Are you living with HIV and finding it more challenging to keep a job or manage daily tasks? If your health makes it difficult to work, you may qualify for SSDI or SSI. However, getting approved isn’t easy. One missing record or an incomplete form could delay your case or lead to a denial.
The lawyers at Disability Advocates Group focus on helping people with serious health conditions like HIV. Contact us now for a free consultation. You can ask questions, get honest answers, and find out how we can help you apply or fight a denial.
What Is the Difference Between SSDI and SSI?
Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI) are both disability benefit programs run by the Social Security Administration (SSA), but they work differently. SSDI pays benefits to people who have worked and contributed to Social Security through their payroll taxes. If you have enough work credits and can’t work anymore due to a health condition, you might qualify for SSDI.
SSI provides benefits to people who have little or no income and few assets, even if they haven’t worked much or at all. To get SSI, you must meet financial limits set by the government and be 65 or older, blind, or unable to work due to a health condition.
Who Can Qualify for SSDI or SSI with HIV?
People living with HIV can qualify for SSDI or SSI if the condition limits their ability to work. Social Security looks at how the virus affects your daily life and your overall health. You don’t have to have AIDS to qualify. Some people with HIV alone have severe symptoms or complications that make it hard to keep a job.
You could qualify if you’ve had repeated infections, a very low CD4 count, certain cancers, severe weight loss, or brain-related symptoms like memory loss or confusion. Some women also qualify based on HIV-related gynecologic problems that don’t improve with treatment.
You must also meet the program rules. For SSDI, you need a sufficient work history. For SSI, you must have limited income and resources. If you meet both medical and program rules, you could be entitled to monthly payments.
How Social Security Evaluates HIV Disability Claims
Social Security uses a step-by-step process to decide if you qualify for SSDI or SSI. First, they check whether you work and earn more than a set amount. If you don’t, they review your medical records to see how HIV affects your ability to work.
If your condition meets the Listing for HIV, you should qualify for disability benefits. If not, the SSA will look at your symptoms, hospital visits, lab results, and daily challenges to determine whether your condition meets the criteria.
The SSA will also look at your age, education, and work history. If they decide you can’t do any job on a regular basis due to your condition, they may approve your claim.
Meeting the SSA’s HIV Listing Criteria
Your medical records must show specific problems linked to the virus to meet Social Security’s HIV listing. You don’t need to meet every part of the listing, but your health must match at least one of the approved categories. For example, you might qualify if you have a very low CD4 count, frequent infections, certain cancers, or serious weight loss.
You could also qualify if you’ve had three hospital stays in a year due to HIV complications. Each stay must last at least 48 hours and be 30 days apart. If none of those apply, you might still meet the criteria if you have long-term symptoms like severe fatigue, pain, or mental health issues that limit your daily activities or focus.
What Happens If You Don’t Meet the Listing
If you don’t meet the SSA’s HIV listing, Social Security will still look at your case to see if you qualify. First, they will review how your condition affects your ability to work. This step is called a residual functional capacity (RFC) review. They will also look at your symptoms, treatments, and medical history to decide what kind of work, if any, you can still do.
The SSA will also consider your age, past jobs, and education. If you can’t return to your old job or switch to a new one, you could qualify for SSDI or SSI.
Medical Evidence the SSA Needs for an HIV Claim
Social Security needs solid medical evidence to review your claim. This includes test results that show you have HIV, like a positive antibody or PCR test. They also want to see CD4 counts, details about infections, cancer, or other HIV-related problems, and any hospital records.
The SSA will also need notes from your doctors, lab test results, and records showing how often you visit the doctor or hospital. They will review how your symptoms affect your daily life, such as problems with memory, mood, energy, pain, or sleep.
Doctor’s notes explaining how HIV affects your ability to work or manage daily tasks can help the SSA better understand your health. Good records can make a big difference in your case.
How an Attorney Can Help with Your HIV Disability Claim
If you’re thinking about filing for SSDI or SSI due to HIV, an experienced lawyer can help you by:
- Gathering complete medical records that show how HIV affects your daily life
- Requesting CD4 count results, lab reports, and other useful test results
- Getting written opinions from your doctors about your work limits
- Reviewing your work history to show how your health affects your ability to work
- Filing your application with the correct information and supporting documents
- Responding to requests for more information from Social Security
- Preparing written arguments that explain why you meet or equal a listing
- Preparing you for a hearing with a judge if Social Security denies your claim
Contact an Experienced Disability Lawyer Now
If you can’t work because of HIV, know that you don’t have to go through the Social Security process alone. Disability Advocates Group can help you understand your options, gather the right records, and take action on your claim. Contact us today for a free consultation to learn more about how we can help.
