How to Argue that Your Polycythemia Vera Diagnosis Equals Listing 7.09

Using a Listing Argument to Win
a Polycythemia Vera Case

  One way to win your Social Security disability case is to argue that you meet a “listing.”  The listings are detailed descriptions of medical conditions published by the Social Security Administration in the Code of Federal Regulations.  When you look at the table of contents for the listings, you will see that Social Security has broken down the body into fourteen (14) different systems.  For example, there are listings for the musculoskeletal system, the cardiovascular system, the digestive system, etc.  The listing for Polycythemia Vera may be found at Listing 7.09, within the general classification of hematological disorders.  Within this Hemic and Lymphatic System, you will find specific conditions and associated diagnoses.

Listing 7.09 - Polycythemia Vera -
Do You Meet the Listing?

  If your medical condition exists at listing level, you qualify automatically for disability benefits. Remember that Social Security’s definition of disability looks for a medical condition that prevents you from engaging in work-like activity.  If your condition exists at a listing level, Social Security presumes that your capacity for work would be so limited that you would not be able to work in a competitive work environment (8 hours a day, 5 days a week).  In the case of Listing 7.09, Social Security is looking for Polycythemia Vera with a certain level of complication (erythrocytosis, splenomegaly, and leukocytosis or thrombocytosis).

  Because listing level conditions automatically qualify you for benefits, Social Security has made the listings very difficult to meet.  Usually, but not always, listing level cases are identified at the initial and reconsideration levels of appeal and approved there.  However, the combination of delays in the evaluation process, and the complexity of many medical charts, and the relative rarity of a disease like PV, a viable listing level case of PV can easily slip thorough and end up before an ALJ at a hearing.

 

  The listing for Polycythemia Vera is short - the entire listing reads as follows:

7.09    Polycythemia vera (with erythrocytosis, splenomegaly, and leukocytosis or thrombocytosis). Evaluate the resulting impairment under the criteria for the affected body system.

Here are brief descriptions for the four complications identified in the listing:

  • Erythrocytosis - excess of red blood cells
     
  • Splenomegaly - enlargement of spleen often caused by excessive red blood cells being destroyed in the spleen
     
  • Leukocytosis - a raised white blood cell count, often associated with an infection
     
  • Thrombocytosis - excessive platelets in the blood, which can lead to blood clots

Because PV is a somewhat rare condition, there is a good chance that most affected claimants will be treating with a specialist, or at least with a physician who is familiar with this condition.  As such, it should not be difficult to get the treating doctor to complete a checklist that tracks the listing.

Ultimately to meet a the PV listing, you will need to show that your disease has caused some complication - either organ damage (such as damage to the kidneys, liver or heart) or a blood chemistry disorder.

By necessity, medical treatment of a PV patient involves blood work and the lab results will most likely track the extent and duration of your condition.

If my client has a cooperative physician I ask the doctor to fill out a checklist that tracks the listing or to write a brief narrative stating that his patient’s condition exists at listing level.

 

 
 
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