Getting Disability Benefits for Anemia and Other Blood Disorders

When you file for disability benefits based on a blood disorder, claims examiners at the Social Security Administration (SSA) will look at a manual called the "Blue Book" to see if your specific diagnosis is included as a listed impairment. The manual discusses what medical evidence applicants need to provide to qualify for disability automatically ("meet a listing" in Social Security lingo).

The Blue Book classifies blood conditions, including hemolytic anemias like thalassemia or sickle cell disease, under section 7.00 for hematological disorders. Blood diseases not included in section 7.00 may be evaluated using the section for another body system. For example, the SSA can evaluate polycythemia vera (a rare form of blood cancer) under the listings for respiratory, cardiovascular, or neurological impairments.

When Is Anemia a Disability?

Anemia occurs when you don't produce enough red blood cells to oxygenate the tissues in your body properly. There are several different types of anemias, not all of which are disabling. For example, iron deficiency anemia—the most common type—is often successfully treated with iron supplements and isn't usually severe enough to qualify for disability benefits.

Other types of anemias are longer-lasting and more difficult to treat. With proper medical documentation, you may be able to qualify for disability with certain kinds of anemias such as sickle cell disease (an inherited disorder that causes normally disc-shaped blood cells to form in the shape of crescents) or thalassemia (another genetic disorder causing your body to manufacture less hemoglobin, an important blood protein, than normal).

Disability Listing for Chronic Hemolytic Anemias

Hemolytic anemia—where your red blood cells are destroyed faster than your body can replace them—is evaluated under listing 7.05. This listing also covers sickle cell disease, thalassemia, and their variants. You can meet the requirements of listing 7.05 in one of the following four ways:

• You have documented vaso-occlusive crises (a painful complication of sickle cell disease) that require intravenous or intramuscular narcotic medication. These crises must occur at least six times in 12 months, with at least 30 days between each crisis episode.
• You've been frequently hospitalized for complications from hemolytic anemia, such as osteomyelitis (bone infection), liver failure, pulmonary hypertension, or stroke. You must have at least three hospital visits for these complications within a 12-month period, the visits must last at least 48 hours each, and they must occur at least 30 days apart.
• You have multiple blood test results showing hemoglobin measurements of 7.0 grams per deciliter (g/dL) or less. These measurements must occur at least three times in 12 months, with at least 30 days between measurements.
• You've been diagnosed with beta thalassemia major, a very serious type of thalassemia where your bone marrow doesn't produce enough red blood cells to keep you alive without blood transfusions. Your medical records must show that you require lifelong transfusions at least once every 6 weeks.

Laboratory tests, blood work, and hospitalization records are crucial to establish that you meet listing 7.05. Make sure to provide the SSA with the names, treatment dates, and contact information of every medical provider you've seen for your hematological disorder.

Can Hypocytic Microchromic Anemia Be a Disability?

Hypocytic microchromic anemia (also called hypochromic microcytic anemia) is a condition where you have fewer red blood cells than normal, and the ones that you do have are smaller than they should be. This kind of anemia is usually, but not always, the result of an iron deficiency.

As with other blood disorders, whether or not your diagnosis of hypocytic microchromic anemia is disabling depends on the results of your lab tests and other objective medical findings. If you're able to manage your symptoms with iron supplements, it's unlikely you'll qualify for disability, but if you've been hospitalized repeatedly (one of the ways you can meet listing 7.05), the SSA can award you benefits.

Disability for Hemophilia and Other Coagulation Disorders

Listing 7.08 addresses disorders involving thrombosis and hemostasis (dysfunctions of coagulation, or how your blood clots), including hemophilia. Conditions that cause the blood to clot too much or too little, like immune thrombocytopenic purpura (ITP), are evaluated under this listing.

In order to meet listing 7.08, you'll need to show that you've been hospitalized for complications from hemophilia or another coagulation disorder at least three times in a 12-month period. Each hospital stay must last at least 48 hours, and they must be at least 30 days apart. Examples of complications that may require hospitalization include embolisms (blood vessel blockages) or uncontrolled bleeding.

Bone Marrow Failure

Red blood cells come from bone marrow, a fatty substance found in your bones. If your bone marrow stops producing healthy blood cells, you may have a condition that qualifies for disability under listing 7.10. Disorders that the SSA may evaluate under this listing include myelodysplastic syndromes, aplastic anemia, granulocytopenia, and myelofibrosis.

The requirements of listing 7.10 are similar to those of other blood disorder listings. You can meet the listing in one of two ways:

• You've been hospitalized for complications of bone marrow failure, such as viral infection, at least three times in 12 months. Each hospital stay must last at least 48 hours, and they must be at least 30 days apart.
• You've been diagnosed with a myelodysplastic syndrome or aplastic anemia requiring blood transfusions at least once every 6 weeks for the rest of your life.

If you received a bone marrow or stem cell transplant as part of treatment for your blood disorder, the SSA considers you automatically disabled for one year under listing 7.17. After the year is up, the agency will revisit your disability claim to see if you've improved enough to return to work.

Repeated Complications of Hematological Disorders

The last listing in the Blue Book category of blood disorders is listing 7.18, a bit of a "catch-all" for people who aren't hospitalized enough to meet the other listings but can still demonstrate serious functional limitations. You may qualify for disability under listing 7.18 if you can show that "repeated complications" of your blood disorder cause a "marked" level of limitations in at least one functional area.

What are Repeated Complications?

For the purposes of listing 7.18, "complications" includes any of the complications mentioned in the previous listings as well as osteonecrosis, retinopathy, skin ulcers, silent central nervous system infarction, cognitive or other mental limitations, or restrictions in joint movement. These complications must result in "significant, documented symptoms or signs," such as pain, severe fatigue, malaise, fever, night sweats, headaches, swelling, or shortness of breath.

"Repeated" means that the above complications occur at a specific frequency and duration. This means the complications must, on average, occur either:

• three times a year, or once every four months, and last for at least two weeks
• substantially more frequently than three times a year, but last for less than two weeks, or
• less frequently than three times a year, but last for substantially longer than two weeks.

Broadly speaking, the more severe your complications are, the less often they need to occur—and the more frequently they occur, the less severe they need to be.

What are Marked Limitations?

Even if you have prolonged, frequent complications from a blood disorder, you won't meet listing 7.18 unless you can show that the complications result in "marked limitations" in your ability to complete your daily activities, maintain social functioning, and complete tasks on time. Having a marked limitation in a particular area means that your symptoms "interfere seriously with your ability to function independently." For example, if anemia makes you so tired that you can only get out of bed every other day, the SSA will likely find that you have a marked limitation in your activities of daily living.

Applying for Social Security or VA Disability Benefits

You can start your application for Social Security benefits online at the agency's official web portal, by calling the national hotline at 800-772-1213 from 8 a.m. to 7 p.m., Monday through Friday, or by going in person to your local Social Security field office.

Veterans who have a service-connected blood disorder may be able to get a VA rating for anemia or other hematological conditions. You can learn more in our article on applying for VA disability benefits.

Keep in mind that unless your blood disorder is very severe, it can be difficult to qualify for benefits. You may want to consider hiring a disability attorney to strengthen your claim. An experienced lawyer can ask for a helpful medical source statement from your regular doctor saying that you meet the criteria of a listing, or can gather enough information about your combined impairments to get you benefits through a medical-vocational allowance.