Hemophilia and Qualifying for SS Disability Benefits

Hemophilia and Qualifying for Disability Benefits

Hemophilia is a rare disorder in which the blood doesn’t clot normally.

Normally, the body pools blood cells to form clots to stop bleeding; clotting factors are proteins in the blood which work with cells to form clots. When these clotting factors are low, or missing, hemophilia occurs. A person who has hemophilia may bleed longer after an injury than other individuals whose blood is clotting normally. Small cuts may not be a problem, but severe forms of the disorder can cause internal bleeding, which can damage organs and tissues and be life-threatening. Hemophilia is almost always a genetic disorder, though approximately one-third of cases have no family history.

While individuals with mild cases of hemophilia may only bleed longer than normal, those with severe cases of hemophilia are at risk for serious complications, among them bleeding in the brain after a simple bump on the head, deep internal bleeding, damage to joints, infection and bleeding in the throat or neck, affecting breathing.

Currently there is no cure for hemophilia; treatment typically consists of intravenous injections of the deficient clotting factors. Sometimes exercises to increase joint strength are prescribed. Demonstrating that you are following your doctor’s treatment plan is an important part of qualifying for disability benefits.

How do I qualify for SSDI with hemophilia?

People with hemophilia can be at risk for heavy blood loss.

In addition to bleeding after surgery or an injury, hemophilia can cause frequent nosebleeds, excessive menstrual bleeding, bleeding in the gums, and bleeding in joints, muscles and organs. Individuals with severe cases of hemophilia may be approved for Social Security Disability income if they can prove that hemophilia prevents them from doing any type of full-time work. Social Security’s Blue Book lists two impairments which qualify for disability benefits: Section 7.08, Disorders of thrombosis and hemostasis and Section 7.18, Repeated complications of hematological disorders.

To qualify under Section 7.08, Disorders of thrombosis and hemostasis, you must have complications of hemophilia that required hospitalization at least three times within a one-year period.

The hospitalizations must last at least 48 hours or longer and occur at least 30 days apart. Some complications that can result in hospitalizations include uncontrolled bleeding, anemia, embolisms or thrombosis.

If your hemophilia is managed by prophylactic factor replacement therapy, but you still experience episodes of bleeding and other symptoms that cause you to miss too many days of work, you may still qualify for SSDI under Section 7.18, Repeated complications of hematological disorders.

Examples of complications include anemia, pain, severe fatigue, joint and muscle swelling, limitation of joint movement, and cognitive or other mental limitations.

If you don’t meet the requirements of either Section 7.08 or 7.18, Social Security will conduct a residual functional capacity (RFC) assessment, taking into consideration your age, education, work experience to evaluate how your limitations affect your ability to work.

For example, if you may potentially experience a dangerous bleed, you may not be able to return to your old job – or any job. The lower your RFC score, the more likely you will be approved for benefits. Social Security may decide that you can’t do your old job and may not expect you to learn a new job. Social Security follows a set of medical-vocational grid rules to determine when the agency expects an applicant to learn a new job. Applicants older than 50 or 55 often fall under a grid rule, which means they don’t have to learn a new job. If you’re unable to work at your old job or learn a new job, Social Security will likely grant you disability benefits. This is called a medical-vocational allowance.

You should also include in your medical records any other medical conditions you may have; for example, asthma, or arthritis.

One disorder may not meet the requirements of a Social Security impairment listing, but if you have more than one medical condition, Social Security must consider how your combined health issues limit your ability to hold a job and perform routine tasks.