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Sickle Cell Anemia

Sickle Cell Anemia: How to Get Disability Benefits

Sickle cell anemia is the most commonly diagnosed blood disorder in the U.S., but it mostly affects persons of African descent, Hispanics, and persons from the Middle East and Asia. Because sickle cell anemia is an inherited disease which is related to malaria, it is more common among those whose relatives—even distant ones—came from a region that is prone to malaria.

Because they are round in shape and flexible, normal blood cells move easily through your body. Healthy blood cells carry sufficient oxygen for a healthy life. However, for those suffering with sickle cell anemia, the blood cells are shaped like sickles—a crescent moon shape—and they are sticky. These mutated blood cells can get stuck in small blood vessels and starve the body of life-giving oxygen. There is no cure for sickle cell anemia, so the standard medical treatment is to relieve pain, and to intervene to prevent other medical problems associated with the disease which can include leg and arm pain, blindness, stroke, gallstones, organ damage, and more.

If you have sickle cell anemia, you may qualify for Social Security disability benefits. However, as with all disability cases, just being diagnosed with the disease does not automatically qualify you for benefits. You must prove to the Social Security Administration (SSA) that your disability prevents you from sustaining work on a full-time competitive basis.

The first step toward qualifying for disability benefits for sickle cell anemia is providing evidence that you have a hematological (blood) disorder. The SSA very specifically spells out what kind of medical evidence can be very important. This is from the Social Security’s Listing of Impairments (known as the “Blue Book”):

  1. “A laboratory report of a definitive test that establishes a hematological disorder, signed by a physician; or
  2. A laboratory report of a definitive test that establishes a hematological disorder that is not signed by a physician and a report from a physician that states you have the disorder; or
  3. When we do not have a laboratory report of a definitive test, a persuasive report from a physician that a diagnosis of your hematological disorder was confirmed by appropriate laboratory analysis or other diagnostic method(s). To be persuasive, this report must state that you had the appropriate definitive laboratory test or tests for diagnosing your disorder and provide the results, or explain how your diagnosis was established by other diagnostic method(s) consistent with the prevailing state of medical knowledge and clinical practice.
  4. We will make every reasonable effort to obtain the results of appropriate laboratory testing you have had. We will not purchase complex, costly, or invasive tests, such as tests of clotting-factor proteins, and bone marrow aspirations.”

Once you have established medically that you have the disease, the SSA will look at certain determining factors to decide not only if your condition has the findings in their special book, but also whether or not you otherwise qualify. These four situations are particularly important:

“Documented painful…crises requiring [IV] narcotic medication, occurring at least six times within a 12-month period with at least 30 days between crises.
OR
Complications of…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.
OR
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
Beta thalassemia major requiring life-long RBC transfusions at least once every 6 weeks to maintain life.”

As you can see, collecting exactly the right medical evidence in a sickle cell disability case can get complicated. Whether or not you can demonstrate that you meet this specific criteria, you may still qualify. For example, like with many claimants, one given condition is only part of the overall health profile. This is why seeking the advice and guidance of an experienced Social Security disability attorney can be critically important. If your symptoms of sickle cell anemia are interfering with your ability to work, call us at Nash Disability Law for a free, no-strings-attached evaluation of your case.