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If you have HIV / AIDS you may qualify for SSDI / long-term disability benefits.

Appealing for benefits is best done under the guidance of an experienced disability lawyer.

Can I get disability benefits if I am suffering from the effects of HIV / AIDS?

The SSA does have a specific listing for HIV. First you must provide medical evidence that you have tested positive. Additionally, an applicant must show evidence of one of a number of conditions to qualify, such as: Primary central nervous system lymphoma, Progressive multifocal leukoencephalopathy, Pulmonary Kaposi sarcoma and complications of HIV infection requiring a certain number of hospitalizations.
If your disability does not match Social Security’s listing, eligibility for benefits may still be possible based on the effects of medications taken.

Author: Attorney Lonnie Roach
Updated: 2/26/2024

HIV Aids disability lawyer

If you or someone you know has been diagnosed with HIV/AIDS, you may qualify to receive Social Security Disability (SSDI) benefits or Long Term Disability (LTD) benefits. Call 512-454-4000 to schedule your Free Consultation today.

HIV is listed specifically as an impairment in the SSA’s Blue Book under Section 14.11 and the best way to qualify for SSDI is to satisfy the requirements of that listing. You will need to provide medical evidence that you have tested positive for HIV and also meet the work requirements set out by the administration.

There is no cure currently for HIV or AIDS, but medications can control HIV and prevent complications.

Antiretroviral therapy or ART is a common treatment that combines three or more medications from different drug classes.

ART helps:

  •    keep the immune system strong
  •   reduces the chance of getting infection
  •   reduces the chance of developing treatments resistant to HIV; and
  •   reduces the chance of transmitting HIV to others

Demonstrating that you are following your doctor’s treatment plan is an important part of qualifying for disability benefits.

HIV or AIDS and Qualifying for Disability Benefits.

HIV is listed specifically as an impairment in the Social Security Administration’s Blue Book under Section 14.11 and the easiest way to qualify for Social Security Disability Income is to meet the requirements of that listing.

First, you will need to provide medical evidence that you have tested positive for HIV.

Social Security considers a variety of definitive laboratory tests when evaluating HIV:

  •    HIV antibody screening test
  •   HIV p24 antigen test
  •   HIV nucleic acid detection test
  •   Isolation of IV in viral cultures
  •   Any other tests specific for HIV and consistent with current medical knowledge.

Social Security will try to get results from your laboratory tests and other medical tests from your doctor or hospital, but if no acceptable documentation exists, Social Security may pay for you to have testing done.

You may also prove you are HIV positive through your medical history or a diagnosis of a disease that is common to those who are HIV positive and has no other cause.

There are several diseases and conditions commonly associated with HIV/AIDS, including:

  •    Pneumocystis pneumonia (PCP)
  •   Candidiasis (Thrush)
  •   Tuberculosis (TB)
  •   Cytomegalovirus
  •   Cryptococcal meningitis
  •   Toxoplasmosis

Additionally, an applicant must show evidence of one of the following to qualify:

  1.   Multicentric Castleman disease affecting multiple groups of lymph nodes or organs containing lymphoid tissue
  2. OR

  3.    Primary central nervous system lymphoma – lymphoma that originates in the eye, spinal cord, meninges, or brain
  4. OR

  5.    Primary effusion lymphoma
  6. OR

  7.    Progressive multifocal leukoencephalopathy – a neurological disorder that causes changes in mental function and personality
  8. OR

  9.   Pulmonary Kaposi sarcoma. – a severe lung disorder
  10. OR

  11.   Absolute CD4 count of 50 cells/mm3 or less.
  12. OR

  13.   Absolute CD4 count of less than 200 cells/mm3 or CD4 percentage of less than 14 percent, and one of the following (values do not have to be measured on the same date):
    1.  BMI measurement of less than 18.5; or
    2.  Hemoglobin measurement of less than 8.0 grams per deciliter (g/dL).
  14. OR

  15.   Complication(s) of HIV infection requiring at least three hospitalizations within a 12-month period and at least 30 days apart. Each hospitalization must last at least 48 hours, including hours in a hospital emergency department immediately before the hospitalization.
  16. OR

  17.   Repeated manifestations of HIV infection such as other mental or physical limitations, infections, or disorders that result in significant signs of HIV as well as limited functions of daily living, limited social functioning, or limitations in concentrating or completing normal tasks.

Long term disability lawyer

SuperLawyers rated Lonnie Roach – highly published lawyer for disability claims in Texas including HIV/AIDS claims.

If you have HIV or AIDS, yet your disability does not match Social Security’s listing, you may still be eligible for Social Security Disability benefits if the effects of medications you are taking severely affect your ability to function.

Social Security will consider the effectiveness of medications you are taking and the side effects of those medications, particularly adverse reactions. They will also look at the time and difficulty it takes to follow treatment, the length of treatment, and how treatment affects your mental functioning, so it is important for your doctor to note any difficulties you are experiencing. Some common side effects of HIV/AIDS medications include abdominal pain, nausea, vomiting, anemia, fatigue, general weakness, anxiety, depression and inability to concentrate.

“Once Social Security determines the limitations caused by your condition, they will employ a vocational expert to assess whether a person with these limitations is employable. Most vocational experts will find a person to be unemployable if their condition or the treatment rendered for the condition causes the person to regularly be absent two or more days a month or be “off-task” 15% or more of the workday.” – Lloyd Bemis Disability Attorney

Structured treatment interruptions called “drug holidays” are often prescribed by doctors for HIV/AIDS patients.

Social Security does not view these breaks as an indication that a patient’s medical condition has improved or that the patient is not following their treatment plan. If you have not had treatment in the past, but recently began treatment, Social Security may delay their determination to see how medications affect your functioning. If you are not taking any medications at all, you will probably not meet the criteria of the listing.

Social Security has some basic financial requirements.

Before you are eligible for Social Security disability benefits, you must satisfy some basic financial requirements. You must: 1) have a disability that has lasted or is expected to last 12 months; and 2) you must have worked in a job where you paid Social Security taxes long enough and recently enough; and 3) you must not earn more than Substantial Gainful Activity (SGA), which is $1,550 per month in 2024 for nonblind applicants and $2,590 per month for blind applicants.
Basic SSDI Requirements –>

If you are 55 or older or have another medical condition you may get approval.

Applicants who are 55 or older often fall under a grid rule, which means they are not expected to learn a new job.
Disability for those over 55 –>

You may also be eligible for Social Security Disability benefits if you have another medical condition.

One disorder alone may not meet the criteria of an impairment as stated in Social Security’s Blue Book, but if you have more than one medical condition, Social Security must consider how those health issues combined limit your ability to hold a job and perform necessary daily tasks.
Disability for Multiple Impairments –>

Should you file a claim?

If you believe that you meet Social Security’s medical and financial requirements, you should apply for benefits. If you are still unsure or would like to talk to someone, please contact us at 512-454-400. We are always ready to take your call and discuss your options with you free of charge. We are happy to help folks just like you find the best solution for their personal situation.

How do I file for Social Security Disability benefits?

Once you have decided to file a claim, you can take the first step and apply for Social Security Disability benefits in person at your local Social Security Administration office, online, or over the phone.
How to Apply for SSDI –>

Appealing denied benefits

Most who file are denied initially. That doesn’t mean you won’t qualify; you just need to file an appeal.
There are four steps to the Social Security appeal process.
SSDI Appeals Process –>

Do I need a disability attorney for SSDI?

You may certainly file a claim on your own, but evidence shows that your chances for approval are increased significantly if you have legal representation.
Do I need an SSDI attorney–>

What if I don’t qualify for SSDI?

If you haven’t worked long enough to earn enough work credits, or if you earn too much income, you may be eligible for disability benefits through another Social Security program, such as Supplemental Security Income (SSI), or from a long-term disability insurance plan through your employer or a privately purchased policy.
What is Supplemental Security Income or SSI?–>

I have long-term disability insurance – should I file a claim?

Absolutely – you should file a claim as soon as you become disabled.
LTD Disability Appeals Process–>

If you have HIV/AIDS and you are unable to work, you may be eligible for Social Security Disability benefits.

An experienced Social Security Disability attorney can review your case and help you file your claim, saving valuable time and improving your chances of approval.

best social security disability lawyer
Disability benefits are an important source of income for those who are unable to work. If you are not able to work due to accident or illness, you may be eligible for Social Security Disability or Long Term Disability benefits. If you have applied for benefits and been denied, contact the attorneys at Bemis, Roach and Reed for a free consultation. Call 512-454-4000 and get help NOW.

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"Words can not truly express the gratitude that I feel toward Mr. Lonnie Roach and his professional team. I give them an A+++. Very compassionate and prompt. Their priorities are first and foremost helping you succeed at your case. When you feel helpless, feeling like someone is on your side can mean the world to you. Thank you for working for the people."
-Amy K.

Attorney Lonnie RoachAuthor: Attorney Lonnie Roach has been practicing law for over 29 years. He is Superlawyers rated by Thomson Reuters and is Top AV Preeminent® and Client Champion rated by Martindale Hubbell. Through his extensive litigation Mr. Roach obtained board certifications from the Texas Board of Legal Specialization. Lonnie is admitted to practice in the United States District Court - all Texas Districts and the U.S. Court of Appeals, Fifth Circuit. Highly experienced in Long Term Disability denials and appeals governed by the “ERISA” Mr. Roach is a member of the Texas Trial Lawyers Association, Austin Bar Association, and is a past the director of the Capital Area Trial Lawyers Association (Director 1999-2005) Mr. Roach and all the members of Bemis, Roach & Reed have been active participants in the Travis County Lawyer referral service.

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