Social security disability benefits are available for a number of disabling conditions that meet the requirements for disability. Since the disability claim processing involves a detailed review of the applicant’s medical records, medical review services are a significant consideration for disability attorneys. It provides an easier way to evaluate the validity of the claim and speed up claims processing. The SSA (Social Security Administration) employs a claims examiner to investigate the strength of the claim and consider the particular disability in their Listing of Impairments manual. This manual provides details regarding how severe an impairment must be to qualify as disabling. This listing also contains a section on blood disorder impairments or hematological disorders.
- Anemia and complications arising from it
- Chronic anemia: One of the most common blood disorders in America, chronic anemia may qualify for disability benefits provided the claimant’s condition has not improved even after treatment.
- Aplastic anemia: A disability claimant who was diagnosed with aplastic anemia and underwent a bone marrow/stem cell transplant could automatically qualify for the benefits from social security. The benefits are paid for a period of 12 months following the transplant.
- Shortness of breath and fatigue that are chronic complications of anemia may be eligible for disability benefits. The medical records should meet the standards outlined in Section 7.18 of the SSA’s Blue Book.
- Sickle cell anemia and Thalassemia: These come under the different sickle cell diseases and variations. These conditions result in the production of less healthy red blood cells and hemoglobin than one’s body needs. A medical record review should reveal the following symptoms:
- Dark urine
- Weakness and/or fatigue
- Protruding abdomen
- Shortness of breath
- Pale appearance
- Inflammation of the liver and spleen
- Deformities in the facial bones
- Anemia and complications arising from it
Patients diagnosed with these conditions could receive disability benefits if they meet one of the following conditions.
- Experienced at least 3 periods of extended hospital stays over a 12-month period
- Had at least 6 documented painful thrombotic crises over a 12-month period
- Diagnosed with chronic severe anemia with hemoglobin measurements at 7.0 g/dL or less, at least 3 times over a 12-month period
- Suffered from beta-thalassemia major or Cooley’s anemia requiring life-long RBC transfusions at least once over a 6-week period.
- Polycythemia Vera: A blood disorder that causes the human body to generate too many blood cells. It causes impairments such as chronic heart failure. To qualify for disability, the SSA would need medical records that indicate such impairments or disabilities.
- Hemophilia or other coagulation disorders: Patients diagnosed with hemophilia or disorders like thrombocytopenia or telangiectasia, may be eligible for social security disability benefits. The medical record analysis should provide evidence that the patient is unable to properly form blood clots. Also, the patient should meet the following prerequisites:
- The complications caused by this disorder resulted in the patient being hospitalized at least three times over a period of 12 months
- Each hospitalization occurred at least 30 days apart
- Each hospitalization lasted at least 48 hours or longer
The above-mentioned blood disorders are inherently disabling, and the SSA may require more than just a formal diagnosis and would need comprehensive documentation of the claimant receiving proper medical care consistently from a qualified healthcare provider. Claimants may find it rather challenging to understand the disability application and review processes. This can be addressed with the help of a SSDI attorney and medical review services.
Medical records and their review constitute a key requirement when it comes to determining eligibility for disability benefits. Once the required records are retrieved from various medical record custodians, the next step is medical record organization and review. Attorneys can make the review process more efficient and streamlined with the support of medical review services. Professional medical reviewers are trained and experienced, and can evaluate whether the patient’s disability fits into a specific criterion for hematological listings.