Applying for Disability Benefits with Mesothelioma

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From time to time we invite people with information useful for mesothelioma patients to contribute their knowledge. This is a guest post by Ram Meyyappan of Social Security Disability Help. Please let us know if you find it helpful.

Mesothelioma in both its early and advanced stages qualifies you medically for Social Security Disability (SSD) benefits. When in its early stages, an application for disability proceeds through the Social Security Administration’s standard review process; however, there are some forms of mesothelioma which qualify you for expedited application review and approval processes through the SSA’s Compassionate Allowances (CAL) program.

Medically Qualifying for SSD Benefits

The SSA maintains a manual of recognized impairments and the evidence required to medically qualify for SSD with each condition. This manual is known as the Blue Book and in order to receive benefits after being diagnosed with mesothelioma one of the following must be true in your case:

  • Malignant mesothelioma must be found in the pleura or pleural cavity around the lungs – either as the primary or original site of the tumors or as metastatic cancer that has spread from elsewhere in the body

OR

  •  Primary or metastatic malignant mesothelioma tumors must be present anywhere in the body and must not be controlled through your cancer treatments or prescribed therapies

To document your mesothelioma sufficiently for satisfying the SSA’s evidence requirements, your medical records must include:

  • An operative report or biopsy/pathology report

OR

  • Hospitalization records, doctor’s reports, or other documentation summarizing your case and the extent and stage of your cancer

If your mesothelioma is unresponsive to treatment, the SSA may also need to see additional documentation reporting the advancement or spread of the disease.

It is unusual for mesothelioma claims to be denied, but when they are it is typically due to a lack of appropriate medical records. For this reason, it is essential that you provide the SSA with copies of as many of the pertinent medical records as you can at the time that you apply for benefits or shortly after submitting your application.

For more information on medically qualifying with mesothelioma, visit: http://www.disability-benefits-help.org/disabling-conditions/mesothelioma-and-social-security-disability

The Compassionate Allowances Program

The SSA’s CAL program is designed to speed up the review and approval process for claims filed for specific diagnoses. Two forms of mesothelioma are included in the list of conditions that are reviewed under CAL guidelines:

  • Peritoneal Mesothelioma
  • Pleural Mesothelioma

While the CAL program ensures your application will be reviewed within just a few weeks and also virtually guarantees approval for benefits, you must still complete the full application process and provide the SSA with appropriate medical records. A biopsy or pathology report is typically all that the SSA requires for disability benefit approval under the CAL program, though including other medical records in your evidence can only strengthen your claim.

Meeting the SSA’s Financial Qualification Rules

Medically qualifying for disability benefits with mesothelioma is fairly straightforward. There are, however, also financial or technical eligibility rules of which you must be aware with both of the SSA’s disability programs.

  • To qualify for Social Security Disability Insurance (SSDI) benefits, you must be a disabled worker with sufficient work credits built up over the course of your employment history. You must also have income from employment that does not exceed $1,070 per month.
  • Supplemental Security Income (SSI) is a need-based program through which you may also receive benefits if you have very limited income and other financial resources or assets available.

You can learn more about SSDI and SI here: http://www.ssa.gov/disability/

Submitting an Application for Benefits

An application for disability benefits can be completed on the SSA’s website (http://www.ssa.gov/applyfordisability/) at any time and this is often the fastest way to initiate a claim. Applying in person at your local SSA office is also an option, though you must schedule an appointment in advance by calling 1-800-772-1213.

Whichever way you file your application for benefits, you must ensure you thoroughly complete all of the required forms and that the information you provide is consistent with the details that appear in your medical records. You should also provide copies of your medical records to the local SSA office, whether you apply online or via a personal appointment. If the SSA does not need to request your medical records from your doctor(s), your wait for SSD may be shorter.

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