*This is an archive page. The links are no longer being updated.
1993.06.29 :  New Rules for Evaluating Disability Claims of Victims of HIV and Other Immune System Disorders

Contact:  Phil Gambino (202) 690-8359 or (410) 965-8904 
June 29, 1993
 
     Louis D. Enoff, acting commissioner of Social Security, 
today announced new rules to update and improve the criteria used 
by the Social Security Administration for evaluating disability 
claims filed by individuals with HIV infection and other immune 
system disorders. 
   
  "The intent of these changes is to facilitate the 
identification of severely impaired men, women and children who 
have HIV infection to ensure the most rapid and accurate delivery 
of benefits possible," Enoff said. 

     The rules announced today update the medical criteria used 
by SSA to determine if individuals are eligible for disability 
benefits.  The rules incorporate the latest medical knowledge and 
information on HIV infection.  Besides including a broad range of 
the various disease manifestations of HIV infection, the new 
criteria include standards disability evaluators will use to 
examine the functional limitations caused by HIV infection.  The 
rules also include specific criteria to take into account the 
manifestations of the infection in women and children. 

     "These new rules include not only the most widely known 
manifestations of HIV infection, but also a range of 
opportunistic diseases, cancers and conditions that research and 
clinical practice have shown are indicative of disabling HIV      
infection," Enoff said.  

       The rules include cervical cancer and gynecologic infections
and conditions such as other chronic viral and bacterial infections
which may not significantly impair the functioning of a person with
a healthy immune system but which may have devastating impact on
persons with immune systems weakened by HIV infection. 

     Disability payments are potentially payable under two 
separate programs--Social Security Disability Insurance (SSDI) 
and Supplemental Security Income (SSI).  SSDI provides cash 
benefits financed through Social Security payroll taxes to 
disabled workers and their families out of the Federal Disability 
Insurance Trust Fund.  SSI provides payments from general tax 
revenues to eligible disabled adults and children with limited 
income and resources.  Under both programs, applicants must meet 
the strict statutory definition of disability--the inability to 
work because of a disabling impairment.  A comparable evaluation 
process is followed for determining disability in children. 
However, instead of evaluating the ability to work, SSA evaluates 
the child's ability to function in an age-appropriate manner. 

     In announcing SSA's updated disability criteria for HIV 
infection, Enoff reiterated that the Centers for Disease Control 
and Prevention and SSA view the infection from different 
perspectives.  While CDC is concerned with HIV infection for      
reporting, prevention and public health policy planning, SSA must 
determine how it restricts a person's ability to function or 
work.  Consequently, SSA is not bound by the CDC AIDS 
surveillance case definition or vice versa. 

     Other rules announced today reflect SSA's procedures for 
determining whether presumptive disability payments based on HIV 
infection may be paid for individuals applying for SSI disability 
payments.  SSI law permits immediate payment of cash benefits for 
up to six months, pending a formal disability decision, to 
applicants who meet specific guidelines and are likely to be 
found disabled under SSA criteria.  The revised rules have 
significantly enhanced the availability of presumptive disability 
payments for men, women and children with HIV infection. 

     Enoff also expressed his appreciation today for the 
excellent comments and suggestions supplied by disability 
advocates and the medical community on the original department 
proposal.  Their input, he said, has resulted in a final rule 
that will benefit all men, women and children with HIV infection.  

     The new rules will be published in the Federal Register on 
Friday, July 2, *This is an archive page. The links are no longer being updated.
1993. 
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NOTE TO CORRESPONDENTS:  Two fact sheets providing more detailed 
information regarding the disability evaluation process and SSA's 
new procedures for evaluating disability claims filed by 
individuals with HIV infection are available upon request.