HIV/AIDS & Disability Compensation

 What is HIV/AIDS?

Human immunodeficiency virus, aka HIV, is a virus that destroys cells in the body that aid in infection resistance, rendering a person more susceptible to other infections and disorders. It is transmitted through contact with certain bodily fluids of an HIV-positive individual, most commonly during unprotected intercourse (sex without the use of a condom or HIV medication to prevent or treat HIV) or through sharing injection drug equipment.

HIV, if left untreated, can progress to AIDS (acquired immunodeficiency syndrome).

The human body is incapable of eliminating HIV, and there is currently no viable HIV cure. Thus, once infected with HIV, it is permanent.

However, by taking HIV medication (referred to as antiretroviral therapy, or ART), people living with HIV can live long and healthy lives while preventing HIV transmission to sexual partners. Additionally, there are effective strategies for preventing HIV transmission through sex or drug use, including pre- and post-exposure prophylaxis (PrEP) (PEP).


HIV, which was discovered in 1981, is the source of one of humanity’s deadliest and longest-lasting epidemics.

After getting infected with HIV, later on the disease will turn into AIDS, which occurs when the immune system of the body is severely compromised by the virus.

In the United States, the majority of persons living with HIV do not get AIDS since taking HIV medication as directed by a doctor halts the disease’s progression.

When a person with HIV has advanced to AIDS:

Their CD4 cell count decreases to less than 200 cells per cubic millimeter of blood (200 cells/mm3). (CD4 levels range between 500 and 1,600 cells/mm3 in an individual with a healthy immune system.) OR, regardless of their CD4 count, they get one or more opportunistic infections.
Without HIV medication, persons with AIDS typically have a three-year survival rate. Without treatment, a person with a deadly opportunistic illness has a life expectancy of roughly a year. HIV medication can still be beneficial and potentially lifesaving for persons at this stage of HIV infection. However, those who begin antiretroviral therapy (ART) shortly after contracting HIV have greater benefits—which is why HIV testing is critical.

The only method to determine for certain whether you have HIV is to undergo testing. Testing is a pretty straightforward process. You can request an HIV test from your health care practitioner. They are also available at a number of medical clinics, substance misuse programs, community health centers, and hospitals. Additionally, you can get a home testing kit at a pharmacy or online.

Utilize the HIV Services Locator to locate an HIV testing location near you.

Self-testing for HIV is also a possibility. Self-testing enables individuals to administer an HIV test and receive their results in the privacy of their own home or other private location. Self-test kits are available at pharmacies and online. Additionally, several health agencies and community-based organizations give free self-test kits.

The FDA fact sheet on the OraQuick In-Home HIV Test, the only FDA-approved in-home HIV test, is available here.

Does HIV Qualify For Disability?

The Social Security Administration’s definition of disability may differ from several other widely accepted definitions. The Social Security Administration’s definition is precise, and being HIV positive does not automatically qualify as a handicap.

To qualify as a disability under the SSA, a condition must make it impossible for you to earn enough money through work to support yourself. This level of monthly income is referred to as substantial gainful activity.

In 2020, the amount of substantial gainful activity for non-blind individuals will be $1260. For blind individuals, this figure is $2110. Thus, in order for HIV to be classified as a handicap by the SSA, the symptoms must stop you from engaging in substantial gainful work.

Another need for HIV to be declared a disability is that it prevents the individual from earning money through learning a new skill or changing employment. This will take into account factors such as age and employment history.

For instance, if you worked in the same profession for twenty years prior to becoming incapacitated, it would be more difficult to acquire the skills necessary to change jobs at that point in your life. It will be easier for someone who becomes disabled at a younger age or has worked in numerous industries to make the adjustment.

Although highly specific requirements must be completed in order to qualify for disability benefits, the Social Security Administration gives explicit explanations of those conditions.

Medically Eligible for HIV Benefits

HIV is classified by the Social Security Administration (SSA) as a viral infection that impairs the immune system. It is listed in the Blue Book’s Immune System Disorders section. The Blue Book is a technical manual intended for physicians and anyone with the requisite ability to decipher dense medical jargon. This indicates that you will almost certainly require the assistance of your physician to fully comprehend HIV disability listing.

Your doctor can assist you in deciphering the eligibility rules and medical evidence required for benefit approval. To be eligible for the Blue Book, your HIV infection must be advanced and causing substantial and recurrent symptoms and consequences despite treatment.

Specifically, the SSA must verify that at least one of the following is true through your medical records:

  • You are frequently or persistently infected with bacteria, fungi, viruses, or parasites.
  • You’ve been diagnosed with cancer and the disease is advanced or terminal.
  • There is a buildup of fluid on the brain or swelling of the brain, which severely impairs your capacity to think or move properly.
  • You’ve lost a significant amount of weight (HIV-wasting syndrome)
  • Uncontrolled and chronic diarrhea has necessitated a month or longer of IV fluids and nutrition via a feed tube.
  • You have various sorts of infections (sinusitis, encephalitis, sepsis, etc.) that require hospitalization, IV therapy, or are resistant to treatment.
  • Due to your recurrent infections and other difficulties, your activities of daily living, or ADLs, have been seriously affected.

If you do not meet or nearly match the criteria for a disability, you will have to undergo extra reviews to evaluate your eligibility.

How To Apply For Disability Benefits If You Have HIV

If you are diagnosed with HIV, it is possible for your infection to proceed to AIDS. HIV progresses to AIDS when the CD4 cell count falls below a certain threshold. The CD4 cell, commonly known as a T-cell, is a type of white blood cell that plays a critical role in your immune system’s ability to fight infection.

Although AIDS is widely recognized, it does not have its own entry in the Social Security Administration’s blue book. If you or someone you know actually have AIDS, however, they will almost certainly qualify under the HIV listing. There are numerous ways in the blue book to qualify for disability compensation if you have HIV. Section 14.11 G will apply to someone living with AIDS. According to the SSA website, the following criteria apply:

CD4 count greater than 200 cells/mm3 or CD4 percentage greater than 14%, and one of the following:

  • BMI less than 18.5; or hemoglobin less than 8.0 grams per deciliter.

This criterion is critical because to the CD4 count threshold of 200 cells/mm3. This CD4 count is the same as the one used to distinguish HIV from AIDS. Therefore, if you have been diagnosed with HIV and have a low BMI or hemoglobin level, you will most certainly qualify. It is critical to understand that this is not the only route for those living with AIDS to qualify for disability compensation. If you match the criteria, you may qualify under any of the blue book’s listings, including those under the HIV classification.

Acquiring Assistance With Your Disability Application

The best way to get assistance with your disability case is to contact a disability advocate or Social Security attorney; both can assist you with your claim. Additionally, you can have someone else accompany you to an application appointment or submit an online application on your behalf.

To learn more about your case, you can complete this no-obligation review form. Utilize all available resources to increase your chances of winning.