News Release: Research

Sep. 15,  2010

Social Security Administration Should Overhaul HIV Disability Benefits, IOM Committee Says

News Article ImageThe HIV Infection Listings, established in 1993, are the criteria currently used by the Social Security Administration to determine whether people with HIV are disabled by their infection and eligible for benefits.

A new report issued by the Institute of Medicine (IOM) says the criteria used by the U.S. Social Security Administration (SSA) to gauge HIV-related disability is outdated and should be overhauled to reflect the progression of HIV/AIDS from a fatal disease to a chronic condition.

The HIV Infection Listings, established in 1993, are the criteria currently used to determine whether people with HIV are disabled by their infection and eligible for benefits. Since the Listings were created, therapy for HIV has advanced and the disease has dramatically changed from a uniformly fatal condition to a potentially chronic manageable infection.

Carlos del Rio, MD, professor and chair of the Hubert Department of Global Health at Emory University’s Rollins School of Public Health, was a member of the IOM committee that offered recommendations on how the SSA can adopt new criteria to update the HIV Infection Listings. The existing Listings require that a person living with HIV must have developed an AIDS-related opportunistic infection or malignancy to qualify for Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI) benefits.

In the recommendations put forth by the IOM committee, applicants would be eligible for benefits even if their disease hasn’t progressed to opportunistic infection or malignancy, but meets one of the following criteria:

  • A CD4 cell count at or below 50 cells per cubic millimeter of blood serum, a laboratory benchmark that indicates an advanced stage of illness
  • One of a few rare but fatal or severely disabling HIV-associated conditions such as dementia
  • An HIV-associated condition that appears in another section of SSA’s full Listing of Impairment, such as cardiovascular disease and hepatitis
  • An HIV-associated condition that is not already included in any other section, such as wasting syndrome

“As therapy for HIV has advanced, the Listings have become antiquated and the clinicians and patients are frequently found in a situation in which a patient is clearly disabled yet unable to fit into the disability criteria established by SSA back in 1993,” says del Rio. “By revising and updating the disability criteria, the IOM committee hopes that SSA will be able to make determinations in a more expedient way.”

The IOM committee’s full report, “HIV and Disability: Updating the Social Security Listings,” was released Sept. 13 and is available at http://www.nap.edu.

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