Hematologic Disorders (Blood Diseases) and Social Security Disability Insurance
Here is an explanation of Social Security's five-step process to determine if a patient with a blood disease qualifies for SSDI:
- Determine if an individual is "working (engaging in substantial gainful activity)" according to the SSA definition. Earning more than $1,040 a month as an employee is enough to be disqualified from receiving Social Security disability benefits.
- Conclude the blood disease disability must be severe enough to significantly limit one's ability to perform basic work activities needed to do most jobs. For example:
- Walking, standing, sitting, lifting, pushing, pulling, reaching, carrying or handling
- Seeing, hearing and speaking
- Understanding/carrying out and remembering simple instructions
- Responding appropriately to supervision, co-workers and usual work situations
- Dealing with changes in a routine work setting
- Blood diseases are listed under the category of impairments known as Hematological Disorders - Medical Listing 7.00. The following criteria have been established indicative of the inability to engage in any substantial gainful activity, i.e., if one has a diagnosis of a blood disease and one of the following, a finding of disabled under the Social Security Act is warranted:
- Chronic anemia persisting for at least three months and documented n more than one examination over that three-month period, requiring one or more blood transfusions on an average of at least once every two months. Medically acceptable imaging includes, but is not limited to, x-ray imaging, computerized axial tomography (CAT scan) or magnetic resonance imaging (MRI), with or without contrast material, myelography and radionuclear bone scans.
- Sickle cell disease or one of its variants, with documented painful (thrombotic) crises occurring at least three times during the fivemonths prior to adjudication, or requiring extended hospitalization (beyond emergency care) at least three times during the 12 months prior to adjudication, or chronic, severe anemia with persistence of hematocrit of 26 percent or less. Appropriate hematologic evidence for sickle cell disease, such as hemoglobin electrophoresis, must be included. Vaso-occlusive or aplastic episodes should be documented by description of severity, frequency and duration.
- Chronic thrombocytopenia due to any cause, with platelet counts repeatedly below 40,000/cubic millimeter, demonstrated by at least one spontaneous hemorrhage requiring transfusion within five months prior to adjudication, or intracranial bleeding within 12 months prior to adjudication.
- Hereditary telangiectasia with hemorrhage requiring transfusion at least three times during the five months prior to adjudication.
- Coagulation defects (hemophilia or a similar disorder) with spontaneous hemorrhage requiring transfusion at least three times during the fivemonths prior to adjudication, and must be documented by appropriate laboratory evidence.
- Polycythemia vera (with erythrocytosis, splenomegaly, and leukocytosis or thrombocytosis) and resulting impairments are evaluated under the criteria for the affected body system.
- Myelofibrosis (myeloproliferative syndrome) with chronic anemia is evaluated according to the criteria for chronic anemia, or is documented by recurrent systemic bacterial infections occurring at least three times during the five months prior to adjudication, or intractable bone pain with radiologic evidence of osteosclerosis.
- Chronic granulocytopenia due to any cause, with both absolute neutrophil counts repeatedly below 1,000 cells/cubic millimeter, and documented recurrent systemic bacterial infections occurring at least three times during the five months prior to adjudication.
- Aplastic anemias with bone marrow or stem cell transplantation are considered under a disability for 12 months following transplantation; thereafter, are evaluated according to the primary characteristics of the residual impairment.
- Explore the ability of an individual to perform work they have done in the past despite their blood disease. If the SSA finds that a person can do his or her past work, benefits are denied. If the person cannot, then the process proceeds to the fifth and final step.
- Review age, education, work experience and physical/mental condition to determine what other work, if any, the person can perform. To determine a blood disease disability, the SSA enlists medical-vocational rules, which vary according to age.
For example, if a person is:
Under age 50 and, as a result of the symptoms of a blood disease (hematological disorder), unable to perform what the SSA calls sedentary work, then the SSA will reach a determination of disabled. Sedentary work requires the ability to lift a maximum of 10 pounds at a time, sit six hours and occasionally walk and stand two hours per eight-hour day.
Age 50 or older and, due to a blood disease, limited to performing sedentary work, but has no work-related skills that allow the person to do so, the SSA will reach a determination of disabled.
Age 55 or older and, due to the disability, limited to performing light work, but has no work-related skills that allow the person to do so, the SSA will reach a determination of disabled.
Over age 60 and, due to blood disease, unable to perform any of the jobs he or she performed in the last 15 years, the SSA likely will reach a determination of disabled.
Any age and, because of a blood disease (hematological disorder), has a psychological impairment that prevents even simple, unskilled work, the SSA will reach a determination of disabled.
Request a no-cost, no obligation disability evaluation to determine your eligibility for Social Security disability.