Aplastic Anemia

Definition

Aplastic anemia (AA) is a rare blood disorder that occurs when the body’s bone marrow does not make enough new cells to replenish blood cells. Although “anemia” usually refers to low red blood cell counts, in AA, white blood cell and platelet counts also are low. “Aplastic” refers to the inability of the stem cells to generate the mature blood cells.

General information

Aplastic anemia is most prevalent in teenagers and people in their early twenties. It also is common among the elderly. The disease can be caused by exposure to chemicals, drugs, radiation, infection, immune disease, and heredity. In about half the cases, the cause is unknown. AA symptoms may include:

  • Fatigue
  • Shortness of breath with exertion
  • Rapid or irregular heart rate
  • Pale skin
  • Frequent or prolonged infections
  • Unexplained or easy bruising
  • Nosebleeds and bleeding gums
  • Prolonged bleeding from cuts
  • Skin rash
  • Dizziness
  • Headache

Aplastic anemia may progress slowly over weeks or months, or it can come on suddenly. The illness may be brief, or it can become chronic. AA usually gets worse unless the cause is removed or the disease is treated.

Untreated AA has a high risk of death. Treatment, by drugs or stem cell transplant, has a five-year survival of about 70%. Younger ages are associated with higher survival rates. Survival rates for stem cell transplant vary depending on age and the availability of a well-matched donor. Five-year survival rates for patients who receive transplants has been shown to be about 82% for patients under the age of 20, about 72% for those 20 to 40 years of age, and closer to 50% for patients over the age of 40. Success rates are better for patients who have sibling donors and worse for patients who receive marrow from unrelated donors.

Older people who may be too frail to undergo bone marrow transplantation, and people who are unable to find a good bone marrow match but undergo immune suppression, have a five-year survival rate of up to 75%. About 10-15% of severe aplastic anemia cases develop into myelodysplastic syndrome and leukemia

Social Security Administration POMS DI 23022.929 — Aplastic Anemia

Confirming a diagnosis of AA requires a bone marrow biopsy. Normally, red blood cell, white blood cell and platelet levels stay within a certain range, so your physician, likely, will order blood testing, as well.

Aplastic anemia does not necessarily constitute a disability because treatment can be successful. Aplastic anemia with bone marrow or stem cell transplantation will be evaluated under SSA medical listing 7.17. Disability can be considered for 12 months following transplantation. Afterward, your condition will be evaluated according the characteristics of your residual impairment. In the case of a child, SSA medical listings 107.03 and 107.06 will be considered, in addition to 7.17.

Aplastic anemia is listed under the Social Security Administration’s (SSA) Compassionate Allowance Program, which was launched in 2008 to expedite certain disability claims. Applying for disability
benefits under the Compassionate Allowance Program requires the same procedure every applicant must follow when applying for SSA disability benefits; however, you will be notified if your condition is being considered as a compassionate allowance.

Your representative can help determine whether your aplastic anemia has advanced to the severity required for a successful disability claim. He or she may be able to help expedite your claim if you have a diagnosis of severe aplastic anemia