA laws and regulations will avoid mistakes and increase your chance of success. An attorney will act on your behalf, completing your application and filing your claim in a timely manner. They can also negotiate a settlement or file an appeal for you. If it becomes necessary to file suit, an LTD attorney can prepare your case against an insurer. Most LTD attorneys handle cases on a contingency basis and charge approximately 25%-40% of a claimant’s past due benefits. You do not pay an attorney’s fee unless the attorney wins your case.

Author: Attorney Greg Reed has been practicing law for 29 years. He is Superlawyers rated by Thomson Reuters and is Top AV Preeminent® and Client Champion Gold rated by Martindale Hubbell. Through his extensive litigation Mr. Reed obtained board certification from the Texas Board of Legal Specialization. Greg is admitted to practice in the United States District Court - all Texas Districts and the United States Court of Appeals-Fifth Circuit. Mr. Reed is a member of the Travis County Bar Association, Texas Trial Lawyers Association, past Director of the Capital Area Trial Lawyers Association, and an Associate member of the American Board of Trial Advocates. Mr. Reed and all the members of Bemis, Roach & Reed have been active participants in the Travis County Lawyer referral service.