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103D CONGRESS

1ST SESSION H. R. 728

To provide for the inclusion of specific items in any listing of impairments

for the evaluation of human immunodeficiency virus (HIV) infection

prescribed in regulations of the Secretary for use in making determinations of disability under titles II and XVI of the Social Security Act.

IN THE HOUSE OF REPRESENTATIVES

FEBRUARY 2, 1993

Mr. MATSUI (for himself and Mr. JACOBS) introduced the following bill; which

was referred to the Committee on Ways and Means

A BILL

To provide for the inclusion of specific items in any listing

of impairments for the evaluation of human

immunodeficiency virus (HIV) infection prescribed in

regulations of the Secretary for use in making determinations of disability under titles II and XVI of the Social

Security Act.

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled,

3 SECTION 1. SHORT TITLE.

4 This Act may be cited as the ‘‘Social Security and

5 SSI AIDS Disability Act of 1993’’.
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1 SEC. 2. SPECIFIC ITEMS REQUIRED IN LISTING OF IMPAIR2 MENTS FOR EVALUATION OF HUMAN

3 IMMUNODEFICIENCY VIRUS (HIV) INFECTION.

4 (a) IN GENERAL.—The Secretary of Health and

5 Human Services shall include, in any listing of impair6 ments for the evaluation of human immunodeficiency virus

7 infection used in making determinations of disability

8 under title II or XVI of the Social Security Act, in addi9 tion to such other items as the Secretary may include in

10 the Secretary’s discretion, items as specified in paragraphs

11 (1), (2), and (3) of this subsection.

12 (1) The Secretary shall include the following

13 among impairments for which meeting a functional

14 test is not required in order to support a determina15 tion of disability, subject only to the requirements

16 that a test for human immunodeficiency virus infec17 tion has been administered and that the results of

18 such test are positive—

19 (A) pelvic inflammatory disease with three

20 or more episodes or one or more episodes that

21 require hospitalization or surgery;

22 (B) cervical cancer, FIGO stage IB; and

23 (C) syphilis or neurosyphilis refractory to

24 appropriate treatment.

25 (2) The Secretary shall include the following

26 among impairments for which meeting a functional
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1 test is not required in order to support a determina2 tion of disability, but which must be persistent or re3 sistant to therapy:

4 (A) pneumonia;

5 (B) pulmonary tuberculosis;

6 (C) bacterial or fungal sepsis;

7 (D) meningitis;

8 (E) septic arthritis;

9 (F) endocarditis;

10 (G) peripheral neuropathy;

11 (H) Kaposi’s sarcoma; and

12 (I) abscess of an internal body organ or

13 cavity (excluding otitis media or superficial skin

14 or mucosal abscesses).

15 (3) The Secretary shall include the following

16 among impairments which must last for at least two

17 months and must exist in combination with one

18 other listed impairment, subject to the requirement

19 that a functional test be met with respect to the

20 combination of impairments—

21 (A) recurrent herpes simplex with lesions

22 which recur more often than every 8 weeks or

23 which are incompletely suppressed despite con24 tinuous maintenance therapy;
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1 (B) chronic anemia with persistent hemo2 globin of less than 10.0 or hematocrit of less

3 than 30.0 (regardless of AZT intake) or the

4 need for blood transfusions more often than

5 twice yearly;

6 (C) genital warts caused by human papil7 loma virus which are unresponsive to therapy;

8 and

9 (D) chronic genital ulcers which fail to re10 spond to treatment.

11 (b) FUNCTIONAL TEST REQUIREMENTS.—

12 (1) IN GENERAL.—With respect to any item in

13 a listing of impairments described in subsection (a)

14 (irrespective of whether such item is listed in sub15 section (a) or is otherwise listed in regulations of the

16 Secretary), any requirement for a functional test

17 shall be treated as met if one of the following re18 quirements are met—

19 (A) a marked restriction of activities of

20 daily living (evidenced in any case in which the

21 individual is most of the time unable to perform

22 independently such daily activities as household

23 chores, grooming and hygiene, using a post of24 fice, taking public transportation, and paying

25 bills);
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1 (B) marked difficulties in maintaining so2 cial functioning (evidenced in any case in which

3 the individual is most of the time unable to sus4 tain interaction and communication);

5 (C) marked difficulties in completing tasks

6 in a timely manner due to deficiencies in con7 centration, persistence, or pace (evidenced in

8 any case in which the individual is most of the

9 time unable to sustain concentration, persist10 ence, or pace to permit timely completion of

11 tasks commonly found in work settings); or

12 (D) repeated episodes of decompensation,

13 averaging 3 times a year or once every 4

14 months, lasting 2 or more weeks each, which

15 cause the individual to deteriorate.

16 (2) MARKED RESTRICTIONS OR DIFFICUL17 TIES.—For purposes of subparagraphs (A), (B), and

18 (C) of paragraph (1)—

19 (A) a finding of a ‘‘marked’’ restriction or

20 difficulty may be based on a restriction or dif21 ficulty with respect to either a single activity or

22 function referred to in such subparagraphs or

23 any combination of such activities or functions,

24 if the degree of restriction or difficulty is such

25 that it seriously interferes with the individual’s
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1 ability to function independently, appropriately,

2 and effectively, and

3 (B) the term ‘‘marked’’ does not imply

4 that the impaired individual is confined to bed,

5 hospitalized, or in a nursing home.

6 SEC. 3. EFFECTIVE DATE.

7 The provisions of section 2 shall apply with respect

8 to determinations of disability made on or after

9 December 18, 1991.

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