
          A Guide to Social Security and SSI Disability
               Benefits For People With Cancer


Introduction

Social Security can provide a lifeline of support to people with
Cancer.  That lifeline comes in the form of monthly Social
Security disability benefits and Supplemental Security Income
payments, Medicare and Medicaid coverage, and a variety of other
services available to people who receive disability benefits from
Social Security.

If you are disabled because of Cancer, this booklet will
help you understand the kinds of disability or Supplemental
Security Income programs.

What's You Need to Know

Part 1 -- Background Information
The first section provides some brief background information about
Cancer and Social Security.

Part 2 -- What Benefits Are You Eligible For?
This section explains the nonmedical rules and eligibility factors
for Social Security Disability Insurance benefits and Supplemental
Security Income Disability payments.

Part 3 -- How Does Social Security Define "Disability?"
This section explains Social Security's definition of "disability"
and how it relates to claimants with Cancer.

Part 4 -- How Does Social Security Evaluate Your Disability
This section explains how Social Security evaluates disability
claims involving Cancer diseases in general.  And it includes up-to-
date information about the way we process claims, especially those
involving women and children with Cancer.

Part 5 -- How Do You File For Disability Benefits?
This section includes information about when and how to apply for
disability, what steps we take to ensure that your claim is
processed quickly and accurately, and most important, what things
you can do to help the process along.  Also included is information
about situations when we can presume a person is disabled and make
immediate payments.

Part 6 -- Helping You Return To Work
This section provides an overview of special rules designed to help
you return to work.

Part 7 -- What you Need To Know About Medicaid And Medicare
This section includes a brief overview of the kinds of benefits
available from the Medicaid and Medicare programs.


PART 1 -- BACKGROUND INFORMATION

     Although thousands of people with Cancer are receiving
Social Security or Supplemental Security Income disability
benefits, we believe there may be others who might be eligible for
these benefits.  Social Security is committed to helping all men,
women, and children with Cancer learn more about the
disability programs we administer.  And if you qualify for
benefits, we are just as committed to ensuring that you receive
them as soon as possible.

PART 2 -- WHAT BENEFITS ARE YOU ELIGIBLE FOR?

We pay disability benefits under two programs: Social Security
Disability Insurance, sometimes referred to as SSDI, and
Supplemental Security Income, often called SSI.  The medical
requirements are the same for both programs, and your disability
is determined by the same process.  However, there are major
differences in the nonmedical factors, which are explained in the
next two sections.

Social Security Disability Insurance Benefits: The Nonmedical Rules
Of Eligibility

Here are examples of how people qualify for SSDI:

o    Most people qualify for Social Security disability by working,
     paying Social Security taxes, and in turn, earning "credits"
     toward eventual benefits.  The maximum number of credits you
     can earn each year is 4.  The number of credits you need to
     qualify for disability depends on your age when you become
     disabled.  Nobody needs more than 40 credits and young people
     can qualify with as few as 6 credits.

o    Disabled widows and widowers age 50 or older could be eligible
     for a disability benefit on the Social Security record of a
     deceased spouse.

o    Disabled children age 18 or older could be eligible for
     dependent's benefits on the Social Security record of a parent
     who is getting retirement or disability benefits, or on the
     record of a parent who has died. (The disability must have
     started before age 22.)

o    Children under the age of 18 qualify for dependents benefits
     on the record of a parent who is getting retirement or
     disability benefits, or on the record of a parent who has
     died, merely because they are under age 18.

     For more information about Social Security disability benefits
in general, ask Social Security for a copy of the booklet,
Disability (Publication No. 05-10029).

How Much Will Your Benefits Be?

How much your Social Security benefit will be depends on your
earnings history.  Generally, higher earnings translate into higher
Social Security benefits.  You can find out how much you will get
by contacting Social Security and asking for an estimate of your
benefits.  We'll give you a form you can use to send for a free
statement that contains a record of your earnings and an estimate
of your benefits.
     In addition to checking your benefit, we encourage you to use
this statement to verify that your earnings have been properly
recorded in our files.  It's important that you do this because any
missing or unreported wages could lower your Social Security
benefit or even prevent you from qualifying for disability
benefits.  If you find a problem, contact your local Social
Security office right away, show them proof of your actual wages,
and the record will be corrected.  This can be particularly
important for people who have been diagnosed with Cancer and have
been treated, so that any potential benefits will not be
delayed by wage correction efforts.
     Disabled widows, widowers, and children eligible for benefits
as a dependent on a spouse's or parent's Social Security record
receive an amount that is a percentage of the worker's Social
Security benefit.

Supplemental Security Income: The Nonmedical Rules Of Eligibility

SSI is a program that pays monthly benefits to people with low
incomes and limited assets who are 65 or older, or blind, or
disabled.
     As its name implies, "Supplemental" Security Income
"supplements" a person's income up to a certain level that can go
up every year based on cost-of-living adjustments.  The level
varies from one state to another, so check with your local Social
Security office to find out more about SSI benefit levels in your
state.
     We don't count all the income you have when we figure out if
you qualify for SSI.  And if you work, there are special rules we
use for counting your wages.  Again, check with Social Security to
find out if you can get SSI.
     In addition to rules about income, people on SSI must have
limited assets.  Generally, individuals with assets under $2000,
or couples with assets under $3000, can qualify for SSI.  However,
when we figure your assets, we don't count such items as your home,
your car (unless it's an expensive one), and most of your personal
belongings.
     Your Social Security office can tell you more about the income
and asset limits.  For more general information, ask for a copy of
the booklet, SSI (Publication No. 05-11000).

PART 3 -- HOW DOES SOCIAL SECURITY DEFINE DISABILITY?  

In this section, we'll explain the criteria you must meet in order
to be considered "disabled." First, we'll explain in general terms
how Social Security defines and determines disability.  Then we'll
discuss how it applies to people with Cancer.

The General Definition Of Disability

Disability under Social Security is based on your inability to work
because of a medical condition.  You will be considered disabled
if you are unable to do any kind of "substantial" work for which
you are suited.  (Usually, monthly earnings of $500 or more are
considered substantial.)   Your ability to work must be expected
to last at least a year.  Or, the condition that keeps you from
working must be so severe that you are not expected to live.
     For children, we decide how the condition affects their
ability to function--to do the things and behave in the ways that
other children of the same age normally would.

How This Definition Of Disability Applies To People With Cancer

A person with symptomatic Cancer is often severely limited
in his or her ability to work.  In other words, if the evidence
shows that you have symptomatic Cancer that severely limits
your ability to work, and if you meet the other eligibility
factors, the chances are very good that you will be able to receive
Social Security or SSI Benefits.
     On the other hand, some people with Cancer may be less
impaired and able to work, so they may not be eligible for
disability.

PART 4 -- HOW DOES SOCIAL SECURITY EVALUATE YOUR DISABILITY?

Social Security works with an agency in each state, usually called
a Disability Determination Service (DDS), to evaluate disability
claims.  At the DDS, a disability evaluation specialist and a
doctor follow a step-by-step process that applies to all disability
claims, thus assuring a consistent approach to evaluating
disability.
     First, the DDS specialists decide whether your impairment is
"severe."  This simply means the evidence must show that your
disability interferes with your ability to work.
     The next step in the process is deciding whether the
disability is included in a list of impairments.  This list
describes, for each of the major body systems, impairments that are
considered severe enough to prevent an adult from doing any
substantial work or in the case of children under the age of 18,
impairments that are severe enough to prevent a child from
functioning in a manner similar to other children of the same age.
     Recently we published a list of impairments for Cancer.
In this list, we have included many conditions associated with
symptomatic Cancer, including some that specifically apply to
women and children with Cancer (See next two sections).
     Some of the Cancer-related conditions included in the Cancer list
of impairments are shown below.  The level of severity that an
impairment must meet to be found disabling are also specified in
the regulations.

o  Pulmonary impairment

o  Hodgkin's disease and all lymphomas

o  Cancer Wasting Syndrome


     Remember: these are just a few examples.  You can see a
complete list of Cancer-related impairments at any Social Security
office.  The complete list will also include the findings necessary
for listed impairments to be considered disabling by Social
Security.
     If you have symptoms of Cancer that are not
specifically included in (or equal in severity to) the impairments
on our list, then DDS disability specialists will look at how
frequently these conditions occur and how they affect your ability
to function.
     The DDS team will evaluate how well you function in three
general areas:  daily activities; social functioning; and the
ability to complete tasks in a timely manner, which requires the
ability to maintain concentration, persistence, and pace.
     If you have "marked limitations" in any one of these
functional areas and repeated manifestations of Cancer meeting the
criteria in the listings, you may be found disabled.  A marked
limitation is one that seriously interferes with your ability to
function independently, appropriately, and effectively.  It does
not mean that you must be confined to bed, hospitalized, or in a
nursing home.  If the specialists decide that you are not disabled
at this point because you do not have a condition that exactly
matches or is equal in severity to one on our list, then they will
look to see if your condition prevents you from doing the work you
normally do.  If it does not, then we look to see if it prevents
you from doing any other type of work you're suited for, based on
your age, education, and experience.  If it does, you may still be
found disabled.
     Remember, at all steps in the process, your impairment must
be documented.  Documentation includes medical records from your
doctors, as well as laboratory test results, X-ray reports, etc. 
The Cancer itself--that is, the presence of tumor--must
be documented as well as any Cancer-related manifestations.  At all
steps in the process it is important that we have evidence of
signs, symptoms, and laboratory findings associated with Cancer
as well as information on how well you are able to function
day-to-day.  The signs and symptoms may include: fevers/night sweats;
enlarged lymph nodes, liver or spleen; lower energy or generalized
weakness; dyspnea on exertion; persistent cough; depression/anxiety;
headache; anorexia; nausea and vomiting; and side effects of
medication and/or treatment, as well as how your treatment affects
your daily activities.

Evaluation Of Cancer In Women

Statistics show that there is an increasing number of women with
Cancer.  In addition to following the criteria outlined in the
previous section, DDS disability evaluators consider specific
criteria for diseases common in women.  These include: vulvovaginal
candidiasis (yeast infection); genital herpes; pelvic inflammatory
disease (PDI); invasive cervical cancer; genital ulcerative
disease; and condyloma (genital warts caused by the human
papillomavirus).  Again, the level of severity necessary for these
impairments to be considered disabling is included in the list of
impairments.

Evaluation Of Cancer In Children

We also have separate listings for children with Cancer. 
These guidelines recognize the fact that the course of cancer
in children can differ from adults.  As with adults, some children
may not appear to have the conditions specified in the guidelines,
or may have listed conditions that are not as severe as the
guidelines require.  When this happens, a functional assessment is
made using criteria contained in the lists.  A child may be
disabled if the Cancer-related impairments substantially reduce
his/her ability to grow, develop, or engage in activities similar
to children of the same age.
     For more information about disability benefits for children,
ask Social Security for a copy of the booklet, Social Security And
SSI Benefits For Children With Disabilities (Publication No. 05-
10026).

PART 5 -- HOW DO YOU FILE FOR DISABILITY BENEFITS

You apply for Social Security and SSI disability benefits by
calling or visiting any Social Security office.  All Social
Security files are kept strictly confidential.  It would help if
you have certain documents with you when you apply.  But don't
delay filing because you don't have all the information you need. 
We'll help you get the rest of it after you sign up.  The
information you'll need may include:

o  your Social Security number and birth certificate;

o  the Social Security numbers and birth certificates for family
members signing up on your record; and

o  a copy of your most recent W-2 form (or your tax return if
you're self-employed).

     If you're signing up for SSI, you will need to provide records
that show that your income and assets are below the SSI limits. 
This might include such things as bank statements, rent receipts,
care registration, etc.
     You'll also need to give us information about how your
condition affects your daily activities, the names and addresses
of your doctors and clinics where you've received treatment, and
a summary of the kind of work you've done in the last 15 years. 

If you have medical evidence such as reports of blood tests,
laboratory work, or a physical, it would be helpful if you brought
them with you.  In the section below (What You Can Do to Expedite
the Processing of Your Claim), we give you some guidelines for
providing us with medical and vocational information that will help
speed up your claim.  But first, we want you to know what Social
Security does to make the process work as smoothly as possible.

What Steps Has Social Security Taken To Ensure Prompt Processing
And Payment Of Disability Benefits?

All Cancer claims are given prompt attention and priority
handling.  For many people applying for SSI with a medical
diagnosis of symptomatic Cancer, the law allows us to
PRESUME they are disabled.  This permits us to pay up to 6 months
of benefits pending a final decision on the claim.  You will
qualify for this immediate payment if:

o  a medical source confirms that the Cancer is severe
enough to meet SSA's criteria;

o  you meet the other SSI nonmedical eligibility requirements; and

o  you are not doing "substantial" work (See section, "The General
Definition of Disability" in Part 3).

     If you have symptomatic Cancer but the local Social
Security office cannot provide immediate payment, a disability
evaluation specialist at the DDS may still make a "presumptive"
disability decision at any point in the process where the evidence
suggests a high likelihood that your claim will be approved.  (If
we later decide you are not disabled, you will NOT have to pay back
the money you received.)
     Special arrangements have been made with a number of cancer
service organizations, advocacy groups, and medical facilities to
help us get the evidence we need to streamline the claims process. 
And many DDS's have Medical/Professional Relations Officers who
work directly with these organizations to make this process work
smoothly.

What You Can Do To Expedite The Processing Of Your Claim

You can play an active and important role in ensuring that your
claim is processed accurately and quickly.  The best advice we can
give you is to keep thorough records that document the symptoms of
your illness and how it affects your daily activities, and then to
provide all of this information to Social Security when you file
your claim.  Below are some guidelines you can follow:

o  Document the symptoms of your illness early and often
Use a calendar to jot down brief notes about how you feel on each
day.  Record any of your usual activities you could not do on any
given day.  Be specific.  And don't forget to include any
psychological or mental problems.

o  Help your doctor help you
Not all doctors may be aware of all the kinds of information we
need to document your disability.  Ask your doctor or other health
care professional to track the course of your symptoms in detail
over time and to keep a thorough record of any evidence of fatigue,
depression, forgetfulness, dizziness, and other hard-to-document
symptoms.

o  Keep records of how your illness affected you on the job
If you were working, but lost your job because of your illness,
make notes that describe what it is about your condition that
forced you to stop working.

o  Give us copies of all these records when you file
In addition to these records, be sure to list the names, addresses,
and phone numbers of all the doctors, clinics, and hospitals you
have been to since your illness began.  Include your patient or
treatment identification number if you know it.  Also include the
names, addresses, and phone numbers of any other people who have
information about your illness.

PART 6 -- HELPING YOU RETURN TO WORK

If you return to work, Social Security has a number of special
rules, called "work incentives," that provide cash benefits and
continued Medicare or Medicaid coverage while you work.  They are
particularly important to people with Cancer who, because of
the recurrent nature of Cancer-related illnesses, may be able to
return to work following periods of disability.
     The rules are different for Social Security and SSI
beneficiaries.  For people getting Social Security disability
benefits, they include a 9-month "trial work period" during which
earnings, no matter how much, will not affect benefit payments; and
a 3-year guarantee that, if benefits have stopped because a person
remains employed after the trial work period, a Social Security
check will be paid for any month earnings are below the
"substantial" level (generally $500).  In addition, Medicare
coverage extends through the 3-year timeframe after the trial work
period, even if your earnings are substantial.
     SSI work incentives include continuation of Medicaid coverage
even if earnings are too high for SSI payments to be made, help
with setting up a "plan to achieve self-support" (PASS), and
special consideration for pay received in a sheltered workshop so
that SSI benefits may continue even though the earnings might
normally prevent payments.
     These and other work incentives are explained in detail in the
publication, Working While Disabled...How Social Security Can Help
(Publication No. 05-10095).  For a free copy, just call or visit
your nearest Social Security office.

PART 7 -- WHAT YOU NEED TO KNOW ABOUT MEDICAID AND MEDICARE

Medicaid and Medicare are our country's two major government-run
health insurance programs.  Generally, people on SSI and other
people with low incomes qualify for Medicaid, while Medicare
coverage is earned by working in jobs covered by Social Security,
for a railroad, or for the federal government.  Many people qualify
for both Medicare and Medicaid.

Medicaid Coverage

In most states, Social Security's decision that you are eligible
for SSI also makes you eligible for Medicaid coverage.  (Check with
your local Social Security or Medicaid office to verify the
requirements in your state.)
     State Medicaid programs are required to cover certain
services, including inpatient and outpatient hospital care and
physician services.  States have the option to include other
services, such as intermediate care, hospice care, private duty
nursing, and prescribed drugs.
     For more information about Medicaid, contact your local
Medicaid agency.

Medicare Coverage

If you get Social Security disability, you will qualify for
Medicare coverage 24 months after the month you became entitled to
those benefits.  Medicare helps pay for:

o  inpatient and outpatient hospital care;

o  doctor's services;

o  diagnostic tests;

o  skilled nursing care;

o  home health visits;

o  hospice care; and

o  other medical services.

     For more information about Medicare, call or visit your local
Social Security office to ask for the booklet Medicare (Publication
No. 05-10043).

FOR MORE INFORMATION

For more information or to apply for benefits, call or visit Social
Security.  It's easiest to call Social Security's toll-free
telephone number.  The number is 1-800-772-1213.  You can speak to
a representative 7 a.m. to 7 p.m. each business day.  The best
times to call are early in the morning, early in the evening, late
in the week, and toward the end of the month.
     The Social Security Administration treats all calls
confidentially--whether they're made to our toll-free numbers or
to one of our local offices.  We also want to ensure that you
receive accurate and courteous service.  That's why we have a
second Social Security representative monitor some incoming and
outgoing telephone calls.


Note from the National Kidney Cancer Association:  There were
changes in Social Security rules that took effect on July 2, 1993
and, also, how SSA evaluates claims based on Cancer.
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