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Stage 4: Just denied disability today...

Friendinpenn's picture
Friendinpenn
Posts: 64
Joined: Oct 2010

Greetings all...

I guess I'm wrong, but I had been told by several that stage 4 cancer was like an automatic approval for social security disability....

However, the case worker said today that it doesn't matter what my ailment is because if I make over a thousand dollars a month income I don't qualify...

After my 30th chemo on Friday was done, now it's been recommended that I stay on some kind of chemo for the rest of my life....

It's been very difficult for me, (and I know many of you try as well) to do an eight hour a day job during chemo...

So I tried to see what my options were today at the social security office and was told what I said above...."It doesn't matter what ailment you have......"

Pissed me off.....

Your friend in Penn

Nana2's picture
Nana2
Posts: 255
Joined: Mar 2010

Dear Jim,
I am so sorry you are not being given disability. I don't understand. I can't imagine trying to work an eight hour job going through what you're going through. I can sure understand you being upset. It just doesn't seem fair. I don't know that much about disability, but maybe someone else will have some ideas that could help. Maybe a lawyer could help.
(hugs)
April

geotina's picture
geotina
Posts: 2064
Joined: Oct 2009

Unfortunately, it is my understanding, you cannot work full time and get Social Security Disability. If you quit working, then a Stage IV is pretty automatic. Yep, unfair especially when you pay into a system.

If you have disability at work go on that and reapply for SSD, you should be able to collect on both.

Take care - Tina

La.Grammy
Posts: 35
Joined: Apr 2010

Have you already applied for disability and been turned down?

My husband is stage 4 & he applied about 2 weeks ago.
We hope to find out our answer within the next month or so.
I know of a person that was stage 4 for about 2 years before she applied.
She was approved. She received 2 years back pay even tho she had not applied for disability during that time. They said she was diabled at the time she was dx as stage 4.

La.Grammy

Friendinpenn's picture
Friendinpenn
Posts: 64
Joined: Oct 2010

So what I was hoping was to fill the gap with ssd...

But again, at part time I make over a thousand gross a month so the guy says it doesn't matter my ailment... I don't qualify....

I took with me a file on my health issues: 30 chemos, 28 radiaions, colon, liver and lung resections, and he would'nt even look at them when I asked him to....

It was like there was no way I was going to be approved because I work at all...

So there's supposedly a SSD program that allows you to work for nine months and collect SSD to encouarage you to try to work....HELLOOOOOOOOOOOOO I want this....

I have been employed where am now for 25 years...I told the guy it wasn't like I have a bad cold and want to collect disability....

Still pisses me off.....

Friend in Pennsylvania

Lori-S's picture
Lori-S
Posts: 1287
Joined: Sep 2010

I totally understand your anger and frustration. I've spent months since dx trying to apply for things and have fallen through the cracks each time. Either, I have too much (which isn't the case anymore) or I made too much, or I was too young or too old or had the wrong cancer. It can be so frustrating. My understanding is that SSD does let you work but, someone I know works only parttime and makes less than $1000/month in order to continue to qualify.

Seems you're like me and stuck in the damn cracks that people fall through. I've spent nearly everything I've had and had to let go of assets and spend assets just to get ready to qualify for things in the future. It's really so sad that in this great country, if you're hit with a serious illness, you have to go nearly bankrupt before you can get help. At one point in my son's illness I was paying $45,000/month for his Rx. This went on for nearly a year before I finally won approval from the insurance companies to have the medications covered for his particular dx. And these were meds that he would have died without. I just thanked God everyday that I was fortunate enough to cover the costs at that time. Sometimes our system seems so unfair. You have my sympathies. HUGS

CherylHutch's picture
CherylHutch
Posts: 1399
Joined: Apr 2007

OMG Lori... this post of yours made my jaw physically drop to my chest!! Short of being a billionaire (and I'm not trying to poke into your private affairs), how does ANYONE afford $45,000/month??? That is over half a million for the 12 months! Seriously, it's not even a matter of how wrong it is that anyone would have to fork over half a million dollars and not get help, but I don't think I know anyone (ok, can I claim I know you? ) that could even begin to afford that kind of money for prescriptions of any kind.

I'm going to walk over to my little apartment kitchenette to make some dinner... totally in shock over this!

Cheryl

Lori-S's picture
Lori-S
Posts: 1287
Joined: Sep 2010

If it's any consolation those were the "good old days". And My cancer dx has really hit my bank account so I'm no where near anything close to that now. I owned 2 businesses at the time and work 24/7 all because I needed to to keep my son going. I guess that was my motivation.

WinneyPooh's picture
WinneyPooh
Posts: 318
Joined: Jul 2009

one thing you might try since you work part time, is to become an independent contractor ( work for your company but on a contract bases, ) you will be self employeed and get a 1099 at the end of the year. since you can take various deductions you can actually earn more money and be on disablity. I do consulting work n and am paid as an independent contractor, I get social security disablity and was approved with this income.

So if this works for you take your monthly income and subtract expenses, and then the end result is your monthly income. Keep the bottom number at or below $700 and you will be fine.

you can keep your health insurance provided by the employer because of your relationship thru the contract.

Try it.

Penny

John23
Posts: 1832
Joined: Jan 2007

On the bright side, they're telling you they expect you to live
a long time, making a big bunch of cash!

Listen, this "problem" is just an obstacle to work around:

------
Social Security work incentives at a glance

Trial work period—

The trial work period allows you to test your ability to work for
at least nine months. During your trial work period, you will
receive your full Social Security benefits regardless of how much
you are earning as long as you report your work activity and you
continue to have a disabling impairment. In 2011, a trial work month
is any month in which your total earnings are over $720, or if you are
self-employed, you earn more than $720 (after expenses) or spend
more than 80 hours in your own business. The trial work period
continues until you have worked nine months within a 60-month period.

Extended period of eligibility—

After your trial work period, you have 36 months during which you
can work and still receive benefits for any month your earnings
are not “substantial.” In 2011, earnings over $1,000 ($1,640 if
you are blind) are considered substantial. No new application or
disability decision is needed for you to receive a Social Security
disability benefit during this period.
------

You just have to fit into that initial requirement, and maintain that
status fairly closely.

More info here: Working While Disabled—How We Can Help

Lori-S's picture
Lori-S
Posts: 1287
Joined: Sep 2010

My understanding of the trial work period is that you first have to be qualified and receiving benefits when you apply for the trial work period. Jim i s not yet qualified or receiving. Correct me if I am wrong

Friendinpenn's picture
Friendinpenn
Posts: 64
Joined: Oct 2010

The reason I'm part time now is because of the continuing cancer I seem to get once a year ....To keep my medical benefits I have to turn my time sheet in to show 30 hours...so every time I go to chemo or have a bad day I have to use paid time off...OK I have to, but that is down to zero...so I lose my benefits... and I just want to fill the gap with SSD....a guy across the road from me gets disability for a bad shoulder, but he goes archery hunting ....takes the boat out fishing and has a hell of a good time off on disability....stage 4 cancer for some reason doesn't count...because I decide to try to work at all

I'm still pissed off.....(Hey Lori-S... thanks for your comments...and I wish you well)

Friend

Buzzard's picture
Buzzard
Posts: 3073
Joined: Aug 2008

A SSD Lawyer will get you what you are entitled to in a hurry. If not don't you have State Representatives that you can contact ? I would be ringing phones and calling people....

Friendinpenn's picture
Friendinpenn
Posts: 64
Joined: Oct 2010

Thanks...It probably will have to go to this...

On a side note to you...I read all of your posts and you have a great way of expressing yourself and things I need to read...you make alot of sense...

Your a good man and I wish you well...

Friend In Penn

scouty's picture
scouty
Posts: 1973
Joined: Apr 2004

There is no SSD lawyer in this country that is going to get you disability benefits if you are working 30 hours a week! No way. Either you are disabled or you're not, that's the way they see it.

I think your anger is misdirected. You've worked at the same place for 25 years and you don't have any kind of disabily plan there? Why are they making you work 30 hours a week to keep your health insurance, that's not right nor is it humane!

Now for SSD, if you can afford to quit your job now and reapply you will get accepted. By law your company would have to give you 1 year of your current health insurance plan. I'm not sure when you become eligible for Medicare insurance but at worst it would be Jan 1 of 2012 BEFORE your health insurance runs out.

No lawyer is going to help you with this without you paying them a fee. You need to find someone that is familiar with SSD and Medicare that won't charge you $125 an hour.

Just my 2 cents after being where you are 6 years ago.

Oh and the whole 9 months thing is after you have been out, not working, and getting SSD benefits and THEN go back to work.

Lisa P.

CherylHutch's picture
CherylHutch
Posts: 1399
Joined: Apr 2007

Hey Jim,

Just trying to relate this to how I understand it since it appears government disability insurance works very much the same in both countries (US and Canada).

When I was first diagnosed (Stage III) in December 2006, I was in pain and not feeling well so went on short term sickness from my job, which was an employee benefit. Short Term illness applied to being off work up to 6 weeks. It became apparent once we knew what we were dealing with and the surgery that I had to have, I was going to be off work longer than six weeks, so my employer advised me to apply for our employee benefit of Long Term Disability (ok, I admit I was lucky that I worked where we had this benefit... so many don't have it and I don't know how people survive cancer if they don't have it). So, I was approved right away for LTD, but as part of their conditions for granting it, I had to apply for any other insurance I was eligible for, so that it would lower the LTD payouts. IE: I was entitled to 70% of my current wage, but if I was eligible for other insurance, then I still would only get 70% between the two monthly payouts. So, I had to apply for Canada Pension (equivalent of your SSD) Disability. I got it right away... starting the month I applied for it. It didn't make any difference to the amount I'd receive every month... I was entitled to 70% of my wage, whether LTD paid the whole thing, or the two benefits shared the cost. Ok... so I was on my monthly LTD/Disability for basically 3 years... until this past February when I hit the magical age of 55. That is the earliest one can retire and collect the company pension where I worked. I had my 35 years with them (well, actually 36 but whose counting since I couldn't retire until I was 55), so I was eligible to retire and collect my company pension. I had to decide whether to stay on LTD/Disability where I was also getting my healthcare insurance monthly premiums paid for, or retire from my employment and collect my pension plan. I was getting 70% of my wage on LTD/Disability and I would get 70% of my wage from my company pension but would have to pay my own healthcare insurance monthly premiums. Can you guess what I chose?

Hehe... probably a wrong guess. I chose to retire. Why would I do that? Because with LTD/Disability combined, I was getting 70% of my monthly salary. By retiring, I got 70% of my monthly salary from my pension PLUS I would continue to get the Canada Pension Plan Disability ($1100/month), which gave me $1100 more a month than if I stayed on LTD/Disability. As for paying my own healthcare insurance monthly premiums... that didn't even enter the equation (which I'm sure it would for many of my American friends). As a retiree benefit, my monthly medical premiums are $18/month... I figure I can afford that since I'm getting the extra $1100/month... and that means all my medical expenses are covered (except for prescriptions, but 80% of them are covered from an Extended Health Care plan I have).

Now... what's not to like above? Well, don't get me wrong... I LOVE being retired. Wouldn't change it for a thing! BUT, it means I can't take on a paying job. Our restrictions for the Disability are even more stringent than yours. If I make more than $5000 in a calendar year, then I will be cut off from the disability. $5000/year means you aren't disabled??? HELLOOOO?? It works ok in my situation because I love not having to work ... and that $1100/month is extra money that I wasn't getting before, so I'm just putting it away. I will get it until I reach the age of 65, in which case the disability pension stops and the Canada Pension/Old Age Security starts.... meanwhile, I've had 10 years of $1100/month that I can use or save or do whatever I want with. But if I WANT to work, then I forefeit that.

Soooo, for me to forfeit it, I would need to be offered a job that pays way more than $1100/month for it to be worth my while.... but at the moment, there is nothing that is worth me having to be stressed out about going to work every day if I'm not feeling well, or missing work because of treatments. When I've got energy (which, knock on wood, I've had a fair amount of even while going through treatments), then I'm more content to volunteer my time to something I LOVE doing and not because I expect or want to be paid. "I'm in a unique position where I CAN'T be paid, will you hire me anyways??" :D

Of course, that doesn't help you out because you do need to work and part time wages aren't quite enough. So that really sucks... but it looks like it's the same in both countries. Not that that's a lot of consolation, other than at least you can take some comfort in knowing they aren't picking on you personally.

Now, if you get a lawyer, the lawyer might be able to convince them it's better for your health that you don't quit your part time job to be eligible for disability help... but if that's what it takes, you will. Of course, the Disability amount won't be enough for you to live on, so then they will have to pay you SSD as well... maybe they will see the logic in letting you work part time and get some help with Disability payments.

Do keep us posted!

Cheryl

John23
Posts: 1832
Joined: Jan 2007

All the info is available here:
Disability Benefits

Keep in mind, that there's a difference between Social Security Disability,
and other disability benefits.

How we make the decision
We use a five-step process to decide if you are disabled.

1.Are you working?
If you are working and your earnings average more than a certain amount each month, we generally will not consider you disabled. The amount changes each year. For the current figure, see the annual Update (Publication No. 05-10003).

If you are not working, or your monthly earnings average the current amount or less, the state agency then looks at your medical condition.

2.Is your medical condition “severe”?
For the state agency to decide that you are disabled, your medical condition must significantly limit your ability to do basic work activities—such as walking, sitting and remembering—for at least one year. If your medical condition is not that severe, the state agency will not consider you disabled. If your condition is that severe, the state agency goes on to step three.

3.Is your medical condition on the List of Impairments?
The state agency has a List of Impairments that describes medical conditions that are considered so severe that they automatically mean that you are disabled as defined by law. If your condition (or combination of medical conditions) is not on this list, the state agency looks to see if your condition is as severe as a condition that is on the list. If the severity of your medical condition meets or equals that of a listed impairment, the state agency will decide that you are disabled. If it does not, the state agency goes on to step four.

4.Can you do the work you did before?
At this step, the state agency decides if your medical condition prevents you from being able to do the work you did before. If it does not, the state agency will decide that you are not disabled. If it does, the state agency goes on to step five.

5.Can you do any other type of work?
If you cannot do the work you did in the past, the state agency looks to see if you would be able to do other work. It evaluates your medical condition, your age, education, past work experience and any skills you may have that could be used to do other work. If you cannot do other work, the state agency will decide that you are disabled. If you can do other work, the state agency will decide that you are not disabled.

There has to be a criteria and cut-off points; I don't think it's
possible to have a functioning system without that. It seems
unfair, but we should realize that the system is there for an
"emergency", or radical situation, and not for the average
individual that can work and make money. All our situations
vary, and it's hard, if not impossible to devise a system that
will suit every need.

In Pennsy's case, he's between the cracks, and it's tough. He's
limited, but not limited quite enough.... what the hell is "enough"?
Good grief.

I already collect SS, but not as a disability (unless you count age
as a disability), and a lot of people told me that I can claim a
disability (cancer) and get more. Uhh... no, I can't. And if I could
possibly work it out, I would leave myself subject to all the paperwork
and "investigations" that come with a disability claim. It's no picnic.
But... as a retiree, I expected worse than I have seen so far, so
I won't complain.

If I were in Pennsy's shoes, I'd try to work it out with my boss to
get the pay to under $750 on the books, and take the rest in
some sort of a "perk", that doesn't have to be recorded as "income".
It's not "cheating", if it's worked out right. Like Income tax, if
you know the limits and keep to those limits, it works out fine!

Best hopes for good health!

John

tootsie1's picture
tootsie1
Posts: 5006
Joined: Feb 2008

I'm sorry I don't have the smarts to give you a great answer. I think a lawyer would be the best avenue.

*hugs*
Gail

AnneCan
Posts: 3693
Joined: Oct 2009

I don't blame you for being PO'd. I am a Canadian + my husband + I are self-employed so I am not much help, but I wanted to say I am sorry for this situation.

pepebcn's picture
pepebcn
Posts: 6352
Joined: Aug 2010

the US.?
Hugs!

jararno's picture
jararno
Posts: 189
Joined: May 2010

Here in the USA your disability payment is based on the money that you have paid into The Social Security System. Every year we get a benefit statement telling us an approximate monthly amount that we could recieve should we qualify for disability. The "average" monthly payment is around $1,100 per month although a few people do receive higher amounts based on higher earnings. If you are making over $1,000 per month you cannot qualify for Social Security Disability. It is definitely a "Catch 22". ( I do not receive any benefits as I have never worked enough to earn credits for disability...I can never qualify unless I get a job and work for many years! Hopefully my husband can afford to keep paying my medical insurance and bills! )

Hope this helps give you an idea of the little money that people are trying to live on!

Take Care.

Barb

John23
Posts: 1832
Joined: Jan 2007

Re:
"I can never qualify unless I get a job and work for many years!
Hopefully my husband can afford to keep paying my medical
insurance and bills! )"

My wife was in the same boat, as I'm sure many married woman
fall into. If you're married and never worked outside home (that's
actually more work/less pay), you can still apply for benefits under
your husbands's SSI account.

I began collecting years earlier than the usual SSI retirement age
to enable her to be able to collect SSI under my SSI account.

The amount one loses by collecting early, is more than made
up by the extended time you end up collecting!

The SSI laws change, so you'd have to check with the local office,
but I would definitely dig a bit deeper.

Best wishes,

John

jararno's picture
jararno
Posts: 189
Joined: May 2010

John....Thanks for the info. In my case I will never receive any Social Security Benefits as my husband is not covered under Social Security. He works for The Federal Government and is covered under a different program as he doesn't pay into Social Security. There are so many variations of programs in United States, hopefully those who qualify will get the help that they need!

Best Wishes,

Barb

Annabelle41415's picture
Annabelle41415
Posts: 4304
Joined: Feb 2009

So sorry to hear of your situation. I'm not sure about anything to do with SS, but if you're working they guess they assume that you don't really have a disability. Glad the others chimed in and gave you some advice. Hope you reapply again. Good luck.

Kim

Crow71's picture
Crow71
Posts: 681
Joined: Jan 2010

Man this sucks.
There really ought to be a way for some one in your situation have access to their social security savings early. You are not asking for some sort of charity. You just need some of that money now. When you turn 76 (yes I am anticipating an age increase) you can figure the rest out. Maybe some of the others' suggestions will help.

It sure is rough to hear "chemo for life." I got that line the first time I met my onc.

Hang in there.

Roger - your friend in NC

ketziah35
Posts: 1150
Joined: Jun 2010

Everyone that I know of is denied. No one gets it wothout having help from an attorney. If they can not afford one they try churches with legal aid or the united way or something. I just spoke to a woman whose son is mentally challenged. You can not tell except he keeps losing jobsbecuz he can not foLow directions due to his challenges. She said the same thing. You won't get anywhere without an attorney on this one. By the way her son was denied 2 times already and they have is childhood medical records and psyche reports. This is definitely a time when you need an advocate.

ktlcs's picture
ktlcs
Posts: 360
Joined: Jan 2010

My husband made well over 1000 a month and although he went on disability aftr his stroke (and before the cancer) once his doctors declared him unable to work he qualified after a bit of a fight. They made us wait 6 months to become eligible and then I fought them for another 6 but we did get it (and retroactively!) I was lucky enough not to need to hire an attorney but often that is the way to go. You've been paying into the system now it is time for you to get the benefit you need and deserve!

Kathy

John23
Posts: 1832
Joined: Jan 2007

Could you please clarify something?

Re:
"My husband made well over 1000 a month and although he went on
disability aftr his stroke (and before the cancer) once his
doctors declared him unable to work he qualified "

Was he making $1,000 per month after his stroke, and after
his doctors found him unable to work?

John

bruins1971's picture
bruins1971
Posts: 228
Joined: Nov 2010

I applied back in April and was approved in less than a month. They then told me that I'd get my first check in October as there was a six month waiting period before you actually get paid. Unlike others I did not get any back pay by that's probably because I get short term disability from work at 50% pay for up to 52 weeks this after the first 13 weeks was at 100% pay. Then after a year I'd go onto long term disability but God willing my scan on Feb 1st will show NED and then I'm going back to work. I'll do the 9 month trial which is cool cause I can get paid from work and still get my full SSD pay. Only thing is if I go back out after that 9 month trial I'd have to start all over again by reapplying which makes no sense if it's the same disability but that's what I was told. Sounds like your gonna have to make less money in order tp get approved.

Your buddy in Dallas
Bobby

snommintj's picture
snommintj
Posts: 602
Joined: Mar 2009

You will qualify because of your condition. You also have to qualify economically. If you have more than 30k in assets you won't qualify. If you make more than a certain amount monthly you won't qualify. If you had more than 30k in assets you have to show where the assets went. If you've paid into the system you can get regular SS, but won't receive medicare for two years unless you need dialysis. Find the criteria and follow it. There is no other way.
Once you qualify, then you can get on one of the work programs if you like. They let you make a little money. Or you can work and make more but they will subtract it from your check. But you still keep the benefits. Qualifying is simply a matter of following the rules. No one can or will make an exception. You have to be considered indigent.

Buckwirth's picture
Buckwirth
Posts: 1272
Joined: Jun 2010

Has no indigency requirement, you are confusing it with another program (SSI? Medicaid?)

Stage IV qualifies faster due to compassionate clause instituted in 2008. There are still other rules, and they have to be met.

This is the best link I could find:

http://www.medicare.com/medicare-coverage-basics/can-i-get-medicare-if-i-am-under-65.html

As I understand it, eligibility starts 6 months after you last work, rather than 2 years (at which time most with a stage IV dx are already dead) which was the previous standard.

Friend,

You have to give up or reduce the income. In the long run these programs will bring you enough benefits to cover the short term pain now. And consider yourself lucky, a mere four years ago you wouldn't have qualified at all.

herdizziness's picture
herdizziness
Posts: 3440
Joined: Apr 2010

Wow, I was approved in 20 days and got my first check the very next month. I didn't wait six months to get it. My medicare starts this February 1st. I applied back in March of last year, had first check in April of last year.
Winter Marie

angelsbaby's picture
angelsbaby
Posts: 1161
Joined: May 2008

went to the office and got his check in 30 days but he paper work said stage 4 terminal that may have made a big differance .

michelle

herdizziness's picture
herdizziness
Posts: 3440
Joined: Apr 2010

That's what mine said too, Stage IV Terminal. I noticed yesterday, the paperwork said Stage IV colon, mets to liver, the word Terminal was gone.
Winter Marie

La.Grammy
Posts: 35
Joined: Apr 2010

Hi Friendinpenn,

Sick pay paid by your employer does not count against you when you file for disability.
You can collect sick pay & apply for your disability at the same time.
Maybe you can get your employer to pay you enough sick pay to keep your insurance going while you file for your disability. Medicare kicks in after 24 months.

Eltina21's picture
Eltina21
Posts: 174
Joined: May 2010

Hi,
My name is Karen and I read your story. I am a survivor of colorectal cancer and a Disability Examiner for Social Security. Part of the criteria to receive Social Security Disability Benefits is that you are not working or earning a certain amount of money. The Social Security Offices have the SGA or Substantial Gainful Employment levels. They change each year. It doesn't mean that you are not disabled, it is just that there is a cap on how much you can earn per month. I truly understand how upset it made you. I pray that things improve for you and have a great day.

Peace and Blessings to You.

Friendinpenn's picture
Friendinpenn
Posts: 64
Joined: Oct 2010

I guess what I was upset about was that I want try to work as much as I can but have days where I can't...I know you would understand this,

Anways, I thought I could continue to work as mucha as I could and social security would fill in the "gap" of my chemo treatment days...

I do understand now that this is not possible unless my income falls below a certain level....

Thanks again for your message

Your Friend-in-Penn

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