Federal Disability Insurance When You Have AIDS

What do you do when you can't hold a job because of AIDS? Disability insurance pays you regularly when you can't work because of illness or injury. One government-funded option is through Social Security.

What Is Social Security Disability Insurance (SSDI)?

You probably think of Social Security as a federal retirement program. But it also provides disability benefits.

You may qualify for SSDI if:

  • You've worked and paid Social Security taxes.
  • You've worked at least 5 of the 10 years before you became disabled (maybe fewer if you're younger).
  • You can't do any job, not just the one you had.
  • You've been disabled 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 depends on what your salary was and how long you've been covered under Social Security. The amount can go down based on payments you get from other programs, like disability insurance your employer pays for, or a private program that you pay for.

Qualifying for SSDI

To receive SSDI benefits, you must show that you have AIDS as well as a disability.

You must have laboratory evidence of HIV infection, and at least one infection people with AIDS commonly get. A low CD4 count (a CD4 count measures the numbers of the type of immune system cells attacked by HIV) alone isn't enough.

Your symptoms, illness, or treatment side effects must be severe. You'll have to prove that they make it very hard for you to:

  • Do everyday activities, like taking public transportation, cleaning your house, or paying bills
  • Interact socially and communicate effectively
  • Concentrate on, stick to, or keep up with tasks to complete them in a timely way

You must consistently report and document what gets in the way of day-to-day living. You should write down symptoms between doctor appointments. Tell your doctor about all the symptoms that limit you, like:

  • Tiredness that forces you to take naps
  • Incontinence that makes it hard for you to leave your house

Tips for a Successful Claim

It's a good idea to seek legal advice when you apply for Social Security Disability. Unfortunately, the legal and medical definitions of "disability" don't always match. Also, what it takes to win benefits claims often doesn't make sense either to doctors or to someone living with HIV.

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The words your doctor uses on a medical chart may have a very different meaning in the law. For example, to a doctor, "HIV stable" may simply show there's been no change in how you're doing. But a mediator may think "stable" means you're doing OK and don't have a disability.

Typically, doctors don't make notes about things you're unable to do. But you'll need this information to win a claim.

Many folks emphasize the "good days" when they see their doctors. Or you may stop mentioning symptoms that you've had for a long time. This can make getting benefits more difficult.

You might feel reluctant to talk about your HIV and your disability and to ask for help. Remember, though, that you aren't burdening your doctor or the Social Security system. The benefit is there to be used, and this is how the process works.

More Resources

You may be entitled to both SSDI and Supplemental Security Income (SSI) -- another federal program -- if your Social Security benefits are low and you have very limited income and resources.

After 24 months of receiving SSDI, you'll also qualify for Medicare benefits. This helps pay for things like:

For more information about federal benefits, call the Social Security Administration at 800-772-1213 or check their website.

A local AIDS organization may be able to give you advice or put you in touch with someone to help file your claim. For legal advice, you can also try:

WebMD Medical Reference Reviewed by Jonathan E. Kaplan, MD on December 16, 2018

Sources

SOURCES:

America's Health Insurance Plans: "Guide to Disability Income Insurance."

Social Security: "Social Security for People Living With HIV/AIDS," "Disability Evaluation Under Social Security."

Jane Gelfand, benefits lawyer, San Francisco.

© 2018 WebMD, LLC. All rights reserved.

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