Is Social Security Disability Available for Hemophilia or Other Bleeding Disorders?

Hemophilia is a genetic disorder characterized by excessive bleeding due to a deficiency of clotting agents in the blood. If you've been diagnosed with a bleeding disorder such as hemophilia and you're unable to work, you may be eligible for Social Security disability benefits. Those with the most severe cases can be approved by meeting Social Security's disability listing for "disorders of thrombosis and hemostasis." The more common way to receive disability benefits, however, is to show that your bleeding disorder prevents you from doing any type of full-time work.

Hemophilia: Symptoms and Treatment

People with hemophilia who suffer even a minor scrape or cut can be at great risk for heavy blood loss. Hemophilia can also cause frequent and persistent nosebleeds, bleeding in the gums, and excessive menstrual bleeding. Internal bleeding is possible as well, primarily within the muscles, joints, and organs.

Two different types of the disorder exist: Hemophilia A and Hemophilia B. The more common variety, Hemophilia A, refers to a deficiency in clotting factor VIII, and it is present in about 1 in 5,000 live male births worldwide. Hemophilia B occurs in about 1 in 25,000 male births, and it is characterized by insufficient clotting factor IX. As with most genetic disorders carried on the X chromosome, hemophilia is much more common in males than in females.

Treatment usually consists of intravenous injections of the deficient clotting factor, and exercises are sometimes prescribed to increase joint strength. Individuals with hemophilia are often advised to refrain from contact sports and other situations where bleeding can occur.

Other Bleeding Disorders: Von Willebrand Disease and Thrombocytopenia

Von Willebrand disease. Von Willebrand disease, like hemophilia, is marked by a clotting factor deficiency. The Von Willebrand factor, found at abnormal levels in those with this disease, helps platelets clump together and ultimately clot the blood. The most common hereditary disease of the blood, Von Willebrand disease occurs in approximately one of every 1,000 people, and males and females experience it with equal frequency. Those with Von Willebrand disease can experience easy bruising, nosebleeds, rashes, oral bleeding, and severe menstrual bleeding. Minor cases of the disease generally don't require treatment, but more serious cases generally call for medication to increase the level of Von Willebrand factor in the blood.

Chronic thrombocytopenia. Platelets are blood cell fragments produced in the bone marrow and used to assist in blood coagulation. They are normally found at the rate of 150,000 to 450,000 per microliter of blood. Those with fewer than 150,000 platelets per microliter have thrombocytopenia, a disease that can cause excessive bleeding, easy bruising, and in its most serious form, intestinal or intracranial bleeding. Most cases of thrombocytopenia are mild, but platelet levels below 40,000 per microliter can be severe, and under 10,000, life-threatening. Possible treatments include corticosteroid medications and blood transfusions.

Social Security's Listings for Hematological Disorders

The Social Security Administration (SSA) has several official listings for hemophilia and other bleeding disorders, which can be found under Section 7.00 - Hematological Disorders.

Listing 7.08, Disorders of Thrombosis and Hemostasis

To meet listing 7.08, you must have had complications of a clotting or bleeding disorder requiring hospitalization at least three times within a one-year period. The hospitalizations must each last 48 hours or more and occur at least 30 days apart. Examples of complications that can result in hospitalizations include embolisms, thromboses, anemias, and uncontrolled bleeding requiring multiple-factor concentrate infusions or platelet transfusions.

While most coagulation defects cause excessive bleeding, hypercoagulation disorders, such as protein C or protein S deficiency and Factor V Leiden, can also meet this listing.

The childhood listing for hemophilia, thrombosis, and hemostasis, listing 107.08, has the same listing requirements.

Listing 7.18, Repeated Complications of Hematological Disorders

The SSA has another listing under hematological disorders you may be able to meet if you don't meet the listing requirements for clotting and bleeding disorders. For instance, your hemophilia may be largely under control due to prophylactic factor replacement therapy, but you still have episodes that have caused you to miss days of work. Listing 7.18 is for repeated complications of hematological disorders. Complications that could qualify under this listing include hospitalizations, joint problems, pain, anemia, or severe fatigue. You must be able to prove that these complications have caused a marked (severe) limitation in one of the following:

• performing activities of daily living
• interacting with others independently and appropriately, or
• completing tasks in a timely manner because of problems with pace, persistence, or focus.

Obtaining a Medical-Vocational Allowance for a Bleeding Disorder

If you don't meet one of the listings above, the SSA offers another way to get benefits. To determine if you're eligible for a medical-vocational allowance, Social Security considers your age, education, work experience, and the functional limitations caused by all of your impairments. If Social Security decides you're unable to return to any of your past jobs or any other job (for example, because of the chance of a dangerous bleed), you'll be approved for benefits via a medical-vocational allowance.

Remember that you must provide sufficient medical documentation to support your claim, including all relevant medical records. In cases involving bleeding disorders, blood tests and other objective evidence are incredibly important. You should ask your family physician or treating specialist to provide a written opinion about your limitations or to complete a Residual Functional Capacity form. A favorable opinion from a treating physician really can make the difference in whether your claim is approved or denied (as long as it includes the details of your limitations and not just a pronouncement that you are disabled).

For more information on how Social Security decides who gets a medical-vocational allowance, see our article on medical-vocational allowances for disability.