Can My Child Qualify for Disability Benefits with a Blood Disease?

It’s a common myth that social security programs are reserved for elderly people. In reality, millions of children and teenagers also participate in these programs, and comprise a considerable portion of disability beneficiaries in the United States.  If you live in Pennsylvania or New Jersey and your child suffers from a blood disease, such as sickle cell or anemia, he or she could be a strong candidate.  What are the eligibility requirements for children to qualify for SSI, or Supplemental Security Income?  How are childhood blood disorder claims evaluated by the Social Security Administration?

Does My Child Qualify for SSI?

Blood disorders are also called hematological disorders, which is the term the Social Security Administration uses in its “Blue Book.”  The Blue Book, or Listing of Impairments, is a large compilation of medical requirements for disability claimants.  There is an entire Listing dedicated exclusively to evaluating disability in young people (Childhood Listings – Part B), with blood conditions compiled together under Section 107.00: Hematological Disorders.

However, before we talk about the different conditions and medical criteria under Section 107.00, let’s look at some of the technical, non-medical requirements for participating in the SSI program. To be considered eligible, your child or young loved one should:

1. Be younger than age 18.  Once age 18 is reached, the teenager who was receiving SSI will be reevaluated by the SSA in what’s called an age-18 redetermination.
2. Not be earning more than $721 per month, if he or she is employed.  $721 represents the 2014 FBR, or Federal Benefit Rate.  This number changes annually to adjust for inflation and the rising cost of living, so be sure to stay current with the new FBR in 2015.
3. Have a medical condition which is serious enough to limit and interfere with his or her daily functions and activities.  Disorders and diseases which can be easily suppressed with treatment are not considered disabling, and therefore do not merit SSI assistance.
4. Have a condition which either (A) has already lasted for at least 12 months, (B) is projected to last for at least 12 months, or (C) is expected to be fatal.

Which Blood Diseases Are Covered by Disability Benefits?

Now that we’ve gone over some of the general SSI eligibility criteria for people under 18, let’s look into Section 107.00 of the Listing of Impairments to see what the SSA medical examiners look for in young claimants citing a blood disease.

(This is also a good time to point out that even if your child doesn’t match the often stringent Listing, they could still qualify if their health issue can be proven severely disabling.)

As of September 2014, Section 107.00 covers the following hematological disorders:

• Hemolytic Anemia — Section 107.03
• Sickle Cell Disease — Section 107.05
• Chronic ITP (Idiopathic Thrombocytopenic Purpura) — Section 107.06
• Inherited Coagulation Disorders — Section 107.08

Note that this represents the complete list — there is no Section 107.04, for example.

Hemolytic Anemia

Hemolytic anemia is not the same as other types of anemia, such as aplastic or iron-deficiency anemia.  Hemolytic anemia means that red blood cells (RBCs) break apart, either in the spleen or bloodstream.  There are numerous causes, all of which are permissible by SSA standards.  This listing is very straightforward, and says simply, “Manifested by persistence of hematocrit of 26 percent or less despite prescribed therapy, and reticulocyte count of 4 percent or greater.”  Your doctor can help you with unfamiliar medical terminology.

Idiopathic Thrombocytopenic Purpura (ITP)

This condition similar to hemophilia, and occurs when the immune system malfunctions and destroys platelets, whose job is stop bleeding.  As a result, people with ITP bruise and bleed very easily.  The ITP listing is also brief, stating only, “With purpura and thrombocytopenia of 40,000 platelets/cu.mm. or less despite prescribed therapy or recurrent upon withdrawal of treatment.”

Inherited Coagulation Disorders

Coagulation is simply another word for clotting.  The SSA will consider all inherited disorders of this type, provided the child exhibits either:

• “Repeated spontaneous or inappropriate bleeding.”
• “Hemarthrosis with joint deformity.”  (Hemarthrosis refers to bleeding into the spaces where joints are formed.)

Sickle Cell Disease

Sickle cell disease most often occurs in people of African descent, though anyone can be affected. This condition takes its name from the sickle shape it creates in RBCs, which are normally round. Due to their irregular shape, sickle cells cannot pass correctly through the bloodstream, resulting in organ damage and pain.

Your child should experience one of the following:

• “Recent, recurrent severe vaso-occlusive crises.”  (A complication of sickle cell.)
• “A major visceral complication” within the past 12 months.
• “A hyperhemolytic or aplastic crisis” within the past 12 months.
• “Chronic, severe anemia with persistence of hematocrit of 26 percent or less.”  (A hematocrit is a test to measure the volume of RBCs in the blood.)
• “Congestive heart failure, cerebrovascular damage, or emotional disorder.”

The experienced Philadelphia disability benefits lawyers at Young, Marr, Mallis & Associates may be able to help your child qualify for SSI.  To set up a free and confidential appointment, call our law offices at (609) 755-3115 in New Jersey or (215) 701-6519 in Pennsylvania, or contact us online today.