HIV and Disability Updating the Social Security Listings (2010) / Chapter Skim
Currently Skimming:
1 Introduction
1 Introduction
Pages 15-32
The Chapter Skim interface presents what we've algorithmically identified as the most significant single chunk of text within every page in the chapter.
Select key terms on the right to highlight them within pages of the chapter.
From page 15... ...
expanded its disability benefits program beginning in 1983 to help support people living with AIDS. It adopted disability criteria for HIV, loosely organized around the 1987 AIDS-defining illnesses identified by the Centers for Disease Control and Prevention, and in 1993 developed the HIV Infection Listings.
|
From page 16... ...
SOCIAL SECURITY DISABILITY SSA pays disability benefits through two programs: Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI)
|
From page 17... ...
expected to last for a continuous period of not less than 12 months." In addition, individuals under the age of 18 are considered disabled if they have a medically determinable physical or mental impairment, which results in marked and severe functional limitations, and which can be expected to result in death or which has lasted or can be expected to last for a continuous period of not less than 12 months. Five-Step Sequential Evaluation Process For adults applying for SSDI or SSI benefits, SSA uses a five-step sequential evaluation process to determine whether a claimant is disabled (see Figure 1-1)
|
From page 18... ...
In determining whether a claimant is disabled, SSA decides whether the claimant's impairment meets or medically equals a listing. Those terms Figure 1-1 are defined as follows: R01767 • Meets: If the evidence in a case establishes the presence of all the fully editable vector image criteria required by one of the listings, then the claimant's impair ment meets that specific listing; and • Equals: If a claimant's impairment is not found to meet the exact requirements of a specific listing, he can still be found disabled if the impairment is at least equal in severity and duration to the criteria of any listed impairment, as established by the relevant evidence in the claimant's case record.
|
From page 19... ...
. If SSA determines the claimant is unable to perform past relevant work, the claim progresses to Step 5.
|
From page 20... ...
and incorporated it as Step 3 of the sequential evaluation process. Most adult claims not allowed based on the Listings require the lengthy RFC assessment to determine whether a claimant can perform past relevant work.
|
From page 21... ...
Reasonable efforts must be made to ensure that an appropriate specialist evaluates cases involving mental disorders or those involving children. Appeals Process After the initial decision, applicants have the opportunity to appeal the determination, following an administrative process that is the same for adult and child claims.
|
From page 22... ...
If the treating source will not or cannot provide the information needed to decide the case, the DDS can order and pay for a consultative examination. "Acceptable medical sources" are sources who can provide evidence to establish a medically determinable impairment (see Box 1-1)
|
From page 23... ...
Nonmedical sources such as spouses, parents and other caregivers, siblings, other relatives, friends, neighbors, and clergy may also be consulted. If the treating source's opinion is not given controlling weight, DDS personnel consider a number of factors in weighing evidence, whether from the treating source or others.
|
From page 24... ...
to broader suggestions about the types of evidence collected and the expertise of disability examiners. Commenters also suggested that SSA recognize advances in care such as new manifestations and identification of clinical markers in the HIV Infection Listings.
|
From page 25... ...
14.08G (HIV encephalopathy) 15 14.08H (HIV wasting syndrome)
|
From page 26... ...
. Between 1999 and 2009, approximately 35 percent of all adult HIV claims were allowed (22 percent met the Listing, 7 percent medically equaled the Listing, and 6 percent were medical–vocational decisions)
|
From page 27... ...
Mea suring individuals' ability to perform activities of daily living and instrumental activities of daily living are another way to measure functional capacity. • Mental domain: Mood and substance abuse disorders are common comorbidities among HIV-infected populations that can lead to functional impairment and potential disability.
|
From page 28... ...
Clinician-administered protocols include the Composite International Diagnostic Interview and the Profile of Mood States, which are more comprehensive assessments of multiple emotional domains. Specific tests are available to measure the impact of the neurocognitive challenges associated with HIV infection.
|
From page 29... ...
The committee concludes that measures of functional capacity ought to continue to be important in the HIV Infection Listings. IOM COMMITTEE Methods To address its statement of task of providing guidance to the SSA about how to increase the utility of the HIV Infection Listings, the committee assessed the evidence about HIV and clinical markers of functioning, disability, and return to work.
|
From page 30... ...
Recognition of this connection is critical because Social Security benefits have a great impact on access to care for people living with HIV/AIDS. Qualifying for Social Security disability benefits in many states is seen as an entrée to other public programs, such as Medicare, Medicaid, and housing programs.
|
From page 31... ...
The committee will review the current medical criteria for disability resulting from HIV infection in SSA's List ing of Impairments ("the Listings") and identify areas in which the HIV Infection Listings should be revised and updated based on current medical knowledge and practice.
|
From page 32... ...
2008a. Annual statistical report on the Social Security Disability Insurance Program.
|
Key Terms
This material may be derived from roughly machine-read images, and so is provided only to facilitate research.
More
information on Chapter Skim is available.