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Chronic Anemia and Social Security Disability

Applying for Social Security Disability Benefits with Chronic Anemia

The National Institutes of Health (NIH) estimate some 3.4 million Americans are affected by chronic anemia, though the condition can occur for a wide variety of reasons. Chronic anemia typically occurs because of another chronic health condition, like thyroid disease, inflammatory bowel disease, cancer, or kidney disease.

Your anemia symptoms and any concurrent medical conditions can certainly affect your ability to work as well as your eligibility for disability benefits. If you do qualify, then you’ll receive benefits on a monthly basis. This consistent income can eliminate or reduce financial worries and let you focus on your health and with getting on with life.

The Costs of Chronic Anemia

Although anemia is quite common in the American population, there have been few formal studies of the medical expenses patients face. One study, published by the Journal of Managed Care Pharmacology in 2005, noted average annual costs per patient were about $14,535. Adjusted for inflation, that’s about $20,000 in annual expense per patient.

Medications and frequent lab work, doctor visits, hospitals stays, and blood transfusions may all be included in your own annual expenses. The severity of your symptoms and the underlying cause of your anemia influence the kinds of medical attention you need and therefore medical bills you’ll face. That being said, most people with chronic anemia end up in the E.R., the hospital, and in blood clinics multiple times per year.

The average emergency room visit costs more than $2,100, and the Washington Business Journal reports an inpatient hospital stay averages $4,300. A blood transfusion costs between $190 and $600 per unit, according to the National Institutes of Health (NIH), and you may require transfusions often if you face bouts of severe symptoms from your anemia.

Medically Qualifying for Benefits for Chronic Anemia

When the SSA reviews your application for benefits, they’ll be looking for two things: How severe is your anemia, and do you have other medical conditions along with it?

Most people that are approved for benefits actually qualify under a disability listing for a related condition, like kidney disease, Rheumatoid arthritis, cancer, HIV, or congestive heart failure.

If you cannot match a listing for a related medical condition, then you will need to meet the SSA’s listing for hemolytic anemias, such as sickle cell anemia, or be able to show that you experience repeated and severe anemia complications that disrupt your everyday abilities.

Anemia must be very severe to meet the hemolytic anemias listing. You must be in and out of the hospital often, have lengthy hospital stays (48 hours or longer), require narcotic pain medications frequently, or need frequent or life-long blood transfusions. Satisfying any of these requirements means not only having the issue described but also hitting a precise timetable. For example, your hospitals stays must be at least three times in 12 months and at least 30 days apart.

All disability listings are similarly complicated and understanding the SSA requirements can be difficult without your doctor’s assistance. This is because the Blue Book contains medical terminology and diagnostic details for proving how severe these potentially disabling conditions may be. In other words, the book is written for doctors and other medical professionals and is difficult for the average person to translate.

You’ll need your doctor’s assistance in collecting medical records and turning over information to the SSA anyway. So be sure to ask for his or her help before you even begin your disability claim.

Qualifying for Benefits without Meeting a Disability Listing

If you can’t meet or closely match a disability listing, you can still get approved for benefits, though you’ll have to go through additional reviews. Specifically, the SSA wants to know about the affects of your anemia symptoms, treatments, and complications on your ability to function on a daily basis.

They discover this information by requesting more details from you, your doctor, and others who know about your daily challenges. This discovery process is known as a “residual functional capacity” or RFC evaluation and requires functional report forms. You’ll receive these in the mail and have to answer extensive questions about your “activities of daily living” or ADLs. Your doctor will also be asked to provide insights into your physical and mental limitations.

The SSA uses your ADLs to understand the effects of your anemia on your ability to complete job duties. For example, anemia causes severe fatigue. If you cannot clean your kitchen without becoming so exhausted that you’re unable to finish, then you also can’t do a job that requires a similar level of physical activity, like a manufacturing or retail position.

To be approved through an RFC, you’ll additionally have to show that you’re unable to get and keep any sedentary job, like an office position. This means the SSA needs to see that your anemia symptoms are so severe that you cannot concentrate, stay awake for eight hours straight, or that you can’t complete tasks in a timely manner due to weakness or fatigue.

It’s important to understand that if you’re approved for benefits in this manner, then you’ll receive a “medical vocational allowance”. This means that you’ve been determined unable to work in any job for which you would otherwise be qualified given your age, education level, experience, and job training.

How to Apply for Disability Benefits with Chronic Anemia

Whether you can meet or match a disability listing or have to go through an RFC, the SSA needs to specific evidence to support the information you report in your disability application. The exact evidence required varies based on the type of anemia you have, whether or not you have other medical conditions, and the disability listing under which you’re most likely to qualify.

Your doctor can help you understand what evidence is necessary, but in general, the SSA must usually see:

  • Lab reports from or signed by your doctor, and which include a definitive diagnosis
  • Hospitalization and emergency room records, showing the frequency and duration of your visits and what you were treated for
  • Blood transfusion records and/or schedules, if appropriate
  • A detailed report from your doctor, documenting your diagnosis, treatments, symptoms, functional limitations, and prognosis

You may qualify for SSDI and/or SSI, but the application process is different for each program. You can apply for SSDI online or at any SSA office. For SSI however, you’ll need to make a trip to the local SSA office to complete your application through a personal interview.

Go to your interview prepared or gather as many records as possible before starting your online application. The SSA will need contact information for your doctors, hospitals, and other healthcare providers. They additionally need your education and work history and information on your personal finances.