Applying for U.S. Disability Benefits with Thrombosis

Note: This blog post is published by Disability Benefits Help, which is unaffiliated with the World Thrombosis Day campaign. This post applies to disability benefits in the United States. For more information, visit www.disability-benefits-help.org/. 

If you are ill and unable to work, there may be financial resources available to you. Both adults and children can qualify for U.S. Social Security disability benefits if they have a physical or mental condition that leaves them unable to work and:

• Is expected to result in death OR
• Has lasted or is expected to last for at least one year

In addition to providing monthly disability payments, the U.S. Social Security Administration (SSA) facilitates access to Medicare, which is the United States’ basic health insurance program for people with disabilities and retirees over age 65. The SSA also offers access to Medicaid, which fulfills the health care needs of those with low income and minimal resources, such as children with disabilities.

Deep vein thrombosis (DVT) could qualify for disability benefits if your case is especially severe. The pain, swelling, and restricted blood flow caused by the clots can make standing painful and put you at risk for a pulmonary embolism or stroke. If your symptoms are so disruptive that you can’t maintain gainful employment, you may be eligible for disability benefits to help you cope with the reduced cash flow as well as provide you with unimpeded access to the medical treatment you need.

Receiving Disability Benefits With Thrombosis

To automatically qualify for SSA disability benefits, it is necessary for an applicant to meet a listing in the Blue Book, which is the SSA’s catalog of disabling conditions and their qualifying medical criteria. Deep vein thrombosis is not a listed condition, but one of its associated complications, chronic venous insufficiency (CVI) is referenced in Section 4.11.

CVI sets in when thrombosis causes enough damage to the veins in your legs to prevent blood from flowing properly to your extremities. To meet the eligibility requirements for this listing, you must have received a diagnosis of CVI and be currently experiencing one or more of the complications listed below:

• Major leg swelling accompanied by tissue discoloration and thickening (brawny edema)
• Burning, cramping or itching in your legs
• Wounds that fail to heal and keep returning after at least three months of treatment

To qualify for disability benefits under the CVI listing, you must submit a completed application form along with results of the following tests:

• Complete physical examination
• Venogram (X-ray imaging of your blood vessels)
• Duplex ultrasound, which tests the direction and speed of the blood flow in your veins
• D-dimers blood test
• Plethysmography test results, which measure blood volume changes in the extremities

Other potentially relevant documentation includes discharge summaries from hospital stays, prescription records, and physical therapy records.

Qualifying for Benefits With a Medical-Vocational Allowance

If you don’t have CVI, you may still qualify for disability with thrombosis. You will need to ask your doctor to fill out a residual functional capacity form (RFC) that the SSA will review to determine the extent to which chronic venous insufficiency has impaired your ability to work and function. An RFC reviews exactly how much physical labor you are capable of doing. You can download an RFC online for your doctor’s review. If your RFC analysis indicates that you are unable to maintain gainful employment, you may still qualify for SSD benefits under a medical-vocational allowance.

A medical-vocational allowance is the SSA’s way of acknowledging that while you do not meet a Blue Book listing, you still clearly deserve disability benefits. The SSA will review your medical documentation to evaluate how the symptoms of thrombosis hinder your ability to perform daily activities as well as functions related to jobs you are trained and qualified for.

If you have worked in the past, the disability examiner will classify your past jobs, determine the physical and cognitive demands involved and decide whether or not you can resume the same employment or successfully transition to some other type of work. If the SSA concludes that your symptoms leave you significantly impaired, you may be granted disability benefits under a medical-vocational allowance.

Applying for Social Security Disability Benefits

For more information about applying for SSA disability benefits in the U.S. when you are living with thrombosis, please visit the SSA’s website, or schedule an appointment at your closest Social Security field office by calling the SSA at 1-800-772-1213. Monthly disability payments will make it easier to support yourself and your loved ones as you continue with thrombosis treatments and therapies.