Educational Information

Disability Benefits for Breast Cancer Patients: Things You Need to Know

Disability Benefits for Breast Cancer Patients: Things You Need to Know

Updated March 2024

Did you know that you might be able to qualify for Social Security disability benefits if you have breast cancer? The U.S. Social Security Administration (SSA) offers monthly disability benefits for qualifying women with breast cancer who cannot work due to breast cancer and its treatment. These disability benefits can help breast cancer patients pay for living and other expenses if they are too sick to work, or if they have lost their job due to their diagnosis and subsequent treatment. Read below for information that can help you unlock breast cancer disability secrets.

Disclaimer: NBCF does not provide medical or legal advice. This information is intended only to provide a general background on available breast cancer disability benefits. Please contact a medical or legal representative with questions.

Table of contents

Is breast cancer a disability?
Who qualifies for breast cancer disability?
What benefits are available for eligible breast cancer patients?
Does breast cancer always qualify as a disability?
Applying for breast cancer disability: What you need to know
Breast cancer disability was denied: Now what?
Breast cancer disability ratings for veterans and service members

Is breast cancer a disability?

According to the Social Security Administration (SSA), the definition of disability is “the inability to do any substantial gainful activity by reason of any medically determinable physical or mental impairment which can be expected to result in death or which has lasted or can be expected to last for a continuous period of not less than 12 months.”

This means that breast cancer can be considered a disability if it causes you to miss work for one year or more and if you meet certain other medical criteria. Typically, those with Stage 3B breast cancer and beyond will qualify for breast cancer disability. However, women with earlier stages may still qualify for certain benefits.

Who qualifies for breast cancer disability?

The Social Security Administration (SSA) has a guide entitled Disability Evaluation Under Social Security, but it is commonly known as the Blue Book. The Blue Book lists the requirements for breast cancer to be considered a disability. For breast cancer to be considered a reason for disability, the cancer must meet at least one of the following criteria:

  • Locally advanced breast cancer, including inflammatory breast cancer, cancer of any size with direct extension to the chest wall or skin, or cancer of any size with spread into the lymph nodes
  • Breast cancer that has spread above or below the collarbones, to 10 or more nearby lymph nodes, or to distant regions of the body (metastatic breast cancer)
  • Breast cancer that returns after previous cancer treatment
  • Breast cancer that is inoperable or untreatable
  • Small-cell (oat cell) carcinoma
  • Secondary lymphedema (swelling due to lymphatic system damage resulting from breast cancer treatment) may be considered a disability if it required surgery to treat and affects the functioning of the arm

You can read the Blue Book’s official definitions for breast cancer disability criteria here, though these criteria may be difficult to understand without the help of a medical professional. You may want to talk with your healthcare provider to help determine whether your type of breast cancer is likely to qualify for a disability and to begin gathering the necessary forms and documentation.

What benefits are available for eligible breast cancer patients?

There are several benefits available for eligible breast cancer patients, including Social Security Disability Insurance (SSDI), Supplemental Security Income (SSI), and support through the Americans with Disabilities Act of 1990 (ADA). There are additional benefits listed below as well.

Social Security Disability Insurance (SSDI)

Social Security Disability Insurance (SSDI) is a federal benefit for people who have disabilities, including breast cancer, that keep them from working. To qualify to receive SSDI, the person applying must have either:

  • Worked in jobs where they paid into Social Security
  • Be self-employed people and pay self-employment taxes
  • Met Social Security’s definition of disability, including breast cancer

For more information about SSDI, including information on how to apply for SSDI, click here.

Supplemental Security Income (SSI)

Supplemental Security Income (SSI) is a program that pays monthly benefits to people with certain disabilities, including qualifying breast cancers, who have limited income and resources. If you have cancer, your SSI application may be processed more quickly. Those who may be eligible to receive SSI include those with:

  • Income and assets below a certain level (levels vary from state to state)
  • A medical condition, such as breast cancer, that prevents the patient from working for at least one year
  • Other applicable conditions and considerations

For more information about SSI, including information on how to apply for SSI, click here.

Americans with Disabilities Act of 1990 (ADA)

The Americans with Disabilities Act of 1990 (ADA) is a law that helps protect the civil rights of those with disabilities, including breast cancer patients who may need additional accommodations at work or getting around. The ADA can support those returning to work during or after breast cancer treatment.

For more information about how the ADA can support breast cancer patients, click here.

Compassionate Allowance Initiative

As part of Social Security Disability Insurance (SSDI), the compassionate allowance initiative is for those with distant metastases or recurrent breast cancer, also called Stage 4 breast cancer or metastatic breast cancer. It is designed to speed up the benefits process for those who cannot work. Compassionate allowance entails less documentation than other breast cancer disability programs, requiring a claim for benefits, medical paperwork, and treatment plans, which healthcare providers can help you locate and organize.

Medical vocational allowance for breast cancer

If you do not meet all of the Blue Book criteria for a breast cancer disability, such as having an advanced stage or terminal cancer, but are too sick to work, you may qualify for a medical vocational allowance. This allowance considers the inability to work for 12 months or more and is based on age, work history, and breast cancer treatment. This allowance relies on a Residual Functional Capacity (RFC) evaluation, which your doctor will complete to assess your ability to stand, sit, walk, carry weight, and more.

Auxiliary benefits

In some cases, your family may qualify for auxiliary benefits. To qualify, a spouse must be under the age of 62 and be the joint caregiver of your children, who must be under the age of 16. Dependent children must be under age 18, enrolled in school full time, and unmarried to qualify.

Breast cancer disability benefits may vary based on breast cancer stage, work history, and need. There is typically a five-month waiting period after disability benefits are approved and before they are disbursed. However, the compassionate allowance program mentioned above can speed this timeframe up significantly for Stage 4 breast cancer patients.

Does breast cancer always qualify as a disability?

Breast cancer does not always qualify for disability benefits.

Typically, cancer must be Stage 3 or higher and locally advanced (spread) to at least 10 lymph nodes or other parts of the body, as outlined in the Social Security Administration’s Blue Book.

If treatment is expected to last less than one year or not result in missed work, it would not be considered a breast cancer disability.

Please check with your medical provider to determine if your type and stage of breast cancer makes you eligible for disability benefits.

Applying for breast cancer disability: What you need to know 

You can apply for breast cancer Social Security disability benefits online at your convenience. The process typically takes one to two hours, but you do not have to complete the entire application in one sitting; you can save your progress and return later with a re-entry number provided by the Social Security Administration. If you file an application online, you can use online tracking to follow its progress.

If you have questions or would prefer to complete the application in person or by phone, you can call 800-772-1213 to make an appointment. This is also an option if you would prefer to apply in a language other than English. You are welcome to bring a family member, friend, or caregiver with you to the appointment.

The Social Security Administration also offers a helpful two-minute video with tips on applying for breast cancer disability.

There are four key steps for online applications:

  1. Examine the application’s “Get Ready” section to ensure you meet the requirements for breast cancer disability and that you have all of the information required, such as medical and work-related forms.
  2. Select “Start a New Application” to begin the process and continue to follow the prompts.
  3. Create or log-in to your account.
  4. Complete the application in full (unless you prefer to do it in more than one session, in which case you can save your application and use the provided re-entry number to return to it at any time). The application includes background information, disability information, a medical release, and confirmation of these items.

It is important to complete this form as completely and clearly as possible to prevent a denial based on missing or incomplete information.

Once your application is completed and filed, the Social Security Administration may contact you with follow-up questions. As a general rule, you will receive a decision letter via mail in about three to five months, which will detail if you have been approved and the amount of disability benefits you can expect to receive.

Breast cancer disability was denied: Now what? 

If your application for breast cancer disability is denied, it may be because you have an earlier stage of breast cancer (typically Stage 0, Stage 1, or Stage 2) or because treatment for your specific breast cancer is expected to last for less than 12 months. However, it may also be related to missing or incomplete paperwork.

If this happens, you can appeal within 60 days of receiving the decision. According to the Disability Benefits Center, about 60% of initial disability applications are denied, but the chances of approval increase with an appeal. It is important to act fast.

Your appeal can include the side effects of treatments such as chemotherapy or radiation that are preventing you from working. You may have also received further testing since the date of your original application that shows progression of symptoms or cancer stage. If you have new medical evidence, this is the time to share it.

You may also be asked to undergo a Residual Functional Capacity (RFC) test, where a healthcare provider assesses your current physical and mental capacity. This may also support your appeal for disability benefits for breast cancer.

You can submit your appeal online, in person, or over the phone.

Breast cancer disability ratings for veterans and service members

Female veterans and service members face breast cancer rates up to 40% higher than women in the general population, according to the Purple Heart Foundation, potentially due to higher rates of stress, exposure to toxic chemicals from working industrial jobs, radio emissions, and other factors. The U.S. Department of Veterans Affairs (VA) now allows veterans under the age of 40 who were exposed to certain toxins during their service to receive mammograms and other breast cancer assessments at an earlier age.

Veterans Affairs (VA) has a different way of determining breast cancer disability for veterans and service members than the U.S. Social Security Administration does for non-service members. Currently, active breast cancer is rated at 100% by the VA, which continues for six months following the last breast cancer treatment when it is reevaluated.

Read more about breast cancer disability benefits for veterans and service members here.

National Breast Cancer Foundation is here for you and your loved ones. Whether you need support, education, or help during treatment, we have a team dedicated to getting you the help you deserve.

Publish Date: January 29, 2016

Comments are closed.

Help support women in need

Donations are always appreciated, but there are lots of great ways to get involved.