When you file an application for disability benefits with the Social Security Administration (SSA), an SSA claims examiner will determine if your impairments are severe enough to meet the SSA requirements for disability. The clams will look at a manual called the Listing of Impairments (sometimes also called the “blue book”) to see if your impairment is listed in the manual. The manual discusses how medically severe a particular impairment must be to qualify as disabling (to “meet the listing”). If your impairment is listed in the manual and exactly meets the criteria in the manual for severity, you will be found disabled.
The SSA understands that it cannot make a manual with every impairment listed. So if your impairment is not listed, or if it is listed but the severity of your condition does not exactly match the severity required in the listing, the claims examiner will determine whether there are any jobs you can be expected to do with your remaining functional capacity.
The Listing of Impairments has a section dedicated to blood disorder impairments, also called hematological disorders, which will set out below. Note that these listings requirements are different depending on whether an adult or a child suffers from the impairment.
Adult Blood Disorders
Anemia is a very common blood disorder but is usually treatable and seldom a basis for receiving disability benefits. But there are those with chronic anemia whose condition isn't improved with treatment. In order for the severity of anemia to meet the listing, you must have a hematocrit persisting at 30% or less (hematocrit is the percentage of red blood cells in your blood) and you must have had at least one blood transfusion at least once every two months (on average).
Sickle Cell Disease and Variations
There are several different kinds of sickle cell diseases and variations, including sickle cell anemia and thalassemia.
In order to meet the listing, your disorder must include one of the following:
- at least three documented painful thrombotic (also called vaso-occlusive) crises within the five months before your application, or
- at least three periods of extended hospital stays within the twelve months before your application
- chronic severe anemia with a hematocrit persisting at 26% or less. Regarding this requirement, keep in mind that if you have a hematocrit between 26% and 30%, you may meet the listing for chronic anemia, provided you have had at least one blood transfusion at least once every two months (on average).
People with thrombocytopenia do not have enough platelets in their blood. Platelets help blood clot, so if you have thrombocytopenia, you may have uncontrolled bleeding. To meet the listing for thrombocytopenia, you must repeatedly have platelet counts below a certain number (40,000/cubic millimeter) and one of the following:
- within the five months before your application, at least one episode of spontaneous bleeding that required a transfusion, or
- within the 12 months before your application, you must had bleeding inside of your head (intracranial).
Hereditary telangiectasia is an inherited hematological disorder that involves the improper formation of blood vessels. In order to meet this listing, you must have a diagnosis of hereditary telangiectasia with bleeding that required a transfusion at least three times within the five months before your application.
Hemophilia and Other Coagulation Disorders
There are several different kinds of hemophilia and other coagulation disorders, but they all share the characteristic that the person diagnosed cannot properly form blood clots. In order to meet this listing, you must have a coagulation defect disorder with spontaneous bleeding that required a transfusion at least three times within the five months before your application.
This blood disorder causes your body to make too many blood cells. Polycythemia vera often results in other impairments, such as chronic heart failure. The SSA will evaluate any resulting impairments under the criteria for that affected body system (for example heart failure would be evaluated under the listings for the cardiovascular system).
Myelofibrosis is a disorder in which your bone marrow is replaced by fibrous tissue (scar tissue). To meet the listing, you must have one of the following:
- chronic anemia (use the criteria for “chronic anemia,” above)
- recurrent bacterial infections that occur throughout the body, at least three times within the five months before your application, or
- severe bone pain with no relief with x-ray evidence of osteosclerosis (increase in bone density).
If you are diagnosed with granulocytopenia, you have low levels of certain types of white blood cells, which makes is easy for you to get an infection. To meet the listing, you must have both of the following:
- neutrophil (a specific type of white blood cell) repeatedly below 1,000 cells/cubic millimeter of blood, and
- recurrent bacterial infections that occur throughout the body, at least three times with the five months before your application.
Aplastic Anemia With Bone Marrow or Stem Cell Transplant
If you suffer from aplastic anemia and have had a bone marrow transplant or stem cell transplant, you will automatically get disability benefits for 12 months following the transplantation.
Blood Disorders in Children
If your child has this impairment, they must show both of the following:
- hematocrit persisting at 26% or less, and
- reticulocyte count of 4% or more (reticulocytes are a specific type of red blood cells).
Sickle Cell Disease and Variations
In order to meet the listing, your child’s disorder must include one of the following:
- recent and recurrent severe vaso-occlusive crises involving the musculoskeletal or abdominal system
- a serious complication involving a large organ within the 12 months before the application
- certain crises involving very low red blood cell counts, or
- strokes, heart failure, or certain specified emotional disorders.
To meet the listing for thrombocytopenia, your child must simply have platelet counts below a certain number (40,000/cubic millimeter).
Inherited Coagulation Disorders
In order for your child to meet this listing, the child must show either repeated inappropriate or spontaneous bleeding or bleeding into a joint that leads to joint deformity.
Each Case is Unique
How your particular disorder relates to the above listings, and whether it can meet, or be considered equal to, the requirements of the listing can be complex. You should speak with your doctor to better understand how your impairment fits into the specific criteria for the hematological listings. If you don't meet one of the above listings, you may still be able to get benefits based on limited functioning. For example, if you suffer from constant fatigue or frequent bleeding episodes, there may not be many jobs you can be expected to do. For more information, read about qualifying for disability based on limited functioning.