Can You Get Disability for Breast Cancer? How to Qualify
June 9, 2022 · 6 min read
Are you unable to work because of breast cancer? If so, there’s a good chance you qualify for monthly payments and free health insurance from the United States government.
Many breast cancer patients and their families receive life-changing benefits from the Social Security Administration. But not everyone with breast cancer is eligible, and government rules can make applying a nightmare.
At Atticus, we help people cut through the red tape and get the benefits they need. We’ll explain clearly how this program works for people with breast cancer, then tell you what to do if you want to qualify.
Can you get disability benefits with breast cancer?
Yes, breast cancer can qualify for disability benefits. If your breast cancer is late-stage, very aggressive, or will require long-term treatment, you’ll qualify for Social Security disability benefits.
You’re also protected from discrimination by the Americans with Disabilities Act (ADA).
However, if your cancer is less aggressive and your doctor expects you to be cured within a year with normal treatment, you probably won’t qualify for benefits.
Does breast cancer automatically qualify for disability benefits?
Only certain kinds of breast cancer automatically qualify for benefits.
Under government rules, some medical conditions — like needing a kidney transplant or losing both your legs — always qualify for disability benefits under the Compassionate Allowances Program. Others — like pregnancy — are never enough to qualify.
Breast cancer is somewhere in between: You can qualify for benefits due to breast cancer, but just being diagnosed isn’t enough.
Instead, whether you’ll receive benefits depends on the progression of your illness and how your condition and treatment impact your ability to work.
When does breast cancer qualify for disability benefits?
Breast cancer usually qualifies you for benefits if any of the following is true:
Your breast cancer is stage IV (stage 4) or metastatic, meaning it has spread to other parts of your body. Breast cancer with distant metastases and breast cancer that is inoperable or unresectable automatically qualifies for benefits.
Your breast cancer is inflammatory breast cancer (IBC), which automatically qualifies for benefits.
Your breast cancer is small cell (also called oat cell).
Your treatment is expected to last for at least a year, and during that time you’ll experience significant side effects that make it hard to work.
The formal guidelines are complicated, but it boils down to this: If you can’t work because of your condition despite trying to overcome it, and as a result you just can’t hold a job, you’ll probably qualify as disabled. Here are some other signs you will be approved for disability.
What benefits can I qualify for with breast cancer?
SSDI is a government program that supports Americans who are medically unable to work. When someone says they’re “on disability” for a long period, they usually mean that they’re getting payments from Social Security Disability.
The program is huge: 7.6 million disabled workers received benefits in 2022, and about 2% of every U.S. paycheck goes to fund the program via taxes.
People who qualify for Social Security Disability get two big benefits:
They also get other benefits, including extra money for young kids, forgiveness of student loan debt, an easier time qualifying for other programs, and higher Social Security Retirement payments later in life. There’s no downside to receiving benefits, and it’s free to apply.
In order to qualify for SSDI, six things usually have to be true:
You’re under 66 years old
You’re getting treatment for a serious medical condition
Because of your medical condition, you can’t realistically hold a job
You’re not currently working (or if you are, it’s part-time and low-paid)
You’re not expected to recover (or be able to work) within a year
Before getting sick, you worked and paid taxes for years
Supplemental Security Income
If you didn’t work previously, but you and your family have very little money, you can still qualify for a related program called Supplemental Security Income (SSI). You can receive up to $943 per month from SSI in 2024, and some people qualify for both SSDI and SSI.
Breast cancer is the second most common cancer diagnosed in women in the United States. Most breast cancer is extremely treatable if detected early, and survival rates increase each year.
Even so, living with breast cancer is frightening and the fight to treat it can be debilitating. Though some people with breast cancer are able to work, many have to stop for long periods or permanently retire.
Here’s how breast cancer can make it difficult or impossible to hold a job:
Cancer treatments (like chemotherapy and radiation) can cause severe side effects, including fatigue, nausea, loss of appetite, diarrhea, constipation, or troubles with memory and focus (often called “chemo fog”).
Getting treatment or surgery can require extensive time away from work, making it impossible to hold onto a regular job.
Breast cancer can be emotionally overwhelming, causing serious mental illnesses like depression or anxiety. Because of these symptoms, many people with breast cancer lose their jobs and find themselves unable to earn a living.
I have breast cancer. Should I apply for benefits?
If you can’t work because of breast cancer and your doctors don’t think you'll get better within a year, you should probably apply for benefits. It’s free and the help can be life-changing.
But applying does take time and effort, and not everyone qualifies — so it’s only worthwhile if you have a chance of success. Here’s our advice:
Apply now if:
You’ve been unable to work because of your cancer (either direct symptoms or side effects from treatment), AND
Your doctor tells you that your cancer is severe (stage IV, small cell, unusually aggressive, etc.) and you’re unlikely to fully recover within a year.
Consider waiting and applying later if:
Your cancer was just diagnosed and it’s not yet clear how severe it is or how long treatment will last, OR
You haven’t yet stopped working (even if you worry you’ll need to soon).
Probably don’t apply if:
Your cancer isn’t having a severe impact on your life, OR
Your doctor expects you to recover within the year, OR
You’re working (earning more than about $1,550 per month) and don’t plan to stop during treatment.
Whether you decide to apply now or later, the best thing you can do in the meantime is to get as much medical care as possible. Build a good relationship with your oncologist (cancer doctor), try the treatment they recommend, and make sure your doctor understands the impact your condition has on your life.
This will help build the paper trail you need to get benefits. And more importantly, it’s critical for your health.
Applying for disability takes preparation. You can win, but this system doesn’t make it easy. So it’s worth taking some time to understand how things work.
The first step is to make a choice: Do you want to (a) Apply on your own, or (b) Get a professional to handle the process for you? Most successful applicants hire a professional — and for breast cancer patients in particular, that’s generally the right call. But not everyone needs to, and not everyone who wants to can. We’ll explain both paths and help you decide.
How the process works
The government fears that people will exaggerate their medical problems in order to get free money. So it puts every applicant under a microscope.
To win, you have to prove — beyond a doubt — that your medical condition is severe and disabling. There are two major stages in the process, and most people will need to go through both:
Initial Application: You submit a lengthy written application with details on past work and treatment and copies of your medical records. A government staffer reads your file and makes a decision. (Only 20% of people win benefits at this stage; most applicants are denied.)
Appeals: If you lose, you appeal your denial and eventually get a hearing with a judge. At the hearing, you get to submit additional evidence, speak to the judge directly, and cross-examine government experts. (Among people who make it to this stage, about 50% win. If you lose, there are several more stages of appeal.)
Unfortunately, the process takes time: Three to six months to get an initial decision, and one to two years (or more) to get a hearing.
Even a small mistake or omission (like a doctor failing to send in records, or a bad answer on a form) can doom an application. The good news is that once you win — even if it takes a long time and several appeals — you get back pay (retroactive benefits) for some of the time you spent waiting.
Why most people seek professional help
Because the process is so complicated, most successful applicants get a lawyer (or trained non-lawyer representative) to help. Lawyers will pull together your medical records, write your application, advise you on getting proper medical treatment, submit all the paperwork, and (if needed) argue your case before a judge.
There are two big upsides to hiring a lawyer: They do almost all the work for you and hold your hand through the process and a disability lawyer increases your chance of winning. (Government studies show that at the appeal stage, people with a lawyer are three times as likely to qualify.)
The only downside is cost. Lawyers aren’t allowed to charge any up-front fee, so it doesn’t matter if you can afford one right now. If they win your case, they get 25% of any back pay (retroactive benefits) that they win for you.
This is worth it for almost everyone — you only pay if you win (if you lose, you pay nothing), you only pay once, and the cost pales in comparison to the amount you get.
Should I hire a professional?
Almost every applicant who applies because of breast cancer should hire a lawyer or other professional. (We don’t say this to everyone — see, for example, our articles on Huntington’s disease or pancreatic cancer.)
Why? This process can be particularly unfair for breast cancer patients. Since it’s hard to diagnose (there’s no official test for breast cancer) and isn’t always disabling, the government treats breast cancer patients with suspicion and requires detailed proof. Having assistance from an expert can make all the difference.
There are only a handful of situations where we tell breast cancer patients to consider applying on their own:
If you have stage IV cancer, oat cell (small cell), or terminal breast cancer: The government treats these cases differently than other types of cancer cases and fast tracks the review of your application. You can likely win on your own, as long as you feel comfortable with government paperwork (about the same as filing your taxes) and requesting medical records.
If you can’t convince a lawyer to take your case: Sadly, this can happen; if your case is quite hard to win, it can be difficult to find a lawyer to represent you. (Though we recommend trying our service before you give up!) In this case, you can apply on your own, and then try again to find a lawyer once you’ve been denied once — at which point it’s often easier.
How Atticus can help
Atticus is a new kind of law firm that helps you navigate the early stages of a disability claim. We help you choose the right approach, hire the right lawyer, and get on with your life. We won’t charge you a dime for our services, so there’s no cost to you. Take our 3-minute quiz to see if you qualify for help.
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