What this listing covers
Listing 13.23 covers malignant cancers originating in the female genital tract, including the uterus, cervix, ovaries, fallopian tubes, vagina, and vulva. This also includes primary peritoneal carcinoma. These cancers involve the uncontrolled growth of abnormal cells that can invade surrounding tissues or spread to other parts of your body.
The impact of these cancers on your daily life is often severe, frequently causing chronic pain, extreme fatigue, and significant physical limitations. Treatment regimens like surgery, radiation, and chemotherapy often result in debilitating side effects that make it impossible for you to maintain a regular work schedule or perform basic physical tasks like lifting, standing, or walking for extended periods.
How SSA evaluates a claim under this listing
Under Listing 13.23, the SSA evaluates your cancer based on its site and the extent of its spread. They look for evidence that your cancer has invaded nearby organs, spread to regional or distant lymph nodes, or is persistent or recurrent despite your initial treatment. For ovarian cancer, they specifically look for extension beyond your pelvis or recurrence after therapy.
The SSA requires that your impairment be severe enough to prevent gainful activity for at least 12 months. They consider the success of your initial treatment plan and whether your disease has progressed or returned. If your cancer does not meet the specific criteria of this listing, the SSA will evaluate your residual functional capacity to determine if you can still perform work-related tasks.
Evidence that strengthens a claim
Your claim is strengthened by comprehensive medical records that document the type, site, and stage of your cancer. The SSA requires operative notes from any surgeries, pathology reports confirming your diagnosis, and imaging studies such as CT scans or MRIs that show the extent of your disease or any metastases.
Documentation of your response to treatment is also critical. This includes records of your chemotherapy or radiation cycles, notes on your persistent side effects, and physician statements detailing your functional limitations. A clear, longitudinal record showing how your cancer and its treatment have prevented you from sustaining work is essential for the SSA review process. An attorney can help you organize this evidence to support your claim.
How an attorney helps
A disability attorney helps by ensuring your medical records are organized to directly address the criteria in Listing 13.23. They can help you obtain necessary functional capacity statements from your doctors to illustrate how your symptoms prevent you from working. If your claim is denied, an attorney can guide you through the appeals process, including preparing you for a hearing before an ALJ.
Frequently asked questions
No, a diagnosis alone does not guarantee benefits. The SSA evaluates whether your cancer has spread beyond your pelvis, involves lymph nodes, or has recurred after initial treatment as outlined in Listing 13.23. An attorney can review your specific medical records to see if they meet these regulatory thresholds.
The SSA relies heavily on pathology reports, surgical notes, and imaging that confirms your cancer has invaded adjoining organs or metastasized. Records showing that your cancer is persistent or recurrent despite treatment are also vital. An attorney can help ensure your medical file contains all the documentation the SSA needs to make a decision.
The SSA considers the complications and residual effects of your anticancer therapy, such as persistent weakness, neurological issues, or gastrointestinal symptoms. If these side effects are severe enough to prevent you from working for at least 12 months, they are factored into your disability evaluation. An attorney can help you document these limitations effectively.
If your claim is denied, you have the right to request a reconsideration and, if necessary, a hearing before an ALJ. You must file these appeals within specific timeframes. A disability attorney can help you identify why your claim was denied and gather additional evidence to strengthen your case for the next stage.
