Criteria for HIV/AIDS-Related Disability Benefits May Change

The Social Security Administration (SSA) is reconsidering the criteria it uses to gauge HIV-related disabilities.

In a report released late last year, the Institute of Medicine outlined its recommendations for updating the SSA’s standards for determining the eligibility of Social Security disability applicants with HIV/AIDS. Currently, people with HIV/AIDS who apply for Social Security disability are evaluated based on a list of criteria known as the HIV Infection Listing.

Established in 1993, the list outlines serious AIDS-defining illnesses that the SSA considers disabling, such as Mycobacterium avium complex or cytomegalovirus. However, advances in HIV/AIDS care have changed the landscape of HIV-related disabilities.

While modern-day antiretroviral therapy can in many cases reduce the need for disability benefits, doctors are also discovering an increasing prevalence of disabling complications, such as neurocognitive impairment, chronic kidney disease, osteoporosis and a number of treatment-associated side effects – many of which were not included in the original HIV Infection Listings.

To account for these changes, the Institute of Medicine recommended to the SSA that people living with HIV/AIDS should meet one of the following criteria to qualify for Social Security disability benefits:

  • A CD4 cell count at or below 50 cells per cubic millimeter of blood serum, a laboratory benchmark that indicates an advanced stage of illness.
  • One of a few rare but fatal or severely disabling HIV-associated conditions, such as pulmonary Kaposi’s sarcoma, certain lymphomas, dementia or progressive multifocal leukoencephalopathy (PML).
  • An HIV-associated condition that appears in another section of the SSA’s full Listing of Impairment, such as cardiovascular disease, chronic kidney disease and hepatitis.
  • An HIV-associated condition that is not already included in any other section, such as neuropathy, neurocognitive disorders and wasting syndrome.

“In short, the IOM committee recommends that SSA move away from a list of less common AIDS-defining opportunistic infections and focus on manifestations and disease states that are more likely to be associated with disability today,” the AIDSMEDS website reported.

If adopted by the SSA, the recommendations will apply only to new Social Security disability applicants and will not affect people currently claiming disability benefits.