Hematological System

• Author: David A. Morton III
• Pages: 741-832

7-1

Chapter 7

Hematological System

Part I – Adults

§7.00 Hematological Disorders

§7.01 Category of Impairments, Hematological Disorders

§7.02 (Reserved)

§7.03 (Reserved)

§7.04 (Reserved)

§7.05 Hemolytic Anemias

§7.06 (Reserved)

§7.07 (Reserved)

§7.08 Disorders of Thrombosis and Hemostasis

§7.09 (Reserved)

§7.10 Disorders of Bone Marrow Failure

§7.11 (Reserved)

§7.12 (Reserved)

§7.13 (Reserved)

§7.14 (Reserved)

§7.15 (Reserved)

§7.16 (Reserved)

§7.17 Hematological Disorders Treated by Bone Marrow or Stem Cell Transplantation

§7.18 Repeated Complications of Hematological Disorders

Part II – Children

§107.00 Hematological Disorders

§107.01 Category of Impairments, Hematological Disorders

§107.02 (Reserved)

§107.03 (Reserved)

§107.04 (Reserved)

§107.05 (Hemolytic Anemias)

§107.06 (Reserved)

§107.07 (Reserved)

§107.08 Disorders of Thrombosis and Hemostasis

§107.09 (Reserved)

MEDICAL ISSUES IN SOCIAL SECURITY DISABILITY 7-2

§107.10 Disorders of Bone Marrow Failure

§107.11 (Reserved)

§107.17 Hematological Disorders Treated by Bone Marrow or Stem Cell Transplantation

Part III – Forms

§7.02F Chronic Anemia

§7.05F Sickle Cell Anemia or Variants

§7.06F Chronic Thrombocytopenia

§7.07F Hereditary Telangiectasia

§7.08F Coagulation Defects

§7.09F Polycythemia Vera

§7.10F Myelofibrosis

§7.15F Granulocytopenia

§7.17F Aplastic Anemia With Bone Marrow or Stem Cell Transplant

7-3 HEMATOLOGICAL SYSTEM §7.00

Form Reference:

See Forms 7.0x series to solicit treating source

medical information relevant to the above adult and cor-

responding child listings.

Part I – Adults

§7.00 HEMATOLOGICAL

DISORDERS

A. What hematological disorders do we evaluate

under these listings?

1. We evaluate non-malignant (non-cancerous)

hematological disorders, such as hemolytic ane-

mias (7.05), disorders of thrombosis and hemostasis

(7.08), and disorders of bone marrow failure (7.10).

These disorders disrupt the normal development and

function of white blood cells, red blood cells, plate-

lets, and clotting-factor proteins (factors).

2. We evaluate malignant (cancerous) hematologi-

cal disorders, such as lymphoma, leukemia, and

multiple myeloma, under the appropriate listings in

13.00, except for lymphoma associated with human

immunodeficiency virus (HIV) infection, which we

evaluate under 14.08E.

B. What evidence do we need to document that you

have a hematological disorder?

We need the following evidence to document that

you have a hematological disorder:

1. A laboratory report of a definitive test that estab-

lishes a hematological disorder, signed by a physi-

cian; or

2. A laboratory report of a definitive test that estab-

lishes a hematological disorder that is not signed by

a physician and a report from a physician that states

you have the disorder; or

3. When we do not have a laboratory report of a

definitive test, a persuasive report from a physi-

cian that a diagnosis of your hematological disorder

was confirmed by appropriate laboratory analysis

or other diagnostic method(s). To be persuasive,

this report must state that you had the appropriate

definitive laboratory test or tests for diagnosing

your disorder and provide the results, or explain

how your diagnosis was established by other diag-

nostic method(s) consistent with the prevailing state

of medical knowledge and clinical practice.

4. We will make every reasonable effort to obtain

the results of appropriate laboratory testing you

have had. We will not purchase complex, costly, or

invasive tests, such as tests of clotting-factor pro-

teins, and bone marrow aspirations.

C. What are hemolytic anemias, and how do we

evaluate them under 7.05?

1. Hemolytic anemias, both congenital and

acquired, are disorders that result in premature

destruction of red blood cells (RBCs). Hemolytic

disorders include abnormalities of hemoglobin

structure (hemoglobinopathies), abnormal RBC

enzyme content and function, and RBC membrane

(envelope) defects that are congenital or acquired.

The diagnosis of hemolytic anemia is based on

hemoglobin electrophoresis or analysis of the

contents of the RBC (enzymes) and membrane.

Examples of congenital hemolytic anemias include

sickle cell disease, thalassemia and their variants,

and hereditary spherocytosis. Acquired hemolytic

anemias may result from autoimmune disease (for

example, systemic lupus erythematosus) or mechan-

ical devices (for example, heart valves, intravascu-

lar patches).

[The applicable Listing of Impairments introduces

each chapter and is typeset in Helvetica. Author com-

ments follow each Listing subsection and are typeset

in Times.]

SSA Listings of Impairments

1. The hospitalizations in 7.05B do not all have

to be for the same complication of the hemolytic

anemia. They may be for three different

complications of the disorder. Examples of

complications of hemolytic anemia that may

result in hospitalization include osteomyelitis,

painful (vaso-occlusive) crisis, pulmonary

infections or infarctions, acute chest syndrome,

pulmonary hypertension, chronic heart failure,

gallbladder disease, hepatic (liver) failure, renal

(kidney) failure, nephrotic syndrome, aplastic

crisis, and stroke. We will count the hours you

receive emergency treatment in a comprehensive

sickle cell disease center immediately before the

hospitalization if this treatment is comparable to

the treatment provided in a hospital emergency

department.