What If I Take A Drug Holiday
Structured treatment interruptions, also known as “drug holidays,” aren’t recommended for patients outside of a clinical trial . Social Security wants to see that you’re taking all your medications regularly and following your treatment as prescribed, or they might deny you benefits because you didn’t follow your doctor’s recommendations.
But if you’re having serious adverse side effects from your medications and you stop taking them for a short period of time, the SSA likely won’t hold it against youâas long as you tell your doctor about the side effects and you both work together to find a more tolerable treatment.
If the SSA thinks your record shows a pattern of not taking your medications properly, though, the agency can deny your claim.
What To Do If Youve Been Subjected To Discrimination
In the event youve been discriminated against in the workplace as a result of HIV, contact your nearest Equal Employment Opportunity Commission . Charges must be laid within 180 days of the alleged infraction. Upon investigation, the EEOC may either act to correct the infringement or issue a right to sue letter to the employee. To learn more or to find the EEOC office nearest you, telephone 800-669-4000 or visit the EEOC website.
The Job Accommodation Network , a service provided by the U.S. Department of Labor, can offer free advice to employers and people with disabilities on reasonable accommodation in the workplace. Telephone 800-526-7234, or visit the for accommodation advice for people with HIV.
If discrimination has occurred in a public accommodation, contact the U.S. Department of Justice at 800-514-0301, or visit the ADA HIV/AIDS portal for information on how to file a DOJ complaint.
Applying For Ssi: Advance Payments
If you’re applying for SSI and have an HIV infection with some severe symptoms, you may qualify for “presumptive disability benefits,” which means you would get immediate payments of disability payments while you wait for a final decision on your disability benefits. Find out more in Nolo’s article on presumptive disability.
Read Also: What Does Undetectable Hiv Mean
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 patients 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.
Medical Evidence Required To Show Hiv Infection
First, a diagnosis of HIV infection must documented by certain laboratory tests that are considered medically definitive. The SSA requires specific documented, positive HIV tests. The listing for HIV infection outlines the various ways that HIV infection is allowed to be documented:
- HIV antibody tests
- isolation of HIV in viral culture, and
- other highly specific laboratory tests that are used to diagnosis HIV.
Individuals who have HIV infection often have their T-helper lymphocyte blood counts taken, because an HIV infection destroys CD4 cells and a low CD4 count can show susceptibility to opportunistic diseases. However, a low CD4 count alone does not establish an HIV infection.
If you don’t have one of the above blood tests, you may be able to prove you have an HIV infection if you have an opportunistic disease or cancer that commonly appears in HIV-positive people.
Also Check: What Is Hiv Rna Early Detection
Qualifying For Disability Benefits With Aids
HIV becomes AIDS when CD4 cell count drops below a specific level. The CD4 cell, also called a T-cell is a white blood cell that is important in your immune systems ability to fight off illness. Although AIDS is different than HIV, it still falls under the same Blue Book Listing as HIV. For someone with AIDS, section 14.11 G of the Blue Book is most relevant. The criteria is:
Absolute CD4 count of less than 200 cells/mm3 or CD4 percentage of less than 14 percent, and one of the following:
-
BMI measurement of less than 18.5 or
-
Hemoglobin measurement of less than 8.0 grams per deciliter.
This criteria is important because of the CD4 threshold of 200 cells/mm3. This CD4 count is the same number that differentiates HIV and AIDS. Therefore if you have been diagnosed with AIDS, you will likely be able to qualify if you have a low BMI or hemoglobin measurement. Keep in mind this isnt the only way to qualify. You can still qualify if you meet the HIV listing criteria.
Symptoms Of Ptsd Include:
- Intrusive thoughts: flashbacks, distress when exposed to symbols of the trauma, recurrent and involuntary memories, nightmares.
- Avoidance of stimuli associated with the event: avoiding the place where the event occurred, avoiding thoughts and feelings associated with the event.
- A significant mood change experienced after the event: detachment from others, blaming oneself for what happened, persistent negative emotional state, decreased interest in significant activities.
- A shift in reactivity associated with the event: increased irritability, hypervigilance, sleep disturbance, exaggerated startle response, problems with memory or concentration.
In order to meet the criteria for a PTSD diagnosis, you must experience symptoms from all of the above categories for more than one month. The above symptoms must also cause a significant disturbance or impairment in social, occupational, or other areas of daily functioning. Individuals with PTSD are also often diagnosed with other mental health conditions, such as anxiety and depression.
You May Like: What Does The Word Hiv Mean
Social Security Benefits For Aids Patients
Social Security disability benefits are available to those with AIDS or are HIV positive. But, just having the diagnosis is not enough. The individual must show that their symptoms limit their ability to work. As mentioned above, some people with HIV remain free of symptoms for years and manage the virus with medication. In these cases, the Social Security Administration will not approve benefits.
Once an HIV infection has defeated the immune system enough, the body becomes a host for opportunistic illnesses. A claimant who has reached this point is typically in Stage 3 and has been diagnosed with AIDS. At this point, the person likely has problems that prevent them from working.
Is Hiv Considered A Disability
The SSA definition of a disability might differ from some other generally accepted definitions. The SSA definition is specific and being HIV positive is not automatically considered disability.
For any condition to be considered a disability by the SSA, it must make it impossible for you to earn enough money through a job to support yourself. This monthly income level is called substantial gainful activity.
In 2020, the substantial gainful activity amount is $1260 for non-blind individuals. This number is $2110 for blind individuals. Therefore, in order for HIV to be considered a disability by the SSA, the symptoms that you have must leave you unable to earn substantial gainful activity.
Another condition that must be met in order for HIV to be considered a disability is that it is not possible to earn money by learning a new skill or changing jobs. This will take into consideration things like age and employment history.
For example, if you have worked the same job for 20 years before you became disabled, it would be more difficult to learn the skills required to change jobs at that point in your life. For someone who becomes disabled at a younger age, or has worked in multiple fields it will be easier to make a transition.
Although there is very specific criteria that must be met in order to qualify for disability benefits, the SSA provides clear definitions of those guidelines.
Recommended Reading: How To Get Rapid Hiv Test
What Is Ssas Definition Of Disability
The Social Security Administration has a very strict definition of disability. While some insurance programs give money to people on a short-term basis, Social Security does not.
You are only considered disabled by Social Security if you are unable to do any substantial gainful work activity because of a medical condition, that has lasted or can be expected to last, for at least 12 months. Learn more about SSAs definition of work here. Additionally, you can also be found disabled if your medical condition is expected to result in death.
There are two types of disability benefits your can receive: Social Security Disability Insurance benefits and/or Supplemental Security Income benefits . You can receive one or both benefits.
To find out more about the differences between SSDI and SSI, read here. Go here to learn how to apply for disability benefits. Likewise, if you need help obtaining the application or appeal forms, then read here. With both types of benefits, past due benefits tie to the date of your application. That is why it is important to file your disability application as soon as you know you are not returning to work. To learn more about past due disability benefits read here.
Immune Deficiency Disorders Excluding Hiv Infection As Described In 1400e With:
A. One or more of the following infections. The infection must either be resistant to treatment or require hospitalization or intravenous treatment three or more times in a 12-month period.
1. Sepsis or
6. Sinusitis documented by appropriate medically acceptable imaging.
B. Stem cell transplantation as described under 14.00E3. Consider under a disability until at least 12 months from the date of transplantation. Thereafter, evaluate any residual impairment under the criteria for the affected body system.
C. Repeated manifestations of an immune deficiency disorder, with at least two of the constitutional symptoms or signs and one of the following at the marked level:
1. Limitation of activities of daily living.
2. Limitation in maintaining social function.
3. Limitation in completing tasks in a timely manner due to deficiencies in concentration, persistence, or pace.
You May Like: What Is Hiv Positive But Undetectable
Medical Evidence You Need To Win Aids Disability Benefits
Medical reports you provide to the SSA should include a thorough description of your medical history. This includes information on your HIV diagnosis, onset, duration, and prognosis. It is important to describe the full clinical course of your illness, as that will help the SSA determine when the HIV infection and other associated conditions became disabling.
Establishing the correct disability onset date is important because it may affect when cash benefits and Medicare coverage begin. Find out more information about Medicare benefits here.
Your medical records should also describe the standard positive and negative findings of a thorough physical examination. Progress notes that document your doctors findings are also helpful. Your reports should include all clinical findings and laboratory findings, including any results of HIV testing.
A diagnosis of HIV infection that is not supported by laboratory test results should be explained. Find out how to support your AIDS disability case with free medical records here. If you have other conditions, like mental impairments such as Depression, you need to include those records too.
Group Disability Insurance For People With Hiv
Many employers offer disability insurance as part of the employee benefits package. Group insurance policies may be either short-term or long-term disability insurance, and both types of coverage may pay benefits for pre-existing conditions. These are guaranteed issue policies, meaning that you get covered as long as youre part of the group.
Check your policy to be certain. Sometimes, disabilities caused by certain pre-existing conditions, including HIV and AIDS, will be excluded from coverage. In other cases, you may have coverage for disabilities caused by HIV and AIDS, but only if youve worked for the company for a predetermined period of time, usually one year.
Five states require employers to provide short-term disability insurance: California, Hawaii, New Jersey, New York, and Rhode Island. Puerto Rico also mandates such coverage.
Don’t Miss: When Was Magic Diagnosed With Hiv
Inflammatory Arthritis Lupus Inflammatory Bowel Disease And Type 1 Diabetes Mellitus Are Examples Of Autoimmune Diseases
Immune deficiency diseases, such as AIDS and Severe Acute Respiratory Syndrome , decrease the bodys ability to fight toxins and infections. Immune system disorders can cause recurrent infections or dysfunction of the bodys organs and tissues that affect a single organ or two or more organs, resulting in moderate to severe limitations and loss of function. Classic symptoms of immune system disorders include fever, fatigue, musculoskeletal pain, malaise and involuntary weight loss.
Evidence Provided By You
Your insurance company will also take into consideration your own information, documentation, and statements. Medical records do not always encompass all the ways your HIV symptoms interfere with your occupational duties. Other evidence you can submit with your claim includes:
- A job description, written in your own words, with notes indicating how your symptoms have impacted your ability to perform each required task.
- A symptom diary, in which you detail the nature of your symptoms and the impact of those symptoms on your daily life, over an extended period of time.
- A personal statement. To support your claim, you can write a personal statement explaining the onset of your HIV, your symptoms, and the ways they prevent you from working. For example, if your HIV-related fatigue is severe, you may have trouble focusing for extended periods of time, arrive late to work from oversleeping, miss deadlines, or make mistakes on projects you ordinarily wouldnt. Make sure to cite specific examples of your symptoms impacting your ability to work. The more detailed, the better.
Also Check: Can I Get Hiv From Oral
Can You Receive Disability Benefits For Hiv Or Aids In Arkansas
We Fight for Injured Victims in Arkansas Every Single Day
For many individuals with a severe disability, impairment, or disease, the decision to stop working can be a difficult one or one that you have no control over. These circumstances can also leave you worrying about how to pay bills and support yourself. Luckily there is some support available from the federal government through the Social Security Disability Insurance and Supplemental Security Income programs. While the program requirements for eligibility differ between the two programs, the medical grounds for eligibility are similar and applicants with HIV or AIDS can often get benefits through either program. An experienced Fayetteville, AR disability lawyer like Ken Kieklak can guide you through the process of filing a disability claim in Arkansas for HIV/AIDS.
Is Hiv Or Aids Considered A Disability
One way to qualify for social security disability is by meeting SSA’s listing requirements for HIV in the Immune System Disorders section of the Blue Book. The Blue Book is SSA’s manual, written for doctors with expertise to understand complex medical terminology. Your doctor can help determine if you meet SSA’s Blue Book listing requirements to be approved for SSDI benefits. To qualify through the Blue Book, your HIV must be advanced and cause significant and frequent symptoms despite treatment.
The Social Security Administration needs to see through your medical records that you at least have one of the following:
-
You experience frequent or persistent bacterial, fungal, viral, or parasitic infections
-
Youve developed cancer and that the cancer is advanced or terminal
-
There is fluid collecting on the brain or brain swelling that causes severe disruption in your ability to think or move effectively
-
Youve had severe weight loss
-
Uncontrolled and persistent diarrhea has required you to have IV fluids and nutrition via a feed tube for a month or longer
-
You experience other types of infections that require hospitalization, IV therapy, or which are resistant to treatment
-
Your frequent infections and other complications have severely compromised your activities of daily living , also called ADLs.
If youre unable to definitively meet the requirements mentioned above, then youll have to proceed through additional stages to determine if your eligible for disability benefits.
Also Check: Can You Have Hiv Without Symptoms
How Do You Know If You Qualify For Ssdi
Social Security Disability Insurance benefits are for people who have worked and paid taxes. You may qualify for SSDI if:
- Youve worked and paid Social Security taxes.
- Youve worked at least 5 of the 10 years before you became disabled. This could be fewer years the younger you are.
- You cant do any job, not just the one you had.
- Youve been disabled and off work for at least 5 months.
- You expect your situation to last for 12 months or longer or to result in death.
How much you get paid on a monthly benefit depends on your past earnings and how long youve been covered under Social Security. Go here for more information about earnings and the amount of your disability benefit. After 24 months of receiving SSDI, youll also qualify for Medicare benefits.
If you have not worked or did not pay taxes, or both, then you may be eligible for apply for Supplemental Security Income benefits. In order to win these benefits, you must be disabled and meet SSAs income and asset requirements.
If you need to find out more about SSI benefits, read here. SSI benefits come with Medicaid. Medicaid covers a variety of healthcare services and medications. Go here to learn more information about Medicaid benefits.
Definitive Documentation Of Your Hiv Infection
The SSA will also require definitive documentation of the manifestations of your HIV/AIDs infection. This includes positive findings on definitive laboratory tests, such as culture, microscopic examination of biopsied tissue or other material , serologic tests, or on other generally acceptable definitive tests.
Don’t Miss: How Hiv Virus Enters The Body
Q: I Have Been Hiv Positive For About Three Years And The Standard Treatment With Retroviral Drugs Is No Longer Working For My Case Can I Get My Ssdi Application Approved More Quickly Through The Compassionate Allowances Program
For the last 30 years we have been fighting against the threat of AIDS.
When the disease emerged in the mid-1980s, some doomsayers predicted a mass epidemic that would devastate the human race. Some experts ventured that medical science would develop a cure shortly. Neither forecast was accurate. For three decades, we have waging a battle to limit the ravages caused by HIV infection, but there are no signs that a final victory is at hand.
Were very sorry to hear that retroviral drug therapytypically the favored treatment optionisnt working for you. We hope you have better luck with other therapeutic options. But were not doctors, were lawyers, and were better positioned to talk about the law behind federal disability benefits.
As you know, the Social Security Disability Insurance program was established to provide workers with a source of income when they are too disabled to function at their jobs. However, the Social Security Administration is a little quirky when it comes to defining what counts as a disability. The standard reference is called the Blue Book, a collection of listings for various ailments. If the medical evidence submitted along with an SSDI application shows that a person meets the standards of the Blue Book listing, the applicant will be notified that he is considered disabled. If his application also meets other rules on income and work experience, he will be accepted for SSDI benefits.
Related Links: