PLEURAL CANCER & SSD BENEFITS

WHAT IS PLEURAL CANCER?

Pleural cancer or cancer of the pleura is a rare and aggressive cancer that affects the lining of the lungs. The pleura is a thin, protective membrane that covers the lungs and lines the inside of the chest cavity.

The main cause of pleural cancer is exposure to asbestos, a mineral once widely used in construction and other industries. When asbestos fibers are inhaled, they can become lodged in the pleura, causing damage over time. However, not everyone exposed to asbestos develops pleura cancer. For example, the disease also occurs in people without any known asbestos exposure.

Pleural cancer has a long latency period, meaning it may take several decades for symptoms to appear after asbestos exposure. Common symptoms include chest pain, shortness of breath, coughing, weight loss, and fatigue. These symptoms are similar to those of other lung conditions, making diagnosis challenging.

About 2,000 new cases of pleural cancer are diagnosed in the United States each year. Pleural cancer occurs more often in men than in women and risk increases with age. However, this disease can appear in either men or women at any age.

Unfortunately, pleural cancer is often found at an advanced stage, which makes it more difficult to treat. Prognosis is generally poor, and the average life expectancy after diagnosis is short, ranging from months to a few years.

SYMPTOMS OF PLEURAL CANCER

The symptoms of pleural cancer vary from person to person. Here are some common symptoms of this condition:

1. Chest pain: Persistent chest pain is a common symptom of pleural cancer. The pain may be sharp or dull and can worsen with deep breathing or coughing.
2. Shortness of breath: As the cancer progresses, it can cause fluid buildup in the pleural space, leading to shortness of breath. This symptom may worsen over time and can occur with a dry cough.
3. Persistent cough: A chronic cough that does not go away can be a symptom of pleural cancer. The cough may be dry or may produce sputum.
4. Fatigue: Generalized weakness and fatigue are common symptoms in people with pleural cancer. The cancer and its treatment can take a toll on the body, leading to fatigue and a lack of energy.
5. Weight loss: Unintentional weight loss can occur in individuals with pleural cancer. This weight loss may be a result of a low appetite or the effect of cancer on the body’s metabolism.
6. Sweating and fever: Some people with pleural cancer may experience night sweats and low grade fevers. These symptoms are not specific to pleural cancer and can occur in other conditions as well.

It’s important to note that these symptoms can be indicative of various respiratory and lung conditions, so it’s essential to consult with a healthcare professional for an accurate diagnosis. If you have a history of asbestos exposure or any concerns about pleural cancer, then it’s crucial to discuss them with your doctor. Your doctor can provide further evaluation and testing.

TREATMENTS FOR PLEURAL CANCER

SURGERY

If you have pleural cancer, then surgery may be a good option for you. Obviously, you should follow the advice of your doctor, but surgery is often done after chemotherapy or radiation.

Surgery may be used to remove the cancerous tissue. Different surgical approaches include:

• • Pleurectomy/Decortication (P/D): The removal of the pleura lining, visible tumors, and any affected nearby tissues while preserving the lung.
  • Extrapleural Pneumonectomy (EPP): The removal of the pleura lining, lung, part of the diaphragm, and nearby tissues. This is a more extensive procedure and is usually done in selected cases.

RADIATION

Radiation therapy uses energy beams from sources such as X-rays to kill cancer cells. During radiation therapy, you lie on a table and a machine directs radiation to the precise areas of cancer in your body. Radiation therapy may be used before or after surgery. It is often done along with chemotherapy treatments. Radiation can also be given inside your body using implanted radioactive sources.

CHEMOTHERAPY

Chemotherapy uses drugs to kill cancer cells. The chemotherapy drugs can be given through a vein in your arm and into your bloodstream. Or, it can be given directly into the chest cavity. This type of therapy is often used after surgery to kill any remaining cancer cells. It can also be used in combination with radiation therapy.

TARGETED DRUG THERAPY

Targeted therapy drugs are sometimes used to treat pleural cancer. These drugs focus on abnormalities that are present within the cancer cells. Currently, however, targeted therapy is not widely used in pleural cancer treatment but may be considered in specific cases.

CLINICAL TRIALS

Clinical trials: Participation in clinical trials may provide access to experimental treatments or novel therapies being tested for pleural cancer.

IMMUNOTHERAPY

This treatment involves the use of drugs that stimulate the body’s immune system to recognize and attack cancer cells. Immune checkpoint inhibitors are sometimes used in pleural cancer treatment.

SSA’S DISABILITY LISTING 13.15 FOR CANCER OF THE LUNGS

In order to win benefits from the SSA, you must prove that your pleural cancer meets listing 13.15. Meeting a listing means you are able to show with objective medical evidence that you have one or more of the following criteria:

13.15 Pleura or mediastinum.

A. Malignant mesothelioma of pleura.

OR

B. Tumors of the mediastinum, as described in 1 or 2:

1. With metastases to or beyond the regional lymph nodes.

2. Persistent or recurrent following initial anticancer therapy.

OR

C. Small cell (oat cell) carcinoma.

YOUR BENEFITS AND SMALL CELL CARCINOMA 

Small cell carcinoma, also known as oat cell carcinoma, is a type of lung cancer that can affect the pleura, the lining of the lungs. This cancer has small cells with an oat like appearance under the microscope. Small cell lung cancer is divided into two main categories: limited stage and extensive stage disease.

When small cell cancer spreads to the pleura, it can lead to pleural cancer. Pleural involvement in small cell cancer is common and often means the disease is at an advanced stage.

The treatment approach for small cell carcinoma with pleura involvement involves a combination of chemotherapy and radiation therapy. Chemotherapy is used to kill cancer cells throughout the body, including those in the pleura. Radiation therapy may be used to target the specific areas of pleural involvement.

It’s worth noting that small cell carcinoma with pleura involvement is an aggressive form of cancer and the outcome can be poor. However, your specific treatment plan and your response to treatment may be positive.

SMALL CELL CARCINOMA AND SURVIVAL RATES

Small cell carcinoma is an aggressive form of cancer. It has a high tendency to grow and spread rapidly, making it more challenging to treat. The prognosis for this type of cancer is generally poorer compared to non-small cell lung cancer, especially in advanced stages of the disease.

It’s important to note that the term “terminal” is used to describe an advanced stage of cancer where a cure and treatment options are not effective. While small cell carcinoma can be challenging to treat, it does not necessarily mean it is terminal for every individual.

The prognosis and outcome of small cell carcinoma depends on several factors, including the stage of the cancer and whether it has spread to other parts of the body. Also, your overall health and your response to treatment impact the outcome. At the early stages of the cancer, you may have more treatment options available to you.

In general, small cell carcinoma tends to have a higher rate of coming back. It is also more likely to spread to distant sites. This happens even with aggressive treatment. The five year survival rate for severe small cell carcinoma is low, with only a small percentage of patients who live beyond that time frame.

WHAT EVIDENCE DOES THE SSA NEED TO PROVE DISABILITY?

The SSA requires medical evidence that proves the type, extent, and site of the primary, recurrent, or metastatic lesions in your pleura. If the primary site of your pleural cancer cannot be identified, then the SSA will use evidence documenting the sites of metastasis to evaluate the cancer under SSA listing 13.27.

If you undergo an operation, such as a biopsy, then the SSA will need a copy of both the operative note and the pathology report. The SSA will accept a summary of your hospitalizations or other medical reports, if you cannot get these documents. However, the evidence will need to include details of the surgery and test findings. Additionally, the SSA may need evidence about the recurrence or progression of your pleural cancer. The will also consider your response to therapy.

In some situations, very serious adverse effects may interrupt and prolong anticancer therapy for a continuous period of almost 12 months. In these situations, the SSA may determine that your condition will prevent you from working for at least 12 months. If that is the case, then the SSA will find you meet listing 13.15.

THE MEDICAL EVIDENCE MUST PROVE YOU HAVE PLEURAL CANCER

Your diagnosis of pleural cancer should include the findings of a cancer biopsy. Also, the findings of the pathologist who tested your tissue samples must be part of your medical records. If your cancer has spread, then there should also be records of secondary, metastatic tumors. If you have had any surgery related to removing cancer tissue, then those records should be sent to the SSA. Send the records as quickly as possible.

This includes any reports from the microscopic exam of any tissue that was removed during surgery. If there is no evidence of your pleural cancer and no spread of the cancer for three or more years, then your cancer will not meet SSA’s rules.

PLEURAL CANCER & YOUR RESIDUAL FUNCTIONAL CAPACITY

If you pleural cancer does not meet or equal a listing, then your RFC can make the difference between winning or losing your benefits. Residual Functional Capacity (RFC) is one of the most important concepts in your SSD case. You can use your RFC to prove that you cannot work. So, what is your RFC?

The RFC is the medical definition of what you can physically do in a work setting. It is what the judge thinks your functional limitations are after taking into account all of your cancer symptoms.

In order to figure out your physical RFC when you have pleural cancer, the SSA will examine your medical records. They will take into account what your doctor states in your medical records. Also, the SSA will review any statements from your doctors. They will also review records from their own doctors.

The SSA will also consider descriptions about your physical limits from your family and friends. For example, your family or friends could write a statement about the chronic pain and fatigue you experience from pleural cancer. Or, from your cancer treatment. Find out more here about RFC and how it, along with age, can help you receive benefits from the SSA. Also, find out more about SSA’s Medical Vocational Guidelines.

Your medical records should contain information about your pleural cancer. Likewise, your records should also  document your symptoms. You need to make sure the medical record is complete. But, you also need to make sure your medical records contain a description of what you can physically do during a work day.

MEDICAL EVIDENCE PROVING YOU CANNOT WORK DUE TO PLEURA CANCER

Pleural cancer can cause pain and fatigue. These symptoms can limit your ability to function at work. Additionally, if any part or all of your lung is removed because of pleural cancer, then this will have a severe impact on your ability to breath. The judge should consider this as part of your RFC. Also, the judge should consider any side effects from cancer treatment, such as memory problems or other mental issues.

This means your doctor should write down whether or not your pleural cancer or your cancer treatments prevent you from working. Also, your doctor should talk about your ability to lift, walk, sit, or carry. In order to outline your RFC, you should ask you doctor to fill out a form that explains your limits. Likewise, your doctor can write a letter that talks about your RFC.

The RFC states how much you can lift and how many minutes you can sit at one time before you need to stand up. Also, your doctor should explain how many minutes you can stand at one time before you need to sit down. If you need to lay down during the day, your doctor should include that information. If you have trouble using your hands, because of the effects of chemotherapy, then your doctor can document it. The RFC statement from your doctor will depend upon how your cancer symptoms impact you. It is very important, however, for your doctor to discuss your limits in the medical records.

THE MEDICAL EXPERT CAN TESTIFY ABOUT YOUR PLEURAL CANCER

Medical Experts (ME) often testify at Social Security hearings. The ALJ calls them to review your medical records for pleural cancer. Also, they explain your medical conditions to the judge. Additionally, they testify as to whether or not your medical condition meets or equals SSA listing 13.15. Similarly, your attorney can request that an ME testify in court. This is, however, mostly done in complex medical cases.

The medical expert who appears at the hearing is not your treating doctor. The doctor at the hearing must have never met you before. Because, the medical expert is there to give testimony about your medical records and should not be for either side of the case.

Medical experts are doctors who the SSA calls to testify about your pleural cancer at the hearing. Usually, the medical expert comes to the hearing. However, they can also testify by video or by telephone.

It is also possible for an ME to answer written questions after the hearing. The judge sends written questions to the expert. The ME’s answers require review and possibly filing objections. If you do not know how to do this, then hire an attorney. Do not make the mistake of not preparing for the medical expert.

THE VOCATIONAL EXPERT & YOUR SSD BENEFITS

The vocational expert (VE) is also an expert witness, just like the medical expert. Normally, the Social Security Judge calls a VE to testify at the hearing. The Judge will ask the VE about jobs that are available to you based upon your RFC. VEs have training in placing people in jobs. They also understand the numbers and types of jobs that exist in the nation. They are at the hearing in order to answer questions about jobs in the national economy.

Once the Judge asks you questions about your medical conditions, she will decide what you are capable of doing during an 8 hour work day. The SSA calls this your RFC. Your RFC what you can physically do throughout an 8 hour work day.  Therefore, your answers to the questions at the hearing are very important. They are just as the important as the medical records you submit.

The Judge listens to your hearing testimony and the takes the symptoms from your medical records to determine how your cancer symptoms impact you on the job. At the end of your hearing, the Judge will ask the VE questions. Likewise, your attorney will also ask questions. Your attorney can also question the VE. It is often the VEs answers that determine whether you will win SSD benefits.

HYPOTHETICAL QUESTIONS FOR THE VOCATIONAL EXPERT

The Judge will ask the VE about whether or not a person with pleural cancer symptoms can work. Typically, the Judge will use three to four different questions. These questions can include many different symptoms from your pleural cancer.

For example, the Judge may ask if a person cannot concentrate on the job due to cancer pain, could they work. Or, the Judge may ask what kind of work would be available to a person who cannot lift more than 10 pounds. The Judge’s questions will include your RFC. Learn more here about your residual functional capacity.

Once the Judge asks questions, your attorney has the right to question the VE. For those who do not hire an attorney, they will need to ask the VE questions on their own. Obviously, most people do not know what questions to ask because they have never been to a hearing. Nor do they have the training they need in order to understand what questions to ask.

VEs testify about what kinds of jobs are available to you. However, they also testify as to the number of jobs that exist in the national economy. For example, a VE may testify as to whether your work skills transfer to other jobs.

A VE may also testify as to the effects of other medical conditions on the range of work you can do. Likewise, the VE can testify about the erosion of the job base caused by all of your medical conditions.

DOES PLEURAL CANCER QUALIFY AS A COMPASSIONATE ALLOWANCE?

Some medical conditions are so serious that the SSA considers them disabling when you file your application.  If the SSA determines that your pleural cancer is a compassionate allowance, then they will process your application quickly.

Pleural cancer or malignant mesothelioma of the pleura is a compassionate allowance. This means that you can file for benefits and receive a faster decision. If you have pleural cancer, then you meet listing 13.15 A. Although pleural cancer is rare, it can occur many years after exposure. For example, symptoms may not appear until 30 to 50 years after exposure to asbestos. Shortness of breath and pain in the chest due to fluid in the pleura are often symptoms of the disease.

Oat cell carcinoma or small cell lung cancer is also a compassionate allowance condition. You can apply for compassionate allowance treatment if you have small cell lung cancer.

Oat cell carcinoma and pleural cancer are two different cancers that arise from different cell types and have different origins. Pleural cancer starts in the mesothelial cells that line the pleura. It usually occurs due to exposure to asbestos fibers and is not related to small cell or oat cell carcinoma.

On the other hand, oat cell carcinoma arises from the cells that line the bronchi in the lungs. It usually occurs due to smoking. Also, it has different symptoms and treatments compared to pleural cancer. It is possible for an individual to have both pleura cancer and small cell cancer simultaneously, if they develop as separate primary cancers.

WHAT WE DO TO HELP YOU WIN YOUR SSD BENEFITS 

You do not need to obtain SSD benefits for pleural cancer on your own. Our law firm can help file your SSD application. Also, we can help you file an appeal after every SSA denial. That way, you can focus on your health and living your life. Our attorneys and staff can:

• Send you the paperwork you need to become our client
• Help you file your application for SSD and SSI benefits
• Contact SSA to make them apply the Compassionate Allowance rules
• Request an appeal if you receive an initial denial from DDS
• Help you confirm your SSA doctor exam
• Request a Hearing with an Administrative Law Judge (ALJ)
• Prepare you to testify at your ALJ hearing
• Represent you at your hearing and question the expert witnesses
• Read more about the job expert
• Learn more about the medical expert
• Request review of an SSA decision with the Appeals Council
• Request review of an Appeals Council denial in Federal Court

If you file your application for SSD benefits online at Social Security’s website, then you have 6 months to complete the application. Once you submit your application online, the SSA sends you an application summary in the mail. You must sign the summary and mail it back.

Additionally, once you receive a denial from the SSA, you have 60 days to file an appeal. You must meet the time limit set by the SSA. If you do not, then you will have to start the process over again. That means you will lose any benefits you could receive on the old application.

WE WORK FOR FREE UNTIL YOU WIN BENEFITS

It also doesn’t cost you any up front money to hire us. Why? Because you only pay us an attorney fee if we win your case. This means if we win, then you pay us out of your back benefits. If you do not win, then you do not pay an attorney fee. How much is the fee? It is 25% of your back benefit, but there is a cap on that amount.

The cap on the attorney free is set by the SSA at $7200. You never pay more than the fee cap at the hearing stage of your case. And, 25% of your back benefit is usually less than the $7200 cap. You will pay whatever amount is less, between the fee cap and 25% of your back benefit.

If there are costs in your case, like getting medical records, then you pay for those costs. But the costs are usually less than $100. Typically, if a doctor charges for copies of your medical records, then that is your cost.

You will owe the costs in your case whether we win or lose your case. However, your attorney fees come from your back benefit and you pay them only if we win your case.

We will use our skills to help you through the Social Security appeal process. It is our goal to make filing for SSD and SSI benefits easier for you. We offer a free review of your case for pleural cancer. There is no pressure to become a client if you call. Even if we don’t accept your case, we will still try to help you.

WHAT WILL IT COST YOU IF YOU DON’T HIRE THE RIGHT LAWYER?

What will it cost you if you don’t hire a lawyer with the legal experience to win your case? If you win benefits, you will win monthly payments for the rest of your life. For example, if you win benefits at 50 years old, then you will be paid monthly for the next 17 years. You may also win two of years of past due benefits. That means what is on the line for you, if you are 50 years old, is 19 years of SSD payments.

Nineteen years is is 228 months. At $1200 a month (which is a lower than average monthly benefit amount), that is $273,600. Additionally, you will win a higher retirement benefit after the age of 67. Let’s say the average higher retirement benefit is $300 a month and you live to be 90 years old. That is another $82,800.

It costs 25% of your back benefit OR $7200 from your back benefit to pay your attorney. You pay us whatever is less and only if you win. Let’s pretend you pay the maximum fee of $7200. If you win your case, then your attorney has just won you $356,400, plus early Medicare benefits. You attorney will be paid $7200 and you will be paid $349,200.

All attorneys charge the same fee, because that is SSA’s law. So, you can go it alone and not hire an attorney, but chances are you will lose $356,400. Or, you can hire an attorney with no experience and pay $7200 if you win. Finally, you can hire an attorney with over 30 years of experience and still pay $7200 and win $349,200. The choice is yours. But, we hope you can see that the cost of a lawyer with 30 years of experience is worth it.

HIRE OUR LAW FIRM TO WIN YOUR SSDI BENEFITS

In the past 30 years, we have won millions of dollars in ongoing and back due due benefits for our clients. If you want to win benefits for pleural cancer, then you need to hire an attorney with the experience to win your case. Also, you need a lawyer to prove to the SSA that they should pay you benefits for your pleural cancer. We can do that. Contact us today.

If you want to learn more about our lawyers and staff, then read our About Us page. For instance, Andria Summers can help you with your Medicare plan. She has also won thousands of SSD cases. Dianna Cannon has been helping clients win SSD benefits for thirty years. Brett Bunkall also has significant experience helping people obtain their SSI and SSDI benefits. We are experts. You can trust us to help you win benefits for pleural cancer.

In the past 30 years, we have won over 20,000 SSDI and SSI cases for our clients. Also, we help our clients with their Medicare benefits. Our experts can help you apply for SSD benefits using the SSA’s website.

Likewise, if you need an appeal, we can help you do that too. There are also many forms you will need to fill out. But, don’t worry. If you have questions about these forms, then we will answer them. You can learn more about SSA’s appeal forms. Call us for a free review of your benefits and pleural cancer case today. Put our legal experience to work for you.