When Can I Get Disability Benefits for Lung Cancer?

Lung cancer occurs when uncontrolled cell growth happens in lung tissue, but it can spread outside of the lungs into other areas of the body. (When cancerous cells spread beyond the place in the body where they originated, it is called metastasis.) Early stages of lung cancer may not cause any symptoms, but as the cancer progresses, common symptoms include persistent cough, breathing problems, constant chest pain, coughing up blood, a hoarse voice, frequent lung infections, fatigue, and weight loss.

Types of Lung Cancer

Lung cancer can be separated into two different groups: small cell cancer and non-small cell cancers.

Non-Small Cell Lung Cancer

The three types of non-small cell cancers are squamous cell carcinoma, large cell carcinoma, and adenocarcinoma. These types of lung cancers spread more slowly than small cell cancer and are more common than small cell cancer: According to the Social Security Administration (SSA), around 87% of lung cancers are non-small cell lung cancers.

Small Cell Lung Cancer

Small cell cancer is considered very aggressive and it grows quickly. It is also sometimes called oat cell lung cancer or oat cell carcinoma.

Qualifying for Disability Under the SSA Listing for Lung Cancer

If your lung cancer falls into any of the three categories below, your condition will be considered severe enough to meet the SSA's disability requirements ("meet the listing") for lung cancer. If this is your case, as long as you meet the general requirements for the SSDI or SSI disability program you are applying for, your application for disability benefits should be approved.

• Non-small cell lung cancer that is either inoperable, unresectable (not all of the cancerous tissue was removed during surgery), recurrent, or has spread ("metastasized") to or past the hilar lymph nodes (located where lymphatic vessels, arteries. and veins enter the lungs).
• Small cell lung cancer.
• Cancer in the superior sulcus (located at the top of the lungs) that has undergone more than one type of treatment, such as radiation and surgery.

With regard to non-small cell cancer, above, if you qualify because the cancer has spread beyond the hilar lymph nodes, even if a distant "metastatic" tumor has been successfully removed or treated in some other way, you still would qualify as having non-small cell lung cancer that has spread beyond the lymph nodes.

With regard to small cell cancer, above, a simple diagnosis of small cell lung cancer will automatically qualify you as disabled for purposes of the SSA, provided you meet the general non-medical requirements of the SSA program you are applying for (SSDI or SSI).

Evidence in Your Medical Record

Your doctor's diagnosis of lung cancer should include the findings of a biopsy of your primary tumor(s), and the findings of the pathologist who examined your tissue samples must be included in your medical records. If your cancer has spread, there should also be documentation of these secondary, metastatic tumors. If you have had any surgeries related to removing cancerous tissue, the surgeon's notes should be in your record, including any reports from the microscopic examination of any tissue that was removed in the surgery. If there has been no evidence of your primary lung tumor and any metastases (secondary tumors that have spread from the primary tumor) for three or more years, your impairment will not meet the criteria under the SSA's lung cancer listing.

Residual Functional Capacity

If you have a diagnosis of lung cancer, but do not meet any of the three criteria listed above to meet the SSA's lung cancer listing, the SSA will look at your "residual functional capacity," or "RFC." The SSA assesses your RFC to determine what you are still capable of doing in an employment situation, taking into account the limitations from your impairment. (If your RFC limits what you can do to the point where you are not able to perform a prior job, the SSA will look at your age, education and experience and will see if you are able to do any kind of work. If the SSA determines that your impairment and the symptoms associated with your impairment are so limiting that there is no job you can perform, you will be awarded benefits under what is called a "medical-vocational allowance.") When determining your RFC, the SSA will look at your medical records, your statement on how your symptoms limit your ability to function, and possibly others' statements.

Some people receive a medical-vocational allowance because their breathing capacity is so diminished they are unable to perform any kind of work. The SSA should look at your breathing capacity by reviewing any pulmonary function tests you have had. These tests frequently involve breathing into a mouthpiece that measures how much air you are able to inhale and exhale.

Since lung cancer is frequently associated with smoking tobacco, many people with lung cancer also have other lung diseases brought about by tobacco use, such as chronic bronchitis and emphysema. Many people with these lung diseases experience severe shortness of breath, which can limit a person's ability to function. Alternatively, if you have had part or all of a lung removed because of your lung cancer, this will have a severe impact on your breathing capacity.

The SSA also considers any long-term side effects from cancer treatment, such as memory problems or other cognitive issues.

Compassionate Allowance with Certain Lung Cancers

Some impairments are so serious the SSA has determined that a simple diagnosis means the person has met the disability standards, allowing the application to be processed very quickly. These are called "compassionate allowance conditions." Small cell lung cancer is a compassionate allowance condition. If you are diagnosed with small cell lung cancer, the SSA will expedite your application for disability and as long as your medical records support that diagnosis, you will be found "disabled" under the SSA. Severe cases of non-small cell lung cancer are also considered compassionate allowance conditions, including non-small cell lung cancer that is inoperable, unresectable, recurrent, or has spread to or past the hilar nodes.