Nearly 1 in 2 Canadians (45% of men and 43% of women) is expected to develop cancer during their lifetime, according to the Canadian Cancer Society. This means that a large percentage of the Canadian working population is very likely to be confronted with cancer affecting their income at one time in their life, whether temporary or permanent disability results..
Workers who are under an employer’s group insurance policy or group benefits plan ask us: “Can you go on long-term disability for cancer?”
While there isn’t a simple or universal answer to this question, let us try to expose the various disabling conditions tied to cancer, and how suffering from various types of cancers relates to claiming and securing long-term disability benefits for cancer, including understanding how long does disability claim take and what the disability claim success rate is.
What Exactly Is Cancer?
Trillions of cells make up our bodies. In normal conditions, these cells grow and divide to form new cells as the body needs them. During our growth phase, but also when we’re injuring ourselves and the body attempts “repair”. When the body no longer needs the cells, they die, and new cells take their place.
When someone is affected by cancer, some of the body’s cells begin to divide and spread, even if the new cells are not needed. These cells can divide so much that they form a tumor, which may be malignant or benign. Cancers are named for the organ or location in which it began. If cancer spreads from its origin to another part of the body, it’s said to have metastasized.
While a cancer diagnosis is certainly devastating, cancer treatments have improved tremendously. In fact, the five-year survival rate for all cancers combined is approximately 66%, with survival rates for some types of cancer exceeding 90%, and many patients achieve remission.
Common Cancer Conditions Leading to Long-Term Disability
Most disability benefits are determined by how the side effects of treatment affect the patient and their ability to work, whether total or partial disability is diagnosed.
Cancer patients have many different treatment options that differ considerably based on the location and stage of cancer, as well as the prognosis provided by their medical team. One such cancer involves the lungs.
The deadliest form of Cancer, Lung cancer, usually needs surgery, chemotherapy and radiation to treat. Other treatments include hormonal therapy, targeted therapy, immunotherapy and stem cell transplants. All have side effects that can hinder a patient’s ability to work or even live a normal life, potentially resulting in chronic or acute disability.
Cancer treatments can also cause long-lasting side effects that can be the basis of a long-term disability claim, requiring comprehensive documentation and evidence compilation. These can affect the lungs, heart, nervous system, and cause muscle weakness and fatigue and other issues that affect a cancer patient’s long-term health.
Some of the cancers that can qualify for disability include:
- Lung Cancer
- Colon Cancer
- Kidney Cancer
- Prostate Cancer
- Testicular Cancer
- Uterine Cancer
- Ovarian Cancer
Stages of Cancer
Stage 1: Cancers that are at stage 1 involve abnormal growth of cells confined to an isolated part of the body. Depending upon the location of that abnormal growth of cells, cancers in stage one can sometimes be removed by surgery. However, successful long-term disability claims that are solely based on cancers in stage one are uncommon.
Stage 2: Cancers at this stage are still growing but are localized or have spread only to the nearby lymph nodes, requiring clinical assessment and therapeutic intervention.
Stage 3: Cancers in stage 3 have typically advanced to lymph nodes further away from the original abnormal growth of cells. Those who have cancer at stage 2 or 3 may be entitled to long-term disability benefits. This is especially true when severe symptoms accompany stage two or three cancer such as weakness, pain, cough, fever, headaches, fatigue, and nausea, which may require specialized medical testimony and documentation.
Stage 4: Cancer that has spread (or metastasized) beyond the regional lymph nodes into more distant parts of the body are labeled stage 4, often classified as terminal in advanced cases. These types of cancers are sometimes able to be treated but more often than not involve very severe symptoms that easily qualify for a successful cancer and long-term disability claim, including those receiving palliative care.
Doctors have customarily classified cancer into different “stages”. These stages are based upon the size of the tumor and the extent to which the cancer has spread throughout the body.
Disability Benefits Stemming From Side Effects of Treatment
Depending upon where the cancer is located in the affected individual and how far the cancer has spread, treatment options vary from patient to patient. For example, a skin lesion that is cancerous can be removed through a routine surgical procedure and will require almost no time off from work. However, lung cancer – one of the deadliest forms of cancer – requires chemotherapy, radiation, and countless visits to an oncologist. Chemotherapy specifically causes tremendous side effects that are debilitating in the affected individual.
Such side effects are fatigue, nausea, pain, digestive problems, and a compromised immune system. Any of these symptoms can prevent an individual from working and performing their activities of daily living. Radiation is similar to chemotherapy because it targets cancerous cells but also destroys some healthy cells in the process. Radiation also can cause side effects such as skin irritation and persistent fatigue. These symptoms also can limit an individual from engaging in their activities of daily living or working.
In many of these cases, these side effects are debilitating and form the basis for short term disability benefits, which last up to 6 months. By and large, STD claims are approved more than LTD claims, though understanding why was my claim denied and how to appeal disability denial is critical for disabled workers.
Proving Long Term Disability
When applying for long-term disability benefits, you must anticipate that the case will be very closely scrutinized by the insurer and underwriter. This is the case even if the cancer has advanced beyond stage 1 into stage 2, 3, or 4.
Your claim must contain all of your relevant medical evidence that speaks to your disability:
- Obtain a copy of your entire medical file and include diagnostic tests such as x-rays, bone scans, CT scans, biopsies, MRIs, and ultrasounds, ensuring thorough documentation for claim preparation.
- Include notes from your clinician, treating physician, and oncologist, along with any expert witnesses who can provide qualified testimony.
- You may also wish to include statements from close friends and members of your family that set forth their observations and your inability to engage in activities of daily living.
Statements from co-workers will also help as they can attest to the fact that you are unable to engage in your necessary work functions. Include as much favorable evidence as possible to avoid common disability claim mistakes to avoid.
How an Experienced Cancer Disability Lawyer Can Help You
It is wise to consult with and retain a licensed and certified lawyer experienced in successfully handling long-term disability claims for individuals suffering from cancer, to build a strong case and overcome all the obstacles you may face, including insurance company tactics and understanding why claims get denied. An experienced lawyer or attorney will help you to communicate effectively with the disability benefits provider and keep track of deadlines, file necessary documentation, and negotiate on your behalf. Experienced lawyers also work with your treating physicians to obtain insightful medical opinions as well as objective evidence that is compelling and demonstrates that you are unable to work.
Retaining a lawyer with experience in cancer and long term disability also takes a huge burden off of your shoulders as you recover and treat your long-term disability. Stress is one of the prime factors with respect to cancer so having an advocate that is skilled and experienced will go a long way towards helping you focus on recovery, whether you’re considering returning to work after cancer or dealing with cancer recurrence and disability.
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