What this listing covers
Hemolytic anemia occurs when your body destroys red blood cells faster than it can replace them. This group of disorders includes congenital conditions like sickle cell disease and thalassemia, as well as acquired forms resulting from autoimmune issues or mechanical heart valves.
These conditions often cause severe fatigue, malaise, and pain that make sustaining a work schedule difficult. You may experience frequent periods of illness that prevent you from completing household chores, maintaining social interactions, or focusing on work tasks.
How SSA evaluates a claim under this listing
Under Listing 7.05, the SSA evaluates your anemia based on specific medical milestones. They look for documented painful vaso-occlusive crises requiring narcotic medication at least six times in 12 months, or complications necessitating at least three hospitalizations within 12 months.
They also consider laboratory evidence showing hemoglobin levels of 7 grams per deciliter or less occurring at least three times in 12 months, or a requirement for life-long red blood cell transfusions for beta thalassemia major. An attorney can help you organize your medical records to ensure your evidence meets these specific frequency and duration requirements.
Evidence that strengthens a claim
Your claim is strengthened by laboratory reports that confirm your diagnosis, such as hemoglobin electrophoresis or analysis of red blood cell enzymes. You should provide records of every hospital admission, including emergency department visits, that detail the specific complications treated.
Beyond lab results, gather evidence that documents the functional impact of your condition. Statements from your treating physician regarding your fatigue, pain levels, and inability to sustain concentration are vital. An attorney can help you gather the necessary physician statements to ensure your evidence is persuasive.
How an attorney helps
A disability attorney helps by ensuring your medical records directly align with the specific criteria in Listing 7.05 and can assist in obtaining detailed functional capacity statements from your doctors to explain how your symptoms limit your work performance, and an attorney can help you if your claim is denied by guiding you through the appeals process.
Frequently asked questions
Sickle cell disease may qualify under Listing 7.05 if it results in frequent painful crises requiring narcotic medication or repeated hospitalizations. You must document these events over a 12-month period to meet SSA requirements, and an attorney can help you ensure your documentation meets these thresholds.
SSA evaluates complications by looking at the frequency and duration of hospitalizations. They require at least three hospitalizations within a 12-month period, with each stay lasting at least 48 hours. An attorney can help you ensure your evidence clearly demonstrates the severity of your condition.
A denial is not the end of your claim. You have the right to request a reconsideration or a hearing before an ALJ. An attorney can help you identify why your claim was denied and prepare the necessary documentation for your appeal.
SSA prefers laboratory reports signed by a physician to establish a hematological disorder. If your reports are not signed, you should provide a supplemental report from your doctor that confirms the diagnosis and explains the diagnostic methods used. An attorney can help you gather the necessary physician statements to ensure your evidence is persuasive.
