Anemia is a condition that occurs when your blood does not have enough red blood cells, the main transporters of oxygen to the organs of the body. If your body is not getting enough oxygen, you may tire out easily, appear pale, feel tired, have a racing heart, be short of breath, lose your hair, or have a general feeling of not being well. Over time, anemia can also cause a worsening of existing heart problems.
Anemia affects different people in different ways. For those who have had a gradual reduction in red blood cells, their body may be able to handle the loss even if their red blood cell count is very low. Alternately, those who lose red blood cells quickly may show significant impairments. Those with illnesses that are already present, especially heart problems, may find that anemia makes their condition worse. And, of course, the severity of the anemia, and whether it responds to treatment, are key in determining whether anemia is disabling; for instance, severely low hemoglobin levels requiring frequent blood transfusions rise to the level of a disability.
There are three main types of anemia: anemia due to blood loss, anemia due to decreased red blood cell production, and anemia due to the destruction of red blood cells (called hemolytic anemia). Hemolytic anemia, such as sickle cell anemia or thalassemia, is analyzed under its own listing by Social Security; see our article on disability for sickle cell disease and thalassemia for more information. Pernicious anemia often results in spinal cord degeneration and can be analyzed as a spinal cord disorder, and aplastic anemia is analyzed as a bone marrow disorder. This article discussed chronic anemia due to other causes, such as iron or folic acid deficiency, cancer, AIDs, rheumatoid arthritis, Crohn's disease, gastrointestinal or menstrual bleeding, or bone marrow disease.
Social Security publishes disability listings for a range of serious conditions, and if you meet the requirements of a listing, you'll be automatically approved for disability. Social Security recently remove its listing for chronic anemia, listing 7.02. But for applications before May 2015, the old chronic anemia listing still applies. The criteria for this anemia listing required that the percentage of red blood cells in your blood (your hematocrit) be persistently 30% or less. You also needed to show that you had at least one blood transfusion every two months, on average.
In 2015, Social Security introduced a new listing that can apply to any adult blood disorder: listing 7.18, for repeated complications of hematological disorders. Severe, chronic anemia can qualify under this listing if it results in significant, documented problems like pain, shortness of breath, or severe fatigue, and if it causes a severe limitation in one of the following:
While this listing doesn't specify that blood tests are required, having documentation of low hemoglobin levels/low hematocrit is necessary to show that the symptoms and limitations required by the listing have a physiological cause. Likewise, evidence of blood transfusions helps to show the severity of the condition.
Alternatively, you can meet the requirements of a listing for an impairment caused by anemia, such as a cardiovascular listing or a respiratory listing. Also, anemia is often a result of an underlying condition that may meet a listing. For example, anemia can be caused by advanced kidney disease, which has its own listing.
Even if you don't meet the requirements of a disability listing, you may still be eligible for Social Security disability benefits if you can prove that you are unable to return to work because of reduced physical capacity. Anemia can greatly affect one's physical capacity. Fatigue, lack of endurance, and shortness of breath are some of the main symptoms that can cause an individual to not be able to perform a job. And physical demands of working such as walking and lifting may not be possible for individuals with anemia. Additionally, underlying health conditions that have led to the anemia, such as heart problems, may further prevent an individual from meeting the physical demands of any job.
To determine whether you can work, Social Security writes up your limitations on a Residual Functional Capacity (RFC) form. The agency then applies a predetermined formula to your RFC, along with your age, education, and work experience, to evaluate whether you should be deemed disabled. The key for disability claimants with anemia will be whether Social Security thinks they can do sedentary (sit-down) work. If they can, they will have a harder time getting disability benefits. For more information, see our article on how Social Security evaluates your ability to work.