This article was provided by Disability Benefits Help. If you have any questions on applying for benefits on behalf of your child, feel free to reach out to our staff at: [email protected].
If your child or teen has been diagnosed with cancer, finances should be the last thing on your mind. Yet sadly, seeking treatment for your child or teen can have a significant impact on your budget. Medical bills can pile up quickly, as can unanticipated day-to-day expenses such as traveling to and from treatment centers and additional daycare needs for siblings. And caring for your sick child can mean a decrease in income as well, as many parents find they must quit or take leave from a job to facilitate their child’s treatment.
Fortunately, help may be available. The Social Security Administration (SSA) offers financial resources for qualifying children with cancer that can help cover medical bills and other day-to-day expenses while your child is in treatment. Moreover, many families may not realize that most children who qualify for disability benefits through the SSA are also automatically enrolled onto Medicaid in most states, easing the burden of medical expenses and freeing up income to cover cost of living.
Technical Eligibility for Disability Benefits
Before applying for disability benefits on behalf of your child or teen, you should evaluate your finances. Disability benefits for children (under age 18 or students under the age of 22) are covered by Supplemental Security Income (SSI). SSI benefits are only for the most needy. This means that if you or your spouse earns a living wage, as defined by the Social Security Administration, your child will not be eligible for disability benefits, regardless of the severity of his or her cancer.
Income eligibility is determined by parental income (including adoptive parents and stepparents) and family size. Therefore, the income threshold for eligibility will be higher for families with two parents and multiple children. For example, a single parent with one child will only be able to earn about $36,000 per year for the child to qualify for SSI benefits. A couple with three children, however, will be able to earn around $54,300 per year and still have a child qualify for SSI. To determine exactly how much you can earn depending on your unique situation, view the SSA’s chart on income limits.
If you earn income higher than the SSA’s guidelines, it won’t hurt to contact the SSA, but odds are that your child will not qualify for benefits. At that point, it’s best to save your family the time and stress and apply for alternative forms of financial assistance.
Medical Qualifications for Children with Cancer
When the SSA receives your application for disability benefits, it will compare your child’s medical records to the relevant section of its “Blue Book”. The Blue Book is a medical guide used to evaluate claimants and determine whether or not a claimant meets the medical eligibility requirements, which for children include having a physical or mental impairment that results in “marked and severe functional limitations” and having an impairment that can be expected to last for at least a year or can be defined as terminal.
All childhood cancers are found in Section 113.00 of the Blue Book. When determining whether your child meets the medical eligibility requirements, the SSA will look at (1) the origin of your child’s cancer; (2) the advancement of the disease; (3) the duration, frequency, and response to treatment; (4) impact of post-treatment side effects or cancer relapse, for your child’s specific type of cancer. It should be noted that Ependymoblastoma (childhood brain cancer) will automatically meet the medical eligibility requirements. In these specific cases, all you’d need for your child to qualify is a biopsy or some other oncologist report proving that your child has ependymoblastoma.
Compassionate Allowances and Pediatric Cancer
Thousands of people apply for disability benefits every year, so it can take months for your child to be approved for benefits. Some cases are clearly disabling, so the SSA will flag these applications for expedited review. These conditions are known as Compassionate Allowances. If your child’s cancer qualifies as a Compassionate Allowance, he or she could be approved in as little as 10 days. Diagnoses that qualify as Compassionate Allowances include, but are not limited to:
- Childhood Lymphoma
- Childhood Lymphoblastic Lymphoma
- Malignant Brain Stem Gliomas
Additionally, your child can qualify for a Compassionate Allowance if:
- The cancer has spread to distant regions of the body
- The cancer has returned despite treatment
- The cancer is inoperable
You do not need to take any additional steps to qualify for a Compassionate Allowance—if the cancer is advanced enough, the SSA will automatically approve your child quickly.
Starting Your Social Security Application
If you’re ready to apply on behalf of your child, your first step should be the SSA’s Child Disability Starter Kit. This will outline all the materials you need to bring with you to apply for benefits in person.
You cannot apply for Social Security benefits online. After reviewing the Child Disability Starter Kit, you can schedule an appointment with the SSA at 1-800-772-1213. There are 1,300 SSA field offices across the country. Be sure to list every hospital where your child has been treated, and every oncologist your child has seen on your application. The more evidence you have on your side, the better the chances of approval.
If your child is denied, the SSA will state why on your denial paper’s remarks. If your child is denied due to financial reasons, it’s unlikely that he or she will ever qualify. If your child is denied due to medical reasons, you should appeal the claim as soon as possible! Your first step will be to file for reconsideration online. Only 30% of applicants are initially approved, but nearly half of applicants eventually receive disability benefits.
Once your child’s application has been approved, your family can focus on what matters most: caring for your child with cancer.