Is HIV a Disability? Eligibility, How to Apply and More

Jennifer E. Engen

The Social Security Administration (SSA) lists HIV and its complications among the health conditions potentially eligible for disability status. Depending upon how significantly your HIV status affects your ability to work, you may qualify for work accommodations or benefits.

Applying for disability status is a process that requires a lot of paperwork from both you and doctor. We’ll go over the information you need to know about eligibility, appeals, and accommodations for disability benefits when you have HIV.

The SSA defines a disability as any condition that keeps a person from performing substantial, gainful employment for 12 months or longer. Health conditions expected to result in death are also covered in this definition.

The SSA recognizes that HIV is one such condition that could lead to disability status. However, not all people with HIV have a disability. HIV symptoms have a spectrum of severity. Some medications make it possible for people with an HIV-positive status to have nearly undetectable viral levels, and little to no symptoms.

To qualify for disability benefits, per the SSA’s guidelines, a person must have medical manifestations of HIV that are significant enough to prevent them from working.

The SSA evaluates individuals for disability status on a case-by-case basis. Both mental health conditions and physical symptoms are examined. Certain complications of being HIV-positive increase the likelihood the SSA would consider you for disability benefits.

These include:

The SSA also considers your condition’s impact on:

  • social functioning
  • completing tasks
  • ability in performing activities of daily living

You can apply for disability status in-person or online via the SSA. The process requires a significant amount of paperwork regardless of the application method you choose.

If applying online, you will need to create a “my Social Security” account. At this stage, you may need to include identifying documents such as a W-2 or tax forms, as well as your phone number and a credit card to confirm your identity.

Some of the major items you’ll be asked to provide during the process are:

  • paperwork showing when you were diagnosed with HIV
  • any laboratory findings showing you are HIV-positive, and other relevant laboratory testing that conveys your current state of health
  • personal or medical reports about how HIV may be affecting you, including both mental health conditions and physical symptoms (such as nausea, muscle weakness, depression)
  • diagnostic reports of medical conditions known to occur with HIV. Examples include conditions such as pulmonary Kaposi’s sarcoma or primary effusion lymphoma
  • work history, including jobs held over the past 5 to 10 years, and your earnings and benefits. Your previous earnings may help determine how much you receive from the SSA

If the SSA denies your application for disability benefits, you have the right to appeal. You have 60 days once you receive this notice to appeal the decision.

Your decision letter will include the SSA’s reasons for denying your claim. These should be addressed in your appeal, which you can submit online or in person at your nearest Social Security office. You can upload additional supporting documents during the process to bolster your claim, such as medical reports.

The appeals process has four levels, meaning you can escalate your appeal should it continue to be denied.

  • submitting an appeal for reconsideration
  • attending a hearing in front of an administrative law judge
  • having your appeal reviewed by the Appeals Council
  • having your appeal reviewed by a Federal Court

Some people may choose to hire an attorney to help them make a disability appeal. If you’re unable to financially secure legal assistance, contact your local Social Security office. They can supply you with a list of service organizations that may be able to help with your appeal at little to no cost. These include:

  • legal aid societies
  • law schools
  • local bar associations

The Americans with Disabilities Act (ADA) of 1990 protects employees who work at a business of 15 or more employees from discrimination. Under the ADA, employees have the right to reasonable accommodations at work if they have a disability. However, the accommodations must not cause unreasonable expense or difficulty for the employer.

When your HIV impairs your ability to work, you can talk with your doctor and employer about some accommodations that may make working easier.

Examples include:

  • more frequent rest breaks
  • changes in work schedule to accommodate medical appointments
  • ergonomic office furniture and equipment
  • permission to work from home, or have a hybrid schedule
  • reassignment to a position with different responsibilities, if available

If accommodations do not prove sufficient, you may consider applying for disability benefits.

Per the ADA, it is illegal for any coworkers and employers to discriminate against you on the basis of having HIV. If you have experienced discrimination due to your condition at work, you should file a complaint with the Equal Employment Opportunity Commission (EEOC).

It’s important to report an incident of discrimination as quickly as possible. Timeframes can vary by state, but some require the incident to be reported within 180 days.

The ADA ensures you’re also protected against discrimination from public, local, and state governmental entities. If you feel you’ve experienced discrimination because of your condition from one of these institutions, you can file a complaint with the U.S. Department of Justice.

HIV is listed among the Social Security Administration’s official list of health conditions eligible for disability status, including receiving monetary benefits. If you can demonstrate HIV impairs your ability to work, the SSA is likely to approve your disability application. The application process can be detailed, and requires a lot of documentation.

Should your application for disability be denied, you have the right to file an appeal within 60 days. This allows you to provide additional evidence addressing the reasons for denial laid out in your decision letter.

If you have HIV and can work, or if your appeal is denied, you can still request accommodations from your employer to make your job more comfortable. You also cannot be discriminated against for your condition, per the Americans with Disabilities Act.

It’s important to stay connected with your doctor to both manage your condition, and to secure necessary paperwork for an SSA claim. Make sure your medical professional fully understands how your HIV impacts your ability to function in daily life, and at work.

https://www.healthline.com/health/how-to-apply-for-disability-benefits-due-to-hiv

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