Prostate Cancer and Disability Insurance Benefits
Can I get disability benefits if I am suffering from the effects of Prostate Cancer?
Author Attorney Greg Reed:
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.
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.
In order to qualify for Social Security Disability, you will need to satisfy a few specific requirements in two categories as determined by the Social Security Administration.
The first category is the Work Requirements which has two tests.
- The Duration of Work test. Whether you have worked long enough to be covered under SSDI.
- The Current Work Test. Whether you worked recently enough for the work to actually count toward coverage.
The second category is the Medical Eligibility Requirement.
- Are you working? Your disability must be “total”.
- Is your medical condition severe? Your disability must be “severe” enough to interfere with your ability to perform basic work-related activities, such as walking, sitting, and remembering.
- Is your medical condition on the List of Impairments? The SSA has a “List of Impairments” that automatically qualify as “severe” disabilities. If your disease is not listed this does not mean you cannot get disability, it means you must prove you cannot maintain employment due to your limitations.
- Can you do the work you did before? SSDI rules look at whether your medical condition prevents you from doing the work you did prior to developing the condition.
- Can you do any other type of work? If you cannot do your prior work, an evaluation is made as to whether you can perform any other kind of work.
More details can be found on our Qualifying for Disability page.
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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