Tuesday, November 17, 2009

Social Security Disability and Breast Cancer

I have a friend who was recently diagnosed with breast cancer. She found evidence of her condition on self-exam. Around the time this had happened, of course, there were news stories out there in the media advising women that self-exams might not be so necessary (my friend would disagree) and also that mammography for breast cancer might need to be done less frequently.

Frankly, these stories stunned me and if they had anything to do with masked attempts to reduce healthcare costs, I am appalled. Reduce costs yes. But don't reduce routine and necessary diagnostic testing of the sort that can make the difference between finding cancer that is still localized to its site of origin...and finding cancer that has metastasized to other parts of the body, making treatment much more difficult, arduous, and, perhaps, fruitless. I'm not a woman, but I'm always going to be in favor of self-exams and routine mammograms, particularly in light of my friend's experience.

My friend was found to have several benign areas that needed removal. She went in and had them removed. Then, they found that there were more growths than had been originally anticipated. Several days later, she was back in again.

Hopefully, this was what was needed to stop things in their tracks. But, as a disability examiner, I've read enough cases that lead me to personally believe you shouldn't ever underestimate cancer. My friend's own mother died of ovarian cancer that, years before she died, had gone into remission and then returned, more aggressive than before. At 71, she declined to take further rounds of chemotherapy because the treatment had made her quality of life so depressing and null. I was in awe of her bravery to make such a decision and I can't say what I might have done had I been in similar circumstances. I only know that her decision was brave, regardless of what anyone's religious theology might have to say about it (and she was, in fact, a devoutly religious woman).

However, one point of this blog post was really to mention some highlights from a article chronicling a study of over 3700 women who had had breast surgery found that women younger than forty were more likely suffer from pain following their surgery.

In fact, of the 3700 hundred women surveyed, more than half said they had lingering pain 2-3 years after surgery. Thirteen percent of the women surveyed said they experienced severe pain, and more than three-quarters of them said they experienced it daily.

What caused the pain? The surgical procedure itself--as well as the nerve damage that resulted from it--contributed to the pain. But also the chemotherapy and radiotherapy that was used to treat the cancer.

My own hope would be that social security, at some point, would take into account the lingering levels of pain experienced by women who have had to endure breast cancer surgery. Anyone over the age of 40 certainly knows that pain can limit one's ability to engage in normal daily activities, including work activities. Yet the social security administration gives scant notice to issues regarding pain and the limitations that are caused by pain. And it illustrates how the disability evaluation system falls short.

One of my own theories as to why social security fails to properly rate pain has to do with the following facts:

1. Social security disability doctors, the ones who work in conjunction with disability examiners, never meet the claimants whose medical records they read and evaluate.

2. The doctors, treating physicians, who actually treat patients do a poor job of investigating and referencing, in their treatment notes, their patient's levels of pain and inferring from this what the resulting effects might be concerning the patient's ability to engage in normal daily activities, including work activity.

3. Disability examiners tend to be younger than 40 years of age and are often younger than 30 years of age. As a consequence, many of them have not experienced significant health concerns themselves and, therefore, have no personal frame of reference that would allow them identify with a claimant's allegations of pain, and to see, in a real way, that pain could legitimately inhibit one's functional abilities.

Of course, the reason why we have so many younger disability examiners in the system is that the salaries are so low that turnover within the disability examiner ranks tends to be very high. Raising disability examiner salaries would not only benefit examiners, it would lead to longer retention of examiners resulting in older and more experienced examiners with a better eye toward evaluating the complaints of older individuals (it is human nature not to be able to understand a problem until we ourselves have, in some fashion, experienced it or something similar to it).

Return to the Social Security Disability SSI Benefits Blog

Other Posts

SSI Disability
What happens after you apply for Social Security Disability or SSI ?
Being Prepared for a Social Security Disability Hearing
What does social security mean when they say you can return to your past work?
Waiting for Social Security disability to be approved can be crushing
Social Security Disability List of Impairments
Filing for Social Security Disability SSI Virginia
Social Security Disability Appeal - Tips on the Appeals Process
Filing for Disability
When the Government stops your Social Security Disability Benefits
A Social Security Disability Check situation
Who is eligible for Social Security Disability or SSI Disability?
Social Security Disability and Part Time Work
Social Security Disability SSI, Work, and the Unsuccessful Work Attempt



Blogger Elise asd2mom.spaces.live.com said...

I know a woman who specializes inpain management. It is a truely underrepresented part of themedical spectrum. Most doctors nomatter who they are and what they treat, including cancer, has very little understanding of how to deal with pain. It should be taught in medical school and respected as a area of practic ebut it is not.

On another issue, I have never met a woman who did not discover her own breat lump from a self exam and they all were in the late 30s or early 40s. The government's findings are irrespeonsible and frightening as to what govenrment health care would actually mean for this country.

4:12 AM  
Blogger thesmallbizpro said...

Thank you for this excellent post.

My wife is a breast cancer survivor of 10 years and still has issues with pain. Her case was caught early, and a lumpectomy and pinpoint radiation were required. In addition, she needed to have sentinel nodes removed as well, resulting in some scaring and pain even after this length of time.

Though my wife is far from disabled by pain, we sympathize with those that are and thank you for calling attention to this issue.

4:53 PM  

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