January 2017

 

Social Security Disability Newsletter

 


Blood Disorders Can Be Severe
and Make Work Impossible



 

Social Security disability benefits are available to many people who suffer from severe hematological disorders that make work impossible. Over the years SSA has revised its analysis of non-cancerous blood disorders such as sickle cell disease, bone marrow failure and disorders of thrombosis and hematosis. This Listing 7.0 is complicated but we will try to summarize the key points.

Many blood disorder claims are challenging because the symptoms are episodic. Also many of the symptoms such as pain and fatigue are difficult to prove and impossible to measure. Hemolytic anemias, which include sickle cell, are considered totally disabling if:

  1. There are at least 6 crises, more than 30 days apart, within a 12 month period requiring injections or intravenous narcotic treatments;
  2. There are at least 3 hospitalizations of at least 48 hours in a 12 month period occurring at least 30 days apart;
  3. Hemoglobin measurements of 7 grams per deciliter or less at least 3 times in a year;
  4. Beta-thalassemia requiring life-long red blood cell transfusions 6 weeks apart to save life.

Hemophilia and other disorders of thrombosis and hematosis are disabling if the evidence documents at least 3 hospitalizations within a 12 month period of at least 48 hours in duration and occurring more than 30 days apart.

Aplastic anemia and other bone marrow conditions are also totally disabling if requiring at least 3 hospitalizations of at least 48 hours during during a 12 month period.

Like in many other transplant listings, bone marrow or stem cell transplantation is disabling for at
least 12 months.

The most useful “catch-all” provision is Listing 7.18 which focuses on medical problems not requiring the extensive medical documentation required in the earlier sections of this Listing. Conditions such as anemia, sickle cell without 6 crises, and other blood disorders can be totally disabling if they cause documented severe pain, fatigue or severe malaise along with a “marked restriction” in one of the following:

  • Limitation of daily activities;
  • Limitation in maintaining social functioning; or,
  • Deficiencies in concentration, persistence or pace causing limitations in completing tasks in a timely manner.

The Listing defines “marked limitation” as a serious interference with the ability to function. The focus is on the Claimant’s overall degree of functioning and does not require someone be totally precluded from each activity, just seriously impaired in the ability to function independently and effectively.

As in any Social Security disability issue proving these limitations and having adequate evidence requires strong documentation from the treating medical providers. Experience has shown that the earlier an experienced representative gets involved with a potential Claimant and explains these requirements, the great the chance for having the application approved.


We Can Help.

As always, our law firm is ready to assist your clients, patients, family and friends with Social Security issues. We can also provide training to professional staff on avoiding inconsistencies and providing more well-reasoned opinions to help your clients. Please contact us for a free in-service training at your location.

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