AIDS and the Law, Fourth Edition
Chapter 9: Public Benefits for Persons with HIV
§ 9.01 Introduction
§ 9.02 Disability Income Programs
[A] Social Security Disability Insurance (SSDI)
[1] Eligibility
[2] Benefit
[3] Relevance for Health Care
[4] SSDI and Immigration Status
[B] Supplemental Security Income (SSI)
[1] Eligibility
[2] Benefit
[3] Presumptive Benefits
[4] Relevance for Health Care
[5] SSI and Immigration Status
§ 9.03 Social Security Procedure
[A] Initial Claims
[B] State Agency Disability Evaluation
[C] Reconsideration
[D] Administrative Law Judge Hearing
[E] Appeals Council
[F] Judicial review
[G] Disability Service Improvement (DSI)
[1] Quick Disability Determinations (QDD)
[2] Medical and Vocational Expert Unit (MVEU)
[3] Federal Reviewing Official
[4] Decision Review Board
[5] Administrative Law Judge Hearing Level
[6] Human Immunodeficiency Virus/Auto-Immune Disorder (HIV/AI) Demonstration Project
§ 9.04 Sequential Evaluation of Disability Claims
[A] Substantial Gainful Activity (SGA)
[B] Severe Impairment
[C] Meeting or Equaling the Listings
[D] Past Relevant Work
[E] Other Work
§ 9.05 Social Security’s Listings for HIV Disability
[A] Disability Standard for Adults with HIV
[1] Opportunistic and Indicator Diseases (Stand-Alone Conditions)
[2] Repeated Manifestations plus Functional Impairment
[3] Irrelevance of CD4 Counts
[B] Disability Standard for Children with HIV
[1] Opportunistic and Indicator Diseases (Stand-Alone Conditions)
[2] Other Manifestations plus Functional Impairment
§ 9.06 Disability Based on Mental Illness
§ 9.07 Disability Based on Substance Abuse
§ 9.08 Practice Pointers for Proving Disability
[A] Intake Interview
[B] Working with Physicians
[C] Persuasive Writing
[D] Working with SSA and State Agency Personnel
[E] Advocacy at Hearings
[1] Prepare Direct Examination
[2] Prepare Cross-Examination
[3] Prepare the Client
[4] Post-Hearing
[5] Attorney’s Fees
[F] Working with Chemically Dependent Clients
§ 9.09 Social Security Post-Entitlement Issues
[A] Overpayments
[B] Fleeing Felon Exclusions
[C] Representative Payee Problems
[D] Continuing Disability Review (CDR)
[E] Returning to Work
[1]Trial Work
[2] Extended Period of Eligibility
[3] Expedited Reinstatement
[4] Earned Income Exclusion
[5] Extended Medicaid Eligibility
[6] Impairment-Related Work Expenses (IRWE)
[7] Plan for Achieving Self-Support (PASS)
§ 9.10 Veterans’ Disability and Health Benefits
[A] Who Is a Veteran?
[B] Service-Connected Compensation
[C] Nonservice-Connected Pension
[D] Special Monthly Pension
[E] Special Issue of HIV and Willful Misconduct
[F] Relationship of VA Income to SSDI/SSI
[G] Application Procedure
[H] Veterans’ Health Care Programs
§ 9.11 Medicaid
[A] General Eligibility Standards
[1] Linkage
[2] Income and Resources
[3] Residence
[4] Immigration Status
[5] Spend-Down or Share of Cost
[B] General Coverage and Scope of Services
[C] Retroactivity
[D] Medicaid Payment of Health Insurance Premiums
[E] Claim Processing and Fair Hearing Rights
[F] Transfer of Assets Penalties
[1] Treatment of Trusts
[2] Liens and Claims
§ 9.12 Medicare
[A] Medicare Parts A and B
[B] Medicare Part D
[1] Standard Benefit
[2] Low-Income Subsidy (LIS)
[3] Prescription Drug Plans (PDPs)
[4] Formularies
§ 9.13 HIV-Specific Public Health Programs
