Anemia and Qualifying for Disability Benefits

Approximately 3 million people in the United States have anemia, according to the Centers for Disease Control. While anemia is a common and treatable disorder, many people who suffer from anemia experience severe symptoms such as shortness of breath and cognitive problems that affect their ability to work and perform daily tasks.

---

If you are suffering from the effects of Anemia and have been denied disability don’t give up, almost 70% are denied initially! Just call 512-454-4000 for a free, no obligation consultation to learn what your options are.

Anemia is a blood disorder where the body does not produce enough healthy red blood cells or hemoglobin.

Hemoglobin is a protein found in red blood cells that carries oxygen from the lungs to other organs. There are many blood disorders that affect red blood cells, anemia being the most commonly known. There are several types of anemia, including:

•    Iron-deficiency anemia. Iron is necessary to produce red blood cells. Iron-deficiency anemia is usually due to blood loss from menstruation, low iron intake, ulcers or cancer.
•    Pernicious anemia. This blood disorder is caused by a deficiency of vitamin B12, an inability to absorb B12, or an autoimmune condition.
•    Anemia due to chronic disease, such as kidney disease or celiac disease.
•    Aplastic anemia occurs when the bone marrow does not produce enough red blood cells or white blood cells. It can be caused by hepatitis, Epstein-Barr, or HIV.
•    Autoimmune hemolytic anemia. In this disorder an overactive immune system destroys the body’s red blood cells.
•    Thalassemia is a genetic form of anemia caused when the body doesn’t make enough of a protein called hemoglobin.
•    Sickle cell anemia is an inherited form of anemia affecting the shape of red blood cells, blocking blood flow and causing pain and organ damage.

Can I qualify for SSDI if I have anemia?

Anemia can also be seriously disabling causing heart problems, trouble concentrating, loss of appetite and numbness and tingling in the hands and feet.

If you have anemia and cannot maintain employment, you may be eligible for disability benefits, but to qualify you will first need to satisfy both the financial and medical requirements set forth by the SSA.

A. Financial Requirements:

Before you are eligible for Social Security disability benefits, you must satisfy some basic financial requirements.

You must: 1) have a disability that has lasted or is expected to last 12 months; and 2) you must have worked in a job where you paid Social Security taxes long enough and recently enough; and 3) you must not earn more than Substantial Gainful Activity (SGA), which is $1,550 per month in 2024 for nonblind applicants and $2,590 per month for blind applicants. If you earn more than the SGA amount, your claim will be denied, and if you have not worked enough recently to earn the necessary amount of work credits, Social Security will deny your claim. (link to work credits page)

B. Medical Requirements:

The Social Security Administration’s Blue Book lists impairments Social Security considers disabling and may automatically qualify for benefits.

One way to qualify for SSDI with anemia is to match the requirements of a listing in the Blue Book. General chronic anemia is no longer listed as a separate impairment, but some types of anemia do have their own listing. Sickle cell anemia or thalassemia is evaluated under Section 7.05, and pernicious anemia is listed under Section 1.15, disorders of the skeletal spine, because the disorder can result in spinal cord degeneration. Aplastic anemia is considered as a bone marrow disorder under Section 7.10. Your anemia must be very severe to meet the criteria of these listings. 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.

If your anemia doesn’t match the criteria of any of the above listings, you may still qualify under Section 7.18 Repeated complications of hematological disorders if your anemia results in problems such as:

•    Retinopathy (damage to blood vessels in the eye)
•    Skin ulcers
•    Osteonecrosis (bone death)
•    Silent central nervous system infarction (stroke without outward symptoms)
•    Reduced joint movement
•    Cognitive limitations such as forgetfulness.

You must also prove that these complications result in the following symptoms:

•    Severe fatigue;
•    Pain;
•    Fever;
•    Night sweats;
•    Malaise;
•    Joint or muscle swelling;
•    Shortness of breath; or
•    Headaches.

AND you must show marked functional limitation in at least one of the following:

•    finishing tasks in a timely manner; or
•    completing activities of daily living; or
•    maintaining social functioning.

Social Security wants to know how severe your anemia is and if you have any other medical conditions.

In order to qualify for disability benefits with any type of anemia, you will need to provide Social Security with complete medical records documenting your disorder, including:

•    Detailed reports from your medical providers documenting your diagnosis, treatments, symptoms, functional limitations and prognosis;
•    Lab reports signed by your doctor;
•    Hospital and emergency room records; and
•    Blood transfusion records.

Be sure to include medical evidence of any other conditions you have.

Many applicants 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. One disorder alone may not meet the criteria of an impairment as stated in Social Security’s Blue Book, but if you have more than one medical condition, Social Security must consider how those health issues combined limit your ability to hold a job and perform necessary daily tasks.

Disability for Multiple Impairments –>

If your anemia doesn’t match a listed impairment, you may still qualify for SSDI based on your limitations.

Social Security will conduct a Residual Functional Capacity assessment to evaluate how your disability affects your ability to perform your old job or if there is any other job you are able to perform, taking into account whether or not you are able to drive, your age, and level of education. Social Security wants to know if your anemia is so severe that you cannot concentrate, stay awake for eight hours straight, or complete tasks in a timely manner due to weakness or fatigue. If Social Security decides you cannot do your old job or don’t have the skills to perform a new job, you may be approved for a Medical-Vocational Allowance.

If you are 55 or older, you may get approval.

Social Security follows a set of rules to determine when the agency expects an applicant to learn a new job.

Applicants who are 55 or older often fall under a grid rule, which means they are not expected to learn a new job. For example, a 55-year-old applicant with no transferable skills might be found disabled. If you can’t go back to your old job, and you don’t have the skills to learn a new one, Social Security will likely grant you disability benefits.

Disability for those over 55 –>

Should you file a claim?

If you believe that you meet Social Security’s medical and financial requirements, you should apply for benefits.

If you are still unsure or would like to talk to someone, please contact us at 512-454-400. We are always ready to take your call and discuss your options with you free of charge. We are happy to help folks just like you find the best solution for their personal situation.

How do I file for Social Security Disability benefits?

Once you have decided to file a claim, you can take the first step and apply for Social Security Disability benefits in person at your local Social Security Administration office, online, or over the phone.

After your application is submitted, Social Security will send your file to the state’s Disability Determination Services office (DDS). A claims examiner will request and review your medical records and may call you for an interview or additional paperwork. When the claims examiner has enough information, Social Security will make a decision and notify you by mail. This normally takes three to four months, but could take longer. Don’t be discouraged if your initial application is denied – most are – and you will have the opportunity to appeal.

How to Apply for SSDI –>

There are four steps to the Social Security appeal process:

1.    File a Request for Reconsideration with the Social Security Administration to completely review the case.
2.    If you don’t agree with SSA’s response to your Request for Reconsideration, you can request a hearing before an Administrative Law Judge (ALJ). ALJs are attorneys who work for the Social Security Administration; they review SSDI and SSI cases and either uphold or overturn decisions to deny SSDI or SSI benefits. If you are not represented by an attorney at this point, now is the time to obtain legal counsel. This is a critical point in the process and will raise your chance for success.
3.    If an ALJ does not grant your claim, you can request that the Appeals Council review your case.
4.    Federal Court review. The final step in the appeal process is filing suit in U.S. District Court.

SSDI Appeals Process –>

Do I need a disability attorney for SSDI or SSI?

If you have anemia and can’t maintain full-time employment, you may be eligible for Social Security Disability benefits, but qualifying is difficult and most initial applications are denied.

The many types of anemia that are classified under hematological disorders and the specific medical evidence required for each one can make filing for disability benefits very complicated. A qualified disability attorney can help you evaluate your eligibility, gather medical and financial documentation, and guide you through the filing process. You may certainly file a claim on your own, but evidence shows that your chances for approval are increased significantly if you have legal representation. At each stage of the process, from the initial application stage to the reconsideration stage and the ALJ hearing stage, an attorney can assist you in completing the detailed forms and questionnaires required by Social Security, collecting and submitting relevant medical evidence, and preparing questionnaires for your doctors. At the ALJ hearing phase an attorney will not only continue to assure that the evidence is complete, but prepare you for questioning by the ALJ, prepare an argument on your behalf and question any doctors or vocational experts selected by the ALJ to testify at the hearing. At the Appeals Council and federal court level, a lawyer can present legal arguments to show your case was wrongfully denied. Fees charged by disability attorneys are regulated by federal law and are usually 25% of disability backpay you are owed. There are no out-of-pocket costs, and if you don’t win your case, you won’t be charged anything.

Do I need an SSDI attorney–>

If you are suffering from Anemia and have been denied disability don’t give up, almost 70% are denied initially! Just call 512-454-4000 for a free, no obligation consultation to learn what your options are. Have some questions? just give us a call, we love to help folks just like you!

What if I don’t qualify for SSDI?

If you haven’t worked long enough to earn enough work credits, or if you earn too much income, you may be eligible for disability benefits through another Social Security program, such as Supplemental Security Income (SSI), or from a long-term disability insurance plan through your employer or a privately purchased policy.

SSI is a program that pays monthly benefits to people with limited income and resources who are disabled, blind, or age 65 or older. SSI is based on income instead of work credits, and is financed by general funds of the U.S. Treasury. You can check eligibility requirements and begin the application for SSI online or by calling Social Security at 1-800-772-1213. https://www.ssa.gov/ssi/text-apply-ussi.htm. In addition to SSDI and SSI benefits, you may be able to get financial assistance from a privately purchased long-term disability policy or a policy through your employer.

I have long-term disability insurance – should I file a claim?

Yes – you should file a claim as soon as you become disabled.

Long-term disability insurance (LTD) protects your income if you are unable to work due to illness or injury and is purchased as part of a group employment plan or privately through an insurance company. Policies pay between 50-60% of your salary and benefits continue until you return to work or for the number of years stated in the policy. However, do not quit your job before you file a claim because LTD coverage is good only as long as you are employed, and be sure to check your policy’s definition of “disabled” as each policy will state the definition of “disabled” which is in use. Also, be aware that long-term disability insurance companies can require a claimant to also apply for SSDI.

LTD Disability Appeals Process–>

Do I need a disability attorney for a long-term disability insurance claim?

It doesn’t matter if you have a long-term disability insurance policy purchased through a private insurance broker or a group policy purchased with your employer; filing a claim for long-term insurance is a complex process.

The wording of LTD policies can be confusing and the laws and regulations which affect the two types of LTD insurance differ in procedures for filing claims and appeals. An experienced LTD attorney with thorough knowledge of ERISA laws and regulations will avoid mistakes and increase your chance of success. An attorney will act on your behalf, completing your application and filing your claim in a timely manner. They can also negotiate a settlement or file an appeal for you. If it becomes necessary to file suit, an LTD attorney can prepare your case against an insurer. Most LTD attorneys handle cases on a contingency basis and charge approximately 25%-40% of a claimant’s past due benefits. You do not pay an attorney’s fee unless the attorney wins your case.
Filing a claim for disability benefits and getting approval can be a long journey, but you can take the first steps today. Feel free to call us for a free consultation to discuss your case and options. Even if you don’t hire us, we are happy to help you make the best choices for your own individual situation.

Do I need an LTD attorney–>

Author: Attorney Greg Reed has been practicing law for 29 years. He is Superlawyers rated by Thomson Reuters and is Top AV Preeminent® and Client Champion Gold rated by Martindale Hubbell. Through his extensive litigation Mr. Reed obtained board certification from the Texas Board of Legal Specialization. Greg is admitted to practice in the United States District Court - all Texas Districts and the United States Court of Appeals-Fifth Circuit. Mr. Reed is a member of the Travis County Bar Association, Texas Trial Lawyers Association, past Director of the Capital Area Trial Lawyers Association, and an Associate member of the American Board of Trial Advocates. Mr. Reed and all the members of Bemis, Roach & Reed have been active participants in the Travis County Lawyer referral service.