Getting Social Security Disability Benefits for Aplastic Anemia or Other Bone Marrow Diseases

Aplastic anemia is a hematological (blood) disorder in which the bone marrow fails to make enough blood cells. Someone with aplastic anemia can suffer from low red or white blood cell counts and a low platelet count—often, all three.

Other bone marrow failure diseases include the following:

• myelodysplastic syndromes
• granulocytopenia, and
• myelofibrosis.

Is Aplastic Anemia a Disability?

If you have severe aplastic anemia, a myelodysplastic syndrome, granulocytopenia, or myelofibrosis, you might qualify for Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI) disability benefits. Social Security has the same medical disability standard for bone marrow disorders for both SSDI and SSI. But not everyone who has a bone marrow disorder will qualify for disability benefits. Qualifying medically for disability will depend on the severity of your condition and your age (more on this below).

In addition, whether adults are eligible for SSDI depends on their work histories, and whether adults or children are eligible for SSI depends on their household income and asset levels. (SSI is for low-income people with disabilities; SSDI is for people with a work history who've paid into Social Security.)

Symptoms, Causes, and Treatment of Aplastic Anemia

Aplastic anemia symptoms can include any or all of the following:

• frequent infections
• fatigue
• weakness
• rapid heartbeat
• shortness of breath
• easy bruising
• bleeding gums, and
• nosebleeds.

Aplastic anemia can be caused by an autoimmune disorder, a viral infection, exposure to certain drugs or chemicals, radiation therapy, or chemotherapy. In many cases, however, the cause is unknown, in which case the disorder is referred to as "idiopathic aplastic anemia."

Treatment for severe cases of aplastic anemia can involve stem cell transplants (bone marrow transplants).

Qualifying for Disability for Bone Marrow Failure

You'll qualify for disability benefits automatically (without having to prove there are no jobs you can do) if your condition meets the requirements of a listing in Social Security's blue book. Bone marrow failure disorders, like aplastic anemia, are evaluated under the listings for hematological (blood) disorders.

Meet the requirements of any of the three listings covering bone marrow failure, and Social Security will consider you disabled.

Listing 7.10: Disorders of Bone Marrow Failure

You can automatically qualify for disability benefits under listing 7.10 with a myelodysplastic syndrome or aplastic anemia if you require life-long red blood cell (RBC) transfusions every six weeks or more frequently.

You can also meet the requirements of listing 7.10 with any bone marrow failure disorder if you've had complications of bone marrow failure requiring hospitalization at least three times within one year. The hospitalizations must each have lasted 48 hours or more and occurred at least 30 days apart.

Listing 7.17: Bone Marrow, or Stem Cell, Transplantation

You'll meet the requirements of listing 7.17 if you've had a bone marrow (stem cell) transplant. Social Security will automatically consider you disabled for at least 12 consecutive months after the transplant procedure. After that first year, your residual impairments will be evaluated based on the affected body system.

Listing 7.18: Repeated Complications of Hematological Disorders

If your bone marrow disease doesn't meet the requirements of listing 7.10 and you haven't had a transplant, you could still qualify for disability if you have repeated complications that meet the requirements of listing 7.18. To meet the listing, you must have frequent complications of ample duration that affect your ability to function.

Complications that can qualify under this listing might involve emergency room visits and short hospitalizations. Examples of some of the complications that can meet the listing include:

• anemia (low hemoglobin count)
• low blood platelet count
• osteonecrosis (bone tissue death)
• retinopathy
• joint problems
• pain, and
• severe fatigue.

You don't have to have the same kind of complication each time. But to meet the requirements of this listing, you must experience documented complications:

• at least three times a year or once every four months if the episodes last two weeks or more each time
• substantially more frequently than three times a year, no matter how long each occurrence lasts, or
• less frequently than three times a year if the episodes last substantially longer than two weeks each time.

To meet listing 7.18, you must also prove that the complications from your bone marrow failure disorder impair your ability to function. To meet the listing, you must have a marked (severe) limitation in one of the following areas:

• performing activities of daily living (like taking care of your personal needs or doing your own shopping)
• completing tasks in a timely manner (because of problems with focus, speed, or endurance), or
• maintaining social functioning (interacting appropriately with others and communicating effectively).

If You Don't Meet a Bone Marrow Disease Listing

Even if your bone marrow disorder doesn't meet the requirements of one of the above listings, you might still qualify for disability benefits. But to get disability benefits, you'll have to prove that you can't work because of the limitations imposed by your condition or that you'll need to miss a lot of work for treatment, transfusions, or hospitalizations.

To decide if your condition will prevent you from working, Social Security will use the medical evidence in your file to assess your residual functional capacity (RFC). Your RFC is the most you can be expected to do in a work setting, given your medical condition. Your RFC will include exertional limitations, such as:

• how long you can stand during an 8-hour shift, and
• how much you can lift and carry regularly.

Your RFC will also cover non-exertional limitations, such as:

• physical abilities like manipulating objects and seeing
• mental abilities like focusing on your work or interacting with others, and
• environmental restrictions like not being able to work in cold weather or around heavy machinery.

Social Security will use your RFC to determine if you can still do your past work and, if not, whether there's any other work you can be expected to do. If the SSA finds that your bone marrow disease prevents you from doing any kind of work, you'll qualify for disability benefits.

(Learn more about how Social Security decides if you can still work.)

Disability Listings for Children With Bone Marrow Disorders

Disabled children under 18 can qualify for SSI disability benefits if they and their parents have little income and few assets. Children are almost never eligible for SSDI (except as dependents of a parent who collects retirement or SSDI benefits) because they don't have the required work history.

Your child might receive SSI disability benefits if the child meets the financial eligibility guidelines of the program and has a condition that's disabling enough to qualify.

How a Child Meets a Disability Listing for Bone Marrow Disease

The childhood listings for bone marrow disorders (in section 107.00) have the same requirements as the adult listings laid out above. A child applying for SSI based on aplastic anemia, a myelodysplastic syndrome, granulocytopenia, or myelofibrosis can qualify medically by meeting the requirements of a listing.

Social Security will look at your child's medical records, especially the results of blood tests and bone marrow biopsies, to determine if the child meets the definition of disabled.

How a Child Can Functionally Equal the Listings

A child who doesn't meet one of the disability listings for bone marrow disorders can still qualify for SSI. You'll need to show Social Security that your child's condition very seriously interferes with the child's daily functioning, despite not meeting the exact requirements of a listing.

Learn more about how your child can qualify for SSI disability benefits by functionally equaling the listings.

You Might Qualify for Expedited Processing

If you required a bone marrow transplant or stem cell transplant, you might qualify for a quicker decision under Social Security's Compassionate Allowances program. Social Security keeps a list of conditions that, by definition, meet the SSA's definition of disabilities.

Aplastic anemia with transplantation is on the Compassionate Allowances List (CAL). Adults and children who've received a stem cell (bone marrow) transplant because of aplastic anemia or another blood disorder in the last year will qualify for this expedited processing.

There's no special application to get your disability claim fast-tracked. Social Security will automatically flag your application if it mentions a CAL condition and will expedite it. Still, it can help to note "Compassionate Allowance" somewhere on your disability application.

If Social Security has all the medical documentation needed to identify your case as a CAL case, your application can be decided in a matter of weeks—instead of the months or years it can take to get a decision on a non-CAL application.

Applying for Disability for Aplastic Anemia or Another Bone Marrow Disease

An adult can apply for SSDI or SSI disability benefits using Social Security's online application. You can access it from anywhere at any time. And you can pause the process if needed, and pick up again right where you left off.

To file a child's SSI application, you must work with a Social Security representative (or hire a lawyer to help). You can request an appointment with Social Security online. Once you do, a Social Security representative will schedule an appointment for you to complete the process.

You can also submit an adult or child disability application in person at your local Social Security office (make an appointment first to avoid a long wait). Or make an appointment to apply by phone (for an adult or child) by calling 800-772-1213 (TTY 800-325-0778).

Learn more about the Social Security disability application process.

_{Updated April 10, 2024}