Skin cancer can be a life-changing diagnosis, not only for your health but also for your ability to work. Depending on the type, stage, and severity of your condition, as well as the side effects of treatment, you may find yourself unable to perform the essential duties of your job. Long term disability (“LTD”) benefits can provide critical financial support during this difficult time, but securing these benefits often requires navigating a complex claims process.
Whether you’re dealing with basal cell carcinoma, squamous cell carcinoma, melanoma, or a rarer type of skin cancer, understanding your rights under your long term disability insurance policy is essential.
Below we’ll answer common questions about filing a long term disability claim for skin cancer and explain strategies for navigating the process.
What types of skin cancer can result in disability?
Skin cancer can lead to disability when its symptoms, treatment side effects, or complications make it difficult or impossible to work. The three most common types of skin cancer are basal cell carcinoma, squamous cell carcinoma, and melanoma. Each type can cause disability under certain circumstances, especially if the condition is advanced or the treatment is extensive.
Basal Cell Carcinoma (“BCC”) and Disability
Basal cell carcinoma is the most common type of skin cancer. While it tends to grow slowly and is often treatable, advanced cases can invade deeper tissues, including muscles or bones, especially if left untreated. Disability can arise if:
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- The cancer affects critical areas, such as the face, neck, or hands, causing functional or cosmetic impairments that interfere with your ability to work; and/or
- Surgery or radiation therapy leads to lasting side effects like chronic pain, scarring, or reduced mobility.
Squamous Cell Carcinoma (“SCC”) and Disability
Squamous cell carcinoma is the second most common type of skin cancer. It is generally more aggressive than basal cell carcinoma and may spread to nearby lymph nodes or other organs if not treated promptly. Disability may result from:
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- Tumors on areas like the lips, ears, or hands, which can impair speech, hearing, or dexterity;
- Side effects of treatment, such as difficulty swallowing (if the cancer is near the throat) or chronic wounds;
- Metastasis (the cancer spreading to other parts of the body), which can lead to more severe symptoms like fatigue, pain, or organ dysfunction.
Melanoma and Disability
Melanoma is the most serious form of skin cancer. It can spread quickly to other organs, making early detection critical. Disability is often linked to:
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- Advanced stages of melanoma that cause systemic symptoms such as chronic pain, extreme fatigue, and significant weight loss;
- Treatments like immunotherapy or chemotherapy, which may lead to debilitating side effects, including nausea, cognitive impairment (“chemo brain”), or immune system suppression;
- Recurrence or metastasis, which can impact vital organs like the brain, lungs, or liver, causing life-altering complications.
Rare Types of Skin Cancer and Disability
Other, less common forms of skin cancer, such as Merkel cell carcinoma or dermatofibrosarcoma protuberans, can also result in disability. These cancers are often more aggressive or recurrent, requiring intensive treatments that can affect your ability to work.
Common Disabling Skin Cancer Treatment Side Effects
Even with successful treatment, the effects of skin cancer and its therapies can be long-lasting. For example:
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- Chronic Pain or Disfigurement: Skin grafts, surgeries, or scars may cause ongoing physical or emotional distress.
- Fatigue: Cancer itself and its treatments often lead to persistent fatigue that can prevent someone from performing job duties.
- Cognitive or Psychological Issues: Depression, anxiety, or cognitive impairment may develop as a result of the diagnosis or treatment, particularly with advanced cancers.
What symptoms of skin cancer cause disability?
The symptoms of skin cancer and its treatment can be both physically and cognitively disabling, making it difficult for you to continue working. These symptoms vary depending on the type of skin cancer, its stage, and the nature of the treatment, but both physical and cognitive symptoms can contribute to a long term disability.
Disabling Physical Symptoms of Skin Cancer
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- Chronic Pain: Skin cancer, especially in advanced stages, can cause persistent pain, particularly if the cancer spreads to deeper tissues, nerves, or bones. Surgical scars or treatment areas can also be sources of chronic pain, making it difficult to sit, stand, or perform repetitive movements required for work.
- Fatigue: Fatigue is a common side effect of cancer treatments like chemotherapy, radiation, or immunotherapy. This level of exhaustion can leave you unable to focus or perform even simple tasks for extended periods, which can severely impact your ability to work.
- Limited Mobility: If skin cancer spreads or requires surgery, you may experience physical limitations. For instance, removal of larger lesions can impair the movement of limbs or other parts of the body, preventing you from completing tasks that require dexterity, strength, or full mobility.
- Compromised Immune System: Treatments for skin cancer, especially advanced types like melanoma, can weaken your immune system, making you more susceptible to infections. This can result in frequent illness or extended periods of recovery, reducing your ability to consistently attend work.
Disabling Cognitive Symptoms of Skin Cancer
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- Brain Fog: Often referred to as “chemo brain,” cognitive impairment from cancer treatments can result in memory issues, difficulty concentrating, and problems with executive function. These issues can severely impact your ability to perform tasks that require decision-making, multitasking, or attention to detail.
- Emotional and Psychological Stress: Living with cancer often leads to high levels of stress, anxiety, and depression. These psychological effects can impair your ability to function in a work environment, particularly if your job requires focus, interaction with others, or emotional stability.
- Sleep disturbances: Insomnia or disrupted sleep patterns are common in cancer patients due to pain, anxiety, or side effects of treatment. Poor sleep can worsen cognitive issues and reduce your capacity to function effectively in the workplace.
If these physical or cognitive symptoms of skin cancer interfere with your ability to work, you may be eligible for long term disability benefits. Consulting with an experienced ERISA attorney can help you understand how your symptoms fit within your policy’s definition of disability and assist you in pursuing a claim.
Can I get long term disability for skin cancer?
Yes, you may receive long term disability (“LTD”) benefits for skin cancer if your condition prevents you from performing the essential duties of your job. To qualify, you’ll need to meet the eligibility requirements outlined in your disability insurance policy, which typically focus on how your medical condition impacts your ability to work.
Disability insurance policy terms can differ, especially privately-purchased individual policies. It's important to review the terms of your policy carefully to understand the specific eligibility criteria for your claim. However, most employer-sponsored LTD group policies require that:
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- You have a covered medical condition, such as skin cancer, which includes basal cell carcinoma, squamous cell carcinoma, melanoma, or rarer types like Merkel cell carcinoma; and
- The condition or its treatment makes it impossible for you to perform your job during the “own occupation” phase of your policy (and later, any job for which you are reasonably qualified).
Skin cancer can qualify you for long term disability in several ways. Even in its early stages, symptoms like chronic pain, scarring, or limited mobility after surgery might make it difficult to handle physically demanding jobs. Advanced or metastatic skin cancer can cause fatigue, pain, or organ dysfunction, which may interfere with virtually any type of work. Additionally, treatments such as chemotherapy, immunotherapy, or radiation often cause side effects, including cognitive impairment (“chemo brain”), nausea, and extreme fatigue, that may leave you unable to focus or complete tasks.
For example, someone working in a high-pressure office job may struggle with concentration or memory due to the cognitive side effects of treatment. Similarly, a construction site manager may find it impossible to meet the physical demands of their role after undergoing surgery or radiation therapy.
To strengthen your claim for long term disability benefits, it’s crucial to provide detailed documentation. If you’re unsure how to navigate the claims process or meet your policy’s requirements, consulting with an experienced ERISA disability attorney can help you protect your rights and maximize your chances of approval.
How do I prove skin cancer is disabling?
Proving that skin cancer is disabling for long term disability purposes requires gathering substantial medical and vocational evidence to demonstrate how your condition and its treatment prevent you from working. Your insurer will require that you demonstrate that your skin cancer’s physical and cognitive symptoms significantly impair your ability to perform the essential duties of your occupation.
Proving that skin cancer is disabling requires strong medical evidence and documentation that clearly demonstrates how the condition—or its treatment—limits your ability to work. Disability insurance companies often require specific types of evidence to evaluate your claim.
Below we’ll break down the specific types of evidence you can use to substantiate your claim.
Medical Evidence to Prove Skin Cancer Disability
Comprehensive medical records are the foundation of your long term disability claim. These records should show the severity of your skin cancer, the treatments you’ve undergone, and how your condition affects your daily functioning.
Key pieces of medical evidence include:
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- Diagnosis: Documentation of your skin cancer type (e.g., basal cell carcinoma, squamous cell carcinoma, melanoma) and stage, supported by biopsy results or pathology reports.
- Imaging and Test Results: Reports from imaging studies like CT scans, MRIs, or PET scans, particularly if the cancer has spread or involves critical areas of the body.
- Treatment Records: Detailed information about your treatments, including surgery, chemotherapy, immunotherapy, or radiation, as well as side effects you’ve experienced. These records can highlight ongoing symptoms like chronic pain, fatigue, or cognitive impairments.
- Treating Physician’s Opinion: A supportive opinion from your treating oncologist or dermatologist can add significant weight to your claim. Specialists have in-depth knowledge of skin cancer and its effects, making their assessments more compelling than those of a general practitioner. They can provide detailed explanations of how the specific symptoms of your skin cancer or the side effects of treatment prevent you from performing the essential duties of your job. This level of expertise is particularly valuable when demonstrating the severity of your condition to your insurer.
- Functional Capacity Evaluation (“FCE”): An FCE measures your physical abilities and limitations, such as strength, range of motion, and endurance. This evaluation can provide objective evidence of how symptoms like pain, reduced mobility, or weakness affect your ability to perform tasks required in your job, such as standing, lifting, or walking.
- Neuropsychological Evaluation: If you experience cognitive impairments due to your cancer or treatments (commonly called “chemo brain”), a neuropsychological evaluation can assess your memory, focus, problem-solving, and overall mental function. This is especially important if your job requires a high degree of concentration or decision-making.
To prove disability, it is important to ensure that your medical records consistently document your symptoms and how they impact your ability to work. You should also regularly follow up with your healthcare providers to keep your records current and comprehensive. Working with an experienced long term disability attorney can help you gather and present the necessary evidence effectively.
Additional Supporting Evidence to Prove Skin Cancer Disability
Along with medical evidence, you can submit additional documentation to your insurer to demonstrate your skin cancer and its impact on your ability to work. This may include:
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- Vocational Assessment: A vocational assessment evaluates whether you can perform your job—or any other job given your training, education, and experience—considering the limitations caused by your skin cancer. This report can strengthen your claim by connecting your medical condition to your inability to work in your field or any comparable role.
- Symptom Journals: Keeping a record of how your condition impacts your daily life can provide personal insight into your struggles with pain, fatigue, or other symptoms.
- Personal Affidavit and Witness Statements: You may consider writing a persona affidavit outlining the history of your skin cancer diagnosis, the scope of your job duties and functions, the extent of your symptoms, and your condition’s impact on your ability to work. This can provide your insurer a wider and more detailed view of how your skin cancer interferes with your daily activities. Additionally, you may consider obtaining witness statements from family, friends, and/or co-workers who can testify to how your skin cancer causes serious symptoms that prevent you from working.
By combining medical records, objective evaluations, and supporting documentation, you can build a strong case that demonstrates how skin cancer and its treatment prevent you from performing the essential duties of your job.
Why do insurers deny skin cancer long term disability claims?
Insurance companies may deny long term disability claims for skin cancer for a variety of reasons, often related to how they interpret your medical condition, treatment outcomes, and policy definitions. Understanding the common reasons for denial can help you prepare a stronger claim or take steps to appeal a denial if necessary.
Common reasons for a claim denial may include:
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- Inadequate Medical Evidence: Insurers may argue that your medical records do not provide enough evidence to prove that your skin cancer is disabling. This can occur if documentation is incomplete, if there are gaps in treatment, or if the medical evidence doesn’t clearly connect your symptoms to your inability to work.
- Lack of Objective Evidence: Insurance companies often prefer objective evidence, such as imaging results, test findings, or standardized evaluations like a Functional Capacity Evaluation (“FCE”) or neuropsychological evaluation. Without these assessments, they may claim your symptoms are subjective or not severe enough to justify disability benefits.
- Improvement with Treatment: Insurers may deny your claim if they believe your skin cancer has responded well to treatment or is in remission. They might argue that if your cancer is under control, you should be able to return to work, even if treatment side effects persist.
- Failure to Meet Your Policy’s Definition of Disability: Depending on your policy, you may need to show that you cannot perform your “own occupation” or “any occupation.” Your insurer may argue that you can still perform work in another capacity, particularly under the more stringent “any occupation” definition.
- Non-Compliance with Treatment: If an insurer determines that you have not followed your prescribed treatment plan, such as refusing surgery, chemotherapy, or radiation, they may deny your claim on the grounds that your disabling condition is avoidable or treatable.
- Pre-Existing Condition Exclusions: Some policies have exclusions for pre-existing conditions. If your skin cancer was diagnosed or treated before your policy became effective, your insurer might deny your claim based on these exclusions.
If your claim has been denied, it’s essential to understand the reason for the denial and how to address it. Gathering additional medical records, undergoing objective evaluations, and seeking legal assistance can help strengthen your appeal. Consulting with an experienced ERISA attorney can also help you navigate the complex claims and appeals process, improving your chances of securing the long term disability benefits you deserve.
How can an attorney help with my skin cancer long term disability claim?
An attorney can provide invaluable assistance with your skin cancer long term disability claim, helping you navigate the complexities of the claims process and improving your chances of securing benefits. Riemer Hess has over 30 years of experience helping our clients win long term disability claims, appeals, and litigation. We understand how much is at stake for our clients—as well as how to navigate the claims process and counter common insurer tactics that lead to denials. We use our experience and client-focused approach to make the process as smooth and stress-free as possible, all the while ensuring that your claim has the best chance of a successful outcome.
Riemer Hess Client Success Story
Here is an example of how Riemer Hess helped a client with skin cancer win her long term disability claim:
Our client “Christina” had survived skin cancer once in her twenties, and it sadly returned in her middle age. Due to the serious symptoms and side effects of treatment, Christina was forced to leave her career as an accomplished management consultant. Her insurer initially approved her long term disability benefits for a year, until abruptly terminating her claim, despite no improvement of her condition.
Knowing she needed help, Christina turned to Riemer Hess, who quickly sprang into action. Our attorneys requested and reviewed her claim file from the insurer. The insurer had done video surveillance on Christina, but the footage did not show any activity contrary to Christina’s reported limitations. Additionally, the insurer had sent Christina for an Independent Medical Evaluation (“IME”) with one of their doctors. It was a cursory and dismissive appointment that lasted only fifteen minutes. Still, the insurer then used the results of the IME to deny her benefits.
Riemer Hess came up with a personalized strategy for Christina’s appeal. First, the insurer had wrongly classified her occupation as “sedentary,” when there was in fact physical activity required. While some of her work was desk-based, as a management consultant, Christina was required to frequently travel to client sites. On a day-to-day basis, her role also necessitated walking through offices, attending meetings, and giving detailed presentations. The insurer had also not considered the high-level cognitive demands of her job. To ensure that her occupational demands were fully reflected in the appeal, Riemer Hess referred Christina to a vocational expert who provided an in-depth analysis of her role.
Additionally, to substantiate Christina’s cognitive impairments caused by her symptoms and cancer treatment, Riemer Hess had her undergo a neuropsychological evaluation. Unlike the insurer’s IME, this assessment focused on testing and documenting her cognitive deficits. The resulting report by the neuropsychologist provided strong objective evidence of Christina’s disabling cognitive symptoms.
Armed with this additional documentation, the attorneys at Riemer Hess wrote a detailed appeal letter outlining each new piece of evidence, rebutting all of the insurer’s reasons for terminating Christina’s claim and pointing out all of the insurer’s inaccuracies in their file. Upon review of the new evidence and the appeal letter, the insurer overturned their denial and reinstated Christina’s benefits. Relieved and grateful for the support, Christina retained Riemer Hess to monitor her ongoing long term disability claim.