Can Breast Cancer Qualify for Long Term Disability Benefits?

Can I get disability for breast cancer?

Yes. If you are dealing with breast cancer and your ability to keep working is being questioned, the issue is usually not the diagnosis itself — it is whether your symptoms and treatment side effects prevent you from performing your job on a sustained, full-time basis.

Many people are surprised to learn that even after treatment is “successful,” they may still qualify for long term disability benefits due to ongoing fatigue, cognitive impairment, or physical limitations. At the same time, insurers often deny these claims by focusing on improvement while ignoring how symptoms affect real-world job demands.

This page explains when breast cancer can qualify for long term disability benefits, what evidence matters most, and why these claims are often denied.

Why are breast cancer claims are often denied?

Even with a serious diagnosis, breast cancer claims are frequently denied or terminated. This is because insurers focus on functional capacity — not the diagnosis itself.

Common denial arguments include:

• “Treatment is complete, so you should be able to return to work”
• “Your scans and labs do not show ongoing impairment”
• “Your symptoms, such as fatigue or cognitive issues, are subjective”
• “You can perform sedentary work”
• “Your condition has improved”

These arguments often ignore how symptoms like fatigue, reduced stamina, or cognitive slowing affect the ability to perform a demanding occupation consistently over a full work schedule.

How breast cancer and treatment affect your ability to work

In a disability claim, the key question is not which symptoms you have—it is how those symptoms affect your ability to perform your job reliably and consistently.

The exact symptoms of breast cancer vary by individual and stage of cancer (as discussed below).

Physical Symptoms and Limitations

• • Pain and/or swelling in the breast;
  • Swollen lymph nodes in the armpit and/or collarbone area;
  • Shortness of breath;
  • Headaches;
  • Fatigue;
  • Loss of appetite;
  • Bone pain
    
    

Cognitive Symtoms and Limitations

• memory issues
• slower processing
• difficulty concentrating
• reduced executive function

Oftentimes treatment alone for breast cancer can cause severe and prolonged side effects which lead to long term disability. Chemotherapy and radiation are two common treatment options that may result in intense, lasting side effects.

For example, chemotherapy can produce what is informally referred to as “chemo brain.” “Chemo brain” encompasses the cognitive impairment that chemotherapy can cause in patients.

Breast cancer treatment may result in cognitive dysfunction such as:

• • Poor memory;
  • Brain fog;
  • Decreased attention span;
  • Decline in executive function;
  • Decreased information processing speeds

While these treatments are necessary to reduce/eradicate the breast cancer, they can have a strong impact on your cognitive function. The ensuing cognitive impairment may make it impossible for you to continue working, especially if you work in a field necessitating high executive function. It is possible to receive long term disability due to the side effects caused by your treatment.

Stages of Breast Cancer

Cancers, including breast cancer, are typically categorized by stages, from stage one through stage four.

• • Stage one cancer is marked by the presence of malignant cancer cells and potentially a small tumor.
  • Stage two cancer denotes the spreading of cancer to both breasts and/or increased tumor size. The lymph nodes may also be affected by cancer at stage two.
  • Stage three breast cancer is marked by the spreading of tumors around the breast and skin area, cancer present in multiple lymph nodes, but remains contained outside of the bones and other organs.
  • Stage four breast cancer is the most advanced stage, where the cancer has become metastatic and is now present in the bones, liver, brain and/or lungs.

While stage four breast cancer will generally mean your condition is the most severe and disabling, disability benefits may be obtained at any stage, depending on your symptoms and the side effects of your treatment.

What evidence helps prove a breast cancer disability claim

Regardless of the symptoms and stage of your breast cancer, your insurance company will require evidence of your impairment in order to grant long term disability benefits. Evidence corroborating your breast cancer disability can come from a number of sources. In this section, we will detail the most substantial evidence to present to your long term disability insurance company to prove your breast cancer disability.

Medical Evidence

Objective medical evidence will be the best way to prove your breast cancer is disabling to your insurance company. This medical evidence can include:

• • Any imaging done (such as MRIs, ultrasounds, bone scans, CT scans, PET scans, etc.) of the cancer-affected areas;
  • Biopsy/pathology reports;
  • Blood tests;
  • Proof of treatment (records evidencing chemotherapy sessions, radiation therapy, mastectomy surgery, etc.);
  • List of your medications and prescriptions;
  • Office visit notes from your physicians (oncologist, primary care doctor, and any other specialist).

In addition to medical records, insurers look closely for:

• documented restrictions and limitations from treating providers
• evidence of reduced stamina or inability to sustain a full workday
• consistency between your reported symptoms and clinical findings
• documentation of failed attempts to return to work, if applicable

It is often important to submit all medical evidence of your breast cancer disability to your insurance company, most especially any imaging or testing that objectively measures your breast cancer symptoms. Additionally, you may want to ask your treating oncologist to write a narrative letter to your insurance company on your behalf. This letter should document your history with your breast cancer diagnosis, symptoms (both physical and cognitive), your compliance with treatment, and the doctor’s opinion on whether you are disabled from working due to your breast cancer symptoms/cancer treatment side effects.

Additional Testing Options

Breast cancer and its treatment can cause symptoms that are not easily gauged in objective testing. For example, you may suffer from symptoms such as cognitive decline or intense fatigue due to your chemotherapy treatments. It is helpful to report these symptoms to your treating doctors. However, these symptoms are generally considered “self-reported,” and therefore subjective. As such, your insurance company may claim they are not severe enough to prevent you from working.

In that case, you may consider additional testing from a specialist to document your symptoms.

Functional Capacity Evaluation

A Functional Capacity Evaluation (also known as an “FCE”) measures your physical functioning and stamina. Insurers often rely on FCEs to argue that a claimant can perform sedentary or light work, even if they struggle to sustain that level of activity over time.

During an FCE, over a two-day period, you are evaluated on your strength, balance, endurance, and other functions. The evaluator will compare your first day and second day scores to see if your physical functioning declines over time, therefore evidencing you are unable to sustain a regular work schedule. This evaluation is not for treatment purposes, but to objectively measure your ability to perform essential functions required for different occupations, whether sedentary or active. If you suffer from poor stamina, fatigue, or muscle weakness due to breast cancer and/or your cancer treatment, this may be a suitable option to support your disability claim.

Neuropsychological Evaluation

A neuropsychological evaluation may be a good option if you are suffering from cognitive impairment due to breast cancer or, more specifically, treatment for breast cancer that is known to cause cognitive decline, such as chemotherapy. This testing is often critical in claims involving “chemo brain,” where standard imaging may appear normal but cognitive function is still impaired.

A neuropsychological evaluation tests different areas of your cognitive function, such as memory, information processing, and verbal fluency. This testing is performed by a neuropsychologist, who will then prepare a report summarizing your results. This evaluation report will include your scoring in different areas, detail your level of cognitive impairment, and provide an opinion as to whether your cognitive dysfunction prevents you from working. The report can then be submitted to your insurance company as evidence of your breast cancer disability.

Vocational Assessment

Insurers frequently underestimate the demands of professional occupations, making vocational analysis especially important.

For most insurance policies, you must prove that you are unable to work in your own occupation due to your breast cancer. However, your insurance company is likely unfamiliar with the ins-and-outs of your job role. While you can submit your resume and a job description from your employer, those may not fully encompass your occupational duties in both the physical and cognitive realm.

You may want to consider obtaining a vocational assessment from a vocational expert. The vocational expert will review your resume, job description, and additionally interview you regarding both your occupation and your medical condition. They will then prepare a report detailing the full physical and cognitive demands of your occupation, how your breast cancer symptoms affect your ability to carry out these duties, and whether they believe you are able to perform your occupation given your breast cancer condition.

The vocational assessment provides your insurance company additional evidence from an expert in the field as to why you are not able to work due to your breast cancer.

Case Study: Breast Cancer

Eleanor was working as an engineering manager at a top firm when she received a devastating breast cancer diagnosis. She immediately underwent aggressive chemotherapy to treat her cancer. Thankfully the chemotherapy was effective, and her breast cancer went into remission as a result. However, the side effects of chemotherapy left her with lasting cognitive impairments. Given the high executive function required in her line of work, any level of cognitive decline compromised her ability to work, and Eleanor struggled to meet the demands of her occupation as a result.

Eleanor realized that the symptoms of “chemo brain”—forgetfulness, slowed thought processing, poor attention span—were impacting her job to the point she could no longer perform in her role. She subsequently left work and filed a long term disability claim with her insurance company.

The insurance company sent Eleanor to two different doctors for “independent” medical examinations. Eleanor complied with all of their requests. She was certain her level of disability was indisputable. However, the insurance company came back and denied her claim. Additionally, the insurance company’s doctors had attributed her cognitive symptoms to a mental illness, even though Eleanor had never been diagnosed with any psychiatric conditions and knew her symptoms stemmed from the chemotherapy treatment.

Understanding that the stakes were too high to go it alone, Eleanor consulted with Riemer Hess and hired them to appeal the insurance company’s wrongful denial. The attorneys at Riemer Hess reviewed her file and realized that Eleanor had not submitted all relevant medical records. They quickly gathered those records to prepare for submission. On top of the existing medical records, Riemer Hess recommended Eleanor undergo neuropsychological testing to substantiate her cognitive decline and obtain a written assessment through a vocational expert.

Riemer Hess prepared an appeal to the insurance company that included the new neuropsychological testing, missing and updated medical records, a vocational report from an expert, an affidavit from Eleanor explaining her disability in her own words, and supportive letters from her treating medical providers. This combination of evidence did the trick, and her insurance company reversed their decision.

The insurance company cut Eleanor a check for her back benefits dating to her original date of disability, and she began receiving monthly benefits moving forward. She was deeply grateful to Riemer Hess for the assistance in securing her long term disability benefits.

This type of outcome often depends on developing the right combination of medical, cognitive, and vocational evidence — not just submitting existing records.

FAQs

Can I qualify for long term disability if my breast cancer is in remission?
Yes. Many claimants qualify based on ongoing symptoms or treatment side effects even after cancer is no longer active.

Is fatigue enough to qualify for disability?
It can be, if it prevents you from sustaining a full-time work schedule and is supported by medical evidence.

What if my scans are normal but I still feel unable to work?
Insurers often rely on objective testing, but claims can still be supported through cognitive testing, treatment records, and functional evidence.

When to speak with a lawyer about a breast cancer disability claim

You may want to speak with a long term disability lawyer if:

• your claim has been denied or benefits have been terminated
• the insurer is relying on an IME or paper review
• your symptoms are being dismissed as “subjective”
• you are being told you can perform sedentary work despite ongoing limitations

A long term disability lawyer can help identify gaps in the evidence, obtain targeted testing where needed, and present your claim in a way that addresses how insurers evaluate disability.

At Riemer Hess, our experienced ERISA attorneys understand the disability insurance claim process and what your insurance company will look for, whether you’re filing a claim, appealing a wrongful denial, or looking to litigate with your insurance company. We have assisted numerous clients with a breast cancer long term disability claim.

Talk with a long term disability lawyer about your breast cancer claim. To arrange for a consultation with lawyers at Riemer Hess, call us at 212-297-0700 or click the button below to schedule an exploratory call.