Social Security Benefits for Chronic Anemia

Anemia is a common condition that is unfortunately unrecognized and not treated as often as it should be treated. While many people are diagnosed with the disorder year after year, those who suffer from the health condition may have an impacted quality of life. Anemia can be the result of other diseases, such as chronic kidney disease, HIV, cancer, autoimmune disease or other chronic health conditions.

Since it is prevalent and has serious health consequences, there needs to be better detection of the disorder so there can be a faster medical response and more effective treatment plan for those who are suffering from the disorder. Clinicians need to be more attentive to the symptoms and act with vigilance in its treatment.

If your anemia is severe and requires blood transfusions, you may be eligible for Social Security Disability Insurance (SSDI) benefits. The Social Security Administration (SSA) pays SSDI benefits to individuals who are deemed legally and permanently disabled according to their guidelines. The SSA awards SSDI benefits to individuals who have worked enough to earn an adequate amount of credits and who have paid in enough taxes to the SSA throughout their working careers. If they are deemed disabled per the SSA guidelines, the disabled individual and some of his or her dependents may be eligible to receive SSDI benefits to help with living expenses.

Social Security Benefits for Chronic Anemia

Financial Expenses Related to Chronic Anemia

While chronic anemia is prevalent, it can be costly to treat. According to NCBI, those who started treatment early end up spending less on treating the condition because it is brought under control much more quickly. If a patient has a chronic condition that sometimes coincides with anemia, the physician should immediately check the patient to see if he or she is suffering from anemia.

Patients who have medical insurance can expect to pay copays for prescriptions and doctor visits. These can cost about $1,200 to $2,500 per year. If the anemia is severe and requires hospitalizations or transfusions, that price can increase significantly as the average hospital stay is about $9,000.

For those who do not have medical insurance, the cost of treating anemia can cost anywhere from $3,000 to $25,000 per year depending upon the response to medication and what treatment options are required to help the individual live as comfortably and as normally as possible.

Different levels of severity impact the expense. Also, the medical conditions that are involved with the anemia also can impact the kind of treatment used and the cost of your medical care. Your costs related to the treatment of your chronic anemia can vary greatly, but just as with any chronic medical condition the costs can run into thousands year after year.

The SSA Evaluation and Medical Qualifications

Anemia is a medical condition that occurs when your blood is lacking red blood cells, which are the main transporters of oxygen to bodily organs. If your body is failing to get an adequate supply of oxygen, you may feel fatigued, have a pale appearance, get tired easily, experience a racing heart, have shortness of breath, experience hair loss or have a general feeling of malaise. All these symptoms can potentially stem from several different medical conditions.

Different people are affected by anemia in a variety of ways. If the anemia has caused a gradual blood cell reduction, their body may be able to adjust to the loss better even with a very low red blood cell count. Those who experience faster loss of red blood cells can often experience significant impairments. Those who already have existing medical conditions may have a worsening of symptoms when the anemia comes into play.

To be eligible to receive SSDI benefits for anemia, you have to prove either they meet the requirements of the SSA’s disability listing for anemia or that their anemia is so limiting that it keeps them from returning to any kind of work.

    The disability listing for anemia in the Blue Book is that your red blood cells in your blood are 30% or less and you need a minimum of one transfusion every two months on average. Low red blood cell accounts are not enough to prove disability, the proof of all blood transfusions is required to meet the listing by showing that you have indeed had all these transfusions.

You can meet the listing requirements caused by anemia, such as a cardiovascular listing because of heart problems or respiratory listing because of shortness of breath. Anemia may be caused by an underlying condition that meets a listing, such as advanced kidney disease which has its own listing as well.

Meeting Disability Criteria with an RFC

Even if you don’t meet the disability guidelines set forth by the SSA in the Blue Book, you can still qualify for SSDI benefits with the help of an RFC. A residual functioning capacity form (RFC) is completed in detail by your physician and specifies your symptoms and side effects and how they impact your life.

As an example, if you are severely anemic and you are very fatigued, it will specify how that will impact your ability to work a full shift. If you tire easily and experience shortness of breath, your physician will make those indications and specify how that will keep you from standing or sitting for long periods of time.

Other examples may include kidney disease, cardiovascular disease or similar problems either causing the anemia or related to it. The anemia can be used in conjunction with other medical conditions in order to determine disability.

Applying Specific Medical Tests to Your Case

Medical tests are used to determine whether you are suffering from anemia and if your medications or transfusions are effectively treating the disorder. Your medical records will also show how these symptoms are impacting your life. It is not uncommon for the SSA to order an additional medical evaluation at their expense.

This evaluation will be for informational purposes only and not for medical treatment. It is designed to help determine the severity of your condition and symptoms. A mental evaluation may also be ordered, which can determine if you are depressed, stressed or suffer anxiety because of the condition and if that impacts your ability to work.

Basic medical tests such as lab work may also be ordered as part of the SSA medical evaluation process. While there are several steps to the disability approval process, you may end up having to appear before an administrative law judge before being approved for benefits.

When applying for disability benefits due to Chronic Anemia or before appearing before an administrative law judge, it may be in your best interest to hire a disability attorney. An attorney can increase your chances of filing a successful Social Security Disability claim.