DI 34227.005 Hemic and Lymphatic Listings from 05/24/02 to 12/14/04
107.00 HEMIC AND LYMPHATIC SYSTEM
A. Sickle cell disease refers to a chronic hemolytic anemia associated with sickle cell hemoglobin, either
homozygous or in combination with thalassemia or with another abnormal hemoglobin
(such as C or F).
Appropriate hematologic evidence for sickle cell disease, such as hemoglobin electrophoresis
must be included. Vaso-occlusive, hemolytic, or aplastic episodes should be documented
by description of severity, frequency, and duration.
Disability due to sickle cell disease may be solely the result of a severe, persistent
anemia or may be due to the combination of chronic progressive or episodic manifestations
in the presence of a less severe anemia.
Major visceral episodes causing disability include meningitis, osteomyelitis, pulmonary
infections or infarctions, cerebrovascular accidents, congestive heart failure, genito-urinary
B. Coagulation defects . Chronic inherited coagulation disorders must be documented by appropriate laboratory
evidence such as abnormal thromboplastin generation, coagulation time, or factor assay.
C. Acute Leukemia (including T-cell lymphoblastic lymphoma). Initial diagnosis of acute leukemia or T-cell lymphoblastic lymphoma must be based
upon definitive bone marrow pathologic evidence. Recurrent disease may be documented
by peripheral blood, bone marrow, or cerebrospinal fluid examination. The pathology
report must be included.
The designated duration of disability implicit in the finding of a listed impairment
is contained in 107.11. Following the designated time period, a documented diagnosis
itself is no longer sufficient to establish a severe impairment. The severity of any
remaining impairment must be evaluated on the basis of the medical evidence.
107.01 Category of Impairments, Hemic and Lymphatic
107.03 Hemolytic Anemia. (due to any cause). Manifested by persistence of hematocrit of 26 percent or less despite prescribed
therapy, and reticulocyte count of 4 percent or greater.
107.05 Sickle Cell Disease. With:
A. Recent, recurrent severe vaso-occlusive crises (musculoskeletal, vertebral, abdominal);
B. A major visceral complication in the 12 months prior to application; or
C. A hyperhemolytic or aplastic crisis within 12 months prior to application; or
D. Chronic, severe anemia with persistence of hematocrit of 26 percent or less; or
E. Congestive heart failure, cerebrovascular damage, or emotional disorder as described
under the criteria in 104.02, 111.00ff, or 112.00ff.
107.06 Chronic Idiopathic Thrombocytopenic Purpura of Childhood. With purpura and thrombocytopenia of 40,000 platelets/cu.mm. or less despite prescribed
therapy or recurrent upon withdrawal of treatment.
107.08 Inherited Coagulation Disorder With:
A. Repeated spontaneous or inappropriate bleeding; or
B. Hemarthrosis with joint deformity.
107.11 Acute Leukemia (including T-cell lymphoblastic lymphoma). Consider under a disability:
A. For 2 1/2 years from the time of initial diagnosis; or
B. For 2 1/2 years from the time of recurrence of active disease.