Prostate Cancer and Disability Insurance Benefits
Author Attorney Greg Reed:
Updated: 8/13/2024
Can I get disability benefits if I am suffering from the effects of Prostate Cancer?
Prostate cancer is recognized as a disabling impairment under section 13.24 of the Blue Book. The determination process for disability status involves assessing the cancer’s origin, extent, treatment responses, and any side effects following treatment. Automatic qualification for disability benefits occurs if the prostate cancer progresses despite hormone treatment, recurs after such treatment, or has metastasized to other internal organs. Applicants must provide substantial medical evidence to demonstrate the severity of their condition and its impact on their work capabilities. For those whose prostate cancer does not meet the impairment listing may still qualify for disability benefits if the inability to work can be proven
Can I get disability benefits if I am suffering from the effects of Prostate Cancer?
Prostate cancer is a cancer that occurs in the prostate, a small walnut-shaped gland in men that produces semen, the fluid that transports sperm. While prostate cancer can be a serious disease, most men with prostate cancer do not die. The American Cancer Society estimates that one in eight men will be diagnosed with prostate cancer at some point in their lifetime. Prostate cancer is one of the most common types of cancer, occurring most often in men 65 and older but rarely in men under 40.
Treatment depends on the patient’s overall health, how fast the cancer is growing, whether the cancer has spread and the benefits and side effects of treatment.
In some cases, treatment may not be needed immediately – or ever. Doctors sometimes recommend surveillance with regular blood tests, exams and prostate biopsies. This approach is often followed when the cancer is not causing any symptoms, is expected to grow slowly and is confined to a small area of the prostate. This strategy may also be recommended when the patient has another serious health condition or is at an advanced age. In more advanced cases, treatment may include surgery, radiation, hormone therapy, chemotherapy, immunotherapy, and targeted drug therapy.
Demonstrating that you are following your doctor’s treatment plan is an important part of qualifying for disability benefits.
Prostate cancer and Qualifying for Disability Benefits.
Prostate cancer is listed as a disabling impairment in Social Security’s Blue Book under section 13.24. When Social Security is evaluating whether a cancer is disabling, it considers the origin and extent of the cancer, treatments and responses to treatment, and post-treatment side effects.
An applicant will automatically qualify for Social Security Disability benefits if:
- they have prostate cancer that progresses despite hormone treatment, or
- their prostate cancer recurs despite hormone treatment, or
- their prostate cancer has metastasized (spread) to other internal organs.
Social Security will want to see medical evidence proving the severity of your prostate cancer and its impact on your ability to work. In addition to a complete medical history, you should be prepared to provide:
- Statements and exam reports from your doctors and specialists.
- Results of bloodwork and laboratory test results, such as PSA levels.
- Results of imaging tests such as x-rays, bone scans, CT scans, MRIs or PET scans.
- Results of surgical procedures, including biopsies and needle aspirations.
- Hospitalization reports.
- Evidence of recurrence and progression of cancer.
If your prostate cancer does not meet the requirements of Social Security’s impairment listing, but you are still unable to work full-time, you may still qualify for disability benefits.
Social Security will conduct a Residual Functional Capacity assessment (RFC) to evaluate what work-related tasks you are still capable of performing. Social Security will consider how long you can walk, stand, or sit and how much weight you can lift, as well as what accommodations you might need, like frequent restroom breaks. Prostate cancer patients need to urinate frequently and often have pain and stiffness in their hips and back. If Social Security finds that, given your RFC limitations, age, education level, and job skills, there are no jobs you can do, you can be granted disability benefits via a “medical-vocational allowance.”
Additionally, if you have another impairment, for example, high blood pressure or arthritis, you may be eligible for SSDI.
Applicants often have more than one illness or injury that prevents them from working full-time. One disorder alone may not meet the criteria of an impairment as stated in Social Security’s Blue Book, but if an applicant has multiple medical conditions, Social Security must consider how those health issues, combined together, limit the applicant’s ability to hold a job and perform necessary daily tasks.
Once Social Security determines the limitations caused by your condition, they will employ a vocational expert to assess whether a person with these limitations is employable.
“Once Social Security determines the limitations caused by your condition, they will employ a vocational expert to assess whether a person with these limitations is employable. Most vocational experts will find a person to be unemployable if their condition or the treatment rendered for the condition causes the person to regularly be absent two or more days a month or be “off-task” 15% or more of the workday.”
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Disability Benefits FAQs
Social Security has some 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.
Basic SSDI Requirements –>
You may also be eligible for Social Security Disability benefits if you have another medical condition.
One disorder alone may not meet the criteria 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.
Disability for Multiple Impairments –>
If you are 55 or older or have another medical condition you may get approval.
Applicants who are 55 or older often fall under a grid rule, which means they are not expected to learn a new job.
Disability for those over 55 –>
You may also be eligible for Social Security Disability benefits if you have another medical condition.
One disorder alone may not meet the criteria 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.
Disability for Multiple Impairments –>
Should you file a claim?
If you believe that you meet Social Security’s medical and financial requirements, you should apply for benefits. If you are still unsure or would like to talk to someone, please contact us at 512-454-4000. We are always ready to take your call and discuss your options with you free of charge. We are happy to help folks just like you find the best solution for their personal situation.
How do I file for Social Security Disability benefits?
Once you have decided to file a claim, you can take the first step and apply for Social Security Disability benefits in person at your local Social Security Administration office, online, or over the phone.
How to Apply for SSDI –>
Appealing denied benefits
Most who file are denied initially. That doesn’t mean you won’t qualify; you just need to file an appeal.
There are four steps to the Social Security appeal process.
SSDI Appeals Process –>
Do I need a disability attorney for SSDI?
You may certainly file a claim on your own, but evidence shows that your chances for approval are increased significantly if you have legal representation.
Do I need an SSDI attorney–>
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.
What is Supplemental Security Income or SSI?–>
I have long-term disability insurance – should I file a claim?
Absolutely – you should file a claim as soon as you become disabled.
LTD Disability Appeals Process–>
Disability benefits are an important source of income for those who are unable to work. If you are not able to work due to accident or illness, you may be eligible for Social Security Disability or Long Term Disability benefits. If you have applied for benefits and been denied, contact the attorneys at Bemis, Roach and Reed for a free consultation. Call 512-454-4000 and get help NOW.
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.
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