How to Get Disability for HIV/AIDS

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

By , Contributing Author
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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 in its early stages, 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 sores. 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. In the first two stages of HIV, there are usually few symptoms that would rise to the level of affecting your ability to work for any amount of time.

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. The listing was changed significantly in early 2017 and it is now under section 14.11 of the listings rather than 14.08. To meet the requirements of the new listing, you must first show that you have been diagnosed with HIV or AIDS through proper medical evidence. Next, you must show that you have one of the following:

  • Castleman disease affecting multiple groups of lymph nodes or organs containing lymphoid tissue
  • central nervous system lymphoma
  • primary effusion lymphoma
  • progressive multifocal leukoencephalopathy
  • pulmonary Kaposi sarcoma
  • absolute CD4 count of 50 cells/mm3 or less
  • absolute CD4 count of less than 200 cells/mm3 or CD4 percentage of less than 14 percent, and one of the following:
    • BMI measurement of less than 18.5, or
    • Hemoglobin measurement of less than 8.0 grams per deciliter (g/dL).
  • HIV complications requiring at least three hospitalizations within a 12-month period. Each hospitalization must last at least 48 hours and be at least 30 days apart.
  • repeated HIV infections, including the conditions listed above that don't meet the criteria above, with one of the following:
    • severe limitation of activities of daily living
    • severe limitation in social functioning, or
    • severe limitation in completing tasks due to problems concentrating, keeping up with the pace, or endurance.

Examples of infections and issues that could meet the last requirement include bacterial, fungal, parasitic, or viral infections, diarrhea, cardiovascular infections like myocarditis or pulmonary arteritis, distal sensory polyneuropathy, glucose intolerance, female gynecologic conditions such as cervical cancer or PID, hepatitis, immune reconstitution inflammatory syndrome (IRIS), lipoatrophy or lipohypertrophy, malnutrition (HIV wasting syndrome), muscle weakness or myositis (muscle inflammation), oral hairy leukoplakia, osteoporosis, pancreatitis, peripheral neuropathy, or Kaposi sarcoma that is in the intestinal tract rather than in the lungs. These conditions must cause significant symptoms such as fever, headaches, severe fatigue, weight loss, nausea, night sweats, or pain. HIV-associated dementia or other neurocognitive or mental limitations could also qualify under this last requirement.

Social Security's HIV listing gives much more detail on what's required to show that you meet the above criteria; you may want to go over the listing with your doctor to see if you meet the criteria.

Note that the newly updated listing from 2017 no longer allows multiple types of bacterial, viral, fungal, or parasitic infections or diarrhea to qualify an applicant for benefits unless they cause one of the severe limitations in the last requirement above (daily living, social functioning, or the ability to complete 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.

Getting Advance Payments Through SSI

Presumptive disability payments provide you with financial support while Social Security decides your claim, but they're only available through the SSI program. Social Security can grant you immediate SSI payments if you have been diagnosed with AIDs or HIV complications. See our article on presumptive disability for more information.

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