Leukemia is a cancer of the blood or bone marrow. There are various types of leukemia that can affect adults; below is an outline of some of the most common. Whether you can get Social Security disability benefits for cancer depends in part on what type of leukemia you have.
Acute lymphocytic (lymphoblastic) leukemia (ALL). ALL is a type of leukemia that affects the lymphoid cells (which work to prevent infections in your body). This cancer causes a high number of immature white blood cells called lymphoblasts to be created. This is a rapidly spreading cancer and can be fatal within months if not treated.
Acute myeloid (myelogenous) leukemia (AML). AML is a type of leukemia that affects the myeloid cells, which include white blood cells, red blood cells, and platelet making cells. This cancer grows quickly and causes a high number of immature white blood cells called myleoblasts to be found in the blood and bone marrow.
Chronic lymphocytic leukemia (CLL). CLL is a slow growing cancer that affects the lymphoid cells. This type of leukemia generally affects individuals 56 and older.
Chronic myeloid leukemia (CML). CML is a cancer that affects the myeloid cells and is generally slow growing at first.
The symptoms that are commonly observed with leukemia include fever, enlarged spleen or liver, easy bleeding or bruising, weght loss, frequent infections, chronic fatigue, weakness, and bone pain and tenderness. Once a diagnosis is made, treatments are generally begun shortly after.
Individuals with leukemia may not be able to do the work they once did, but that does not meant that Social Security will deem them disabled. In order to qualify for Social Security Disability benefits, you must either show that you meet the requirements of a disability listing from the Social Security “blue book” (or have impairments that can be considered equivalent) or prove that you are not able to return to any type of work.
There is a specific listing for leukemia in the Social Security “blue book,” the agency's listing of impairments that can automatically qualify for disability. To meet the requirements of the listing, you must show that you have one of the two types of leukemia noted below:
Because some of this listing is dependent upon the success of the initial treatment, Social Security may delay making a decision on disability benefits to allow time for your treatment to work. In addition, you will meet the leukemia listing only for a certain amount of time following your leukemia diagnosis or stem cell transplant. In general, you'll be considered disabled for two years after the date of the leukemia diagnosis or the latest relapse, or at least one year from the date of a stem cell transplant, whichever is later.
After that time period has passes, Social Security will look at any effects you continue to have from the leukemia or the treatments for the leukemia to determine if they cause enough functional limitations for you to be considered disabled—or if they allow you to meet another disability listing. If your leukemia were to return, you could qualify again under the leukemia listing again.
If the diagnosis and medical evidence that you have does not match the above listing exactly, you may still be able to qualify for disability benefits if your symptoms and test results can be considered as severe as those required by the listing. To "equal" a listing, you have to show that your type of leukemia is very similar to those mentioned in the a listing and is equal in severity and duration to the leukemia mentioned in the listing.
For example, chronic lymphocytosis leukemia (CLL) is not specifically noted in the disability listing. However, in its accelerated or blast stage, this type of leukemia can have the same disabling effect as chronic myelogenous leukemia (CML). It is important to have your doctor note in your medical records that the leukemia types are similar and are equal in severity and duration.
Social Security want to see evidence of the origin of the cancer and the extent of the cancer throughout the body as well as how often and long you receive treatments for and whether the treatments are successful and have side effects. For biopsies or other operational methods used to show the existence of the leukemia, you should include the operative notes and pathology reports. If they are not available, the medical reports reporting such findings will be accepted.
For acute leukemia, you can show through a definitive bone marrow exam that you have this type of leukemia. If you did not have a bone marrow exam, other medically acceptable methods of diagnosis may be used.
For CML, a chromosome analysis that shows Philadelphia chromosome should be done when possible. If a chromosome analysis was not done or it did not show the presence of the Philadelphia chromosome, you may use other prevailing methods of diagnosis.
For CLL, you must show lymphocytic laboratory results of 10,000/mm3 for at least three months. While this type of leukemia is not specifically noted in the disability listing, CLL can either be evaluated with listings based on the complications caused by the cancer (anemia or low white blood cells) or could be considered equivalent to the CML listing or indolent lymphoma listing.
Social Security has a special process for diseases that are particularly severe and can meet Social Security's medical eligibility requirements with clear medical evidence. Acute leukemia and CML in its blast phase are the two types of leukemia that are included in the Compassionate Allowance program, which expedites your application.
Social Security recommends including medical evidence with disability your application so that your application will be approved quickly. For acute leukemia, a bone marrow exam is needed in the medical evidence to show a definitive diagnosis. For CML in blast phase, medical evidence should include a complete blood count and bone marrow exams. Chromosome studies and molecular analysis can also be provided to confirm the diagnosis.
For more information, see our article on Social Security's Compassionate Allowance program.
If you have leukemia that doesn't meet or equal the requirements of Social Security's leukemia listing, either because of the time limitations or because you have CLL, you may be able to get benefits if you nevertheless suffer from the symptoms, complications, or limitations from your leukemia, cancer treatments, or stem cell transplant.
To determine whether you can do your past work, Social Security will use your symptoms and limitations to create your Residual Functional Capacity (RFC) assessment, which is an opinion of what you can and can't do because of your medical condition. To determine whether you can do "other work," Social Security uses your RFC as well as your age, education level, and work experience in making the determination of whether or not you can work any job.
For those with leukemia, persistent fatigue and weakness are the biggest barriers to being able to perform exertional physical tasks at work. Other symptoms, including easy bleeding and bruising and bone pain and tenderness, may make completing some physical tasks difficult and possibly unsafe. Those who have had a stem cell transplant will need to be extra cautious with physical activities due to their high risk of bleeding.
Nonexertional activities, including the ability to do tasks using your hands and fingers, such as typing or filing, would be less affected by leukemia and the treatments used to treat it. However, fatigue could justifiably hinder your ability to do even nonexertional physical tasks.
Treatments for leukemia cause additional symptoms that may affect mental abilities, including decreased concentration, memory, and ability to multitask. All of these symptoms could decrease an individual's ability to understand and successfully complete work tasks. Depression can also be a side effect of leukemia treatment and can affect an individual's ability to perform properly at work mentally.
Sensory abilities include your ability to work in different environments. Those with leukemia might have environmental limitations due to the increased risk of infection. Various leukemia treatments increase the risk of infection and limit an individual's ability to work in places were there may be a lot of germs, such as working with children, working in a hospital, or even working in a workplace with a lot of employees. The risk of infection jumps drastically after a stem cell transplant, and working with others may not be possible at all after a stem cell transplant.
After developing your RFC, Social Security will compare your RFC with your past work to decide whether or not you can still complete those responsibilities. If not, Social Security will use specific rules to determine whether someone with your age, education, skills, and RFC should be able to learn a different type of work. For more information, see our section on how Social Security rules dictate if you're disabled.