Social Security Disability for stage 4 prostate cancer

I have been looking for ways to help pay the out of network costs in order to see a specialist for the rare form of prostate cancer (metastatic ductal, effecting <1% ) that I have. Looking on the Internet the government has fast tracked metastatic stage 4 prostate cancer for disability payments. I am going to look into it, but I may not be eligible as I get a (small) pension from early retirement. However, there may be others out there that could apply. Here is some information:
https://secure.ssa.gov › poms.nsf › lnx
blog.chron.com › advocate › 2014/04

I hope that this could help others with advanced cancer.

that web site is gettin many hits from the forum as we speak

If you have been diagnosed Stage 4 prostate cancer (hormone refractory and or mets) you are eligible for SSDI or SSI , depending if you are under or over 65. You can apply online but for fastest service, call, make an appointment, and visit your local SS office. You will need copies of your medical records to verify your condition. Ask for the "Compassionate Allowance" consideration as it will greatly speed up the process. 1-800-772-1213

Yes, there is an income and asset test you must pass..While your house and car do not count, any other property in your name, bank accounts, investment accounts, real estate that totals over $2000 makes you ineligible for these programs..If you are already collecting Social Security and your benefit is over $800 or so, that will also exclude you....

Post Edited (Fairwind) : 5/12/2016 10:53:57 PM (GMT-6)

Dr WHO, I am assuming that you are not currently working, correct? Also I assume that you haven't reached age 62, so are not yet eligible for social security retirement. Given these assumptions I concur that you should pursue a social security disability claim and determine whether you qualify for the Compassionate Allowance method.

Just because you are not working and have cancer does not mean you will qualify for social security disability. It has to be shown that you meet the social security definition for qualification.

There is no real cost to apply unless you have to engage an attorney, which is very common. If you do not qualify for Compassionate Allowance you will probably be in for a process that will take many months if not years to get a determination. The first application is routinely denied and forces you into an appeals process that usually takes a lot of time. We normally advice people to engage an experienced social security legal specialist to start the process.

It is important to apply early as any award dates back to the application. The attorney's fee generally comes out of the retroactive award on a contingency basis. I suggest you have a discussion with a legal specialist who can properly advise you based on your specific situation.

Fairwind, that is as I understand and essentially what one of our members found out a couple of years ago. The person had numerous lung mets so there was no question that he met the definition and he was not working at the time. As I remember he did not use an attorney. However, the definition in the compassionate Allowances is for visceral mets (not bone mets) or castrate resistant. Most PCa does not qualify for CA or social security disability. I don't know that Dr Who clearly meets that definition based on his signature and only social security can confirm his status.

The website is clear that the CA is not a separate program. Rather it is an accommodation to put the most severely disabled at the front of the line for potentially earlier determination and payment of benefits. The key is that they do have to be disabled. We have men on this board that have visceral mets and/or castrate resistant, but are able to work and do so. They do not qualify for social Security disability even though they could use the Compassionate Allowance process.

Of course he can start on his own by meeting with social security and providing the information to determine whether he qualifies for CA. If he doesn't qualify for CA, then he would go into the non-CA approach where an attorney is nearly a necessity. In either event, which can not be pre-determined by us, I concur and strongly recommend he start the process immediately. Benefits, if awarded, are payable from the application date. Now is the time to apply.

JNF you are 100% correct..Once I started collecting my SS retirement benefits I was no longer eligible for SSDI . My phone conversation lasted less than 2 minutes....

Another question for everyone:

With regular SS retirement, if you die while on SS will your spouse get your SS or hers (is it which ever is greater)?

Is that the same for SSD? For example, if you're in your 50s and on SSD, does the same apply? Will the spouse get your SS once she becomes the age for normal SS?

Thanks

Purg,

Great information from your experience. I have helped many clients through the SSDI process and in every case the ones that had the specialist at the beginning got the quickest results. The ones that went it alone always took much longer and eventually had to get an attorney. When you are unable to work the time it takes to get the benefits started means everything.

An exception is when you also qualify for a disability income benefit from an insurance policy, either at work or individual, that has a benefit offset by any SSDI award, which is very common. In those cases the insurance company and/or employer will usually require that you apply for SSDI and they will work the case. They have a strong financial incentive to help get the award as it reduces their payout.

However, just because you qualify for an insurance or employment benefit doesn't mean you will qualify for SSDI as the requirements are generally different. Most insurance plans deem you disabled if you can't continue to perform your own job for some period of time. SSDI requires that you can't perform any substantial gainful activity due to a medical condition (physical or mental impairment) that will either result in death, or has lasted or is expected to last at least twelve continuous months.

I always advise people to first go to a SSDI specialist attorney for a review. Normally the first meeting is free. If the attorney believe the situation presents a valid claim and they take the case, they get paid from the eventual benefit award. And as you mention the amount of their fee is regulated.

Dr that is not how it works.

First, you have to meet the definition of disability. That you are ..."unable to do substantial gainful activity due to a medical condition which will either result in death or has or is expected to last at least 12 months." So first, are you unable to work due to the PCa or any other physical or mental condition?

Where the stage of PCa matters is to determine whether you can use the Compassionate Allowances Program to fast track your application. The CAP requires that the PCa be ..."either metastatic (Stage IV) to lung, liver, or other internal visceral organ (excluding bone metastases); or progressive or recurrent despite initial hormonal therapy."

From what you are saying, I understand that you are not recurrent castrate resistant. In other words, HT has not yet failed. Also, that no visceral (organ) mets have been found. I do not know whether involvement of pelvic lymph nodes meet the definition of "visceral internal organ". So that has to be factually determined.

This is why my best advice is to seek out a competent SSDI attorney and have a consultation. Gather all your medical info like the dx, bx report, scans, doctors reports, treatment specifics, etc. and get to a qualified professional. I think you will get one of three answers: first, you appear to qualify let's apply, or second, I don't know if you qualify but let's apply to get an official determination, or, third you don't qualify so no need to apply.

Please remember that the level of the disease does not guarantee that you will get SSDI. The level of the disease first only determines whether you can use the Compassionate Allowance Program to fast track the application. You still have to be determined as meeting the definition of being disabled. The Compassionate Allowances program can turn years into months to get a determination if it is available to you. If you are disabled, but not eligible for the CA program you still apply through the regular channels, but won't be fast tracked.

Again, go see a professional who does this for a living. It shouldn't take more than a 30 minute meeting to know exactly what to do.

My recollection of our member in Atlanta is that he was seriously ill before his PCa was dx'd. When they found the PCa his PSA was very high (over 100), had high G score, and numerous lung mets. They even tried to biopsy the lung mets and I met him to drive him home after the biopsy. He went directly to social security and applied through the Compassionate Allowances Program and was approved in a matter of a few months. Thankfully, treatment has been very effective for him and is holding the PCa at bay. Hopefully he will see this thread and provide more specifics for you.

Here is a link that has the best information I could quickly find. http://www.disabilitysecrets.com/social-security-disability-cancer.html. It indicates that there are some very advanced cancers that gain immediate approval. It does discuss regional lymph nodes in a way that I infer wouldn't qualify unless the spread was past the regional nodes. But again, an expert will be able to determine what to do.

Best wishes and happy researching. Now that PhD will really come in handy!!

Most of all best wishes on successfully treating the beast. I hope you do very well.