1. These listings are only common examples of hematological disorders that we consider
severe enough to prevent a person from doing any gainful activity. If your disorder
does not meet the criteria of any of these listings, we must consider whether you
have a disorder that satisfies the criteria of a listing in another body system. For
example, we will evaluate hemophilic joint deformity or bone or joint pain from myelofibrosis
under 1.00; polycythemia vera under 3.00, 4.00, or 11.00; chronic iron overload resulting
from repeated RBC transfusion (transfusion hemosiderosis) under 3.00, 4.00, or 5.00;
and the effects of intracranial bleeding or stroke under 11.00 or 12.00.
2. If you have a severe medically determinable impairment(s) that does not meet a
listing, we will determine whether your impairment(s) medically equals a listing.
(See sections 404.1526 and 416.926 of this chapter.) Hematological disorders may be
associated with disorders in other body systems, and we consider the combined effects
of multiple impairments when we determine whether they medically equal a listing.
If your impairment(s) does not medically equal a listing, you may or may not have
the residual functional capacity to engage in substantial gainful activity. We proceed
to the fourth, and, if necessary, the fifth steps of the sequential evaluation process
in sections 404.1520 and 416.920. We use the rules in sections 404.1594, 416.994,
and 416.994a of this chapter, as appropriate, when we decide whether you continue
to be disabled.
7.01 Category of Impairments, Hematological Disorders
7.05 Hemolytic anemias, including sickle cell disease, thalassemia, and their variants (see 7.00C), with:
A. Documented painful (vaso-occlusive) crises requiring parenteral (intravenous or
intramuscular) narcotic medication, occurring at least six times within a 12-month
period with at least 30 days between crises.
B. Complications of hemolytic anemia requiring at least three hospitalizations within
a 12-monthperiod and occurring at least 30 days apart. Each hospitalization must last
at least 48 hours, which can include hours in a hospital emergency department or comprehensive
sickle cell disease center immediately before the hospitalization (see 7.00C2).
C. Hemoglobin measurements of 7.0 grams per deciliter (g/dL) or less, occurring at
least three times within a 12-month period with at least 30 days between measurements.
D. Beta thalassemia major requiring life-long RBC transfusions at least once every
6 weeks to maintain life (see 7.00C4).
7.08 Disorders of thrombosis and hemostasis, including hemophilia and thrombocytopenia (see 7.00D), with complications requiring
at least three hospitalizations within a 12-month period and occurring at least 30
days apart. Each hospitalization must last at least 48 hours, which can include hours
in a hospital emergency department or comprehensive hemophilia treatment center immediately
before the hospitalization (see 7.00D2).
7.10 Disorders of bone marrow failure, including myelodysplastic syndromes, aplastic anemia, granulocytopenia, and myelofibrosis
(see 7.00E), with:
A. Complications of bone marrow failure requiring at least three hospitalizations
within a 12-month period and occurring at least 30 days apart. Each hospitalization
must last at least 48 hours, which can include hours in a hospital emergency department
immediately before the hospitalization (see 7.00E2).
B. Myelodysplastic syndromes or aplastic anemias requiring life-long RBC transfusions
at least once every 6 weeks to maintain life (see 7.00E3).
7.17 Hematological disorders treated by bone marrow or stem cell transplantation (see 7.00F). Consider under a disability for at least12 consecutive months from the
date of transplantation. After that, evaluate any residual impairment(s) under the
criteria for the affected body system.
7.18 Repeated complications of hematological disorders (see 7.00G2), including those complications listed in 7.05, 7.08, and 7.10 but without
the requisite findings for those listings, or other complications (for example, anemia,
osteonecrosis, retinopathy, skin ulcers, silent central nervous system infarction,
cognitive or other mental limitation, or limitation of joint movement), resulting
in significant, documented symptoms or signs (for example, pain, severe fatigue, malaise,
fever, night sweats, headaches, joint or muscle swelling, or shortness of breath),
and one of the following at the marked level (see 7.00G4):
A. Limitation of activities of daily living (see 7.00G5).
B. Limitation in maintaining social functioning (see 7.00G6).
C. Limitation in completing tasks in a timely manner due to deficiencies in concentration,
persistence, or pace (see 7.00G7).