Social Security Disability Benefits For Hematologic Disorders (Blood Diseases)

SSDI Hematologic Disorders (Blood Diseases) Eligibility Guidelines

1. Determine if an individual is working (engaging in substantial gainful activity) according to the SSA definition. Earning more than $1,470 a month as an employee is enough to be disqualified from receiving Social Security disability benefits.

2. 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.

3. 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:

7.05 Hemolytic anemias, including sickle cell disease, thalassemia, and their variants (see 7.00C), with:

A. Documented painful (vaso-occlusive) crises requiring parenteral (intravenous or intramuscular) narcotic medication, occurring at least six times within a 12-month period with at least 30 days between crises.

OR

B. Complications of hemolytic anemia requiring at least three hospitalizations within a 12-month period and occurring at least 30 days apart. Each hospitalization must last at least 48 hours, which can include hours in a hospital emergency department or comprehensive sickle cell disease center immediately before the hospitalization (see 7.00C2)

OR

C. Hemoglobin measurements of 7.0 grams per deciliter (g/dL) or less, occurring at least three times within a 12-month period with at least 30 days between measurements.

OR

D. Beta thalassemia major requiring life-long RBC transfusions at least once every 6 weeks to maintain life (see 7.00C4).

7.08 Disorders of thrombosis and hemostasis , including hemophilia and thrombocytopenia (see 7.00D), with complications requiring at least three hospitalizations within a 12 month period and occurring at least 30 days apart prior to adjudication. Each hospitalization must last at least 48 hours, which can include hours in the hospital emergency department or comprehensive hemophilia treatment center immediately before the hospitalization (see 7.00D2).

7.10 Disorders of bone marrow failure, including myelodysplastic syndromes, aplastic anemia, granulocytopenia, and myelofibrosis (see 7.00E), with:

A. Complications of bone marrow failure requiring at least three hospitalizations within a 12-month period and occurring at least 30 days apart. Each hospitalization must last at least 48 hours, which can include hours in a hospital emergency department immediately before the hospitalization (see 7.00E2).

OR

B. Myelodysplastic syndromes or aplastic anemias requiring life-long RBC transfusions at least once every 6 weeks to maintain life (see 7.00E3).

7.17 Hematological disorders treated by bone marrow or stem cell transplantation (see 7.00F) . Consider under a disability for at least 12 consecutive months from the date of transplantation. After that, evaluate any residual impairment(s) under the criteria for the affected body system.

7.18 Repeated complications of hematological disorders (see 7.00G2) including those complications listed in 7.05, 7.08, and 7.10 but without the requisite findings for those listings, or other complications (for example, anemia, osteonecrosis, retinopathy, skin ulcers, silent central nervous system infarction, cognitive or other mental limitation, or limitation of joint movement), resulting in significant, documented symptoms or signs (for example, pain, severe fatigue, malaise, fever, night sweats, headaches, joint or muscle swelling, or shortness of breath), and one of the following at the marked level (see 7.00G4)

A. Limitation of activities of daily living (see 7.00G5).

B. Limitation in maintaining social functioning (see 7.00G6).

C. Limitation in completing tasks in a timely manner due to deficiencies in concentration, persistence, orpace (see 7.00G7).

4. 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.

5. 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.