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 hemostatis." The more common way to receive disability benefits, however, is to show that your bleeding disorder prevents you from performing gainful work.
When a person with hemophilia suffers even a minor scrape or cut, he or she 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.
There are two different types of the disorder, 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 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.
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.
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 which 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 official listing for hemophilia and other bleeding disorders is found under Section 7.00 - Hematological Disorders.
Prior to 2016, there were two listings, one for thrombocytopenia and one for hemophilia or other coagulation disorders. Adults could meet these listings if they had spontaneous bleeding requiring a transfusion at least three times during the preceding five months. In 2015, the listings were merged into one, listing 7.08, for disorders of thrombosis and hemostatis. (Children with coagulation disorders required repeated inappropriate or spontaneous bleeding, or bleeding in a joint accompanied by joint deformity to meet the childhood listing.)
To meet the new 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. Note that hypercoagulation disorders, such as protein C or protein S deficiency and Factor V Leiden, can also meet this listing. The childhood listing, listing 107.08, has the same listing requirements.
There is 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. There's a new listing, listing 7.18, 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 you also have a marked (severe) limitation in one of the following:
It's also possible to "medically equal" either listing if you can show that your symptoms are just as disabling as those described in the listing. However, the burden is on you and your attorney to prove that your condition medically equals one of the listed impairments. (Note: It's difficult to prove your condition medically equals a listing without a disability attorney.)
If you don't meet a listing, there's 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.