Skin cancer is the most common type of cancer in the United States, affecting about 6.1 million American adults every year. It occurs when skin cells grow abnormally, often (but not always) caused by sun exposure. Detecting skin cancer early is crucial, as most skin cancer can be effectively treated when caught in its early stages.
While many skin cancers aren't disabling, the more severe types of skin cancer can be. When left untreated, some forms of skin cancer can spread to other parts of the body, like the lymph nodes, bones, or other organs, causing severe complications. If your skin cancer keeps you out of full-time work for at least 12 months, you may be eligible for Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI).
The American Cancer Society identifies three main types of skin cancer. Some types are common but easily treatable, while others are less common but require more invasive treatment options.
Basal cell carcinomas make up 80% of all skin cancer diagnoses in the United States. This type of slow-growing cancer typically doesn't spread to other parts of the body. Treatments for basal cell carcinoma generally include removing the cancerous tissue with surgery, freezing, or topical creams. If the affected tissue is very large or in a position that is difficult to treat, radiation therapy may be used instead.
Squamous cell carcinoma is the second most common type of skin cancer. Unlike basal cell carcinoma, squamous cell carcinoma can metastasize (spread to other parts of the body) if left untreated.
The risk of metastasis depends on factors such as the size and location of the cancerous tissue—for example, squamous cell carcinoma on the lower lip is more prone to spreading. Treatment is similar to that of basal cell carcinoma.
Melanoma is the least common type of skin cancer, but it's very serious because it can spread quickly in the body. Melanoma is caused by damage to cells that produce skin pigmentation (called melanin). While most skin cancer is curable if diagnosed early enough, melanoma that has spread can be very difficult to cure completely and can return years later.
Surgery to remove the cancerous tissue is the first step in treating melanoma. If the cancer has spread to nearby lymph nodes, they must also be surgically removed. More aggressive treatment, such as chemotherapy, immunotherapy, radiation therapy, and additional surgeries, may be needed in cases where the cancer has spread beyond the lymph nodes. Side effects of these treatments can include pain, nausea, and fatigue.
If symptoms or treatment for your skin cancer causes physical or mental limitations that prevent you from working full-time, you may qualify for SSDI, SSI, or both. You must meet both the financial eligibility criteria of the program you're applying for and the medical definition of disability before you can receive benefits.
Financial eligibility for SSDI is based on your work history, while SSI has income and resource limits. For both programs, you'll also need to show that you earned below the substantial gainful activity threshold for at least 12 months. Medically, you'll need to prove that your skin cancer is disabling in one of two ways:
Social Security's Blue Book section 13.00 for cancer ("malignant neoplastic diseases") contains listings for different types of cancers and the medical evidence needed to meet the specific listing. In this section are two listings relevant for applicants with skin cancer.
Listing 13.03 for skin cancer requires medical documentation of either:
Listing 13.29 for malignant melanoma requires evidence of at least one of the following:
Your medical records should state the type of cancer you have, where the cancer started, and whether the cancer has spread. Make sure you send Social Security records from all medical providers where you've received treatment, including any operative and pathology notes from a biopsy.
If you don't meet the above requirements exactly but you think your condition is essentially the same as the listed impairments—for example, you have a rare form of skin cancer, not listed above, that spreads despite treatment—you can try to establish that you equal a listing. You'll typically need a doctor to agree that you equal a listing, so you should ask your oncologist (cancer doctor) to review the listings and submit a medical source statement to that effect.
You can still qualify for benefits without meeting or equaling a listing if Social Security doesn't think you can do any full-time jobs. To decide whether you can work, the agency will look at your medical records and functional limitations to determine your residual functional capacity (RFC). Your RFC describes the physical and mental tasks you can or can't do on the job.
Realistically, early-stage skin cancer probably won't have a major impact on your RFC. You might have a short recovery period after treatment, but it's usually not long enough to fulfill the 12-month duration requirement for disability benefits. But advanced stages of skin cancer may require more invasive treatments such as surgery, radiation, or chemotherapy. These treatments often come with unpleasant side effects—including fatigue, pain, nausea, memory issues, and sensory loss—that can significantly interfere with your ability to work.
Every functional limitation that's supported by medical evidence should be included in your RFC. For example, your oncologist might say that you should avoid excessive sun exposure in order to reduce the risk of cancer recurrence. That could be reflected in your RFC as a restriction against working outdoors. If your past jobs all involved working outdoors, Social Security could find that you can't do your past work, and, if you're at least 50 years old, you might not be expected to "adjust" to other types of work.
The more restrictions you have in your RFC, the more likely it is that no jobs exist that you can do, and the greater chance you'll be awarded benefits. But it's generally difficult to get disability based on skin cancer alone if you don't meet a listing. You'll have an easier time winning your case if you have multiple medical conditions that keep you from working.
VA disability benefits aren't awarded in the same way that Social Security disability benefits are. To get VA compensation for skin cancer, you'll need to prove that your skin cancer is service-connected. You can establish a service connection by showing that your skin cancer is related to an event (or events) that happened to you during active military service.
Establishing a service connection for skin cancer can be a pretty straightforward process. According to the American Academy of Dermatology, studies have shown that military members are at an increased risk of developing skin cancer. This is because many service members are exposed to harmful UV rays for prolonged periods of time and lack adequate sun protection during deployment.
The VA assesses skin cancers under the Schedule of Ratings, Section 4.118. The diagnostic codes used for disfigurement, scars, and burns (7800 or 7801-7805) are also used to determine a veteran's disability rating for skin cancer. Ratings range from 0% to 80% depending on the location and size of the skin cancer scar after surgery.
If you're seeking VA compensation for metastasized squamous cell carcinoma, the VA will first consider if the scope of the skin cancer and treatment falls under the above diagnostic codes and associated ratings. But if your skin cancer has spread to your lymph nodes or other organs and you need any treatment more extensive than a basic excision—such as chemotherapy, radiation therapy, or further surgery—the VA will assign you a 100% rating as of the date you started treatment.
This 100% rating will remain as long as you're receiving treatment. Six months after your treatment has ended, the VA will re-evaluate your rating under diagnostic code 7818 for malignant skin neoplasms.
VA melanoma ratings are evaluated the same way as squamous cell carcinomas are. You can receive a 100% rating for malignant melanomas that have spread beyond the skin and are affecting other parts of the body. Melanoma VA disability rating guidance can be found under diagnostic code 7833.
You can submit your application for Social Security benefits in four ways:
If you're applying for VA compensation, the easiest way to file is by using the Veterans Online Application (VONAPP) website at www.ebenefits.va.gov. For more information, see our article on filing for veterans' disability benefits.
Need a lawyer? Start here.