If you have HIV / AIDS you may qualify for SSDI / long-term disability benefits.
Can I get disability benefits if I am suffering from the effects of HIV / AIDS?
Author: Attorney Lonnie Roach
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.
Human immunodeficiency virus (HIV) attacks cells that defend the body from disease and infection.
If untreated, HIV can develop into AIDS (acquired immunodeficiency syndrome) a potentially life-threatening condition. About 1.2 million people are living with HIV in the United States today and 14 percent are unaware that they have the disease.
HIV weakens the immune system by destroying CD4 T cells, the white blood cells that fight disease in the body.
The fewer CD4 T cells a person has, the weaker their immune system is. HIV can be transmitted through sexual behaviors or spread through contact with infected blood; for example, from mother to child during pregnancy, blood transfusions, or infected needles. A person cannot be infected by ordinary contact with another person nor is HIV spread through air, water or insect bites.
The first stage of HIV is known as the primary stage where most people experience flu-like symptoms lasting two to four weeks.
Signs and symptoms include:
- swollen lymph glands
- sore throat and mouth sores
- muscle aches and joint pain
- night sweats
The next stage is the clinical latent infection stage or chronic HIV.
Though the HIV virus is present during this stage, a person may not have any symptoms. This stage may continue for years if HIV has not been previously detected and the affected individual is not receiving antiretroviral therapy. As the virus continues to destroy immune cells, it develops into symptomatic HIV and mild infections and chronic indications appear.
- swollen lymph nodes
- weight loss
- oral yeast infection
In its final stage HIV progresses to AIDS, but because of better anti-viral medications and treatments most people who are infected with HIV do not develop AIDS.
If untreated, HIV will develop into AIDS in eight to ten years. At that point the immune system is severely damaged and an individual becomes more likely to develop infections and cancers that wouldn’t normally cause illness in a healthy immune system.
Contact a Social Security disability attorney at 512-454-4000 for a free consultation and see if you can get disability benefits while suffering from HIV. If you have been denied disability don’t give up!
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.
- 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
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)
- Cryptococcal meningitis
Additionally, an applicant must show evidence of one of the following to qualify:
- Multicentric Castleman disease affecting multiple groups of lymph nodes or organs containing lymphoid tissue
- Primary central nervous system lymphoma – lymphoma that originates in the eye, spinal cord, meninges, or brain
- Primary effusion lymphoma
- Progressive multifocal leukoencephalopathy – a neurological disorder that causes changes in mental function and personality
- Pulmonary Kaposi sarcoma. – a severe lung disorder
- Absolute CD4 count of 50 cells/mm3 or less.
- 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).
- 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.
- 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.
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.
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.
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.
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.
Author: 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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