Disability Doc

Categorize the malignancy

• Where the malignancy originated
• If it is a primary tumor
• If it is a recurrent tumor

NOTE: If the primary site cannot be identified, SSA uses the evidence documenting the site(s) of metastasis to evaluate the malignancy under Listing 13.27.

Clarify extent of involvement of the malignancy

• Have the treating source clarify tumor stage if it isn’t clear
• If it is locally advanced
• If it is metastatic
• Local metastasis - tumors that have metastasized to regional tissue or regional lymph nodes
• Distant metastasis - tumors that have metastasized beyond the regional lymph nodes

NOTE: Malignancies that have distant metastases usually meet a listing, with the exception of the following tumors:

• Testicular tumors
• Well-differentiated thyroid carcinoma
• Prostate adenocarcinoma with bone metastasis
• Hodgkin’s lymphoma

These exceptions require at least three months of longitudinal records to decide whether the intended treatment is effective.