Approximately 150,000 people are diagnosed with colon cancer and rectal cancer every year. For most people diagnosed with cancer, financial strain is a huge concern, and for many, it could lead to financial toxicity.
According to the National Cancer Institute, financial toxicity is “a term used to describe problems a patient has related to the cost of medical care. Not having health insurance or having a lot of costs for medical care not covered by health insurance can cause financial problems and may lead to debt and bankruptcy.”
If you or someone you love has been diagnosed with colon cancer or diagnosed with rectal cancer, you may be eligible for financial assistance. The Social Security Administration (SSA) offers monthly benefits for people with colorectal cancer who are no longer able to work due to complications or treatment. While disability benefits may seem complex, it’s actually possible to qualify a number of ways.
Medical Eligibility via The Blue Book
The SSA maintains its own online resource for disability eligibility, known colloquially as the Blue Book. The Blue Book states that to qualify for disability benefits with colon cancer, you must meet one of the following criteria:
- You have an adenocarcinoma that’s inoperable or has returned despite one round of treatment
- Any squamous cell cancer of the anus has returned after surgery
- Your colon cancer has spread beyond regional lymph nodes
- You have small-cell colon cancer
To qualify via the Blue Book, you typically need to have colon cancer that’s stage III-B or beyond. This leaves tens of thousands of applicants who are technically “ineligible” for benefits via the Blue Book. If this is the case for you or your loved one, there are still ways to qualify.
Medical Eligibility With An Early Stage Of Colon Cancer
If you have colon cancer that’s at a stage before III-B, you could still qualify if you can prove the following to the SSA:
A) you’ll be unable to work for at least 12 months
B) you cannot perform any work that you’re qualified for
The SSA will look at your work history, education, and age to make a determination as to whether you’ll be approved for disability without meeting a Blue Book listing.
Applicants with a very physical job history will have the easiest time qualifying without the Blue Book because they’ll be able to argue that the complications and side effects of chemotherapy, radiation, or surgery will make it impossible to be active daily. The SSA may argue that while a police officer is unable to perform hard labor while receiving cancer treatment, a receptionist may be able to work despite his or her treatment.
Older applicants with an early stage of colon cancer will also have an easier time qualifying. Once you’re over age 50 the SSA assumes that you cannot completely switch careers and be retrained for a sedentary job that may be easier to perform despite colon cancer treatment.
For the best chance of qualifying without meeting the Blue Book colon cancer listing, ask your primary care physician or oncologist to fill out a Residual Functional Capacity (RFC) evaluation on your behalf. An RFC outlines the extent of the physical activity you’re able to perform due to your upcoming or ongoing treatment. With this information, the SSA will be able to understand your physical limitations due to colon cancer treatments. You can download an RFC online for your doctor to fill out on your behalf.
What If Your SSA Disability Claim is Denied?
Unfortunately, nearly 70% of disability claims are denied. Keep in mind that while this statistic seems staggering, this is including applications from minor children who have strict income thresholds the family needs to meet. It also includes applications from people who have disabilities that are difficult to prove “totally disabling,” like mood disorders. Colon cancer should have a much higher approval rate, but the odds are still good that you’ll be denied when you initially apply.
There is a thorough appeals process available if you are denied for disability benefits. The first stage is called Reconsideration—you fill out a one-page sheet online and ask the SSA to look at your claim again. Reconsideration claims are again usually denied.
The next step (and final step for most) in the appeals process is the disability hearing. At this stage, you’ll be able to present your case in front of a judge. The judge will ask a vocational expert to question you on your career history, working ability, and upcoming colon cancer treatments. Many claimants choose to work with a disability attorney or licensed disability advocate at this point, but working with a lawyer is completely optional. Hearings have a very high approval rate—more than ½ of all hearings are approved. Your approval rate may be higher depending on where you live and what judge presides over your case.
The most challenging part of appealing a claim is the waiting period. If you go all the way to court, expect to wait over two years to finally be approved for disability benefits. The good news here is that once approved, you’ll be entitled to a lump sum from all the months you waited for benefits while you were eligible due to colon cancer.
Starting Your Application
The easiest way to apply for disability benefits with colon cancer is online on the SSA’s website. You don’t even need to notify your doctors that you applied—the SSA will reach out to hospitals to gather medical records on your behalf. If you’d rather apply with assistance from a Social Security representative, you can also schedule an appointment to apply at your closest SSA office. To make an appointment to apply in person, call the SSA toll free at 1-800-772-1213.
If your medical records change in any way, always let the SSA know. The more medical evidence you have on hand, the higher your chances of approval. Once you’re receiving disability benefits, you can focus on what matters: your health.
About Disability Benefits Help
Disability Benefits Help is an independent organization dedicated to helping people of all ages receive Social Security disability benefits and maintaining eligibility once approved. We’ve published thousands of articles on how to qualify over the years. If you have any questions on how to qualify for Social Security disability benefits with colon cancer, feel free to email us at firstname.lastname@example.org, to reach out to us on our forum, or connect with us on social media.