Breast cancer is the leading type of long term disability claim when it comes to cancers. As with other cancers, breast cancer can be the basis for short or long term disability if you are no longer able to work as a result. Usually, cancer patients who need to go on disability do so either because of the disease itself or because of the side effects, including those from various treatments.
To qualify for long term disability from breast cancer, you must be unable to work
The inability to work is the basis of all short or long term disability claims. Cancer claims are no different. Therefore, the severity of your breast cancer and where you are at in terms of treatment will often determine whether or not you qualify for benefits under your disability insurance policy. Many cancer patients will go through a period of time when they are still able to work and then reach a point where they simply cannot do it anymore, even if temporarily.
Your inability to work should be well documented in your medical records. It is therefore very important that you discuss exactly what your job entails with your doctor. If your doctor understands what you do for a living, he or she can better advise you and hopefully help you devise a plan to remain employed and discuss what you can expect moving forward with your prognosis. However, if you are unable to work at the moment, your doctor should be making detailed notes about how you are feeling and why- from a medical standpoint- you are not able to return to the workplace.
How long can I stay on Long Term Disability following a Breast Cancer Diagnosis?
The answer to this will depend upon the terms of your policy which sets forth a maximum time limit, especially if diagnosed near to retirement age. Of course, if you are able to work before exhausting the time limits of your policy, then your disability coverage terminates when you are released back to work. Unfortunately, insurance companies often disagree with a patient or the patient’s own doctor about when a woman with breast cancer can resume her employment activities. While many people are able to go back to work approximately 18-24 months following a breast cancer diagnosis, not everyone can. Having a solid long term disability policy becomes especially important as time goes on, as these policies are intended to cover a percentage of your income while you are out sick.
Is short term disability an option after my initial breast cancer diagnosis?
The length of your insurance disability benefits is also determined in large part by your treatment plan. Some forms of treatment, especially if your breast cancer is in its early stages, may only require you to go on short term disability. Chemotherapy and radiation treatments are exhausting and physically taxing, making work difficult if not impossible for many people. Once these treatments are complete, many people can return to work without requiring long term disability. However, longer term medications with harsh side effects keep many people out of work for longer periods of time following a cancer diagnosis. Extended time away from work is also often the case for individuals receiving stem cell transplants, which requires a longer time in treatment. In these instances, it is not at all uncommon to require both long and short term disability.
What do I need to be aware of when applying for long or short term disability after a diagnosis of breast cancer?
Policies often have an elimination period, which is essentially a waiting period before you can receive benefits under your disability policy. It acts similar to a deductible, whereby you are responsible for a certain portion of time (as opposed to money) before you can recover. This period of time is defined in your policy.
Also, disability policies will dictate whether or not it is necessary to show only that you cannot work in your own occupation, as opposed to the stricter standard of any occupation. For example, in an ‘own occupation’ standard- if you are an airline pilot, you would have to show that you cannot work as an airline pilot. However, if you are operating under an ‘any occupation’ standard and you would be suited to work on the ground – perhaps behind a desk instead of in a cockpit – you would not be able to collect benefits. The passage of time often shifts the requirement from ‘own occupation’ to ‘any occupation’. Most long term disability policies cease after two years if you are determined able to work at any occupation. Pre-existing conditions are another exclusion to be aware of, as defined by the policy.
Whether or not you are entitled to benefits under your long term disability insurance policy is going to come down to a combination of the legal terms of your insurance policy and what is shown in your medical records. The for-profit insurance companies make the initial decision and will often overlook crucial factors in your favor. The result can be a denial of benefits, requiring an appeal. Appeals are meant to be complex, but the insurance company will make it sound easy because they do not want you to get a lawyer. Be aware of this.
What should I do if I’ve been denied insurance disability benefits for breast cancer?
You are not alone. Insurance companies routinely deny benefits for any number of reasons. If your plan is governed by ERISA, you have appeal rights- generally 180 days from the date of denial. If you have been denied benefits for short or long term disability following a breast cancer diagnosis, do not accept that decision without speaking to a disability insurance lawyer. We help people in Illinois appeal their short and long term disability benefits . To understand more about the process and why you should not attempt to appeal it yourself, download my free book.
We are not a national firm which means that we will not be distracted by trying to help everyone in the country. (If you live outside of IL, call us anyway as we may be able to help you find a trustworthy lawyer who handles these cases). You do not have to worry about coming into the office, all you need to do is give us a call and our lawyer will be happy to review your denial letter from the insurance company.