Recently on our disability forum a user asked, I have been diagnosed with HIV, and I do not think I can work. I heard that I might qualify for SSDI benefits. What information does the Social Security Administration (SSA) need to evaluate and process my claim? I want to win the first time I apply and not have to appeal my denial over and over again.
What is Human Immunodeficiency Virus (HIV)?
HIV is caused by a retrovirus which weakens a persons immune system, making them susceptible to a wide variety of other severe health conditions such as cancer. Any number of health conditions related to the HIV virus may become so severe that a claimant is unable to work for at least 12 continuous months.
Now, before applying for SSDI benefits for HIV its important to understand the requirements. First, not only does your condition have to be severe, you also cannot currently be working and making too much money when you apply, and you have to have worked and earned sufficient work credits to be considered insured for SSDI benefits. If any of those conditions are not met, you will automatically be denied SSDI, regardless of the severity of your current health condition.
Now, you specifically asked about the type of medical evidence you will need to win your SSDI case for HIV. In the next section we will take a closer look at that question.
What medical evidence do I have to have to win my SSDI for HIV?
The first medical evidence you will need to win your case is documentation of the HIV infection. This can include serum specimen that contains HIV antibodies, a specimen that contains immune-reactive parts of the HIV antigen, or other tests specifically used for HIV detection.
After you have medical evidence which establishes a definite diagnosis, the SSA will evaluate the severity of your condition. To make this determination they will consider whether your HIV condition meets or equals a listing in the SSA Listing of Impairments.
HIV may allow for allow conditions to flourish within your body. For example the SSA will determine if you have bacterial infections, fungal infections, viral infections, cancers, skin conditions, blood or neurological abnormalities, cardiomyopathy, diarrhea, nephropathy, or HIV wasting syndrome. Each of these conditions is listed and has specific symptoms which are considered so severe that they are disabling.
The best thing to do is to talk to your doctor and discuss your condition and any condition you have which could be severe enough to meet a listing or limit your ability to work.
Although your doctor will not complete the SSDI application for you, he may be willing to discuss the listing with you, and if your condition meets a listing, ensure that you have the right medical evidence to support your case.
What do I do if I am denied benefits?
What do you do if you are denied? Most denials can be appealed within 60 days from the date of the denial letter. Review your denial letter and find out why you were denied. Talk to a lawyer if you have questions about your HIV case.
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