Listing 13.06 Leukemia in 2026

Leukemia is one of the few cancer listings in the SSA Blue Book that grants a specific, hard-coded automatic disability duration. Not a probability. Not a subjective assessment. A defined number of months from a defined trigger. That makes 13.06 one of the friendliest listings in Section 13.00 for claimants with a clear pathologic diagnosis.

Here is the verbatim rule text. Listing 13.06 covers Leukemia as follows. Paragraph A covers acute leukemia (including T-cell lymphoblastic lymphoma). SSA will consider you under a disability until at least 24 months from the date of diagnosis or relapse, or at least 12 months from the date of bone marrow or stem cell transplantation, whichever is later. Thereafter, SSA will evaluate any residual impairments under the criteria for the affected body system. Paragraph B covers chronic myelogenous leukemia (CML), as described in 1 or 2. B1 is accelerated or blast phase (see 13.00K2b(ii)). SSA will consider you under a disability until at least 24 months from the date of diagnosis or relapse. B2 covers chronic phase, as described in a or b. B2a says SSA will consider you under a disability until at least 24 months from the date of diagnosis. B2b covers progressive disease following initial anticancer therapy.

That is the whole rule. Two paragraphs, five sub-paths. Each gives you a fixed disability window that runs from a specific clinical trigger. Below I walk through each path, cover the diagnostic evidence SSA needs, explain how TKI-treated CML gets handled (the therapy that turned CML into a manageable chronic disease), and cover how post-transplant residuals extend disability past the 12 or 24 month window.

Why the fixed durations matter

Most disability listings require you to prove ongoing severity through subjective symptoms, functional testing, or complications. Leukemia is different. The 2015 revision of Section 13.06 codified specific disability durations because the acute phase of leukemia treatment is inherently disabling regardless of individual variation. You cannot work through induction chemotherapy. You cannot work through consolidation. You cannot work through the immediate post-transplant period. SSA acknowledged this by writing minimum guaranteed durations into the rule.

The word minimum matters. The rule says at least 24 months, not exactly 24 months. If your residuals continue past 24 months, disability continues. The rule uses the 24-month mark as the trigger for a CDR (continuing disability review), not as a termination date.

Roughly 62,770 new leukemia cases were projected in the United States for 2026 (AML about 22,000, ALL about 6,600, CML about 8,930, CLL about 21,000 (but CLL is evaluated under 13.05, not 13.06), and other/rare types about 4,000). About 24,000 deaths per year. Five-year survival is now about 66 percent overall, but that hides massive variation by subtype and age. AML in patients over 65 has 5-year survival near 10 to 15 percent. Pediatric ALL has 5-year survival above 90 percent. CML in TKI-responsive patients has near-normal life expectancy. CLL 5-year survival is 88 percent.

Paragraph A: acute leukemia and T-cell lymphoblastic lymphoma

Paragraph A covers every acute leukemia. That includes acute myeloid leukemia (AML) in all subtypes (M0 through M7 under FAB, or per the current WHO 2022 and ICC 2022 classifications), acute lymphoblastic leukemia (ALL) both B-cell and T-cell, acute promyelocytic leukemia (APL, which is AML with t(15;17) and PML::RARA fusion), acute myeloid leukemia with recurrent genetic abnormalities (AML with t(8;21), inv(16), NPM1 mutation, biallelic CEBPA, etc.), acute erythroid leukemia, acute megakaryoblastic leukemia, mixed phenotype acute leukemia (MPAL), acute leukemia of ambiguous lineage, and blastic plasmacytoid dendritic cell neoplasm (BPDCN).

The rule explicitly includes T-cell lymphoblastic lymphoma even though it presents as a lymphoma (mediastinal mass, no marrow involvement, or minimal marrow involvement below 25 percent). That is because T-LBL is molecularly and biologically identical to T-ALL, differing only by the site of predominant disease. If marrow involvement exceeds 25 percent, it becomes T-ALL by convention.

Diagnostic evidence SSA requires

The initial diagnosis of acute leukemia must be based upon a definitive bone marrow pathology report. That means a bone marrow aspirate and biopsy showing 20 percent or more blasts (WHO/ICC threshold), or the presence of AML-defining genetic abnormalities (like t(8;21), inv(16), t(15;17)) at any blast percentage. For ALL, blast percentage is not required as a threshold in the current WHO classification, but immunophenotyping must confirm B-cell or T-cell lineage.

SSA also accepts additional diagnostic information based on chromosomal analysis (karyotype and FISH), cytochemical stains (myeloperoxidase for AML, TdT for ALL, PAS for erythroid), surface marker studies by flow cytometry (CD34, CD117, CD13, CD33, MPO for AML; CD10, CD19, CD20, CD22, TdT for B-ALL; CD3, CD7, TdT for T-ALL), or molecular studies (FLT3-ITD, NPM1, IDH1/IDH2, CEBPA, TP53 for AML; BCR::ABL1, KMT2A rearrangements for ALL). Recurrent disease may be documented by peripheral blood, bone marrow, or cerebrospinal fluid examination.

The 24-month clock

The 24-month automatic disability window starts on the date of diagnosis. If you were diagnosed on March 15, 2026, your listing-level allowance runs through at least March 15, 2028. If you relapse during that window, the clock resets to the relapse date. If you relapse on August 10, 2027, your new window runs through at least August 10, 2029.

If you receive a bone marrow or stem cell transplant during the disability period, the alternate 12-month clock applies. The 12 months runs from the transplant date. Whichever period ends later (24 months from diagnosis, 24 months from relapse, or 12 months from transplant) controls. Example: diagnosed March 15, 2026. Transplant December 1, 2027. The 24-month diagnosis window runs to March 15, 2028. The 12-month transplant window runs to December 1, 2028. December 1, 2028 controls because it is later.

Paragraph B1: CML accelerated or blast phase

CML has three phases: chronic phase (about 85 percent of new diagnoses), accelerated phase, and blast phase (also called blast crisis). The distinction matters because accelerated and blast phase CML behave clinically like acute leukemia and carry a much worse prognosis than chronic phase CML.

SSA defines accelerated phase in 13.00K2b(ii) using the World Health Organization criteria in effect at the time of the rule adoption. Accelerated phase includes persistent or increasing WBC above 10,000 despite therapy, persistent or increasing splenomegaly despite therapy, persistent thrombocytosis above 1,000,000, persistent thrombocytopenia below 100,000 unrelated to therapy, clonal cytogenetic evolution (additional chromosomal abnormalities beyond the Philadelphia chromosome), blasts in blood or bone marrow of 10 to 19 percent, or basophils in blood or bone marrow of 20 percent or more.

Blast phase is defined as 20 percent or more blasts in blood or bone marrow (matching acute leukemia criteria), extramedullary blast proliferation, or large focal accumulations of blasts in the bone marrow biopsy.

Paragraph B1 grants 24 months of automatic disability from the date of diagnosis of accelerated or blast phase, or from the date of relapse into accelerated or blast phase from a prior chronic phase. This includes cases where chronic-phase CML on TKI therapy progresses to accelerated or blast phase because of TKI resistance (usually T315I mutation or compound BCR::ABL1 mutations).

Paragraph B2a: CML chronic phase

Paragraph B2a is the surprise-friendly path. Even chronic-phase CML with a good TKI response gets 24 months of automatic disability from the date of diagnosis. That is because the initial diagnosis period involves significant symptoms (fatigue, splenomegaly, cytopenias, TKI side effects during dose titration), and the response to therapy is not immediate.

The 24-month window starts on the date of chronic-phase CML diagnosis (confirmed by BCR::ABL1 by RT-PCR or FISH, or by t(9;22) Philadelphia chromosome on karyotype). After 24 months, SSA looks at your current status. If you achieved MMR (BCR::ABL1 IS at or below 0.1 percent), CCyR (complete cytogenetic response, meaning zero Ph+ metaphases), or DMR (deep molecular response, BCR::ABL1 IS at or below 0.01 percent, MR4 or better) and you are tolerating TKI therapy without significant residuals, your disability likely ends at the 24-month CDR. If you have not achieved MMR by 12 months (per NCCN guidelines) or you have significant TKI toxicities (grade 3+ diarrhea, pleural effusions with dasatinib, cardiovascular events with nilotinib or ponatinib, hepatotoxicity, prolonged cytopenias), disability continues.

Modern TKI options for CML

First-line TKIs include imatinib (400 mg daily), dasatinib (100 mg daily), nilotinib (300 mg twice daily), and bosutinib (400 mg daily). Second-generation TKIs (dasatinib, nilotinib, bosutinib) achieve faster and deeper responses than imatinib but carry more toxicity. Ponatinib is reserved for T315I-mutated disease or third-line use because of arterial thrombosis risk. Asciminib is the newest agent, an allosteric ABL1 inhibitor approved for chronic-phase CML after two prior TKIs or with T315I mutation.

Under the current 2026 clinical framework, most chronic-phase CML patients on a properly selected TKI achieve MMR within 12 to 24 months and have near-normal life expectancy. That is why the 24-month automatic window typically ends without extension for compliant, TKI-responsive patients. But it does not end automatically. The CDR requires SSA to affirmatively find that residuals no longer support disability.

Paragraph B2b: progressive disease after initial therapy

Paragraph B2b covers CML in chronic phase where initial therapy failed to control the disease. Failure can look like: no complete hematologic response by 3 months, no partial cytogenetic response by 6 months, no complete cytogenetic response by 12 months, no MMR by 18 months, loss of previously achieved response, or emergence of resistance mutations.

Unlike B2a which has a fixed 24-month window, B2b runs until adequate response is achieved on subsequent therapy. If you failed imatinib and now respond to dasatinib, B2b runs through your dasatinib response period. If you failed multiple TKIs and require transplant, B2b bridges you to the transplant window under Paragraph A rules (12 months post-transplant minimum).

Post-transplant residuals: the pathway past the 24-month or 12-month window

Bone marrow or stem cell transplant (BMT/HSCT) is a major intervention. The 12-month post-transplant automatic disability under 13.06A parallels the 12-month rule in Listing 7.17 for hematopoietic stem cell transplants. At 12 months, SSA reviews for continuing disability based on residuals.

Common post-transplant residuals that continue disability past the 12-month window include acute graft-versus-host disease (Grade 2 to 4, present in 30 to 50 percent of allogeneic transplants), chronic GVHD (present in 30 to 70 percent of allogeneic transplant survivors at 2 years, requiring long-term immunosuppression), prolonged cytopenias (thrombocytopenia below 100,000, ANC below 1000, requiring transfusion or G-CSF), CMV/BK/EBV reactivation with end-organ disease, PTLD (post-transplant lymphoproliferative disorder, 5 to 10 percent of allogeneic transplants), veno-occlusive disease (VOD/SOS), transplant-associated thrombotic microangiopathy (TA-TMA), pulmonary complications (BOOP, bronchiolitis obliterans syndrome, IPS), and long-term secondary malignancies. See our full breakdown of the 7.17 hematopoietic stem cell transplant listing for the full residuals framework.

Pre-diagnosis onset and treatment period

Acute leukemia patients often lose the ability to work weeks before formal diagnosis. Symptoms like fatigue, easy bruising, unexplained fevers, weight loss, and bone pain can precede the diagnostic marrow biopsy by 4 to 8 weeks or more. SSA allows a medical-vocational allowance for that pre-diagnosis period if you can document symptoms and functional limitations.

During the induction and consolidation treatment period, disability is universally accepted. Induction hospitalization typically lasts 4 to 6 weeks. Neutropenic nadir occurs 7 to 14 days after chemotherapy start and lasts 2 to 3 weeks. During nadir, patients are hospitalized or restricted to home isolation with severe activity limits. Consolidation cycles repeat every 3 to 4 weeks for 3 to 6 months. Even in optimal outcomes, patients cannot maintain any regular work schedule during this period.

Pediatric 113.06

Children with leukemia are evaluated under 113.06, which mirrors adult 13.06 in structure. Pediatric acute leukemia is dominated by ALL (about 75 percent of pediatric leukemia). Pediatric ALL has excellent survival (above 90 percent for standard-risk B-ALL) but requires prolonged multi-agent chemotherapy (2.5 to 3.5 years total for boys, 2 to 2.5 years for girls).

Under 113.06A, pediatric acute leukemia gets 24 months of automatic disability from diagnosis or relapse, or 12 months from transplant, whichever is later. Because pediatric ALL therapy runs 2 to 3.5 years, the 24-month window typically covers only the initial intensive phase plus consolidation. Maintenance phase (which involves oral chemotherapy and monthly clinic visits but is much less intensive) can continue disability past 24 months if the child has significant treatment toxicities (neuropathy from vincristine, avascular necrosis from steroids, cardiotoxicity from anthracyclines, cognitive effects from CNS-directed therapy).

Common denial reasons and how to counter them

Denial one: adjudicator says you achieved remission so you no longer meet 13.06. Counter: the rule grants at least 24 months from diagnosis regardless of remission status. Point to the rule text. Even MRD-negative patients with excellent response remain listing-level disabled through the 24-month window.

Denial two: adjudicator says your CML is on imatinib and you are working part-time, so you do not meet B2a. Counter: B2a grants 24 months automatic disability from diagnosis. Part-time work below SGA ($1,620 per month non-blind in 2026) does not disqualify you. If you exceed SGA, SSDI stops but the listing meet remains valid for the SSI or non-cash Medicare purposes.

Denial three: adjudicator says your transplant was over a year ago and you have no severe residuals, so disability ends. Counter: the alternate 12-month post-transplant window is a minimum. Look at total window: 24 months from diagnosis versus 12 months from transplant, whichever is later. Also check for subtle residuals (mild chronic GVHD, hypogammaglobulinemia requiring IVIG, chronic fatigue with reduced ECOG performance status).

Denial four: adjudicator misreads T-cell lymphoblastic lymphoma as a lymphoma under 13.05. Counter: the rule text specifically includes T-LBL under 13.06A, not 13.05. Point to the parenthetical in 13.06A. T-LBL and T-ALL are the same disease, evaluated together under leukemia rules regardless of presenting site.

State-level filing notes

Leukemia claims process quickly in most states because the pathology diagnosis is definitive and the listing is precise. CAL (Compassionate Allowance) fast-track designations that apply to leukemia include Acute Leukemia (all subtypes), Adult-Onset Peripheral T-Cell Lymphoma (which includes T-LBL under 13.06A), and Aplastic Anemia (which does not qualify under 13.06 but qualifies under 7.06). If your subtype matches a CAL condition, mark it on SSA-3368 for expedited processing.

Fastest state DDS processing for acute leukemia claims tends to be in Hawaii, Vermont, and North Dakota. Slowest tends to be in California, New Jersey, and Texas. Regardless of state, CAL flagging cuts processing to 15 to 30 days for clear cases.

Frequently asked questions

Next steps

If you have a confirmed diagnosis of acute leukemia (AML, ALL, T-LBL, APL, or any acute variant), CML in accelerated or blast phase, or chronic-phase CML, file your SSDI claim now. The listing is precise, the disability duration is codified, and CAL fast-track handles most cases in 15 to 30 days. Bring your bone marrow pathology report, cytogenetics and molecular results, treatment records, and any transplant documentation.

Related reading: Listing 13.05 Lymphoma, Listing 7.17 Hematopoietic Stem Cell Transplant, and Section 13.00 Cancer General Rules.