HIV or AIDS Patients are not Always Eligible for Social Security Disability Benefits

The US government, through the Social Security Administration (SSA), has a disability benefits plan available to people unable to work due to a disabling medical condition.  The disability benefits are provided under the Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI) programs. Individuals suffering from HIV/AIDS could be eligible to receive the disability benefits under either or both of these programs, but not everyone with HIV or AIDS will qualify.

Eligibility criteria for Social Security

disability benefits for HIV or AIDS patients

Not all individuals with HIV/AIDS will qualify the disability benefits, as the SSA rules require a severe medical impairment that leaves the claimant unable to work. Claimants must meet certain basic criteria regarding their medical condition and their work history to qualify.

Work eligibility

To obtain disability payments you cannot be working at substantial gainful levels which the SSA says is $1,000 a month in 2010.  If you work at SGA levels it will be very hard to show you are disabled, as the SSA definition of disability says you cannot work and be disabled.  There are some exceptions to this rule that professionals can help you examine, mainly the idea of ‘accommodated work”.

Medical eligibility

Individuals with HIV/AIDS can be eligible for disability benefits only if their HIV/AIDS is serious enough to prevent them from working. The severity of the disabilities in individuals suffering from HIV/AIDS is evaluated by an expert medical team which evaluates whether the disability has limited the individual’s ability to perform certain basic functions such as walking, remembering, sitting, etc.

The Social Security Administration has also indicated that the individuals diagnosed with HIV/AIDS should also be suffering from certain secondary infections or conditions to be eligible for disability benefits. If any of these conditions are not present then the disability claim may be denied. A few of the conditions considered under the disability claims include: bacterial, fungal, protozoan or helminthic, and/or viral infections; cancerous tumors; non healing skin ulcers; and HIV wasting syndrome.

The Medical Listing that deals with HIV/AIDS is 14.08.  Those who do not meet all or most of the criteria required in the listing may not be eligible for disability benefits.  If you don’t meet a listing then you could still win if your condition equals a listing.  Even if you cannot meet or equal a listing there still could be a way to prevail if you can show Social Security that you cannot sustain employment.  Legal advice can help elaborate multiple legal theories for your specific condition; typically a lawyer will depend on multiple ways to win as a disability hearing strategy.

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Can my Social Security benefits be seized to pay child support, or for other reasons?

Supplemental Security Income payments cannot be levied or garnished.  In general, federal law protects Social Security benefits from assignment, levy, or garnishment.  However, there are five exceptions in which Social Security benefits may be garnished.  The federal government can garnish Social Security benefits to enforce child support or alimony obligations.  They may also collect unpaid Federal taxes from Social Security benefits.  Other Federal agencies can garnish money from your Social Security benefits to pay a non-tax debt owed to that agency according to the Debt Collection Act of 1996 (Public Law 104-134).  Finally, certain civil penalties allow for the collection of money from benefits to satisfy debts owed under the Mandatory Victim Restitution Act.

However, creditors other than the federal government may not garnish your Social Security benefits.  For example, credit card companies, mortgage companies or auto loan creditors cannot garnish your Social Security benefits.

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Chronic Heart Failure Can Become a Disabling Condition

Congestive Heart Failure (CHF) is a progressive disorder that causes an overall weakening of the cardiovascular system. CHF primarily occurs when the heart is unable to pump enough blood into the muscles, tissues and other organs of the body.

Reported to be the third-most leading cause of disability in the US, congestive heart failure is basically classified into two types:

i)             Systolic dysfunction: In this form of CHF, the heart loses its ability to pump out blood during the contraction phase.

ii)           Diastolic dysfunction: This form of CHF reduces the heart’s ability to relax and fill with blood during the relaxation phase.

CHF and Disability – Research and Statistics

A recent study reported the current figure of CHF sufferers in the US to be a whopping 5 million, with a huge number of 550,000 individuals developing the disorder every year[1], while CHF is estimated to be causing 300,000 deaths every year in the US alone.

Meanwhile, another study conducted by the University of Michigan Health System and the VA Ann Arbor Healthcare System found the disability rate in CHF patients to be much higher than average, with this category of patients having greater difficulties in daily activities such as grocery shopping and even just walking across a small room.  If CHF is keeping you from being able to work you may be eligible to receive Social Security disability benefits.

CHF and Warning Signs

As a medical condition, CHF can severely affect the patient’s ability to perform everyday activities and live an active life, starting from the early signs of the disease itself. Below are some of the key signs that might signal the onset of CHF, along with the related discomfort:

i)             Chest discomfort – Most of the patients experience moderate to extreme discomfort in the centre of the chest, generally lasting for a few minutes.

ii)           Feeling of discomfort in other regions of upper body – Other areas that can become effected include either or both of the arms, neck, back, stomach, or even the jaw.

iii)          Shortness of breath or exhaustion can occur on its own or along with chest discomfort.

iv)          Excessive sweating, giddiness, loss of sleep and appetite, and nausea.

Key Disabilities

Owing to the nature of the disease, chronic heart failure can cause disabilities of various kinds, disrupting normal life to a great extent. The key limitations, or disabilities, that arise from these conditions are the following:

a) Physical disabilities

The most prominent physical disability can be severe exhaustion, or exercise intolerance, on the part of the patient. Even mild physical exertion can become difficult to perform for someone with CHF. The body requires oxygen and nutrients to fuel physical activities, and these cannot be provided at the necessary levels in a patient with CHF.

Since the entire mechanism of the body seems to be under an attack due to decreased oxygen flow, performing basic activities can become daunting. Daily life activities such as vacuuming, sweeping or using a lawnmower can become increasingly difficulty to perform, making return to work a difficult or impossible proposition.

For a person suffering from CHF, an attempt to perform such strenuous activities is usually followed by a period of shortness of breath which makes the task extremely uncomfortable and ultimately impossible to complete.

c) Psychological conditions

A person suffering from CHF can also suffer from severe psychological and interpersonal issues making it increasingly difficult to concentrate at work, and follow instructions and directions.  Often people become scared of their condition and they face anxiety problems.

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Am I Eligible for Social Security Disability Insurance (DIB) Coverage?

To receive Social Security Disability insurance benefits (DIB), you must have a medical impairment that is expected to last at least twelve months or result in death.  Social Security does not pay partial benefits or a percentage according to the degree of your disability.  To be eligible for DIB, you must fulfill the requirements of two tests.

The first test is the “recent work test” which depends on your age at the time you became disabled.  This rule depends on the calendar quarter of your birthday based on three different age groups.  The year is broken up into four quarters consisting of three months each:  January 1 through March 31; April 1 through June 30; July 1 through September 30; and October 1 through December 31.

If you become disabled before you turn 24 years of age, you need 1 ½ years of work during the three-year period ending with the quarter your disability began.  After you turn 24 years of age, but before age 31 you must work during half the time for the period beginning with the quarter after you turned 21 and ending with the quarter you became disabled.  If you are over 31 years of age, you need to have worked at least five years out of the ten year period ending with the quarter your disability commenced.  Clearly this can become complicated very quickly.  It is best that you hire an attorney to help you understand this complex test as well as the other aspects of the application process.

The second test is the “duration of work test”.  This test checks to see if you have worked long enough to qualify under Social Security rules.  For an easy view of this test, refer to the table below from the Social Security administration’s website:

If you become disabled… Then you generally need:
Before age 28 1.5 years of work
Age 30 2 years
Age 34 3 years
Age 38 4 years
Age 42 5 years
Age 44 5.5 years
Age 46 6 years
Age 48 6.5 years
Age 50 7 years
Age 52 7.5 years
Age 54 8 years
Age 56 8.5 years
Age 58 9 years
Age 60 9.5 years
Posted in Basics of SSD, Date Issues, Filing Initial Application, Questions & Answers | 1 Comment