Social Security Disability (SSDI) process / questions

Parent Cafe
1

I’m looking for information about the SSDI process. My H was diagnosed (again) with cancer. In 2014 it was rectal cancer and this year it is anal cancer. The doctor says that this cancer is the same type as the rectal cancer. Luckily, we caught it early. He had a flex sig in March where nothing was seen and then another one this month when the doctor found a 3 cm growth.

He’s going in for surgery on Wednesday and will end up with a colostomy. I want him to apply for SSDI but not sure if he qualifies. After some initial research I found that recurring cancer of the large intestine (which the rectum/anus is covered), could possibly qualify for SSDI.

Does anyone have any recommendations or knowledge of this process?

Additional info-
H was a truck driver / vehicle operator when this first happened. He had a problem at the same time of being fired from his job. We sued, he won but it was a hostile work environment so he resigned from his position. He went back to school to become a PT assistant but didn’t quite make the cut for the cohort. Was just getting back into school again to try and figure out what to do when this happened. He has no desire to return to trucking and we’re not sure even if he would be able to after the colostomy due to the physical labor requirements.

any ideas or suggestions are appreciated.

2

I have no knowledge of SSDI. But i was wondering if H was in the military? That may be an additional avenue.

3

@rockymtnhigh . H and I met in the military but he got out. Luckily, I stayed in for 20 and retired. At least all of the medical bills are covered!

4

Have you spoken with the hospital social workers? They often have a lot of knowledge about how to get services. My friend is an oncological SW and she has tons of resources.

There are attorneys who file for SSD but since you are a vet, you should look into what the military offers in the way of free or reduced fee legal advice or assistance or try the legal clinics of the local law schools.

My best to you and your husband for a complete recovery.

5

My understanding is that Social Security requires that you be disabled for a year before your disability benefits will be approved and can begin. Here’s information from the SS website:

https://www.ssa.gov/planners/disability/

And best of luck and lots of hugs to you and your husband. This doesn’t sound like a lot of fun.

6

@VeryHappy -

There are a couple of conditions where you can get immediate SSD. The 2 that come to mind are ALS and end stage renal failure, primarily because many of those diagnosed don’t make it one year. Also, if someone is on SSD for 2 years, they become Medicare eligible, no matter their age.

7

Not sure of specifics, but generally speaking you must be completely and permanently disabled from any job to qualify for social security disability. So if the cancer is newly diagnosed and considered treatable I think he would not meet criteria. There is no partial or temporary disability with social security. Good luck to you and your husband with his treatment and recovery.

8

I was also going to suggest an attorney/firm that specializes in SSD applications if possible. But try to find a competent, reputable firm.

Also, I don’t think it’s uncommon to be denied the first time.

Does he have access to disability insurance at work (though it sounds like he’s not working right now)? Sometimes they will help the person file for SSD (though they have incentive to do so).

But my first step would be to research attorneys who handle this type of situation. Also, do you have copies of records, etc.? Keep what you have in what spot so that you’re ready if you need it.

ETA: sorry you all are going through this.

9

I’d get an attorney experienced with Social Security Disability to help you. It’s complicated.

10

I would second the suggestion to speak to the hospital social worker. I have a family member who went through this several years ago with end stage renal failure. The social worker was incredibly helpful and, although it can be a long process, it can certainly be done without resorting to a lawyer to do it for you. My best wishes for your H and for getting SSD arranged.

11

Agree that claimants do NOT need to use attorneys for SSDI, especially if they have good med records and mds who will say they are disabled. Attorney fees for SSDI are capped by statute if you do use an attorney – it’s a portion of your recovery.

12

@ChickleDoodle. Long-time CC lurker here finally logging in to reply to this. First, I’m sorry you’re going through all this. My H went through a cancer diagnosis and surgery in 2015 at the age of 62 and retired as a result. His job involved physical work he simply wasn’t able to do anymore.

Someone told us to apply for SSDI, and we did so in early 2016. The process involved providing a ton of documentation – every doctor’s visit, names and addresses of providers, employers, etc. It was a little work to put it all together, but all very doable. Then DH made an appointment with SS. We went to the local office, and they went through a long questionnaire with him. Our documentation came in very handy. The woman who handled his case seemed to feel we’d covered all the bases. She was noncommittal, but we came away feeling his case was not at all unusual and that he’d probably be approved.

Once his file was submitted, we were told it would take three to six months for an answer. Three months later, like clockwork, we noticed an automatic deposit in our checking account from SS. This was followed a few days later by a formal letter, approving his application. Not only does he now get the SS payment he would have received at 66, but they back-paid SS from the date of his forced-by-illness retirement, so we also got a large second deposit. We did not need an attorney. We simply followed the guidelines for application on the website. I’d encourage you to read through the SS website information on applying for SSD, note all the information, and make an appointment. If your H is not able to work at his job, he’s probably eligible. Best of luck to you.

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@Leaper12, thanks so much for coming out of lurkdom.

I hope your husband is doing alright

14

Thanks, @deb922. He’s doing really well, thankfully…new stage of life!

15

ChuckleDoodle, all the best to your DH and you.

SSDI begins five months after the date a person is considered disabled. Since this is a recurrence, your H’s chances of getting approved may be better.

Here is the list of Compassionate Allowances conditions for which someone would automatically qualify for SSDI. https://www.ssa.gov/compassionateallowances/conditions.htm That’s not to say if your disease is not on this list, you can’t get SSDI. It will just require more evaluation. Be sure he presents previous medical history in the application and that the doc specifies this is a recurrence of the primary cancer.

One of my brothers was diagnosed with a stage 4b cancer that’s on the Compassionate Allowance list – the date of disability was considered the date of diagnosis (last July). He applied in September once the docs got their records together and had an approval letter from SS by mid-November. He became eligible for benefits at the end of January, he started earning them in February, and got his first payment in March. Other posters are correct in that after 24 months of SSDI eligibility, he would qualify for Medicare. https://www.ssa.gov/planners/disability/dapproval4.html

Is he on Tricare?

16

Would he qualify for VA veterans benefits, service connection, or nonservice connection disabilities?. Disabled American Veteran DAV rep help sort it out, like at a VAMC.

17

Lots of good advice in this thread. Where I live, most attorneys tell clients not to engage their services until after a first denial for disability. The attorney can help with the appeal and, if necessary, additional appeal/meting with the ALJ (administrative law judge). And yes, if/when granted, it is retroactive to the initial application/date of disability.

18

Attorneys, while perhaps not necessary in the initial stages, may be able to give you some informal tips on how to avoid obvious errors or gaps in the application process.

WSJ (?) had an article a few years ago that the govt was tightening up on the SSD process and trying to establish more “even” decision making.

19

VERY Generally, SSDI approved if a person is found to have a medical condition (or aggregate of conditions) that will render them unable to work for a year or more; unable to sustain (i.e. work regularly) gainful (i.e. about $1,130 or so gross/avg/month). Age, education, transferability of job skills also considered. Also, SSA is not looking to see if a person can perform their past work, just if they can sustain gainful employment and, if so, are there are jobs available in the economy (not even in a person’s area)…if you can sit in a chair and scan ID badges at a gym an hour away, and work somewhat regularly and make a bit over $1,100. a month, a person will likely not be found to be disabled.

If approved, the first five months from “disability onset” date (the day SSA finds a person disabled) is not paid (think of it as short-term disability period), and then paid thereafter.

A person has to show they were still “insured” as of the disability onset date (meaning worked enough to "pre-pay the long term disability/SSDI “premiums” via payroll tax). If someone has not worked regularly, or did not pay taxes, or are filing for SSDI a long time after working, they may not even be “covered” for SSDI at the time they think their disability began. If not “covered”, that’s where SSI may apply?

You don’t have to be disabled for a year before you apply - as long as a person has a disability that is expected to prevent them from working for a year or more (think of someone in a terrible car accident where they are rendered a quadriplegic - file right away). Some people may wait a bit to file, after the date they feel is their onset date, to make certain they have a good medical history that SSA can gather at the time they do file…also, if approved, SSA pays back pay up to 12 months prior to application, so if filing and approved right away, with their alleged on-set date accepted by SSA, as long as a person files about 17 months after their onset date, same amount of disability is paid to them (beware taxes on back pay). Again, this is all general.

A person can apply on line, and it takes about 5 months or more to hear (SSA obtains medical records)…if denied, can file appeal/reconsideration, within 60 days of denial, and then it takes 3 or so months for reconsideration. Maybe longer, if SSA asks for their docs to examine the person, etc. If denied at the second/appeal/reconsideration level, they can then file for a hearing (which are about 18 months to 2 years out, from hearing request) within 60 days of the second denial.

It may be helpful to have attorney rep at a hearing, and they tend to get fees of about 25% of back pay amount. So if a super strong case, and a person does not want to pay attorney fees, they could easily apply on line and, if denied at the first and second level, then retain an attorney. Note that if a person has a hearing, and it’s denied at that level, and if they apply again, the earliest the on-set date can be, moving forward on a new application, is the date of hearing (where denied).

Tough to get SSDI, a long process, a long time not working (but if disabled, the person can’t work, so apply). If a person doesn’t have a condition that will “lump them into a “listing”” of medical conditions that SSA dictates “disabled” from the start…the time from filing an initial application to a hearing can be 3 years or so! Even then, if approved, SSA may find the “on set date” just the day of hearing, or some time in between the alleged date by the person and the hearing, or the date the person claimed is their on-set date…lots of moving parts! A person should be able to check with an attorney to get some basic information.

Good luck to them, find an attorney if need be, and they may be able to file in person at their local field office, so that would be helpful. At least make certain, if filing on line, the application is thorough - note all doctors, medications, etc. and call SSA if they have questions. Hopefully maybe they would fall into one of the immediately approved “listings”.

(and if they happen to have had LTD through their employer, go that route first…the LTD carriers often times file for SSDI themselves, and collect the benefits to net against what they pay…plan dependent).

20

@ChuckleDoodle, do NOT hire an attorney, at least not initially. @cycleride provided a lot of good information above and it appears that your H’s claim may fall under a listing, assuming the pathology confirms recurrent adenocarcinoma. If that’s the case, this should be a “black and white” type of decision, and I would anticipate a favorable decision on the initial application. You don’t want to have to pay an attorney if you don’t have to. Good luck.