Pernicious Anemia and SCD: Can I Get Disability Benefits?

If you suffer from pernicious anemia or subacute combined degeneration of the spinal cord, and it affects your ability to function at work, you may be eligible for Social Security disability benefits.

About Pernicious Anemia

Pernicious anemia is a condition, or autoimmune response, in which there is a decrease in the red blood cells in your blood caused by your intestines' inability to properly absorb vitamin B12. Your body needs vitamin B12 to produce red blood cells; therefore when your intestines lack the necessary protein needed to absorb the B12 (intrinsic factor), you develop pernicious anemia.

Causes of pernicious anemia can include a weakened stomach lining or an autoimmune system disorder that attacks the cells that make that protein. Additionally, individuals with the following diseases are at a higher risk for pernicious anemia:

• Addison's disease
• chronic thyroiditis
• Graves disease
• Crohn's disease
• hypoparathyroidism
• hypopituitarism
• myasthenia gravis
• type 1 diabetes, and
• vitiligo.

Symptoms of Pernicious Anemia

Symptoms of pernicious anemia vary greatly from one individual to the next but are generally mild in nature and include:

• diarrhea or constipation
• fatigue
• light-headedness upon standing
• loss of appetite
• difficulty concentrating, and
• shortness of breath.

Long-Term Effects of Pernicious Anemia

Long-term vitamin B12 deficiency can lead to damage to the nervous system. Symptoms can be permanent if treatment is not started within six months of initial symptoms; permanent symptoms may include:

• confusion
• depression
• loss of balance
• tingling and numbness in the hands and feet
• gastric cancer, and
• spinal cord degeneration.

A condition called subacute combined degeneration (SCD) of the spinal cord can occur after long-term vitamin B12 deficiency, which damages the nerves of the spinal cord. SCD can affect the brain and peripheral nerves as well, and as a result, affect one's ability to stand, balance, and walk effectively.

Qualifying for Social Security Disability

To qualify for Social Security Disability (either Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI)), you must prove that you either meet the requirements of one of Social Security's official disability listings or are unable to work due to your impairments. Also, your impairment must last or be expected to last at least twelve months.

Meeting a Disability Listing

You should submit all necessary evidence, including health records, to prove that you meet a listing in order to increase the likelihood of receiving benefits quickly.

Until May 2015, Social Security had a specific listing for subacute combined cord degeneration with pernicious anemia in its Blue Book, listing 11.16. To meet this listing, you had to prove you had:

• a diagnosis of pernicious anemia
• impairment in at least two of your extremities causing difficulty walking or using your arms and hands, and
• no significant improvement despite treatment.

In 2015, Social Security removed the disability listing for SCD and pernicious anemia, saying that the disorder generally doesn't remain at a severe level for 12 months. If, however, SCD does result in severe, long-term impairment despite medical treatment, Social Security says that SCD will be evaluated under the neurological listing 11.08 for spinal cord disorders. Under this listing, you would qualify for disability if you have extreme difficulty standing up from a seated position, balancing while standing or walking, or using the upper extremities. Alternatively, if you have severe physical difficulties along with cognitive, social, or concentration issues, you could also qualify under this listing.

For those with pernicious anemia without SCD, 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, or severe fatigue. You would also have to prove that you also have a severe limitation in:

• performing activities of daily living
• maintaining social functioning, or
• completing tasks in a timely manner because of problems with pace, persistence, or focus.

If your pernicious anemia is not as severe as either of these listings requires, but you have a condition secondary to another ailment, such as Addison's disease or diabetes, the underlying ailment may qualify under a listing in the Blue Book.

Proving You Are Unable to Work

If your pernicious anemia has advanced to the point that it interrupts your ability to work, you may be able to qualify for disability benefits even though you don't meet the disability listing. In assessing your ability to work, Social Security will look at your physical, mental, and sensory limitations in a Residual Functional Capacity (RFC) evaluation. Social Security may also consider your age, education level, and work experience in their determination of benefits.

For those with pernicious anemia, mild symptoms are not enough to prevent an individual from working at any job. However, if you have suffered permanent damage, it may hinder your ability to work. Here are some ways that damage from pernicious anemia can affect your ability to work.

• Loss of balance would affect your ability to perform physical tasks as work, such as lifting or carrying items.
• Tingling in your hands could affect your ability to do physical tasks that involve fine motor skills.
• Depression and confusion could affect your ability to start and complete tasks at work and properly interact with others at work.
• Tingling and numbness in your hands and feet could limit your ability to perform certain jobs due to safety concerns with lack of feeling in those areas.