What is Leukemia?
Leukemia is a cancer that affects blood cells and blood-forming tissues. For this reason, it is sometimes called blood cancer. Leukemia usually affects white blood cells, also known as leukocytes or leucocytes, but it may also affect red blood cells and platelets. Leukemia cells outnumber normal cells in patients with leukemia.
Leukemia typically occurs in adults over the age of 55, but it is also the most common cancer in children under the age of 15. While leukemia can affect people of all ages, certain types affect children more than adults. For this reason, many people associate leukemia with childhood cancer.
Even with treatment, leukemia can cause incapacitating limitations and long-term disability. This is especially true for those diagnosed with acute leukemia. If you suffer from acute leukemia or any other form of leukemia that prevents you from working you may be eligible to receive long-term disability benefits or Social Security Disability benefits.
Types of Leukemia
There are multiple types of leukemia, some slow-growing (chronic leukemia) and others that progress much more quickly (acute leukemia). Acute leukemia subtypes can develop quickly and grow aggressively, requiring urgent treatment at diagnosis, whereas chronic leukemia may not require treatment for years. The type of leukemia is determined by the type of cell that is affected and the speed of progression. Some of the most common types of leukemia include:
- Acute Lymphocytic Leukemia (ALL)
- Also known as acute lymphoblastic leukemia, acute lymphocytic leukemia causes the bone marrow to produce an excessive amount of lymphocytes, a type of white blood cell, in the blood, lymph nodes, and bone marrow.
- Acute Myeloid Leukemia (AML)
- Acute myeloid leukemia causes the bone marrow to produce irregular myeloblasts, which are another type of white blood cell. It can also cause the production of irregular red blood cells or platelets.
- Chronic Lymphocytic Leukemia (CLL)
- Chronic lymphocytic leukemia has the same effect as ALL, but it progresses slowly, and it may not require treatment for years.
- Chronic Myelogenous Leukemia (CML)
- The majority of chronic myelogenous leukemia patients have a gene mutation called the Philadelphia chromosome, which is a swapping of DNA between it (chromosome 22) and chromosome 9.
Hairy cell leukemia is a rare form of leukemia that gets its name from the appearance of the leukemia cells when viewed under a microscope – the leukemia cells look hairy. Most leukemias result in a high number of white blood cells, but with hairy cell leukemia and large granulocyte lymphocytic leukemia (LGL leukemia), the number of white blood cells may be low.
Symptoms of Leukemia
Early symptoms of leukemia include fever, abnormal bruising, fatigue, headaches, infections, and excessive, easy bleeding. Other symptoms include pale skin, rashes, and enlarged liver, spleen, and lymph nodes. Joint pain and bone pain, often severe, are common as the disease progresses. Children with leukemia may not grow normally, suffering developmental delays.
Diagnosis of leukemia, as with most types of cancer, is dependent on diagnostic testing, particularly of the blood and bone marrow. The first part of the process is a clinical exam, where the patient’s symptoms and medical history are taken.
Diagnostic testing for leukemia includes:
- Blood tests
- Bone marrow biopsy
- Urine testing
- Lymph node biopsy
- Lumbar puncture
- Imaging testing such as MRI, CT scan, chest X-rays, and ultrasound
Further diagnostic testing may be necessary to determine which type of leukemia the patient has, as treatment plans vary. Diagnostic testing is often repeated to monitor the progression of the disease and the success and side effects of treatments such as radiation.
Leukemia must be treated, or it can become fatal. Even the types of leukemia that are not aggressive require monitoring. Early diagnosis is key to a successful recovery. Leukemia treatments have significantly improved, there are a variety of treatments used to treat the disease, and it is not the death sentence that one might imagine.
Treatment for leukemia is mainly chemotherapy. In aggressively growing leukemia, chemotherapy may be followed by radiation therapy. Other treatments include blood transfusions, a bone marrow transplant, or a stem cell transplant.
Even if treatment is successful, patients can experience symptoms for the rest of their lives and maybe considered disabled. For this reason, those currently treating leukemia and those that have survived the disease may qualify for disability benefits.
Evaluating Disability for People with Leukemia
Simply being diagnosed with a type of leukemia is not enough to qualify for disability benefits. Be sure to provide blood test results, bone marrow biopsies, and the results of any other diagnostic tests that confirm your leukemia diagnosis. The insurer or the SSA will need a Residual Functional Capacity (RFC) assessment that indicates how your symptoms affect and limit your life activities.
Leukemia can leave patients with severe fatigue and weakness, debilitating pain, vomiting, and digestive disorders. The immune system deficiencies that many patients develop can leave them prone to dangerous infections, which could prevent you from reliably reporting to work. Someone with a compromised immune system may not safely be exposed to disease, making professions that involve exposure such as nursing or childcare especially difficult.
Besides the symptoms of leukemia itself, the side effects of treatments can be debilitating. Chemotherapy can leave patients with cyclical vomiting, severe fatigue, and muscle weakness. A patient may not be able to work if they cannot get to a bathroom when needed or if the job requires muscle strength and dexterity. Many treatments, such as a stem cell transplant, require extended periods in the hospital or numerous trips to the treatment clinic.
Even if the person does not qualify for disability benefits for their leukemia alone, they may be eligible as a result of their other conditions. As such, you should submit medical evidence of any conditions that contribute to your inability to work. It is important to consider your total health when filing disability claims.
ERISA Long-Term Disability Benefits for Leukemia
Patients with leukemia may be unable to work because of their disease and its related complications. Patients who find themselves unable to work because of their leukemia should apply for long-term disability insurance benefits. The insurance company will review their medical evidence to see if they qualify under the terms of your specific disability insurance plan.
Definition of Disability
Most LTD plans consider a person disabled if they have a medical condition that causes them to 1) be unable to perform their work duties for the first two years of the policy and 2) be unable to complete the work duties of almost any occupation for the years following the initial 2-year period. Each LTD plan defines disability as slightly different, so look over your plan policy to see how your plan determines “disabled” before submitting any claims.
What the Insurance Company Needs from You and Your Medical Providers
You should tell the insurance company about any doctor that has treated you for your leukemia. However, your doctor cannot simply state that you are disabled. The insurance company will need to obtain all relevant medical records from each doctor to get the full picture of your health. These records include office notes, clinical exams, diagnostic tests, orders for chemotherapy or radiation therapy, and lab results. If for any reason they cannot get these records from your doctors, you should request them and provide them to the insurance company yourself.
You will need to provide proof of your diagnosis and your ongoing symptoms, as well as proof of how you are affected by your symptoms and any side effects of treatment such as chemotherapy and radiation therapy. Providing detailed documentation is key to a successful claim. Residual Functional Capacity (RFC) assessments determine how you are affected by the condition and what you can do despite your limitations. It is used to determine what jobs you may still be qualified to perform. Make sure that you are as honest as possible with your doctors so that they can complete an accurate RFC for you.
Social Security Disability Benefits for Leukemia
The Social Security Administration has identified certain types of cancer that will automatically qualify you to receive benefits for a leukemia Social Security Disability claim, but it has to be the right type of cancer. Social Security Disability Blue Book Listing 13.06 covers the criteria you must meet to receive disability benefits as a result of acute, chronic myelogenous, blast phase, and chronic leukemia:
13.06 Leukemia. (See 13.00K2.)
A. Acute leukemia (including T-cell lymphoblastic lymphoma). Consider under a disability until at least 24 months from the date of diagnosis or relapse, or at least 12 months from the date of bone marrow or stem cell transplant, whichever is later. Thereafter, evaluate any residual impairment(s) under the criteria for the affected body system.
B. Chronic myelogenous leukemia, as described in 1 or 2:
1. Accelerated or blast phase (see 13.00K2b). Consider under a disability until at least 24 months from the date of diagnosis or relapse, or at least 12 months from the date of bone marrow or stem cell transplant, whichever is later. Thereafter, evaluate any residual impairment(s) under the criteria for the affected body system.
2. Chronic phase, as described in a or b:
a. Consider under a disability until at least 12 months from the date of bone marrow or stem cell transplantation. Thereafter, evaluate any residual impairment(s) under the criteria for the affected body system.
b. Progressive disease following initial anticancer therapy.
Patients filing disability claims for their leukemia will have to prove that they are impacted in such a way that they cannot perform their old job or any job that they could be trained to work. Despite the severity of the condition, many leukemia claims are denied by the Social Security Administration (SSA). To qualify for Social Security Disability benefits, your condition must prevent you from working for one full year. Even after you are found to be considered disabled, the SSA has a mandatory 5-month waiting period before you are eligible to receive benefits.
Working with a Disability Attorney
Even if you have been denied benefits, your case is not over. Many people are denied benefits the first time they apply. You have the right to file an appeal and try to get more information that may help your case. Getting expert help is often the difference between being denied and being approved for benefits in a leukemia disability case. Working with an experienced disability lawyer will give you the best chance of getting the benefits you deserve for your leukemia disability claim.
Nick Ortiz is one of a small number of board-certified Social Security Disability attorneys in the country. We only charge a fee if your claim is approved – so if you do not get paid, our services are free. We also offer free case evaluations for cases that fall within our practice areas, so you can seek out help for free.
While the process can be daunting, your expert disability attorney will be able to guide you through the process and obtain the medical evidence to support your claim. They do not get paid until you win your case. You can seek help without worrying about upfront costs or unexpected bills.
The Ortiz Law Firm has successfully represented people with leukemia disability cases and has experience representing claimants across the United States. If you would like to talk to one of our experienced disability lawyers about your leukemia and its impact on your ability to work, call us at (888) 321-8131 or contact us online to schedule your free case evaluation. We would be happy to evaluate your case and discuss how to help you through the disability process.