Carcinoid and Neuroendocrine Tumors and Social Security Disability Benefits

Carcinoid tumors are usually slow growing tumors that arise from the neuroendocrine system, which produces hormones. Many carcinoids begin in the digestive track and can lead to carcinoid syndrome, which refers to an array of symptoms that occur as the tumors secrete chemicals into the bloodstream.

The complications that arise from having an advanced carcinoid or other neuroendocrine tumors—such as  pancreatic neuroendocrine tumors—can dramatically alter your daily life, keeping you from working and earning a living.  If you are facing circumstances such as these, you may be eligible to receive Social Security Disability benefits.

Social Security DisabilityIn this article, we will help you understand the benefits that are available to you and will help you prepare to begin the application process.

SSD Benefit Programs

The two primary disability assistance programs offered by the Social Security Administration (SSA) are Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI).  Below you will find a brief description of each program:

  •  SSDI benefits are offered to disabled workers and their eligible family members. Eligibility for SSDI is dependent on an applicant’s employment history, Social Security taxes, and their particular illness or condition. This program is best suited for individuals who have worked and paid taxes for many years. Learn more about qualifying for SSDI benefits, here.
  • SSI benefits are offered to disabled individuals of all ages who earn little to no income. Eligibility for SSI is dependent on an applicant’s income, financial resources, and their disability. To qualify for SSI benefits, applicants must fall within the financial limitations set by the SSA.  This program is best suited for low-income individuals who have limited work experience. Learn more about qualifying for SSI, here.

In some circumstances, applicants may be eligible to receive benefits from both programs.

Social Security card

Medical Eligibility

To qualify for SSDI or SSI benefits, an applicant must have a disability. According to the SSA, this means the following:

  • The applicant cannot do the work they did prior to becoming disabled; and
  • The applicant has a physical or mental condition that keeps them from doing other types of work; and
  •  The applicant’s condition has lasted—or is expected to last—at least one year or  will result in death.

In addition to these more general requirements, applicants seeking disability benefits must also meet medical criteria pertaining to their particular condition. These criteria are compiled in a technical guidebook maintained by the SSA—more commonly referred to as the Blue Book. All applicants must meet the Blue Book listing associated with their condition.

Because carcinoid tumors can affect multiple body systems, there is not one main Blue Book listing that you will need to meet. Instead, you will have to consult the Blue Book to find a listing that is closest in severity to your symptoms and condition.  Below you will find an outline of several listings that you may qualify under:

Listing 13.14—Malignant Neoplastic Diseases of the Lungs
Listing 13.16—Malignant Neoplastic Diseases of the Stomach or Esophagus
Listing 13.17—Malignant Neoplastic Diseases of the Small Intestine
Listing 13.18—Malignant Neoplastic Diseases of the Large Intestine
Listing 13.19—Malignant Neoplastic Diseases of the Liver or Gallbladder
Listing 13.20—Malignant Neoplastic Diseases of the Pancreas
Listing 13.23—Cancers of the Female Genital Tract
Listing 13.25—Malignant Neoplastic Diseases of the Testicles

Be sure to look into these listings to find the specific requirements that you will be required to meet. Although each of these listings is slightly different, almost all types of cancer will be evaluated based on the following:

  •     The origin of the cancer;
  •     The extent of the cancer’s involvement;
  •     The duration, frequency, and response to treatment; and
  •     Any post-therapeutic residuals.

In the event you are unable to meet any Blue Book listing, you may still be eligible for disability benefits under a medical vocational allowance.  To do so, you will need to complete a Residual Functional Capacity (RFC) form. This form will assess your physical capabilities, your mental capabilities, your past work experience, and your age to determine what types of work you are able to do. If the SSA determines that you are unable to do any type of work, you will likely qualify for disability benefits.

The Application Process

It is important to remember that disability benefits are intended to help those who have severe, long-lasting health conditions. For this reason, a diagnosis alone will not be enough to qualify a person for disability benefits.  All applicants must collect copies of relevant medical records to validate their claim. This may include:

  •     Medical records that document the location of tumors
  •     Surgery and pathology reports
  •     Records of all hospitalizations
  •     Findings of physical and mental examinations
  •     Evidence about the recurrence, persistence, and malignancy of your tumors
  •     History of your treatments and how you responded to each

It will also be necessary to collect copies of the appropriate records pertaining to your finances and employment history. Access a complete list of these documents here.

You can begin the application for disability benefits online or with the help of a representative at your local Social Security Administration office.  If you choose to apply in person, you will have to schedule an appointment in advance. Be sure to take your time when filling out the necessary paperwork. Any incomplete, inaccurate, or inconsistent information may cause your claim to be delayed or even denied.

After submitting your initial application, it may be several months before you receive the SSA’s decision. If you are approved you will receive a letter containing the details of your payments. Unfortunately, more than half of all initial applications are denied.  Often, this is due to one of the following:

  •  lack of hard medical evidence
  •  income exceeds Substantial Gainful Activity (SGA)— $1,070 a month for  2014
  •  failure to follow treatment
  •  failure to cooperate with the SSA’s requests

If you are denied, do not give up. You are allowed to appeal the SSA’s decision within 60 days of receiving your notice of denial.  Although it can be discouraging to receive a denial, applicants often stand a much better chance of being approved during the appeals procedures. In fact, many more applicants are approved during appeal hearings than after the initial application. This is often due to the following:

  • Hearings allow an in-person testimony, giving you a chance to explain your            limitations.
  • Many applicants opt to hire an attorney or advocate to help them during an    appeal hearing.
  •  A judge will consider your doctor’s opinions and will give them more weight.

Be sure to file your appeal within the given timeframe. If you fail to do so, you will be required to start the application process all over again. Use the appeals process as an opportunity to fix your mistakes and strengthen your claim.

For more information regarding Social Security Disability benefits visit the Social Security Disability Help blog.

Molly Clarke is a blogger who writes about Social Security Disability issuesSpecial thanks to Molly Clarke, author of this article.  Molly is a blogger who regularly covers Social Security Disability issues and provides tips on how to navigate the system.

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