I have been a reader of your forum for years. My husband has castrate resistant, metastatic prostate cancer. He has close to a dozen bone mets. The most severe bone met is on C2, which effectively obliterated C2, rendering his cervical spine forever unstable. He switched his steroid from prednisone to dex last Oct. Other than that, he’s on Lupron.
While dex staved off chemo for the time being, it did have a marked impact on his ability to perform his job. He is a high level policy maker for safety in our state and doesn’t feel comfortable continuing to work.
His disability retirement application is in process. His oncologist received this last week and asked my husband to fill out their form to properly address this.
Knowing that most of these applications are denied the first time (we’d really like to avoid hiring an attorney for this, which friends of ours have had to do), are there key terms/phrases to use in this narrative to make the application a slam dunk?
Thank you all for your participation in this forum in general, and responses to this question in particular. It greatly helps (and sometimes saddens) both of us. But it is always honest and informative.
Written by
High_flyer
To view profiles and participate in discussions please or .
Hello, I was diagnosed with metastatic PC at 47yo, four bone mets. I am in the US and applied for and received Social Security Disability (SSDI) at 53yo. At the time I was still hormone sensitive. I applied for SSDI on my own the first time and I was denied. I did not believe I needed an attorney so I just put down what my medical condition was at the time and the problems I was having. I suggest all the issues your husband is having be documented with his oncologist for SS to read, not just him writing the problem without medical documentation. SS rep did call me and asked some questions.After the denial I went to an attorney who handled SSDI. He filled out the appeal forms and again a SS rep called and asked questions. Several months later the SSDI money just dropped into my bank account without any prior notification of approval. SS does take out 25% of your backpay, or $6,000 max for attorney fees.
My attorney received $6k for our one time visit. Yes it bothered me greatly that he received that much for filling out the appeal forms but I look at it that I did receive SSDI and he would have gone to court if the appeal was denied. In retrospect I should have gone to him from the start, at least I would have met him twice. My personal recommendation is go with the attorney from the beginning. Do not do this on your own.
I am now 58 and castrate resistant since last year. I did the Provenge last year and started generic Zytiga in December along with the Lupron I have been on since diagnosed. My numbers have dropped and will ride this as long ad I can.
Wow. Your story IS our story. Timelines. Treatments. Responses to treatments. Everything. Thanks for the info. I’ll look into an attorney. I hoped to avoid that, but you’re not the first person to suggest the use of one from the getgo.
Hi,Sounds like you are in the US. We are in the UK but got an organisation called Citizens advice to help us, as we were also denied the first time around. It was a free service, do you have anything similar to that where you live ? You could check yellow pages ?
Its all about 'Mobility' here, so you must emphasis on this
I’ll look for something similar her. I’m not sure, but there’s bound to be something.
Is your husband out on disability from work? If not, then that should be your objective. Go out on long term disability from work first and then apply for SSDI when required.
Thanks for your comments. I’ll try to explain a little more.
He’s 53 so social security isn’t an option. Due to the terminal prognosis, his condition won’t improve. Therefore, he’s going for disability retirement, not long term disability, as he’s not expecting to return.
Mobility honestly isn’t an issue right now. Cognition is the trigger for him. It takes him 12-14 hrs to work an 8 hour day. He’s responsible for making state-wide policy decisions about safety. The remarkable decline in being able to find words and formulate sentences (he calls it Brain Cloud. Thank you, Joe vs the Volcano) make it nearly impossible for him to do his job to the level expected for his position.
My wife went out on Disability back in 2003 due to Head & Neck cancer.She went out on long term disability first. Then after 6 months the disability company required her to apply for SSDI. She was approved easily. LTD covers normally 60% of gross income then covers that 60% minus whatever SSDI pays out each month. You want to pursue that option if available
in reply to
I was 53 when diagnosed in May 2019. I understand his mindset I think.
One more response. .I had a coworker that went out October 2020 on LTD for ALS. It doesn't get more terminal than that. So I don't think the terminal part is an issue but I'm not an authority by any means. Was your husband told LTD wasn't available? LTD typically pays until 62. Your husband could live that long..who knows.
If he's terminal. Why isn't he on hospice? Just because someone has terminal disease, the end is often guess work. Your husband can't work due to the debilitating side effects of treatments...don't throw terminal into the mix. That is another can of worms you don't need to open.
I was 55 when diagnosed and was a high school teacher. I definitely had, and continue to have, the "brain fog" that your husband has. It is difficult to focus for much time on difficult problems. I get frustrated much more often than I used to. That, and the ADT fatigue, meant I could no longer cope with 30 teenagers for 6 hours every day and deal with the planning, marking, etc.
I live in Canada so the system is different. I easily qualified for long term disability insurance through my work and I also receive the government disability pension. Both were approved within a few weeks. My workplace disability insurance will convert to a regular employment pension if and when I reach 61.
Best of luck with getting through the bureaucracy. I am glad that I am no longer working and can focus on healthy living with a lot less stress.
I'm sure you have already read all this, but this is from the source......
The definition of disability under Social Security is different than other programs. Social Security pays only for total disability. No benefits are payable for partial disability or for short-term disability.
We consider you disabled under Social Security rules if all of the following are true:
(1) You cannot do work that you did before because of your medical condition.
(2) You cannot adjust to other work because of your medical condition.
(3) Your disability has lasted or is expected to last for at least one year or to result in death.
It appears to me that they do provide good guidance, and you can see some of the guidelines that may make it difficult to be approved....it seems the first thing that must be done is to attempt to qualify for disability coverage under employer benefits.
Here is the most important qualifying rule....
" If you can’t do the work you did in the past, we look to see if there is other work you could do despite your medical impairment(s).
We consider your medical conditions, age, education, past work experience, and any transferable skills you may have. " IF YOU CAN'T DO OTHER WORK, WE'LL DECIDE YOU ARE DISABLED." If you can do other work, we’ll decide that you don’t have a qualifying disability and your claim will be denied. "
I think probably the above statement is the reason that a determination from an employer-based disability plan and/or one or more determinations from MDs are so helpful......indeed, perhaps crucial in many cases.
A question I have, and you may too........ if a person has no access to employer-provided disability, or claim with employer plan is denied, and the person simply feels incapable of continuing at a satisfactory level, can you receive unemployment if you then feel forced to resign? Or must you wait until your employer quits you?????
I'm fairly certain this IS the most important thing to realize.......
" IF YOU CAN'T DO OTHER WORK, WE'LL DECIDE YOU ARE DISABLED."
Failing to meet this requirement is why a majority of applications are denied...IMHO. As frustrating as it can be for good guys, there is no doubt that there are quite a few fellow citizens who would prefer to game the system if SS did not diligently administer these rules. If they are too stringent, we need to press our government to change the rules.....realizing any easing of the rules will require higher taxes.
Many years ago, Richard Nixon's conservative economic adviser Milton Friedman, proposed that the US have a guaranteed minimum income for all citizens. Such a program would have done away with all the costs of these administrative agencies, and the headaches of all those applying for DI....there would have been no applicants. I believe such an idea was actually presented to the D congess at that time, but they declined!! I wrote a paper on this while in college......indeed was surprise to find Nixon and his adviser proposing such a massive change!! I thought the idea had merit. The closest we have come is minimum wage rules I guess, and the earned incme tax credit for lower income Americans.
There seems to be an ssumption that a huge number of our fellow citizens would be bums and decide to live on a minimum income if given the opportunity?
I hope there was at least one minor actionable statement included in my diatribe??
I applied once for SSD and was approved. I have a similar dx to your husband. Stage 4 PCA is viewed as incurable. I think the MO assisting with the forms required is important. I was seeing a PCa specialist who was well versed with filling out the forms required, I think this helped greatly. My SSD will convert to SSR when I turn 65. I also receive LTD through my employer at the time I was dx. Probably the worst part was having to wait for Medicare to kick in after qualifying for SSD and paying COBRA for insurance.
I am in the middle of an SSDI claim as we speak. I applied on my own and was denied pretty quickly so I hired an attorney. They are indeed expensive but at this point the cost is well worth it as it will provide me with a revenue stream going forward. I was a Jr. High teacher with a Master's degree and with all my issues quickly burned through my sick and personal leave. I retired a year early so I wouldn't starve to death and was surprised to hear that is doesn't affect my SSDI. My appeal will be heard in April and read in my paperwork that I had to be out a year without work before I would qualify for a hearing. I do some consulting for my former district but ensure that I don't make more than $200 a week. I am super confident in my attorney. His words to me were "I don't take cases I can't win" Good luck with your claim moving forward.
Wouldn't you be on STD then transition to LTD and from LTD to SSDI after a period which is usually 6 months. This person is talking about by-passing the LTD and going straight to SSDI. I think that is unwise unless LTD is not an option but I did come away with that understanding.
Financially it is better for me to retire than to do disability through the job and you can't take them simultaneously. My wife and I are in travel mode and need a steady stream of income. Selling half my rentals will provide or my wife when I pass. Well thought out plan with nothing but upside for us
One advantage of US SSDI is that you can get on Medicare health insurance before age 65. Here is the "Program Operations Manual System" US SSDI uses to determine qualification. secure.ssa.gov/apps10/poms....
My experience ( I’m stage IV metastatic with spinal compression), like you I went to and attorney first. I signed some forms that he would represent me then he gave me a number at SSA. I called that number and the set up and appointment for the following week. During the next call I gave the agent my medical history along with my Drs. Information ( call was about 40 mins long). At the end I said I will here back in several months? He said no about 10 days as they have a different review process for our cases ( I’m guessing stage IV metastatic ,I’ve gone through radiation twice, 6 rounds of LU 177 as part of the vision trial, two 6 round sessions of Taxatere, and now in 8 rounds of Jevtana).
Any way I heard back in 10 days that I was approved and that my approval date was 2 years earlier than when I applied. This allowed me to start Medicare at the start of the year. I guess my recommendation is call the SSA yourself since the lawyer I hired did not ever get involved.
Content on HealthUnlocked does not replace the relationship between you and doctors or other healthcare professionals nor the advice you receive from them.
Never delay seeking advice or dialling emergency services because of something that you have read on HealthUnlocked.
long term disability LTD
Your experience with going on SS disability 
Jim Marshall retires but Australian links on JimJimJimJim.com
Dr Myers retirement
My Oncologists is retiring
