Disability Benefits for Bone Cancer

How SSA Evaluates Bone Cancer Under Listing 13.11

SSA evaluates cancers of the skeletal system, including primary bone cancers (sarcomas) such as osteosarcoma, Ewing sarcoma, and chondrosarcoma, under Blue Book listing 13.11. The listing is met when the cancer is:

• Inoperable or unresectable — the surgeon could not operate, or could not remove all of the tumor.
• Recurrent — the cancer has come back after surgery or other treatment.
• Metastatic — the cancer has spread to or beyond the regional lymph nodes, or to distant sites such as the lungs or other bones.

Some aggressive bone sarcomas, such as Ewing sarcoma, may also be considered under SSA's Compassionate Allowances program when they are advanced.

Surgery and Its Lasting Effects

Bone cancer treatment is often intensive, combining chemotherapy with major surgery. Depending on the tumor's location, treatment may involve amputation of a limb or limb-sparing surgery that replaces bone with a metal prosthesis or graft. Either way, the result is a lasting loss of function — difficulty walking, standing, lifting, or using an arm or hand. Even when the cancer is removed and does not meet the listing, the physical limitations from surgery, combined with the effects of high-dose chemotherapy, frequently qualify a person. SSA can evaluate the loss of a limb or major joint under the musculoskeletal listings as well.

Medical Evidence SSA Needs for a Bone Cancer Claim

The records that decide most bone cancer claims document the tumor, the surgery, and the resulting loss of function:

• Biopsy and pathology reports confirming the sarcoma type and grade.
• Imaging — X-rays, MRI, CT, and PET or bone scans showing the tumor's size and location and any spread, plus any note that the tumor is inoperable or unresectable.
• Operative reports describing amputation or limb-sparing surgery and any prosthesis or graft.
• Treatment records — chemotherapy regimens with dates and documented side effects such as hearing loss, heart or kidney effects, and neuropathy.
• Rehabilitation and functional records — physical therapy notes and descriptions of how well you walk, stand, or use the affected limb.

Descriptions of your actual mobility and use of the limb after surgery are especially important, because that is what an amputation or limb-sparing case usually turns on.

Qualifying Based on Function After Bone Cancer

When bone cancer is removed and does not meet listing 13.11, the claim usually rests on the lasting loss of function, evaluated through a residual functional capacity (RFC) assessment. After amputation or limb-sparing surgery on a leg, many people cannot stand or walk for more than short periods and cannot meet the demands of past physical work. Surgery on an arm or hand limits lifting, carrying, reaching, and fine manipulation. High-dose chemotherapy leaves fatigue, hearing loss, and neuropathy that add further limitations.

SSA combines these restrictions into an RFC and compares it to your past work. Loss of a limb or a major weight-bearing joint can also be assessed under the musculoskeletal listings. If your RFC rules out your past work, the medical-vocational grid rules apply, based on your age, education, and skills. Claimants age 50 and older limited to sedentary work, or 55 and older limited to light work, are often found disabled under the grids even without meeting the cancer listing.

Tips for a Stronger Bone Cancer Claim

These steps strengthen bone cancer claims:

• Get the pathology and imaging into your file early, since they establish the tumor type and whether it is inoperable, recurrent, or metastatic.
• Document your function after surgery. Describe clearly how far you can walk, how long you can stand, and what you can lift or handle with the affected limb.
• Note any amputation or prosthesis, because loss of a limb can be evaluated under the musculoskeletal listings too.
• Report chemotherapy side effects such as hearing loss and neuropathy at every visit.
• Keep physical therapy notes, as they document your real-world mobility for SSA.