Benefits under Social Security for Sickle Cell Anemia

Sickle Cell Anemia- Overview

If you are unable to work due to sickle cell anemia, you may be eligible for Social Security Disability benefits. Social Security Disability Insurance (SSDI) gives the ability for patients to receive payments that are diagnosed with sickle cell anemia or other people in their families if they have worked long enough to earn enough credits to pay the required amount of Social Security taxes. To qualify for SSDI, the claimant’s condition must be sufficiently severe to leave him or her completely incapacitated.

Social Security Disability benefits are available only to those who are considered chronically disabled, which means they have been unable to work for a year or more. The Social Security Administration collects a great deal of information about the claimant and his or her condition during the application procedure. Medical documents must be received in order for the disability assessment staff to establish if the individual meets the criteria for disability.

The Social Security Administration’s Evaluation and Medical Qualifications

Qualifying for Social Security Impairment benefits with a sickle cell anemia diagnosis is highly particular according to the Blue Book, the Social Security Administration’s medical reference for establishing what constitutes a complete and permanent disability.

Sickle cell anemia is classified as a hematological disorder in section 7.0. To begin, you must have medical paperwork confirming that you have a hematological disease.

  • A laboratory report including a conclusive test establishing the presence of a hematological condition, and this report must be signed by a physician.
  • A laboratory report including a conclusive test determining that you or a loved one have a hematological disorder that is not signed off by a physician but is accompanied by a physician’s statement confirming that you do actually have the disorder.
  • When a laboratory report for a decisive test is not available, a report from a physician that is compelling in nature indicating that your diagnosis was verified using diagnostic procedures or relevant laboratory tests may be used.
  • The Social Security Administration will make all reasonable efforts to obtain the results of any necessary laboratory testing. However, tests that are prohibitively expensive, complicated, or invasive, such as bone marrow aspirations or clotting factor protein analysis, will not be purchased.

    In considering the category of impairments applicable to an individual with sickle cell anemia, the following elements help Social Security determine if you are disabled:

  • Acute pain crises that have been reported as requiring injectable or IV opioids at least six times in the last 12 months with a minimum of 30 days between episodes.
  • Complications of anemia necessitating at least three hospital admissions separated by at least 30 days in the preceding 12 months. Each hospitalization should last at least 48 hours and may include time spent in the emergency room or comprehensive sickle cell disease clinic prior to admission.
  • Hemoglobin concentrations of 7.0 grams or less per deciliter at least three times during a 12-month period, with a 30-day interval between readings.
    You may be eligible for Social Security Disability benefits if you meet one of the three criteria.

Obtaining Assistance with Sickle Cell Anemia Application for Disability Benefits

Due to the fact that sickle cell anemia may qualify for SSD benefits in a variety of ways, you must work together with your doctor to verify that your documentation meets one of the procedural review requirements for eligibility. This will assist shorten your wait for an eligibility determination and may also boost your chances of earning SSD benefits.

Additionally, if obtaining a timely and favorable determination on your eligibility is a priority, you may wish to investigate the benefits of working with a Social Security advocate or disability attorney to complete your initial application and gather the necessary paperwork to support your claim.