Nosebleeds Can Lead to The Need For Social Security Disability
Nosebleeds are common in dry climates and in winter. But for some individuals, nosebleeds can be a sign that there is a more severe physical problem at play. Individuals with Hereditary Hemorrhagic Telangiectasia (HHT) are prone to nosebleeds.
HHT is a disorder of the body's blood vessels. “Some of the networks of blood vessels that join arteries to veins (capillaries) aren't correctly formed. In small blood vessels, these abnormalities are called telangiectases. When they occur in larger vessels, they are called arteriovenous malformations (AVMs).” Nosebleeds are a very common symptom, but other symptoms include:
Shortness of breath
Telangiectasias, which are small red spots on the face, mouth, and fingers
HHT is a genetic blood vessel disorder. The “most commonly affected organs are the nose, lungs, GI tract, brain, and liver.” There are a number of genes involved and HHT is shown to run in families.
“A diagnosis of HHT can often be made based on a physical examination, results of imaging tests and a family history.” Doctors look for a number of criteria:
Recurrent nosebleeds that seem to start for no reason.
Visible telangiectases on lips, the inside of the mouth, on the fingers or nose.
Internal telangiectases or AVMs on the lungs, brain, digestive tract, or liver.
Family history of a parent, sibling or child with HHT.
Genetic testing can be used to identify the genetic cause of HHT and confirm a suspected diagnosis. To detect internal telangiectases, doctors may order x-rays, MRIs, CT scans, or echocardiograms.
There is no cure for HHT, but a number of treatments exist. If the individual suffers from nosebleeds and home remedies do not work, laser coagulation therapy may be used “around the margins of telangiectases to destroy and seal off the vessels that are bleeding.” Sometimes it is necessary to have septal dermoplasty where the “mucous lining of the nose is replaced with a graft of thicker skin.” Sometimes doctors will embolize or “block off an artery that carries blood to a malformed vessel. This is usually only effective for six to eight weeks because other arteries will replace the blocked one.”
If telangiectases on the skin begin to bleed, then laser coagulation therapy is commonly used.
“Bleeding in the stomach or the intestines is often difficult to treat due to the large number of telangiectases that may occur in the gastrointestinal tract. Telangiectases can be treated with laser, a heater probe, hormonal treatment or a combination of therapies. Anemia caused by blood loss is typically treated with iron supplements or blood transfusions.”
If an AVM is in the lung, then a doctor may perform a pulmonary angiogram to block the AVM before problems occur.
If an AVM is in the brain, then treatment “depends on the size, location, and how it was formed. Treatments include surgery, embolization, stereotactic radiosurgery and, in some cases, observation.”
When AVMs occur in the liver, then serious complications can arise. In rare cases, a liver transplant may be necessary.
Social Security Disability
Most individuals with HHT can live a productive life with proper treatments. There are individuals for which treatments are unsuccessful and they are unable to continue gainful employment. The Social Security Administration will consider HHT a disability if the individual has “a hemorrhage requiring transfusion at least three times during the 5 months prior to adjudication.”
Social Security Disability applications require extensive documentation on an applicant's medical condition. If you are considering applying for disability benefits, contact our experienced attorney to assist you.