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Qualifying for Social Security Benefits With HIV or AIDS

If you are living with HIV or AIDS, you might be eligible for financial aid. The Social Security Administration (SSA) offers monthly disability benefits for people in need. While HIV might not “automatically” qualify, thousands of people are eligible for assistance every year. This guest blog by Deanna Power, Director of Outreach at Disability Benefits Help, sheds some light on the process.

Medical Qualifications Via the Blue Book:

The SSA maintains its own qualifying criteria for disability benefits, known colloquially as the Blue Book. HIV and AIDS can both qualify for benefits under Section 14.11. There are nine ways to qualify with HIV:
  1. You’ve been diagnosed with Castleman disease
  2. You have any central nervous system lymphoma
  3. You have any primary effusion lymphoma
  4. You have progressive multifocal leukoencephalopathy (a rare brain disease with a high mortality rate)
  5. You have pulmonary Kaposi sarcoma (cancer that lines blood vessels)
  6. You have a CD4 count of 50 cells/mm3 or less
  7. You have a CD4 count of 200 cells/mm3 or less, plus a BMI under 18.5 or low hemoglobin levels
  8. Your HIV complications require three hospitalizations within a year, and each hospitalization is at least a month apart. Each hospitalization must last at least 48 hours including time spent in the emergency room
  9. You HIV complications that aren’t as severe as the above listings, but still have significant symptoms including nausea, muscle weakness, neuropathy, headaches, and more, which limit at least one of the following:
    • Your ability to complete activities of daily living, like preparing food or getting dressed
    • Your ability to maintain social functioning, like communicating with others at work
    • Your ability to complete tasks in a “timely” manner
Many of the HIV listings require blood work or other medical evidence, so it’s always a good idea to review the qualifying criteria with your provider to determine if you’re eligible for benefits. AIDS will always meet one of the above criteria, so if you have an AIDS diagnosis you will not have any difficulty medically qualifying. HIV approval is not guaranteed.

Additional Information Needed to Qualify:

The SSA will gather all of your medical evidence on your behalf, so as long as you note where you’ve received treatment, the SSA can evaluate your claim. You’ll also need the following information to apply:
  • Your Social Security number and birth certificate
  • A copy of your most recent W-2
  • What types of jobs you’ve had over the past decade
  • How HIV or AIDS affects your daily living activities

It’s important to be as thorough as possible when describing your work ability when living with HIV or AIDS, because it’s possible to qualify without meeting any medical criteria by showing that your complications or symptoms leave you unable to earn $1,170 per month (or $1,180 per month in 2018). This is what the SSA considers to be a “gainful living.”

A helpful piece of medical evidence to have on your side is a Residual Functional Capacity (RFC) evaluation. This form outlines exactly how much physical activity you’re able to perform. You can download an RFC online for your doctor to fill out on your behalf.

Tips on How To Apply

The easiest way to apply is online on the SSA’s website, but you can also apply at your closest Social Security office. Make an appointment to apply online by calling the SSA toll free at 1-800-772-1213. If you need any additional assistance filing your claim, you can call the SSA for guidance—a good idea is to find your local office and call your location directly to speak with someone significantly faster than calling the SSA’s main line.

The average claim is approved within three to five months. You can use your monthly benefits on hospital bills, medication costs, rent or a mortgage, or any other daily living needs.

Posted By: Guest Blogger: Deanna Power, Disability Benefits Help - Friday, December 08, 2017

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