Can I Get Disability Benefits for Lung Cancer?

Lung cancer is the result of uncontrolled cell growth in lung tissue. Early stages of lung cancer might not cause any symptoms, but the cancer can spread outside of the lungs (metastasize) into other areas of the body, resulting in chest pain, fatigue, and breathing problems. If these symptoms interfere with your ability to work full-time for at least twelve months, you may be eligible to receive Social Security disability benefits (SSDI or SSI). 

Claims for disability based on a diagnosis of small cell lung cancer may be fast-tracked for approval under Social Security's "compassionate allowance" program. Non-small cell lung cancer can qualify for disability automatically if the medical records show that cancer has metastasized to the lymph nodes or is otherwise unable to be fully removed. When applying for benefits due to lung cancer, it's important to know what your options are so that you can spend less time dealing with the paperwork and instead focus on your health and treatment options. 

When Does Lung Cancer Automatically Qualify You for Disability?

You can get disability benefits automatically by meeting the requirements of Social Security's "Blue Book" listing for lung cancer. "Listings" are medical conditions that the Social Security Administration (SSA) has determined to be serious enough to qualify for disability without having to show that you can't work at all (which can be challenging and time-consuming). You'll need to have very specific medical evidence in your case file in order to get benefits by meeting a listing. 

The type of lung cancer you have will determine how the SSA evaluates your claim under listing 13.14 for malignancy of the lungs. For small cell lung cancer, simply having a diagnosis is sufficient to meet the listing. For non-small cell lung cancer, you'll need to provide medical documentation of either one of the following: 

• You have cancer that is either inoperable, unresectable (meaning that not all of the cancerous tissue was removed during surgery), recurrent, or has metastasized to an important part of your immune system called the hilar lymph nodes.
• You have 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. If the SSA finds you meet this section of the listing, the agency will reevaluate your case after 18 months to see if you’re still disabled.

People with non-small cell cancer who’ve had the cancer metastasize beyond the hilar lymph nodes will still qualify under listing 13.14 even if a distant tumor resulting from the metastasis has been successfully removed or treated.

Compassionate Allowance for Lung Cancer

Both small and non-small cell lung cancers are compassionate allowance conditions, meaning that the SSA considers them to be serious enough to process very quickly. Then, as long as the medical records indicate that listing 13.14 is met, the application will be approved.

For small cell lung cancer, having a diagnosis alone is enough to get expedited processing under the compassionate allowance program. Non-small cell lung cancer isn't a diagnosis-only compassionate allowance, but if your medical records show that the cancer is inoperable, unresectable, recurrent, or has spread to or past the hilar nodes, you'll qualify for a compassionate allowance fast-track. The SSA updates the list regularly to reflect advances in medical technology, so it's a good idea to check the current list of compassionate allowances before you apply for benefits. 

Evidence You Need in Your Medical Record for Disability

Your medical record is the foundation of your disability claim, so you'll want to have evidence that you've been diagnosed and treated for lung cancer when you apply for benefits. Once you file your claim, Social Security will (with your permission) start requesting medical records from doctors, clinics, and hospitals where you’ve gotten treatment for lung cancer. The agency will want to see the following information in your records:

• your doctor’s diagnosis of lung cancer
• a biopsy of your primary tumor or tumors
• the findings of the pathologist who examined your tissue samples
• medical imaging (such as X-rays or MRIs) of any secondary, metastatic tumors
• any pulmonary function tests that show diminished lung capacity
• surgical notes related to the removal of cancerous tissue, and
• any radiation treatment (such as chemotherapy) that you’ve undergone.

Keep in mind that if your medical records don’t contain evidence of your primary lung tumor and any metastatic tumors for three or more years, the SSA will consider your lung cancer to be in remission and no longer automatically disabling. But even if your cancer is currently in remission, you might be able to qualify for a closed period of disability for the time that you were undergoing cancer treatment.

Can I Get Disability for Lung Cancer If I Don't Meet the Listing? 

Meeting a listing isn't the only way that you can qualify for disability benefits—if you have limitations from the symptoms of (or treatment for) lung cancer, you can get benefits if your residual functional capacity (RFC) rules out all types of work. Your RFC is a set of restrictions that describe the most you’re capable of doing in a work environment. Social Security looks at your medical records, your activities of daily living, and any doctors’ opinions to determine your RFC.

For example, many people with lung cancer have severe shortness of breath when exerting themselves, so their RFC will likely contain restrictions on how long they can stand or walk and how much weight they can lift. (Strength-related limitations on the type of work you can do are called exertional limitations.) The agency also considers any long-term side effects from cancer treatment, such as memory problems or other cognitive issues, which are then included in your RFC.

After assessing your RFC, Social Security will look at your work history and compare the demands of your past jobs with your current RFC to see if you could do those jobs now. If you can’t, the agency then needs to determine whether any other jobs exist that you could do despite the limitations in your RFC. People 50 years of age and older can sometimes qualify for disability benefits even if Social Security thinks they could do other jobs as long as they don’t have the transferable skills required to adjust to different work.

Most people under 50 will have to show that they can’t do even the easiest, sit-down jobs before they can get disability. If Social Security doesn’t think you can do a basic desk job or work on an assembly line where you don’t have to be on your feet very often, lift heavy objects, or perform detailed tasks, the agency will approve your application for benefits.

How Much Can I Get in Disability Benefits for Lung Cancer?

Social Security doesn’t pay benefits based on the type of disability you have, so there’s no specific award amount for lung cancer. Rather, the amount of money you’ll receive depends on whether you’re eligible for Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI).

SSDI eligibility is based on your earnings history and how many work credits you’ve acquired before you became disabled. Employment doesn’t matter for SSI eligibility, but it is a needs-based benefit subject to low income and asset limits. You can learn more (and calculate your estimated benefit amount) in our article on SSDI and SSI monthly check amounts.

How Do I File for SSDI or SSI?

Starting an application for SSDI or SSI is a fairly straightforward process. You can choose from one of the methods below to begin your claim.

• One easy way is to file online. You don’t have to complete the application in one sitting, and you’ll get a tracking number so you can check the status of your claim.
• You can also apply over the phone by calling Social Security at 800-772-1213 (TTY 800-325-0778) 8 a.m. to 7 p.m., Monday through Friday.
• If you prefer to file in person, you can schedule an appointment with a representative at your local Social Security field office.

When completing the application, you’ll need the contact information and treatment dates for all of your medical providers and the names, addresses, and dates of employment for all of your employers in the last five years. For more information, check out our step-by-step guide on applying for SSDI or SSI.

What Do I Do If My Disability Claim Is Denied?

You have 60 days from the date that you receive a denial letter to appeal the denial. You may receive a denial if you have non-small cell lung cancer that hasn't metastasized or caused any functional limitations that keep you from working, or if you don't meet the non-medical eligibility requirements for both SSDI and SSI. 

The appeals process can take some time if you aren't on the compassionate allowances fast-track, and you may need to eventually request a hearing in front of an administrative law judge. In the meantime, you can strengthen your claim by submitting additional medical records documenting any changes in the progression of your cancer or the effectiveness of your treatment. Because lung cancer is frequently associated with smoking tobacco, you may also be receiving care for other pulmonary (breathing-related) diseases, such as chronic obstructive pulmonary disease (COPD), asthmatic bronchitis, and bronchiectasis or pneumoconiosis. Make sure to let Social Security know about any new doctors you've seen for treatment of these disorders or any new diagnoses as they develop. 

You may also want to consider contacting a disability attorney to help increase your chances of a successful appeal. Disability attorneys work on contingency—meaning they get paid only if you win—and many offer free consultations, so it doesn’t hurt to ask around to find a lawyer you like.