At one time a diagnosis of HIV/AIDS was associated with finality. However, with today’s medical advances, a person with HIV/AIDS can live a long life with the proper medical care. However, despite medical abilities, HIV/AIDS and necessary treatment can be debilitating.

If you have HIV/AIDS, you may qualify for HIV / AIDS Social Security disability benefits. If you are unable to work or your activities of daily living are severely limited because of your condition, you should apply for benefits. Our knowledgeable Georgia HIV/AIDS Social Security Disability representatives at Adams & Associates Disability, Inc. are ready to help you start the application process.

What Is HIV/AIDS?

HIV (human immunodeficiency virus) can become AIDS (acquired immunodeficiency syndrome) if left untreated. HIV is a virus just like the flu; however, the human body cannot completely get rid of HIV. Once you get the virus that causes human immunodeficiency, you have it for life.

The virus that causes HIV attacks T cells in the immune system, which helps fight infections. If HIV is untreated, it can reduce the number of T cells to the point that a person is more likely to get infections, including infection-related cancer. When a person develops significant infections or cancer due to HIV, they develop AIDS, which is a final stage of HIV.

Although no cure exists for HIV, there are effective medical treatments that can prevent the progression to AIDS and the development of infections and cancer. Antiretroviral therapy (ART) may be used to increase the lifespan of someone living with HIV. The medication can even lower the chances of transmitting the virus to other people. A person who receives proper medical treatment can live as long as someone without HIV.

For more information about HIV/AIDS and treatments, visit Aids.gov.

Debilitating Symptoms And Side Effects

Although modern medicine can effectively treat HIV/AIDS, the disease can still have devastating effects on the body. ART medications and treatment for severe infections and cancer can also have a negative impact on a person’s health.

Symptoms of HIV include:

• Fever
• Chills
• Rash
• Night sweats
• Muscle aches
• Sore throat
• Fatigue
• Swollen lymph nodes
• Mouth ulcers

Recurring infections and cancer can also be symptoms of HIV; however, if untreated they can result in the development of AIDS. ART medications can greatly decrease the symptoms of HIV, but they also have side effects that can be debilitating, including:

• Bleeding
• Anemia
• Blood loss
• Heart disease
• High blood sugar and diabetes
• Lactic acidosis
• Kidney, liver, or pancreas damage
• Severe nausea and vomiting
• Chronic diarrhea
• Numbness and tingling
• Extreme fatigue

Although the side effects can be significant, the medications can prevent the advancement of HIV, recurrent infections, and cancer development.

When Is HIV/AIDS A Disability?

The Social Security Administration (SSA) details factors that make HIV severe enough to be a disability on its Adult Listing of Impairments, Category 14.08 Human Immunodeficiency Virus (HIV) Infection.

Proof of disability requires positive diagnosis of HIV/AIDS. This can be proven with verifiable medical tests, including laboratory blood work, and physician notes. Physician notes should document the onset of the disease and extent of impairments that you experience.

You must also show that you experience any of the following associated with HIV/AIDS:

• Bacterial infections – You may experience multiple or recurrent bacterial infections, including but not limited to, mycobacterial infections, nocardiosis, and non-typhoid salmonella.

• Fungal infections – You may have aspergillosis, candidiasis, coccidioidomycosis, cryptococcosis, histoplasmosis, mucormycosis, or pneumonia.

• Protozoan or helminthic infections – These include cryptosporidiosis, isosporiasis, microsporidiosis, strongyloidiasis, and toxoplasmosis.

• Viral infections – You may have cytomegalovirus, herpes simplex virus, herpes zoster, or progressive multifocal leukoencephalopathy.

• Malignant neoplasms – This may include carcinomas, sarcomas, lymphomas, and squamous cell carcinomas.

• Conditions of the skin or mucous membranes – You may have extensive fungus or ulcers that do not respond to treatment.

• HIV encephalopathy – This may be characterized by cognitive or motor dysfunction that limits function and is progressive.

• HIV wasting syndrome – This may be characterized by involuntary weight loss, chronic diarrhea, and chronic weakness.

• Diarrhea – You may have digestive disturbances that last one month or longer and is resistant to treatment, requires intravenous hydration, intravenous alimentation, or tube feeding.

• One or more infections – These may include sepsis, meningitis, pneumonia, septic arthritis, endocarditis, or sinusitis that is resistant to treatment or requires hospitalization or intravenous treatment.

• Repeated infections – These may limit activities of daily living, the ability to maintain social functioning, and the ability to complete tasks in a timely manner due to deficiencies in concentration, persistence, or pace.

This list is not exhaustive, and the Adult Listing includes many more details regarding requirements for qualification of disability.

Filing for HIV / AIDS Social Security Disability Claim

You may apply online, in person, via telephone, or by mail through the Social Security Administration. You must include significant medical documentation with your initial application in order to be approved right away. Experienced Georgia HIV/AIDS Social Security disability representatives with Adams & Associates Disability, Inc. can help you gather the appropriate information and submit a successful claim or help make an effective appeal if your initial application was denied. Call 1 (888) 551-1190 to schedule an appointment.

Proving Medically Determinable Impairment

The Social Security Administration (SSA) has set guidelines that establish eligibility for Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI). Importantly, you must be disabled due to a “medically determinable impairment” in order to qualify for disability benefits. That means you must have a condition that can be proven with verifiable medical evidence.

It can be difficult to prove that an impairment is severe enough that you qualify for Social Security benefits. The experienced Clayton Social Security disability representatives at Adams & Associates Disability, Inc. can help you understand the application process and gather information necessary to proving your claim.

Defining An “Impairment”

In order to understand what a medically determinable impairment is, you must first know what qualifies as an “impairment.” An impairment is a physical or mental condition that results from abnormalities of an anatomical, physiological, or psychological nature. That condition must cause functional limitations of daily activities that prevent you from working.

The SSA maintains a listing of impairments and medically determinable requirements for both Adults and Children. If you can show that you have an impairment through the methods described on that listing, then you may qualify for benefits if your impairment is so severe that it prevents you from working, or, for children, causes marked or severe functional limitations.

Medically determinable impairments on the Adult Listings (Part A) include the following:

• Musculoskeletal System – major dysfunction of joints, reconstructive surgery or surgical arthrodesis, disorders of the spine, amputation, fracture of certain bones, soft tissue injuries

• Special Sense and Speech – loss of visual efficiency, disturbance of labyrinthine-vestibular function, loss of speech, hearing loss with or without cochlear implant

• Respiratory System – chronic pulmonary insufficiency, asthma, cystic fibrosis, pneumoconiosis, bronchiectasis, lung infections, pulmonary vascular hypertension, sleep-related breathing disorders, lung transplant

• Cardiovascular System – chronic heart failure, ischemic heart disease, recurrent arrhythmias, congenital heart disease, heart transplant, aneurysm of aorta or major branches, chronic venous insufficiency, peripheral arterial disease

• Digestive System – gastrointestinal hemorrhaging requiring blood transfusion, chronic liver disease, inflammatory bowel disease (IBD), short bowel syndrome (SBS), weight loss due to any digestive disorder, liver transplant

• Genitourinary Disorders – chronic kidney disease, nephrotic syndrome, complications of chronic kidney disease

• Hematological Disorders – hemolytic anemias (sickle cell disease, thalassemia, etc.), disorders of thrombosis and hemostasis, bone marrow failure, hematological disorders treated by bone marrow or stem cell transplantation, repeated complications of hematological disorders

• Skin Disorders – ichthyosis, bullous disease, chronic infections of the skin or mucous membranes, dermatitis, hidradenitis suppurativa, genetic photosensitivity disorders, burns

• Endocrine Disorders – disorders of the pituitary, thyroid, parathyroid, and adrenal glands, diabetes mellitus, pancreatic disorders

• Congenital Disorders – non-mosaic down syndrome, mosaic down syndrome, any other catastrophic congenital disorders

• Neurological – convulsive or nonconvulsive epilepsy, central nervous system vascular accident, brain tumors, Parkinson’s disease, cerebral palsy, spinal cord or nerve root lesions, multiple sclerosis, amyotrophic lateral sclerosis, anterior poliomyelitis, myasthenia gravis, muscular dystrophy, peripheral neuropathies, subacute combined cord degeneration, other degenerative diseases, cerebral trauma, syringomyelia

• Mental Disorders – organic mental disorders, schizophrenia and other paranoid and psychotic disorders, affective disorders, intellectual disability, anxiety-related disorders, somatoform disorders, personality disorders, substance addiction disorders, autistic disorder

• Cancer – any type of cancer, including sarcomas, lymphomas, leukemias, melanomas, and carcinomas, even if the primary site is unknown

• Immune System Disorders – lupus, vasculitis, sclerosis, HIV/AIDS, connective tissue disease, inflammatory arthritis, Sjogren’s syndrome

Childhood Listings (Part B) include many of the above, but also include a category for infant issues like low birth weight and failure to thrive.

If you have a condition that is not listed on the Adult or Child Listings, your condition may still qualify as a medically determinable impairment. If your doctor told you that you have a condition that prevents you from working, you may still apply for benefits and use the listing that most closely matches your condition to describe your limitations.

How To Prove You Have An Impairment

You must do more than report to the SSA that you have a condition that is as severe as one described in the Child or Adult Listings. You must prove that it is medically determinable. That means you must provide evidence of your impairment through reliable medical opinions and verifiable medical tests.

Reliable medical opinions must from medically licensed service providers. Most doctors, psychologists, and psychiatrists have the appropriate medical licenses to provide opinions to the SSA. However, massage therapists, chiropractors, acupuncturists, yoga instructors, physical trainers, and sports medicine caregiver do not usually have the training and education to obtain a medical license. Thus, their records and notes hold little weight with the SSA. The best source of information about your impairment is a licensed physician with a specialist certification, such as a podiatrist or optometrist.

Opinions and records provided by licensed physicians must contain verifiable medical evidence from tests and evaluations. A description of your symptoms as told by you is not enough. Acceptable tests include clinical and laboratory tests, such as MRIs, CAT scans, blood screens, and biopsies. Evaluations, such as mental exams performed by licensed psychologists or psychiatrists, are also acceptable.

In addition to providing the appropriate type of medical evidence from an acceptable provider, you must also include medical evidence from the onset of your disability through the current date. The SSA will want to see medical documentation of all treatments and prescriptions over time to show that you are unable to work on a sustained basis. You must show that your condition is ongoing and severe.

A Social Security Disability Representative Can Help

The SSA will deny your claim for benefits if you do not prove that you have a medically determinable impairment that is severe enough to prevent you from working and is expected to last at least one year or result in death. You can improve your chances of approval by providing the necessary medical documentation from an acceptable licensed provider to show that your impairment is disabling.

A knowledgeable Clayton Social Security disability representative can help you gather the appropriate information and submit it to the SSA. Contact Adams & Associates Disability, Inc. today at (888) 551-1190.

 

Very few Social Security disability applications are approved immediately. Most claimants either give up or are forced to appeal. With the help of a Georgia Social Security disability representative, you will have a better chance at being approved. Call today to find out how we can help you.

An application for disability can be complicated. You must gather a lot of information, including medical documentation, educational records, and work history. The more details you can provide to the Social Security Administration (SSA), the better. However, despite your best efforts, you may still be denied. If your claim is denied, do not give up hope. You may still be approved through the appeals process.

The Appeals Process

Many people are confused about the application process. It can be complex, and there are several levels through which you must progress if you are repeatedly denied. Disability applications may go through five levels of review:

1. Initial Determination
2. Reconsideration
3. Administrative Hearing
4. Appeals Council Review
5. Federal Court Review

Each of these levels gives the claimant an additional opportunity to submit evidence to the SSA. Each level also requires a new review of your information and an in-depth look at your conditions.

Initial Determination

During the initial determination of your application, a claims examiner will be assigned to review your entire claim for disability benefits. They will review all of the forms and evidence that you submit.

After verification of your non-medical eligibility, such as your age, employment, marital status, and other coverage information, your medical evidence will then be reviewed by a trained staff member. The initial determination will consider the following:

• Whether you have an impairment or combination of impairments; and,
• Whether your impairments are expected to last at least 12 months or result in death; and,
• Whether you can complete substantial gainful activity.

You must have verifiable medical proof that you have a severe impairment that is expected to last the specified amount of time and that it prevents you from working. If you do not provide enough evidence, your application may be denied.

Requesting For Reconsideration

If your initial application is denied, you may request for reconsideration of your application and evidence within 60 days of that denial. You may also take this opportunity to submit additional evidence in any areas of your application that were weak.

If your application was denied because the medical evidence did not show that your condition was expected to last at least 12 months or result in death, you may obtain further medical documentation that will prove that fact. Similarly, if the SSA did not feel you were unable to complete substantial gainful activity, you may undergo additional medical tests and examinations that further describe your limitations. The more evidence you provide, the better chance you have at being approved upon reconsideration.

Very few applications are approved upon reconsideration. However, you have further options.

Administrative Hearing

If your application is denied upon initial review and reconsideration, as are many applications, then you may appeal to an administrative law judge (ALJ) within 60 days of the reconsideration denial. Less than one-quarter of the people who are denied at the initial and reconsideration levels appeal their claims to the ALJ; however, doing so allows you an opportunity to speak with someone about your claim.

During an administrative hearing, you will appear in front of an ALJ, who will review your application and any evidence you have submitted. You may also submit additional evidence. The ALJ will hear your testimony and that of any person you wish to bring to the hearing. This is an important step in proving your abilities to complete activities of daily living.

The ALJ will then take your claim under advisement and make a decision concerning your eligibility for disability benefits.

Appeals Council

If the ALJ denies your claim, you may appeal to an appeals council within 60 days of that denial. However, the appeals council does not have to review the ALJ’s decision. You must show that the ALJ made a specific error in his or her consideration. If the appeals council does consider your claim, the council will decide to reverse, change, or uphold the previous decisions of your claim.

If the appeals council reverses the decisions of the ALJ and lower levels, your claim will return to the ALJ for reconsideration with instructions. The appeals council will inform the ALJ of the error that was made, or provide him or her with additional evidence, and the ALJ will again consider your claim.

The appeals council may also change the ALJ’s decision. They may change the onset date of your condition, a decision regarding specific evidence, or some other aspect of your claim. However, this does not constitute a complete approval or disapproval of the ALJ’s decision. This is simply a small change to the decision made by the ALJ.

If the appeals council upholds the ALJ and lower level evaluators’ opinions, you may appeal the denial of your claim to the federal court level within 60 days of their decision. Also, if the appeals council refused to consider your appeal, you may skip to the federal court level.

Federal Court Review

While many applications are denied through the appeals council level, people who seek review by a federal court are often approved. By this time, you have had the opportunity to continue treatment and improve your evidence. Your claim may have been reviewed by an independent medical examiner or by a Social Security medical advisor. You are able to state in a brief exactly why your claim qualifies you for benefits. The federal court will carefully consider every piece of evidence, and will make a new decision that is not based on those already made by examiners.

Seeking Claim Approval

The process of applying for disability benefits can be daunting. You may face several difficult decisions as you appeal your claim. However, you should not give up. At each level you have an additional opportunity to submit evidence and make statements regarding the severity of your impairment and your abilities. You will gain clarity at each level regarding what the SSA needs in order to approve your claim.

If your claim for Social Security disability insurance benefits were denied, or if you are seeking to file an initial claim, consult an experienced and knowledgeable Georgia Social Security disability representative to assist you through the appeals process. Contact Adams & Associates Disability Inc. at 1-888-551-1190.