September 12, 2014

Social Security Disability Benefits for HIV/AIDS

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Acquired Immunodeficiency Syndrome (AIDS) is a disease that affects the body’s immune system.  AIDS is the last stage of the infection caused by the human immunodeficiency virus (HIV).  By attacking the immune system, HIV hinders the body’s ability to fight off infections.  HIV can be transmitted through sexual contact, exposure to infected bodily fluids, childbirth, or breastfeeding.

Some symptoms of HIV infection may include a flu-like illness appearing two to four weeks after exposure to the virus.  After this illness, there is usually a latency period, typically lasting from 3 years to over 20 years, in which the patient will have very few, if any, symptoms.  Near the end of the latency period, fever, weight loss, gastrointestinal problems, and muscle pains may occur.

Once HIV infection progresses to AIDS, more symptoms may occur.  These could include pneumocystis pneumonia, cachexia (HIV wasting syndrome), esophageal candidiasis, or respiratory tract infections.  People with AIDS also have a greater chance of contracting infections, viruses, and cancers.

In order to meet the Social Security Administration (SSA)‘s listing for HIV infection, you must  have documentation of laboratory testing showing you are infected.  You also must be able to show that you suffer from one of the following:

  • Bacterial infections: mycobacterial infections, nocardiosis, or salmonella (recurrent non-typhoid); or multiple recurrent bacterial infections requiring hospitalization or intravenous antibiotic treatment three or more times in a twelve (12) month period
  • Fungal infections: aspergillosis, candidiasis (at a site other than the skin, urinary tract, intestinal tract, or oral or vulvovaginal mucous membranes), cocidiodomycosis (at a site other than the lymph nodes),  cryptococcosis (at a site other than the lungs), histoplasmosis (at a site other than the lungs or lymph nodes), mucormycosis, or pneumonia (or extrapulmonary infection)
  • Protozoan or helminthic infections: cryptospridiosis, isosporiasis, or microsporidiosis, with diarrhea lasting for one (1) month or longer; extra-intestinal strongyloidiasis, or toxoplasmosis of an organ other than the liver, spleen, or lymph nodes
  • Viral infections: cytomegalovirus disease (at a site other than the liver, spleen, or lymph nodes), herpes simplex virus, herpes zoster, or progressive multifocal leukoencephalopathy
  • Malignant neoplasms: carcinoma of the cervix, Kaposi’s sarcoma with extensive oral lesions or involvement of the gastrointestinal tract, lymphoma, or squamous cell carcinoma of the anal canal or anal margin
  • Conditions of the skin or mucous membranes with extensive fungating or ulcerating lesions not responding to treatment
  • HIV encephalopathy characterized by cognitive or motor dysfunction that limits function and progresses
  • HIV wasting syndrome: involuntary weight loss of ten percent (10%) or more of weight or BMI, or other significant involuntary weight loss; with either chronic diarrhea or chronic weakness
  • Diarrhea: lasting for more one month or longer, resistant to treatment, requiring intravenous hydration or tube feeding
  • One or more of the following infections: sepsis, meningitis, pneumonia, septic arthritis, endocarditis, or sinusitis
  • Repeated manifestations of HIV infection: resulting in significant, documented symptoms or signs and one of the following at a marked level: limitation of activities of daily living, limitation in maintaining social functioning, or limitation in completing tasks in a timely manner due to deficiencies in concentration, persistence, or pace

Follow this link to the SSA’s website for more information on the listing for HIV infection.  If you do not meet the listing for HIV infection, you may still meet Social Security’s requirements to qualify for disability benefits.  You must be able to show that your symptoms from HIV infection in combination with any other mental or physical conditions you have prevent you from being able to perform a full-time job.

Documented medical findings are very important to your Social Security disability claim.  The SSA wants to see that you are receiving continuing treatment for your condition and that you have been diagnosed by a qualified medical provider. Progress notes, diagnoses, and testing by specialists  are often more helpful to your disability claim than records from your primary care physician.  You should be able to show that in spite of your best efforts to obtain treatment and comply with your doctors’ instructions, your symptoms are still severe enough to keep you from being able to work.

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