HIV – Filing for SSD Benefits

by | Apr 17, 2015 | Law

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Clients living with HIV/AIDS can qualify for disability benefits from the Social Security Administration (SSA) through the Supplemental Security Income (SSI) program or by way of Social Security Disability Insurance (SSDI). Medical requirements are the same for both programs, which have varying criteria with respect to resources and needs.

The Social Security Act’s Title XVI authorized implementation of the SSI program. This program is a needs-based program for people who have HIV with low incomes. Title II of the Social Security Act provides authorization for the SSDI program, which requires that participants be at least 31 years old, and working for at least 10 years.

Initiating the Process

If you have HIV, you can start the application process for benefits after you quit work or find that your work hours are limited because of physical limitations or failing health. If clients meet both sets of program criteria, they can apply for both programs simultaneously. However, before application is made, it is best to consult with one of our SSD attorneys. He can assist you in making application and backing up the initial paperwork with the proper medical forms, lab tests, x-rays and MRIs.

SSDI/SSI Criteria

Disability for either the SSDI or SSI is defined as the inability of a claimant to work because of a medical condition. Individuals who are HIV positive are considered disabled if they can no longer perform any type of substantial gainful activity (SGA). This incapacity to work must be severe enough that the applicant will not be able to work for at least a year or his condition is such that it will eventually lead to death.

Some HIV Patients Do Not Have to Quit Working

Opportunistic infections that result from HIV generally are limiting enough to prevent a person from working. Therefore, the applicants who submit HIV disability claims usually obtain SSDI or SSI benefits. However, that being said, HIV does affect individuals differently. As a result, some HIV patients are not as impaired as others are, and therefore are able to work. Other clients, on the other hand, have weaker immune systems.

Determining Disability

The review process implemented by the SSA can be quite lengthy when it comes to HIV as the prognosis and severity differs from patient to patient. When the SSA determines an applicant’s level of disability, it looks at three major criteria.

These criteria include the claimant’s ability to partake in daily living activities, to socially interact and to complete work responsibilities on time. The SSA publishes a “blue book” that lists all the HIV-associated impairments that are considered severe by nature.

Some of the listings include bacterial infections, fungal infections, viral infections, skin or mucus membrane conditions, hematologic abnormalities, neurological conditions and HIV wasting syndrome. Chronic infections that require repeated treatment greatly increase one’s chance for being approved for SSI/SSDI benefits.