June 9, 2026

Archives for March 2010

How to Argue for Disability When Your Medical Condition Produces Good Days and Bad Days

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I received the following condition from a young lady named Sarah, who is living with a blood disorder called Diamond Blackfan Anemia.  This condition requires blood transfusions about every three weeks and results in good days and bad days over the course of a month.

She writes:  I have Diamond Blackfan Anemia, which is a bone marrow failure condition that requires chronic blood transfusions as my blood levels continue to drop each day.  Additionally I am on many medications for other complications from this condition.  I am 30 years old and have always worked, but it is now getting to the point where I can no longer do so.  My doctors have recommended I apply for SSDI and not work anymore.  My boss has cut my hours and I begin the process soon.

I am concerned about the kinds of questions I will be asked: “How far can you walk?” “How long can you sit?”, etc.  The truth is, right after I have a transfusion, it’s not a problem at all.  I am even able to exercise during those days.  But I get transfusions every three weeks.  In the 10 days or so before a blood transfusion, I can’t do much of anything.  I miss work frequently due to fatigue.  The transfusions themselves take a day or two to recover.  My question is, how do I answer these questions without hurting my chances of getting on disability?

I think that this question is relevant to any number of conditions that produced “good days” and “bad days.”  I think that the best strategy is to discuss the limitations that arise from your condition as they would affect your performance of work functions over the course of a month.   For example, in this case, Sarah might say “my condition requires me to obtain a blood transfusion approximately every 3 weeks.  Immediately after the transfusion I feel fairly good and I have sufficient energy to perform my job duties.  But by the end of the 2nd week after my transfusion, my energy level drops dramatically, I become extremely fatigued and I have a difficult time concentrating or getting through a workday without taking numerous unscheduled breaks.

In this particular case, Sarah should also reference Listing 7.02, which provides that a person who requires a blood transfusion once every 2 months or more often would qualify for disability on the medical record alone.

State Agency Adjudication Procedures

In this episode, I answer two questions that relate to activities in the State Agency adjudication offices:

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Question 1 is from a gentlemen named Ron, who writes “we received a letter from SSA it states that the medical requirements have been met for disability benefits.  then states we realize you stopped working on 10/05/2006 when they apply the SS rules to the medical evidence we find your condition did not prevent you from working until 3/19/2007. they says they have not made a decision about meeting non- medical requirements and they will shortly, what could that mean?”

Related reading about SSA date calculations:  http://bit.ly/ssa-dates

Question 2 is from a gentleman named Anthony who asks about the non-examining physicians who assist the State Agency adjudicators evaluate your medical records – “during 2002-2003 (possibly before & after), in the State of Florida there was much fear that Medical Disability Examiners were going to be outsourced… and/or were about to be outsourced —- can you comment via your reply?”