How to Get Sickle Cell Anemia Disability Benefits
Sickle cell anemia is a hereditary blood disorder affecting approximately one in every 5,000 children. Individuals with sickle cell anemia create abnormally shaped red blood cells (hemoglobin) that are easily damaged and can clog up blood vessels. Symptoms of sickle cell anemia include persistent fatigue (due to a lack of oxygen in the blood), pain, swollen hands and feet, increased susceptibility to infection and more.
In addition to the range of symptoms possible with this condition, sickle cell anemia can lead to strokes, bone infections, spleen problems, gallstones, hypertension, kidney failure, skin ulcers, and other serious or even life-threatening complications. It can also result in crises or severe episodes. These crises come in four different forms:
- Aplastic crisis — In this crisis, red blood levels drop so much that the patient experiences faster heart beat and significant fatigue.
- Hemolytic crisis — This crisis can cause damage to the kidneys because of a fast drop in red blood cell numbers.
- Thrombotic (vaso-occlusive) crisis — During this crisis, blood flow in the body collects in or is restricted to organs. This can cause severe pain and even organ damage.
- Splenic sequestration crisis — In this medical emergency, the abdomen becomes hard due to enlargement of the spleen.
Many individuals wonder if sickle cell anemia is a disability. Since there is no cure for sickle cell anemia, the disease can make working a normal job difficult even if affected individuals are able to manage their symptoms. For this reason, it is possible to qualify for federal disability benefits with sickle cell anemia.
Sickle Cell Anemia Disability Options
If you suffer from sickle cell anemia, you can apply for disability benefits under one of the following programs:
- Social Security Disability Insurance (SSDI): SSD benefits are paid out similarly to Social Security retirement benefits. To qualify for SSDI, you will need to have worked a certain number of hours over the past year and to have contributed to Social Security (through your payroll taxes).
- Supplemental Security Income (SSI): If you have not worked enough hours to qualify for SSDI, you can apply for benefits through the SSI program. Criteria for receiving SSI is needs-based rather than income-based.
Denied Disability for Sickle Cell Anemia?
It is not uncommon for patients with sickle cell anemia to be denied benefits the first time they apply, even if they have severe anemia and should qualify under eligibility requirements. No matter how severe your anemia is, the Social Security Administration will only offer benefits if you can medically prove your condition and can prove your condition is severe enough to qualify for benefits.
If you have been denied benefits, you’ll want to read the denial letter to determine whether there is any information about the reasons behind your denial. Have you failed to submit adequate medical information? Did you not meet the sickle cell anemia disability eligibility requirements? Did you make small mistakes on the paperwork?
If you cannot determine why you were denied benefits, or if you are struggling to prove your eligibility, contact Lisa M. Ritacco for a consultation. Lisa M. Ritacco focuses on Social Security and workers’ compensation claims. With more than seven years of experience, Lisa M. Ritacco understands what it takes to prove eligibility for sickle cell anemia benefits and other benefits. It can be powerful to work with a Social Security attorney who understands the requirements and can guide you through the process step by step. It can save you time on subsequent denials and can ensure you have the best chance possible of securing benefits.
Proving Eligibility for Sickle Cell Anemia Disability Benefits
In order to be eligible sickle cell anemia disability benefits, you must be able to prove at least one of three things:
- you have been hospitalized for an extended period for your condition at least three times during the past year
- you have proof of at least three instances of painful thrombotic crises over the past five months
- you have a hematocrit level of no more than 26 percent, showing severe anemia
Medical evidence of one or more of these three things will help you meet Blue Book sickle cell anemia disability eligibility. In order to prove your disability, you will want to have blood tests to determine your anemia and you will want to keep careful records of any treatment or any changes in your condition.
For example, you will need documentation if you have been hospitalized to prove the extent of your hospitalization and the frequency of your hospitalization related to your condition. You must also keep documents to show the hospitalization occurred due to sickle cell anemia. Seeking medical attention each time you have painful thrombotic crises and keeping track of when you visit a doctor, as well as the medical treatment you receive, can help you establish your eligibility for Social Security benefits.
In fact, it’s difficult to keep too many records when it comes to proving your eligibility. Create a file for yourself at home where you can keep copies of paperwork as well as a listing of your symptoms, medical appointments, treatments and any other information related to your condition.
Benefits for Children
Parents can apply for SSI or SSDI benefits for a dependent child up to the age of 18 who has sickle cell anemia. Program eligibility for SSI is based on parental income and eligibility for SSDI is based on you and your spouse’s work history and contribution to Social Security. When your child turns 18, their condition will be re-evaluated and if they are found unable to work due to their disability, benefits will transfer to them. If a child has been disqualified for benefits based on your work history, he will be able to apply again when he turns 18, and his application can be reconsidered based on his own circumstances.
Applying for Disability With Sickle Cell Anemia
To apply for disability benefits under SSDI or SSI, it is necessary to submit sufficient medial evidence that the disease makes it impossible for you to continue working. This should include hemoglobin electrophoresis test results confirming the presence of the disease, as well as a record of your current and historical hemocrit levels. Your doctor may also provide results from hemoglobin electrophoresis tests to support your claim.
To be considered unable to work, you’ll also need to demonstrate a history of painful blood clots, frequent hospitalization, severe anemia or a related impairment such as congestive heart or kidney failure. You must show hemocrit levels consistently at 26% or lower or other indications showing your condition is severe, persistent and prevents you from working.
Since sickle cell anemia can present a wide range of symptoms and experiences, you will most likely need to document the condition extensively to secure sickle cell anemia disability benefits. For example, if you have been hospitalized for a sickle cell crisis, having details about your hospitalization can help. To get SSI for sickle cell anemia, you must generally show that your symptoms prevent you from working for more than a year. You may also show that your symptoms are equal to the standards for the SSI disability listing.
If you’re applying for disability insurance for sickle cell anemia, legal advice from an attorney may be able to help you create the strongest application possible. If you need to speak to an attorney, Philadelphia disability lawyer Lisa M. Ritacco has over nine years of experience helping clients file and appeal SSDI and SSI disability claims. If you’re about to apply for benefits, or you have previously been denied, contact our team first. Your initial consultation is always free.