Sickle Cell Anemia and Social Security Disability Benefits

Learn about your options for getting Social Security disability benefits based on sickle-cell anemia.

By , J.D. · Albany Law School
Updated by Diana Chaikin, Attorney (Seattle University School of Law)

Sickle cell anemia is a type of blood disorder that affects the shape of red blood cells. Normally, red blood cells are disc-shaped, but in people with sickle cell anemia, some blood cells are crescent-shaped (or "sickled"). These misshapen cells can get stuck in the vessels that carry blood throughout the body, preventing enough oxygen from reaching muscles and organs.

Sickle cells also break down more quickly than normal cells—they last between 10 to 20 days, compared with the usual 120 days—leaving a shortage of red blood cells, a condition called anemia. Anemia causes symptoms such as fatigue and dizziness that can limit your ability to complete your daily routine and work even simple jobs.

Is Sickle Cell Anemia a Disability?

Not all types of sickle cell disease result in anemia. Some types of sickle cell disease tend to cause milder symptoms, including HbSC (named for the affected genes that produce hemoglobin, a red blood cell protein) or HbS beta thalassemia. HbSS and HbS beta zero thalassemia genetic mutations, however, result in sickle cell anemia and cause more severe symptoms.

If symptoms from your sickle cell anemia are so severe that they prevent you from working full-time for at least twelve months, you can qualify for Social Security disability benefits.

Disabling Symptoms of Sickle Cell Anemia

While symptoms can vary greatly among people with sickle cell anemia, common chronic (ongoing) symptoms include:

  • pain in the abdomen, chest, and joints
  • shortness of breath and fatigue
  • excessive thirst and frequent urination
  • rapid heartbeat, and
  • poor eyesight.

In addition to the above chronic symptoms, people with sickle cell anemia can experience acute (sudden) episodes of intense pain called pain crises. A pain crisis can vary in frequency, length, and severity. There are four different types of crises:

  • Vaso-occlusive (thrombotic) crisis. This occurs when sickle cells get stuck in blood vessels and restrict blood flow to the organs, causing pain and organ damage.
  • Splenic sequestration crisis. This occurs mainly in children, when blood cells get stuck in the spleen (an organ that filters blood), and it requires immediate medical attention.
  • Aplastic crisis. This occurs when bone marrow—the part of your body that makes blood cells—suddenly stops producing red blood cells.
  • Hemolytic crisis. This occurs when a larger number of red blood cells are destroyed more rapidly than they can be produced.

Disabling Complications of Sickle Cell Anemia

Sickle cell anemia is associated with many other illness and disorders, including:

Be sure to document any medical treatment you've received for complications from sickle cell anemia. The Social Security Administration (SSA) is required to consider all of your medical conditions when determining whether you're disabled, either by meeting or equaling a listed impairment or by getting a medical-vocational allowance.

How to Get Disability Benefits for Sickle Cell Anemia

Sickle cell anemia is one of Social Security's listed impairments, meaning that you can get disability benefits if your medical records contain specific evidence that the agency has already determined is enough to prove that you're disabled. The evidence required for sickle cell anemia is set out in Listing 7.05, hemolytic anemias.

Meeting the Sickle Cell Anemia Disability Listing

If you have a diagnosis of sickle cell anemia, you can meet the requirements of Listing 7.05 in one of the following four ways:

  • You've needed to take intravenous or intramuscular narcotics to treat frequent pain crises (at least six times in the past year, with a minimum of 30 days between crises).
  • You've been hospitalized at least three times for sickle cell anemia complications in the past year. Each hospitalization can't be shorter than 48 hours and can't occur less than 30 days apart.
  • You regularly have low hemoglobin (defined as 7.0 g/dL or less) measured at least three times within a 12-month period, with each measurement at least 30 days apart, or
  • You have beta thalassemia major (the most severe type of hemoglobin deficiency) and will need lifelong red blood cell transfusions at least once every six weeks.

Your medical records should include the results of a test called hemoglobin electrophoresis—which measures the different types of hemoglobin in your blood—and a recent history of your hematocrit levels. (Hematocrit is the percentage of red cells in your blood.) Your records should also contain evidence of hospitalizations, as well as doctor's notes detailing the intensity, length, and frequency of your pain crises.

If you don't have the specific evidence required to meet the sickle cell anemia listing, you may be able to qualify under one of the related listings for hematological (blood) disorders. For example, if you've undergone bone marrow or stem cell transplantation, you'll qualify for disability automatically for one year under Listing 7.17.

Getting a Medical-Vocational Allowance for Sickle Cell Anemia

You can still get disability benefits even if you don't meet the sickle cell anemia (or any other) listing so long as you can show that symptoms from your disorder keep you from doing any job. The SSA will look at your medical records and your functional limitations in order to assess your residual functional capacity (RFC).

Your RFC is a set of restrictions that reflect what you can and can't do in a work setting. An RFC for someone with sickle cell anemia might include restrictions such as:

  • no standing or walking more than 2 hours out of an 8-hour day
  • no lifting or carrying more than 10 pounds occasional
  • avoid exposure to temperature extremes
  • would need to be off-task 25% of the time, and
  • would miss more than 2 days of work per month.

The more severe and extensive your symptoms are, the more restrictions you'll have in your RFC. For example, if you have pain crises that last for 5 days per month—documented in the medical records—then your RFC should state that you'd be absent from work 5 days per month.

Social Security will compare your RFC with the physical and mental demands of jobs you've done in the past. If you can't do your past jobs with your current RFC, the agency will then—depending on your age, education, and work experience—look to see whether other, easier jobs exist that you can do despite your limitations. For information on how this works, see our articles on how Social Security decides whether there are jobs you can do.

Disability Benefits for Children With Sickle Cell Anemia

Children with sickle cell anemia can qualify for benefits under the child listing (107.05). The requirements to meet the childhood listing are the same as those for adults. Children who don't meet the listing can still be found disabled if they "functionally equal" the listings. Social Security's policy ruling on sickle cell disease offers information and examples on how the SSA evaluates limitations on children's functioning.

Updated December 19, 2022

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