According to the American Cancer Society, about 19,880 women had a new diagnosis of ovarian cancer in 2022. In fact, a woman’s risk of getting ovarian cancer during her lifetime is about 1 in 78.
Sadly, ovarian cancer ranks fifth in cancer deaths among women, and accounts for more deaths than any other gynecological cancer. Some of this is due to a delay in diagnosis since symptoms often mimic less serious conditions. This explains why in more than 60% of ovarian cancer patients, the diagnosis occurs at an already advanced stage.
The Social Security Administration (SSA) recognizes that around 76% of women with ovarian cancer only survive one year after diagnosis. About 45% live no more than five years.
Because of these grim statistics, ovarian cancer is one of the conditions the SSA includes on their Compassionate Allowances (CAL) list. These are illnesses that are eligible for expedited disability claims processing because of the urgency of the situation. Applicants may waive the requisite 5-month waiting period that is the norm for standard Social Security disability (SSD) claims.
However, patients must still show evidence of their condition and other qualifying criteria to ensure their application is successful.
Read on to learn what is necessary to win a disability claim for ovarian cancer.
What are the Symptoms of Ovarian Cancer?
As previously aforementioned, ovarian cancer is frequently misdiagnosed because the symptoms are similar to many common maladies. Additionally, there is no good screening tool like a Pap smear for cervical cancer or colonoscopy for colorectal cancer.
As a result, oncologists are trying to spread awareness of the core symptoms such that women might recognize them earlier. Common signs include:
- Pelvic or abdominal pain
- Difficulty eating or feeling full quickly
- A frequent need to urinate
- Inexplicable fatigue and lower back pain may also come into the mix
Ovarian cancer is more prevalent in white women than African American women. And it mainly develops in women 63 years old or older (about 50% of cases fit this demographic). Potential claimants already receiving Social Security retirement benefits should know they cannot receive disability in addition to those funds.
But ovarian cancer may occur in younger women as well. Thus, the need for Social Security disability programs for patients not yet at retirement age.
Thankfully the American Cancer Society says ovarian cancer diagnosis rates have been slowly falling over the past 20 years. However, it’s still a serious women’s health issue and the SSA recognizes it as such.
What Disability Options are Available for a Woman with Ovarian Cancer?
When it comes to disability, there are two options for which an individual with ovarian cancer may apply.
Social Security Disability Insurance (SSDI) takes into account previous employment history. It requires applicants to show work during at least five of the previous 10 years to qualify. And they must demonstrate payment of Social Security taxes during that time period as well.
Supplemental Security Income (SSI) is an option for low-income applicants and is available even without a qualifying work history. SSI provides modest financial benefits based on an individual’s overall income and assets.
Both programs require that an applicant cannot make more than $1,350/month from Substantial Gainful Activity (SGA) in 2022. That threshold number goes up to $1,470/month in 2023. But whenever applying, a potential claimant must show these baseline financial requirements in addition to medical records.
What Medical Evidence Must an Ovarian Cancer Disability Applicant Provide?
It is important for an applicant to submit documentation of their condition to support their disability claim.
To satisfy the SSA’s definition of disability, an applicant must provide medical evidence of their diagnosis. The requirements for ovarian cancer fall under Section 13.23E, the SSA’s “Blue Book” for eligible conditions.
Under this listing, there are a handful of ways for an applicant to demonstrate they medically qualify. Their records need to show one of the following:
- The cancer is not a germ cell tumor, and there is evidence of:
- Extension beyond the pelvis, such as to the bowels or abdominal area.
- Spreading (metastasis) to or beyond the regional lymph nodes.
- Recurrence after anticancer treatments (generally 3 months later will qualify).
- The cancer is germ cell, and it has returned after initial anticancer treatment.
- The cancer is small cell/oat cell. This variation is usually more aggressive and difficult to treat.
To demonstrate the extent/progression of the disease, an applicant should be willing to provide a combination of these tests:
- Blood and/or urine tests
- GI series
- Exploratory laparoscopy
- Abdominal CT scan, and/or MRI of the abdomen
- Pathological evaluation of biopsy specimen or cytology specimen
A pathology report or an operative report are the methods the SSA prefers for an oncologist’s documentation. If there is no surgery, also try to get a clinical note from a surgeon that the cancer is inoperable.
What If My Diagnosis Doesn’t Quite Meet the Blue Book Definition?
Women with a Stage I or Stage II diagnosis for ovarian cancer may not directly qualify through the SSA’s criteria.
Fortunately, there is another way to request benefits known as a Medical Vocational Allowance if you’re at least 50 years old.
This kicks in when an applicant doesn’t meet the standard disability evaluation but is clearly unable to do their job. For example, if chemotherapy, radiation, surgery, or other anticancer treatments have side effects so severe a person cannot work. In that case, a claimant might still qualify.
When applying under the Medical Vocational Allowance contingency, the SSA will once again review all medical records. Then they will determine what, if any, work an applicant may be able to do with their condition and treatment. This is an individual’s Residual Functional Capacity (RFC).
If the SSA decides work will be too difficult for an applicant because of their diagnosis, treatment or progression, they’ll award benefits.
When to Get Legal Help
While ovarian cancer definitely qualifies for disability and may receive expedited processing as a Compassionate Allowance, approval isn’t automatic.
It can feel overwhelming dealing with a serious condition like ovarian cancer while simultaneously trying to manage disability paperwork. That’s why consulting with a skilled Social Security disability lawyer at this juncture may be a smart move.
Keep in mind that most disability attorneys work on contingency, so there are no fees upfront. And applicants with representation are 3x more likely to have a successful claim right away. Ultimately, the SSD process is tough to navigate, and hiring an attorney can take away some of the stress.
But also remember, it’s okay to ask for help. Especially during a challenging time like a cancer diagnosis. You don’t have to do it all alone.
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Kimberly Dawn Neumann
Kimberly Dawn Neumann is a multi-published NYC-based magazine and book writer whose work has appeared in a wide variety of publications ranging from Forbes to Cosmopolitan. She graduated summa cum laude from the University of Maryland, College of Journalism. For more, visit: www.KDNeumann.com, Instagram @dancerscribe, and Twitter @KimberlyNeumann