Disability Benefits for Multiple Myeloma

How SSA Evaluates Multiple Myeloma Under Listing 13.07

SSA evaluates multiple myeloma, a cancer of the plasma cells in the bone marrow, under Blue Book listing 13.07. The diagnosis is confirmed by blood and urine protein tests or by bone marrow findings. The listing is met in these ways:

• Failure to respond or progressive disease — the myeloma does not respond to the initial course of anticancer treatment, or it continues to progress despite that treatment.
• Stem cell or bone marrow transplant — if your myeloma is treated with a transplant, SSA considers you disabled for at least 12 months from the date of the transplant, and then evaluates any lasting effects.

What This Means in Practice

Multiple myeloma is generally not curable, and most people need continuous or repeated treatment. If your myeloma progressed or did not respond to first-line therapy, you likely meet the listing. Beyond the listing itself, myeloma causes complications that are disabling in their own right: bone pain and fractures from the way the disease weakens bones, kidney damage, anemia that causes profound fatigue, high calcium levels, and a weakened immune system that leads to repeated infections. Nerve damage from the disease or from treatment drugs is common. SSA can evaluate these complications under other body-system listings or through a residual functional capacity assessment, so even a person whose myeloma is responding to treatment may qualify based on the damage already done.

Medical Evidence SSA Needs for a Multiple Myeloma Claim

Multiple myeloma claims are documented through laboratory, imaging, and treatment records:

• Diagnostic tests — serum and urine protein electrophoresis, free light chain assays, and bone marrow biopsy confirming the diagnosis.
• Response and progression records — lab values over time showing whether the myeloma responded to treatment or progressed, which is what the listing turns on.
• Imaging — skeletal surveys, MRI, or PET scans documenting bone lesions and fractures.
• Treatment records — chemotherapy and immunotherapy regimens, and transplant records with dates.
• Records of complications — kidney function labs, anemia, high calcium, infections, and neuropathy.

Because the listing depends on how the disease responded to treatment, a clear treatment timeline with lab results is especially valuable. Transplant dates should be prominent, since they establish the 12-month disability period.

Qualifying Through Complications and Function

If your multiple myeloma is responding to treatment and does not meet the listing outright, a residual functional capacity (RFC) assessment usually carries the claim, because the disease leaves lasting damage. Bone lesions and fractures limit lifting, bending, standing, and walking, and often cause chronic pain. Anemia causes fatigue that requires unscheduled rest. Kidney damage brings its own limitations, and peripheral neuropathy from the disease or from drugs reduces grip strength and the ability to stand or walk safely. A weakened immune system means workplaces with infection exposure must be avoided, and infections cause frequent absences.

SSA combines these limitations into an RFC and compares it to your past work. If you cannot return to your old job, the medical-vocational grid rules apply, based on your age, education, and skills. Claimants age 50 and older limited to sedentary work, or 55 and older limited to light work, are often found disabled. Frequent treatment visits and infection-related absences can rule out full-time work on their own.

Tips for a Stronger Multiple Myeloma Claim

Keep these points in mind:

• Build a treatment timeline. Show whether the myeloma responded to or progressed despite first-line therapy, since that is the heart of listing 13.07.
• Apply promptly after a transplant. The 12-month disability period starts on the transplant date, and benefits can continue if lasting effects persist.
• Document your complications. Bone fractures, kidney problems, anemia, and neuropathy can qualify you even when the myeloma itself is under control.
• Report bone pain and infections at every visit so they are consistently in the record.
• Keep imaging up to date, because new bone lesions and fractures are strong evidence of ongoing disability.