Disability Guidelines May Change

The Institute of Medicine has provided guidance to the Social Security Administration on updating its Listings of Impairments, a tool that helps SSA quickly assess whether someone with HIV or another condition qualifies for benefits. The HIV listings were last updated in 1993.

The following are the new recommendations to qualify someone as eligible for SSA disability payments:

> A CD4-cell count at or below 50 cells per microliter of blood. "Because CD4 counts can change in response to antiretroviral therapy, claimants allowed disability in this way should be regularly reevaluated," IOM's report states.

> Several rare but fatal or severely disabling HIV-associated conditions, including dementia and certain types of AIDS-related cancers. Benefits for these diseases should be permanent, the IOM says.

> Severe HIV-associated conditions, such as hepatitis or heart disease, which are already covered by another section of SSA's full listing. These claimants should be regularly reevaluated, according to the IOM.

> HIV-associated conditions, such as wasting syndrome, that are not included in another section of the listing. These conditions must be severe and limit function. "Claimants allowed in this way should be regularly reevaluated," IOM suggests.

The biggest change would be that HIV-positive applicants seeking disability would have to reapply to SSA every three years. That policy pertains only to new applicants, not to those already receiving disability through SSA.

Raeline Nobles, executive director of the Dallas-based nonprofit AIDS Arms, says the SSA currently allows disability for people with a CD4 count of 200. She says she sees many clients who get along fine with a CD4 count of 100. "But politically, it might be a way to cut some expensive corners," she says, adding, "50 seems awfully low to me."

View the report: "HIV and Disability: Updating the Social Security Listings.”