How Sickle Cell Patients Qualify for Disability

How Sickle Cell Patients May Qualify for Disability

Sickle cell anemia is among the most common blood disorders in the United States, affecting approximately 100,000 Americans. It occurs in 1 out of every 365 black or African-American births. Also known as Sickle Cell Disease (SCD), this condition prevents your red blood cells from providing enough oxygen to your body. While not all sickle cell patients will qualify for Social Security disability (SSD) benefits, some will. Read on to see if you may qualify and what the Social Security Administration looks for in approved claims.



What Sickle Cell Symptoms Help You Qualify for Disability Benefits?

The SSA Blue Book lists criteria for evaluating sickle cell disease as a disability under Hematological Disorders, Section 7.05: Hemolytic Anemias. To start, the SSA expects you to experience one or more of the following during the past 12 months:

  1. At least 6 different severe pain episodes requiring narcotic drug treatment. These episodes, or crises, must happen at least 30 days apart from one another. In each case, your doctor either injected your pain medication into a muscle, or you received it intravenously (IV).
  2. SCD complications requiring hospitalization for at least 48 hours to treat on 3 or more separate occasions. You don’t have to suffer from the same complication every time you stayed in the hospital to meet this requirement. Time you spent in the ER or at a comprehensive SCD disease center prior your hospital stay can count towards that 48-hour total.
  3. Your doctor recorded hemoglobin measurements of 7g/dL or less on three or more occasions at least 30 days apart.

Some common SCD complications that can count for requirement #2 listed above include:

  • Gallstones
  • Jaundice
  • Kidney, spleen, or liver damage, including renal or liver failure
  • Severe leg and/or arm pain
  • Stroke
  • Chronic heart failure
  • Osteomyelitis (i.e., a bone infection)
  • Pneumonia
  • Edema from nephrotic syndrome
  • Pulmonary hypertension, which means you’re dizzy, short of breath and feel pressure in your chest
  • Routine blood transfusions to control your severe anemia

Medical Evidence That Best Supports Your Sickle Cell Disability Claim

In order to prove you qualify for benefits, you need to show recent medical evidence supporting your claim. Anything from the past 12 months will prove helpful, especially the following:

  • Definitive test results or a lab report showing your hematological disorder diagnosis signed by your physician. If you don’t have a lab report or recent test results, the SSA may accept a persuasive report from your physician. This report should mention things like how often you see your doctor and treatments you received during the past year.
  • A residual functional capacity (RFC) form filled out and signed by your doctor. This helps show the SSA that your SCD symptoms limit your ability to work and negatively affect your daily life. Pain, severe fatigue, your treatment, or prescription drug side effects can all affect your ability to work full-time.
  • Printed list of all medications you currently take, including prescriptions, over-the-counter drugs, and supplements. Be sure to list your dosages, frequency, and any side effects you experience as well.
  • Doctor’s visit receipts, lab test results, treatment notes and hospitalization or surgery records for the past 12 months. This shows that despite regular treatment from your doctor or hematologist, your SCD symptoms did not improve.

Technical Qualifications for Disability Benefits

In addition to everything listed above, generally, you need 40 Social Security work credits to be eligible for disability benefits. That means you worked in jobs where you paid Social Security taxes long enough (and recently enough) to qualify. You can earn up to four work credits in any calendar year. Your total yearly wages or self-employment income determine how many work credits you currently have. Basically, you must have worked 5 in the last 10 years full-time and paid Social Security payroll taxes.

In addition, the SSA will not pay disability benefits to anyone already receiving some Social Security payments each month. So if you’re over 62 and draw early retirement, regular Social Security, spousal or survivor’s benefits, you cannot qualify for SSDI.

Lastly, your SCD must prevent you from working for at least 12 months in a row. The SSA uses your medical evidence to review this step, but they’ll also look at your job history, age, and educational background. If you’re younger than 50 and have a college degree, they might deny your claim. But if you’re older, only finished high school or didn’t graduate, then you’re more likely to qualify for SSDI.

No matter how bad your health problems are, if you can’t meet these technical requirements, it’s impossible to get SSDI.

It’s vital to provide the SSA with timely, accurate and complete information. Most people have no idea how to fill these complicated forms out correctly. In fact, the SSA turns down as many as 2 in every 5 eligible applicants the first time! Some people later get disability benefits after they appeal, but that process can take up to two years.

You’re 3x as likely to secure disability benefits on your first try if you apply through a Social Security attorney. People who qualify for legal assistance through this website typically get $12,000 in lump-sum benefits on top of monthly disability. Still have questions? Sign up for a free phone call with a nearby attorney who can give you confidential advice at home. Since these attorneys work on contingency, you owe $0 for legal assistance if the SSA won’t approve your claim. And if you do win benefits, then you’ll only pay a small, one-time fee.

Ready to see if you may qualify? Click the button below to start your free online benefits evaluation now!

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Mandy Voisin

Mandy Voisin is a freelance writer, blogger, and author of Girls of the Ocean and Star of Deliverance. As an accomplished content marketing consultant, mom of four and doctor's wife, Mandy has written hundreds of articles about dangerous drugs and medical devices, medical issues that impact disabled Americans, veterans' healthcare and workers' compensation issues since 2016.