Leukemia (loo-KEE-mee-uh) is an umbrella term for several kinds of cancer that develop in the blood cells. The specific type of leukemia diagnosed depends on the type of blood cell that becomes cancerous and how quickly it grows. Some of the faster-growing leukemias are considered automatically disabling by Social Security, while others can become disabling once they cause significant functional limitations that keep you from working.
Depending on the type of leukemia you have, you may qualify for disability benefits if your medical records show that you meet the requirements of a listed impairment—a special class of disorders that automatically qualify for disability—or by being unable to perform any full-time work. Applicants with very advanced or rapidly progressing cases of leukemia may even qualify for expedited approval of benefits under Social Security's Compassionate Allowance program.
There are four main types of leukemia, which can vary in symptoms, severity, and treatment. Leukemia can be acute—meaning it comes on suddenly and severely—or chronic, meaning that it gets progressively worse over time. The cancer can also affect the lymphocytes or the myeloid cells, two kinds of blood cells that are important in immune system functions.
Common symptoms of leukemia include fever, enlarged spleen or liver, easy bleeding or bruising, weight loss, frequent infections, chronic fatigue, weakness, and bone pain and tenderness. Treatments are generally begun shortly after diagnosis, including chemotherapy, radiation therapy, medication, gene therapy, and stem cell or bone marrow transplantation.
When you apply for disability benefits, claims examiners at your state's Disability Determination Services will need to see that you're financially eligible for Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI). SSDI and SSI are the two disability benefit programs run by Social Security. Eligibility for SSDI depends on your work history, while SSI is a needs-based benefit available to people with low income and assets. Some applicants are eligible for both benefits.
As long as you're legally able to receive at least one type of benefit, claims examiners will then determine whether your medical records establish that you meet Social Security's definition of disability. Applicants with certain types of leukemia may be able to meet (or equal) the requirements of a listed impairment, while others can qualify by showing they can't do any work.
When claims examiners talk about "meeting a listing," they're talking about a disorder in Social Security's Listing of Impairments (also called the "Blue Book" as a nod to the historical color of the manual). Each listing describes certain medical evidence that is sufficient for Social Security to approve an application for benefits, without needing to determine whether the applicant can work. Having enough evidence to get benefits this way is referred to as "meeting a listing."
Not every medical condition is in the Blue Book—only disorders that the Social Security Administration (SSA) considers especially severe are listed impairments. Leukemia is one of them (listing 13.06). Your application will be evaluated based on the type of leukemia you've been diagnosed with.
Note that chronic lymphocytic leukemia (CLL) isn't addressed under listing 13.06. That's because Social Security evaluates the complications caused by CLL under different listings, such as 13.05(A)(2) for non-Hodgkin's lymphoma or the listings for blood disorders (section 7.00).
Because some of the requirements of listing 13.06 depend on the outcome of your initial treatment, Social Security may delay making a decision on your application to allow time for your treatment to work. And because this listing has certain time constraints—a 12- to 24-month "grace period" during which the agency assumes you're disabled—Social Security will reexamine your case after the time has elapsed to see whether you're still disabled. For example, if your leukemia returns, you could qualify under listing 13.06 again.
Even if the evidence in your medical record doesn't match the listing requirements exactly, you can still qualify for benefits by "equaling" the listing. Equaling a listing means that you're just as disabled as somebody who meets the listing exactly, because your symptoms and test results are equally as disabling.
To equal a listing, you'll have to show that your type of leukemia is very similar in severity and duration to the types mentioned in listing 13.06. For example, chronic lymphocytosis leukemia (CLL) isn't specifically addressed in 13.06. But during its accelerated or blast stage, this type of leukemia can have the same disabling effect as chronic myelogenous leukemia (CML), another type of chronic leukemia that's included in the listing.
The best way to show that your leukemia equals a listing is to have your doctor—preferably your oncologist—write a medical source statement explaining why your disorder is functionally the same as the listing.
If you don't have leukemia that meets or equals the listing requirements—perhaps your stem cell transplant was more than one year ago, or you have CLL—you can get benefits if your symptoms or treatment keep you from working. Social Security determines what you can and can't do at work in a process called assessing your residual functional capacity (RFC).
Your RFC is a reflection of the functional limitations you have as a result of your leukemia symptoms and treatment. A typical RFC for somebody with leukemia might contain the following limitations:
After assessing your RFC, Social Security will compare the duties of your past jobs to decide whether you can do that kind of work now, given the limitations in your current RFC. If you can't, the agency will use specific rules to determine whether somebody with your RFC, age, education, and skills is able to perform any other work. You can qualify for disability benefits by ruling out all other jobs in what's called a medical-vocational allowance.
Your medical records are the foundation of your disability application. Social Security needs to see objective evidence supporting a leukemia diagnosis, including:
The agency will also want to see follow-up records, such as blood, bone marrow, or spinal fluid tests that demonstrate the extent of your treatment, how successful it is, and what residual effects it may cause.
Social Security will ask you where you've received medical treatment when you file for disability benefits. Be sure to list the names, dates, and locations of all medical providers on the application form. It's a good idea to confirm your treatment history with your regular doctor, since multiple laboratories may have run your tests, or you may have gone to different hospitals for biopsies.
Social Security has several methods you can use to file your application for benefits.
Although it's not required, you may want to consider hiring an experienced disability attorney to start your application (or help you appeal a previous denial). Your lawyer can handle all communications with Social Security, keep you updated on the status of your case, and make sure all the appropriate information is submitted in a timely manner.
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