Can You Get Disability Benefits for a Brain Tumor?
December 12, 2022 · 4 min read
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If you have a brain tumor, and your condition (or the side effects from your treatment) prevent you from working, then you could qualify for disability benefits.
Disability benefits provide monthly payments (up to about $3,600 for SSDI) and free healthcare—which can be a big help while you’re focusing on your health.
Getting a handle on how the Social Security Administration (SSA) determines eligibility can be tricky—but understanding their criteria is essential for navigating the application process. We’ll break down, in layman's terms, how the SSA evaluates brain tumors, how to qualify for benefits, and how to apply.
We've also created an easy, 2-minute, disability quiz that'll give you instant insight into your eligibility for benefits. After you take it, you can talk with one of our client advocates, who can give you more personalized legal advice.
The medical definition of a brain tumor is the malignant (cancerous) or non-malignant growth of abnormal cells on the brain. The SSA doesn’t outline eligibility criteria explicitly for brain tumors, but it does devote a significant amount of detail to cancer as a broad category. SSA also discusses brain tumors under the category of primary nervous system cancers (section 13.13).
Although there are dozens of different types of brain tumors that could qualify for benefits, the most common types are:
Metastases: These occur when cancer has spread from another part of the body to the brain. Lung cancer, breast cancer and melanoma are the most common primary sources. Breast cancer and ovarian cancer with metastasis qualify for automatic medical eligibility.
Meningioma: These are typically non-cancerous tumors found in the outer layer(s) between the brain tissue and skull.
Glioblastoma: This is also called a grade IV astrocytoma and is an aggressive tumor in the brain tissues.
Astrocytoma (Grades 1-3): This is the most common type of brain tumor found in adults, originating in the brain cells.
Criteria for getting disability with a brain tumor
For many, getting disability benefits can be a long process, but there are steps you can take to make things go more smoothly. For starters, you should be ready to show documentation regarding both the diagnosis and treatment of your brain tumor. The medical evidence should show you are unable to perform work duties, or that you struggle with the functions of daily life.
Here are some common pieces of medical evidence that helps the SSA determine your eligibility:
Medical history, test results, and/or lab work that specifies the type, extent, and site of the brain tumor. If the primary site of the cancer can not be determined, the SSA will refer to medical evidence documenting the various locations of cancer throughout your body.
A copy of the biopsy or needle aspiration, if an operation has occurred as part of the diagnosis or treatment. You’ll want to include an operative note and pathology report. If these documents are unavailable, the SSA will accept the summary of hospitalization(s) or other medical reports, as long as it includes details of the findings at surgery and any pathological findings.
Documentation about the recurrence, persistence, or progression of the brain tumor and how it has responded to any treatments.
Records of the types of therapy/treatment you receive and for how long, including if you have updated scans.
The list of doctors on your oncology team, such as a Specialist or Radiologist.
Records that show the long-lasting impacts of treatment, if you have long-lasting effects from the brain tumor treatment (more than 12 months).
Questions to ask yourself before beginning the disability application process
The formal guidelines the SSA uses to determine if you qualify for disability for a brain tumor are complicated, but it comes down to this: if you are unable to work because of a brain tumor, then you could qualify for disability.
If you answer “yes” to some or all of the following, you likely qualify:
Is my brain tumor cancerous? Is it stage 3 or 4?
Am I seeing an oncologist?
Do I take regular, prescribed medications for my brain tumor?
Do the medications I take impact my ability to perform normal daily functions, including my ability to work?
Do I need assistance to perform my daily tasks at home and work?
Do I have medical exams, labs, evaluation reports, and treatment protocols from the last 90 days?
You should apply for disability benefits now if:
You’re working with a physician for your brain tumor and following the prescribed treatment plan AND
You can no longer work because of the symptoms AND
You’re not making any money from work because of limited hours or pay due to your illness
Consider waiting to apply later if:
You haven’t yet stopped working (even if you worry you’ll need to soon) OR
You are newly diagnosed with a brain tumor and the treatment plan or prognosis is unclear
Probably don't apply if:
Your brain tumor isn’t having a severe impact on your life, OR
The physicians expect you to recover within the year, OR
You're working (earning more than about $1,400 per month) and don't plan to stop
If you’re ready to apply for benefits, apply sooner rather than later. Because the application process can take months (or longer), the sooner you apply, the quicker you can receive benefits.
Take our 2-minute eligibility quiz for free help. You’ll get instant insight into your eligibility, and can connect with one of our client advocates. They can give you advice specific to your situation, and our services are always free.
Two types of Social Security disability payments
When applying, keep in mind there are two types of Social Security Disability you can apply for: Social Security disability insurance and Supplemental Security Income. You can either apply for one or the other, or both at the same time.
Social Security disability insurance (SSDI) generally offers higher monthly benefit payments. You need a certain amount of “work credits” to qualify. If you’ve worked and paid taxes at least five of the past 10 years, but are no longer able to work, you likely qualify for SSDI.
What if my brain tumor does not meet the criteria?
If your condition doesn’t satisfy the criteria above, you should still consider applying for disability benefits anyways—especially if you are unable to work due to a brain tumor diagnosis and treatment.
The bottom line is the application process can be hard to navigate. Your initial application will likely get denied if you can’t clearly meet all the SSA criteria, but you can appeal your case.
Only about 20% of people applying for disability benefits win their claim with the first application. If you decide to appeal, it gives you a chance to submit new medical evidence and present your case in front of a judge. Presenting your case to a judge means you’re much more likely to win; nearly half of all applicants are approved at this stage.
How much are disability benefits for brain tumors?
Although the SSA does not specifically classify payments for brain tumors, the average Social Security disability check for someone diagnosed with a neoplasm (cancer) is $1,579.04 per month.
The maximum disability payment allowed for this condition is $3,600 per month for SSDI and $914 per month for SSI in 2023. The payment remains the same, no matter the condition and even if you have multiple qualifying conditions. These payments are set by law.
There are multiple factors considered when calculating your exact disability benefit payment, such as how many years you worked, your work history, and any additional income sources. You can find further details with our guide to how much people make on SSDI and SSI.
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