How to Get Disability for HIV/AIDS

Learn how you can get disability benefits from Social Security on the basis of HIV or AIDS.

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Human immunodeficiency virus (HIV) is a virus that causes progressive failure of your immune system. The failure of the immune system can lead to life-threatening opportunistic infections and cancer. In almost all cases, HIV will develop into Autoimmune Deficiency Syndrome (AIDS). This progression from HIV to AIDS generally takes about ten years. Patients with HIV infections that haven't progressed into AIDs, and even some patients with AIDs, won't be found disabled.

Symptoms and Treatment of HIV

There are three stages of HIV for individuals. During the period after when you are first infected, individuals can experience symptoms such as fever, swelling of the lymph nodes, sore throat, rash, muscle pain, and mouth and throat soars. Symptoms that are less common include headache, nausea, vomiting, an enlarged spleen or liver, weight loss, thrush (an infection of the mouth), and neurological symptoms. There are also individuals who experience no symptoms during this time.

As the immune system begins to fail, the HIV infection progresses into early symptomatic HIV infection. Mild symptoms include chronic rashes, fatigue, diarrhea, weight loss, cough, and shortness of breath. As the immune system’s ability to function declines, more serious symptoms will arise.

HIV develops into AIDS when certain blood tests are met and illnesses are present. Serious opportunistic infections, severe weight loss, and a decline in mental function are some of the symptoms that are associated with AIDS. 

Treatment for HIV and AIDS involves multiple pills at multiple times throughout the day. Side effects can make the treatment cumbersome. Possible side effects of treatment include nausea, vomiting, diarrhea, irregular heartbeat, shortness of breath, skin rashes, and weakening of your bones.

Getting Disability for HIV/AIDS

The HIV listing in Social Security's "blue book" (the agency's official listing of disability requirements) is complex. To meet the requirements of this listing, you must first show that you have been diagnosed with HIV or AIDS through proper medical evidence. Then you must show that you have one of the following:

  • Bacterial infection, which includes:
    • Recurrent diarrhea caused by the presence of Salmonella bacteria in the blood
    • Bacterial infections such as tuberculosis and leprosy that appear at places in the body other than the lungs, skin, or lymph nodes in the head, neck, or lungs
    • Nocardiosis, a lung or whole body infection that can cause various breathing and neurological problems
    • Multiple or recurrent infections that require hospitalization or antibiotics intravenously at least three times or more in one yea
  • Viral infection, which includes:
    • Herpes caused by herpes type 5 that occurs in parts of the body other than your liver, spleen, or lymph nodes
    • Herpes simplex virus that causes 1) a skin or mucus membrane infection that lasts more than one month; 2) an infection in another area of the body; or 3) an infection that has spread to other areas of the body
    • Shingles that spreads and is resistant to treatment
    • PML, progressive inflammation of the white matter in the brain in multiple areas
  • Fungal infection, which includes:
    • Yeast infection in a part of the body other than the skin, urinary tract, intestines, mouth, or vagina
    • Aspergillosis, a fungal infection or allergic reaction caused by Aspergillus fungus, which can cause pneumonia and other symptoms
    • Coccidioidomycosis, commonly known as “Valley fever” or “California fever,” that affects areas other than the lungs or lymph nodes
    • Cryptococcosis, a fungal infection that can cause fever, fatigue, chest pain, dry cough, swelling of the stomach, headache, blurred vision, and confusion, it it occurs somewhere in the body other than the lungs
    • Histoplasmosis, commonly known as “Cave disease” or "Darling's disease,” that affects the body somewhere other than in the lungs or lymph nodes
    • Mucormycosis, an infection that occurs in the sinuses, brain, or lungs
    • Pneumonia caused by the Pneumocystis fungus or a Pneumocystis infection that has moved beyond the lungs
  • Protozoan or helminthic infection, which includes:
    • Parasites affecting the intestines that causes diarrhea for one month or longer
    • Strongyloidiasis (roundworm infection) outside the intestines
    • Toxoplasmosis, an infection caused by the Toxoplasma gondii parasite, that occurs somewhere in the body other than the liver, spleen, or lymph node
  • Cancer, which includes:
    • Cancerous tumors in the cervix that are stage II or worse
    • Cancerous lesions that cause extensive lesions in the mouth or occur in the lungs, intestines, or other organs in the abdomen
    • Cancer in the lymph nodes
    • Squamous cell cancer, a common form of skin cancer, in the anal canal
  • Skin or mucus membrane condition, which includes:
  • HIV encephalopathy with:
    • Swelling of the brain that causes
    • Cognitive or physical impairments
  • HIV wasting syndrome, with:
    • Loss of 10% of your body weight, and 
    • Diarrhea at least twice a day or fever for a month or longer
  • Diarrhea, which:
    • Lasts a month or longer
    • Does not respond to treatment, and 
    • Requires intravenous hydration or a feeding tub
  • One of the following infections, if it doesn't respond to treatment or leads to hospitalizations three or more times in one year:
    • Sepsis
    • Meningitis
    • Pneumonia
    • Septic arthritis
    • Endocarditis
    • Sinusitis
  • One of the above symptoms that is not severe enough to meet the above requirements but causes impairments in the activities of daily living, ability to function socially, or capacity to focus on and finish tasks.

Proving You Are Disabled

To "meet" the HIV listing, you'll have to present medical records with very specific medical findings illustrating that you meet the requirements of one of the above complications. For the details, see our article on the medical evidence required to win disability for HIV-AIDS.

An important difference for this listing from other disability listings is that there is no need to show that you have been impaired for 12 months, or that you expect to be impaired for at least 12 months. If you show that you meet the listing requirements above, that is enough to show you are disabled.

If you do not meet the HIV listing, Social Security will assess whether your symptoms affect your capacity to work so much that there is no type of job you can do. For more information, see our article on Proving Your HIV/AIDS Prevents You From Working: The HIV RFC.

by: , Contributing Author

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