The Clinical Guide to Supportive and Palliative Care for HIV/AIDS

A Clinical Guide to Supportive and Palliative Care for HIV/AIDS • Chapter 18: Legal and Financial IssuesAll of the programs and legal options described in this chapter can enhance the sense of wellbeingof a person living with HIV. Knowing that all potential avenues of support have beenutilized and that plans are in place in the event of incapacity or death is a part of the largereffort to ensure that persons with HIV live with respect and dignity.PART 1.ACCESSING INCOME AND HEALTH CARE SUPPORT PROGRAMSFederal and State governments and the private insurance industry offer a broad range of programsdesigned to ensure that disabled individuals, including those living with HIV, have access tofinancial resources and health care and treatment programs. These programs provide supportto people living with HIV, particularly those who find themselves without the ability to affordbasic necessities, such as food, shelter, and clothing, let alone meet the high costs associatedwith the care and treatment of a debilitating illness such as HIV.A. INCOME SUPPORT1. Federal Social Security ProgramsThe Federal Social Security Administration (SSA) provides two types of income supportprograms for disabled individuals: Social Security Disability Insurance (SSDI) and SupplementalSecurity Income (SSI). Both programs provide financial support on a monthly basis to disabledindividuals. Individuals living with HIV may be eligible for one of these programs or both.In order to be eligible for either SSI or SSDI a range of rules apply. For both programs an individualmust be permanently and totally disabled. The SSA defines disability as a severe medical condition(physical or mental) that prevents or is expected to prevent an individual from engaging in anysubstantial gainful activity for 12 or more consecutive months, or will result in death. An AIDSdiagnosis will often qualify an individual as disabled. The additional eligibility rules for both programsare discussed in detail below. More information on these programs is also available through theSSA at 1 (800) 772-1213 or on the SSA web site at www.ssa.gov.■ Social Security Disability Insurance (SSDI or SSD)SSDI, often shortened to SSD, is a governmental disability insurance program. In additionto the eligibility requirement that an individual must be permanently and totally disabledas defined by the SSA, successful applicants must have a lawful immigration status andhave a sufficient work history. Since SSDI is a federal insurance program and not a needbasedprogram an individual’s income or assets generally do not effect eligibility or monthlybenefit payments.The SSDI program pays a monthly benefit to disabled individuals with HIV who have madesufficient Social Security contributions through payroll deductions or self-employment taxpremiums (under the Federal Insurance Contribution Act, or FICA). What qualifies as sufficientcontributions depends upon an individual’s age at the time she or he became disabled.• Those 31 years of age or older must have paid sufficient taxes for at least 20 of the last40 3-month periods or “quarters.”• Those between the ages of 24 and 30 must have paid sufficient taxes for at least half ofthe quarters between their 24 th birthday and the time of disability.366U.S. Department of Health and Human Services • Health Resources and Services Administration • HIV/AIDS Bureau