Getting Disability Benefits for Brain Cancer or Glioblastoma Multiforme

Someone with a brain cancer diagnosis can usually qualify for disability benefits—often receiving quick approval from the Social Security Administration (SSA) without the need for a hearing.

You can meet the medical requirements for receiving Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI) disability benefits if you have a malignant brain tumor that is:

• inoperable
• metastatic (spreading), or
• not responding to treatment.

The most common type of brain cancer, glioblastoma multiforme (GBM), meets these medical requirements and will qualify someone for SSDI or SSI. You can receive disability benefits for other types of brain cancer, too. Sometimes you can get disability without meeting the above criteria if your brain cancer limits your ability to perform full-time work, or if the side effects from treatment leave you unable to work.

But it's important to remember that to get disability, you'll need to meet both the medical criteria and the non-medical criteria for SSDI or SSI—primarily based on your employment history, income, and assets.

Brain Cancer Symptoms and Treatments

A brain tumor is an abnormal mass of cells in the brain or central spinal canal—the primary central nervous system (CNS). A brain tumor is malignant (cancerous) when those cells grow and divide uncontrollably.

If the cancer starts in the brain, it's called a primary brain tumor. Tumors that spread to the brain from another part of the body, like the lungs, colon, or breasts, are known as secondary tumors or metastatic tumors.

Whether primary or metastatic, brain tumors can cause a variety of severe symptoms, such as:

• nausea
• headaches
• seizures
• problems with speech, and
• trouble seeing or hearing.

Several treatment options are used for brain cancer, and their chances of success hinge on the size and location of the tumor and whether the cancer has spread to the rest of the body. Surgery can be an option to remove or reduce the size of a brain tumor, but many tumors are inoperable.

Other options for treating brain tumors include radiation therapy and, less commonly, chemotherapy. Side effects from these therapies can be severe and can form a basis for a disability claim on their own.

(To learn about getting SSDI or SSI for non-cancerous CNS tumors, see our article on disability and benign brain tumors.)

The Social Security Listings and Brain Cancer

Those who meet the requirements for Social Security's "Blue Book" listing on neoplastic diseases (which includes brain cancer) will automatically meet the medical requirements for disability benefits. If your cancer meets the listing you'll likely be approved without having to wait for a hearing.

Meeting the Disability Listing for a Brain Tumor

Brain cancer falls under the listing for central nervous system (CNS) cancer (listing 13.13). To meet this listing, your cancer must have originated in your brain or spinal cord and it must be:

• a highly malignant type of tumor that responds poorly to treatment (see below), or
• a primary CNS cancer that's:
• metastatic (spreading), or
• progressive or recurrent following initial anticancer therapy.

Social Security lists three types of highly malignant brain tumors that automatically qualify for disability. Just a diagnosis of one of these meets the requirements of the listing:

• glioblastoma multiforme
• diffuse intrinsic brain stem glioma, or
• ependymoblastoma.

You'll also meet the listing criteria with grade III or IV CNS cancer of one of the following types:

• astrocytomas
• sarcomas
• medulloblastoma, or
• other primitive neuroectodermal tumor (PNET).

Medical Evidence Needed to Meet the Brain Cancer Listing

To determine if you meet the listing, Social Security will look at all the evidence in your case. You'll need medical evidence of the type, extent, and site of your cancer, such as:

• the tumor's primary site (where it started)
• whether it recurred after treatment, and
• whether it's metastatic (and where it spread to).

Social Security will want to know where your cancer started and how it has advanced. The SSA will also want information about any anticancer therapies you've tried (including side effects and effectiveness) and the impact of any cancer that remained after treatment.

Your file should include your doctor's notes and reports from all the medical tests you've had, including diagnostic imaging and lab work. If you had a biopsy, Social Security will want to see both the operative notes and the pathology report.

A written statement from your doctor regarding your diagnosis and outlook can carry a lot of weight. Social Security will also consider your doctor's opinion about whether you meet the listing.

Another Way to Qualify for Disability Benefits for Brain Cancer

Even if your diagnosis doesn't meet the above listing, you can still qualify for SSDI or SSI benefits under a "medical-vocational allowance." You can get such an allowance if Social Security determines that you can't return to any past work or be expected to switch to less demanding work.

What Factors Does the SSA Consider?

Social Security makes medical-vocational determinations based on your residual functional capacity (RFC), an assessment of your remaining capacity to do work-related activities.

If you can't return to any past jobs, Social Security will also consider your:

• age
• work history (transferable job skills), and
• education.

How Brain Cancer Affects Your RFC

Your condition and limitations might prevent you from performing full-time work because of the underlying cancer or because of the side effects of treatment. Radiation therapy—especially whole-brain radiation—is notorious for its brutal side effects, such as:

• nausea
• fatigue
• cognitive difficulties, and
• a compromised immune system.

Social Security will consider all your recent medical records in determining your RFC and whether you can perform full-time work. Your treating physician's opinion, especially your oncologist's, will directly affect Social Security's determination of your RFC.

Getting Your Doctor's Help

You can ask your doctor to write a letter on your behalf or complete an RFC form. Your doctor should consider both your underlying cancer and the side effects of treatment when offering an opinion on your ability to:

• stand
• walk
• lift
• carry
• bend, and
• stoop.

Your doctor should also state how your brain cancer and medical treatment affect your ability to focus and follow directions. Other important factors include things like:

• how much work you‘d miss in the average month
• whether you'd require unscheduled breaks, and
• how much rest you'd need during the day.

Compassionate Allowances and Glioblastoma Multiforme

Social Security's Compassionate Allowances program allows someone with a very serious qualifying condition to be approved for disability benefits in a few weeks—not months or years. Glioblastoma multiforme is one of the conditions on the Compassionate Allowances list.

GBM is a fast-spreading tumor formed from the glial tissue in the brain and spinal cord (and can also be referred to as Grade IV astrocytoma). Symptoms of this disease can include the following:

• memory loss
• personality changes
• vomiting
• headaches, and
• seizures.

The median survival time after being diagnosed with GBM is 12 to 16 months.

If you're applying for disability benefits after being diagnosed with this type of brain tumor, make sure Social Security has all your medical records as soon as possible. You could get approval under the Compassionate Allowances program in as little as two weeks from the date you file your application. To make sure your claim is expedited, point out that your condition is on the Compassionate Allowance list when you apply.

How to Apply for Disability for a Brain Tumor

You can apply for SSDI by completing the online application from any place at a time that's convenient for you. You can also pause and resume the online application process as often as needed without losing your place.

Many people are now eligible to start their SSI application online. Or you can request an appointment online if you want a Social Security representative to help you apply for SSI benefits.

If you prefer, you can apply for SSDI or SSI by phone by calling Social Security toll-free at 800-772-1213 (TTY 1-800-325-0778).

You can also apply for SSDI benefits in person at your local Social Security office. Contact the field office and make an appointment ahead of time to avoid a long wait.

Learn more about how each application method works so you can choose the best one for you.