All About Disability

What is disability?

Many cancer patients are not able to keep working after their diagnosis. However, needing income to pay bills and support family remains an issue. This is where disability coverage options come into play. For all disability claims, you must be unable to work for an extended period of time.

The Social Security Administration could classify you as disabled if:

• You have a “severe” medical condition that makes you unable to work.
• You cannot do the work you did before.
• You cannot adjust to other work because of your medical condition(s).
• Your disability has lasted or is expected to last for at least 1 year or result in your death.

What are the different kinds of disability?

There are two main types of disability coverage: short-term and long-term. Short-term tends to be when you expect to be out of work for less than a year. Long-term coverage is for when you expect to be out of work for at least a year. Disability coverage can come from a variety of sources:

• Employer affiliated/sponsored: This can be short and/or long-term. You may need to elect disability coverage during your company’s open enrollment period in order to be eligible. The amount you receive is usually a percentage of your salary.
• Private disability plans: These are plans that you buy from a third-party provider and pay monthly premiums for coverage. These plans can be short or long-term. Many buy supplemental disability plans to make up income not covered by their employer-affiliated plans.
• State disability: California, Hawaii, New Jersey, New York, Rhode Island, and Puerto Rico have state-sponsored disability programs. If you live in one of these states, your employer has paid into the state disability fund. Short and long-term disability claims are managed by the state.
• Social Security Disability Insurance (SSDI): SSDI, or social security disability insurance, is for individuals who are unable to work for at least one year due to disability and who have paid into the social security system (through wage taxes) for a number of “quarters” (typically 40 quarters (equal to ¼ of a year) or 10 years: this number is lower if you become disabled at a younger age).
  • The amount of your disability payment is tied directly to what you have paid into the system. The more money you made while working, the higher your disability payment will be. There is a maximum amount anyone can receive of around $3800 per month.
  • SSDI payments do not equal what you were making while working full time; it may only be about 40% of that amount.
  • You may be able to collect disability from multiple sources (i.e. your employer or private disability, Veterans benefits, and Social Security). Your employer or the private disability company may require you to also apply for SSDI. Your total amount of disability compensation from all these sources cannot be more than your base salary pre-disability.

What if I don’t have enough work history to qualify for disability?

• You may be eligible for Supplement Security Income (SSI).
  • SSI is for individuals who are unable to work and do not have enough work history credits to qualify for SSDI or are over 65 or blind and have limited assets/resources.
  • SSI provides income and in most states Medicaid (health insurance) to these individuals.
  • With SSI, your application date is very important, because once you are approved, your payments are retroactive to this date. There is also no waiting period to begin receiving SSI after approval.

How do I apply for disability?

• If you are unable to work, your first call for help should be to human resources at your employer to discuss your disability options, the application process, and supporting documentation needed to support your disability claim.
• If you live in a state with a state-sponsored disability, contact the state disability board as soon as possible when you are no longer able to work to initiate your disability claim.
• If you have private disability coverage, contact the company as soon as you are unable to work.
• Applications for SSDI and SSI can be made online, at the local field office, or by calling their toll-free number 1-800-772-1213.

I have advanced cancer, are there options to speed up the review of my application?

• Certain advanced cancer diagnoses fall into a special fast-track disability approval category called "compassionate allowance." This "fast-tracking" allows for faster approval of disability applications. If you have a compassionate allowance diagnosis, be sure to tell the field officer or phone representative when you begin your application by stating, "I have a compassionate allowance diagnosis: it is _________."
• Just because you are approved for a compassionate allowance does not mean you will begin to collect disability any sooner.
• For SSDI, there is a five-month waiting period for collecting payments from the start of the inability to work (not the disability). You receive benefits at the beginning of the sixth month after disability. It is important to document clearly when your disability begins and makes you unable to work.
• If you continue to work AFTER your diagnosis, the start of your disability is the first day you do not work-not the day you were diagnosed. If you have a reduction of hours, this may impact your disability start date as well--but this is based on what is considered "substantial gainful activity"--you cannot make more than $1550 per month and be considered disabled.
  • Example: you are diagnosed with acute leukemia on May 1st and unable to work beginning that day. Acute leukemia is a compassionate allowance diagnosis, so your disability claim is approved in July. You will receive your first SSDI payment 6 months after the beginning of your disability, on November 1st.
  • If you are diagnosed on May 1st but continue working until July 1st, your disability date is July 1st. You would then be eligible for your first disability payment in January.

Should I hire a disability lawyer?

• This is a very personal decision. Remember you are hiring a lawyer to represent your disability claim. This means they will take a portion of your payment when you are approved. There is a maximum amount they can take from your back pay, which is 25% or $6000, whichever is higher. Be aware that this may not cover all of your attorney’s fees.
• If you are denied disability, it may be helpful to hire an attorney to help with the appeals process.

What about health insurance?

• Health insurance is not guaranteed just because you are on disability. If you are unable to work, most employers are required to offer COBRA continuation coverage. Learn more about COBRA coverage here.
• If you are approved for SSDI, you will receive Medicare coverage beginning two years (24 months) after the first month you are eligible for monthly benefits. This is called the Medicare waiting period. This date is based on the date you are eligible to receive your monthly payment---usually, this is the date your disability started plus the five-month waiting period.
  • BUT---if you applied some time ago, and your application has taken some time for approval, you may have already met a portion of the waiting period for both your payments to start and for your Medicare eligibility. Be sure to ask Social Security about your specific Medicare eligibility date if you aren’t sure.
  • In many states, if you are approved for SSI, you will also receive Medicaid.
  • You may also be eligible to purchase a plan through the Healthcare Marketplace or, depending on your income and where you live, Medicaid.

Key Take-Aways

• Work is very important to us. It defines much of our identity, provides us with an income, and often with our health insurance benefits. Choosing to stop working, even temporarily, is a complex, difficult, personal decision.
• If you decide you can no longer work as a result of your cancer diagnosis and treatment, inform your healthcare team immediately. Medical documentation is essential to support your disability claim.
• It is important to keep good records of all of your disability claims and paperwork filed on your behalf. Ask your social worker for assistance and guidance when applying.

Resources for More Information

Social Security Administration

General disability information

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

Disability Starter Kit

https://www.ssa.gov/disability/disability_starter_kits_adult_eng.htm

Supplemental Security Income

https://www.ssa.gov/ssi/

State Disability Programs

California

https://www.edd.ca.gov/disability/

New Jersey

https://myleavebenefits.nj.gov/worker/tdi/

New York

http://www.wcb.ny.gov/content/main/DisabilityBenefits/employee-disability-benefits.jsp

Rhode Island

https://dlt.ri.gov/tdi/

Puerto Rico

http://www.benefitresourcemgmt.com/state_pr.asp