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SSA Listing 7.05 Hemolytic Anemias

Hemolytic anemias encompass a group of blood disorders, including conditions like sickle cell disease, thalassemia, and their variants. These conditions can significantly impact an individual's health and quality of life. If you or a loved one is living with a hemolytic anemia and considering applying for Social Security Disability benefits, it's important to understand how the Social Security Administration (SSA) evaluates these conditions. In this blog post, we will explore the criteria outlined in listing 7.05 and how the SSA assesses disability claims for hemolytic anemias.

Evaluation Criteria for Hemolytic Anemias

To meet the requirements of listing 7.05, individuals must fulfill one of the following criteria:

  • Documented Painful (Vaso-Occlusive) Crises: The individual must have experienced documented painful crises requiring parenteral (intravenous or intramuscular) narcotic medication at least six times within a 12-month period, with at least 30 days between each crisis.

  • Complications Requiring Hospitalizations: The individual must have experienced complications of hemolytic anemia requiring at least three hospitalizations within a 12-month period, with at least 30 days between each hospitalization. Each hospitalization must have lasted for at least 48 hours, including any time spent in a hospital emergency department or comprehensive sickle cell disease center immediately before the hospitalization.

  • Hemoglobin Measurements: The individual must have hemoglobin measurements of 7.0 grams per deciliter (g/dL) or less at least three times within a 12-month period, with at least 30 days between each measurement.

  • Beta Thalassemia Major: The individual must have beta thalassemia major, a severe form of the condition requiring lifelong red blood cell (RBC) transfusions at least once every 6 weeks to sustain life.

Considerations for Disability Determination

When evaluating disability claims for hemolytic anemias under listing 7.05, the SSA takes into account the following factors:

  • Medical Documentation: Comprehensive medical records, including detailed reports from treating physicians, diagnostic tests, treatment plans, and hospitalization records, are crucial in supporting the presence and severity of the hemolytic anemia and its related complications.

  • Frequency and Duration of Crises or Hospitalizations: The SSA evaluates the frequency and duration of painful crises or complications requiring hospitalizations. It is important to provide medical evidence that demonstrates the occurrence of crises or complications, the need for medical intervention, and the impact on the individual's daily functioning and ability to work.

  • Hemoglobin Levels: For individuals meeting the hemoglobin measurement criterion, providing multiple laboratory test results showing hemoglobin levels of 7.0 g/dL or less helps support the severity of the anemia and its impact on the individual's health.

  • Treatment Compliance: Compliance with prescribed treatments, including medication regimens, transfusions, and other necessary interventions, is an essential factor in evaluating disability claims. The SSA considers whether the individual has followed the recommended treatment plan and made efforts to manage their condition effectively.

Understanding how the SSA evaluates hemolytic anemias under listing 7.05 is crucial for individuals seeking Social Security Disability benefits. Gathering comprehensive medical evidence, including detailed reports from treating physicians, diagnostic tests, and hospitalization records, is vital to support the presence and severity of hemolytic anemias and their related complications. Working with a qualified disability advocate or attorney can provide invaluable guidance throughout the application process, increasing the chances of a successful disability claim.