One of the most stressful problems faced by HIV+ people is trying to support themselves and cover their bills. Fortunately, there are benefits programs that can help.

Benefits may include monthly income, health insurance, food stamps, and medication programs. Benefits are so important because they can increase your access to housing, health care, medication, methadone maintenance (drug treatment), in-home support services, food, and vocational rehabilitation. If you are not working or working and earning a minimum amount of money, benefits may be available to you so that you can provide for these basic needs.

Benefit programs are run by the county, state, or federal (national) government. Federal programs almost always have the same rules. State and county programs vary depending on where you live.

Some benefit programs require that you be disabled based on HIV, mental health, and/or other conditions. Other programs require that you have limited income and assets (possessions). It’s important and empowering to know that you may be entitled to benefits that can act as a safety net and help improve your quality of life if you are unable to work.

This benefit may be available through your county and is usually based on need. You have to have limited money in order to be eligible for county assistance. Counties may also require rent receipts, volunteer work, vocational training, and/or an application for Supplemental Security Income (SSI), a federal disability program. Usually, this type of assistance provides the least amount of money available so you should see if you are eligible for any of the other programs listed below. Contact your county for more information.

This benefit is only available for people who have a recent work history in California, New Jersey, New York, Puerto Rico, Hawaii, or Rhode Island. Your doctor or psychologist has to certify that you cannot do your regular job due to a disability, such as HIV-related fatigue. It pays 60 percent of your pre-disability income and is not taxed. Contact the Employment Development Department in one of these states.

This used to be called AFDC (Aid to Families with Dependent Children), but since 1997 it has been called TANF and is run through the state and county where you live. If you are an eligible single parent, you can get TANF grants for your children and/or yourself. TANF can also come with Medicaid, but the program is time limited to five years unless you qualify for a special exception. Contact your county for more information. If you are unable to work after five years, you probably want to apply for Social Security Disability.

You can get SSDI if you have a fairly long formal work history. The amount you get is based on your work history. You can get SSI if you have limited money and don’t qualify for SSDI. Some people get both if their SSDI is less than the SSI limit (the federal SSI rate is $579/month for an individual in 2005, although some states pay more).

Medical Rules:

According to Social Security, disability is:

• The inability to earn $830 per month (2005 amount).
• Due to a documented medical condition.
• Likely to last for at least one year or result in death.

In order to prove disability, it is important to see a doctor and/or mental health practitioner on a regular basis and report all symptoms that may prevent you from working. Report symptoms of HIV and/or mental health you are experiencing such as:

• Fatigue
• Diarrhea
• Yeast infections, bladder infections, and/or pelvic inflammatory disease
• Neuropathy
• Weight loss
• Rashes
• Fungal and/or bacterial infections
• Night sweats
• Lack of appetite or sleep
• Depression, anxiety, bipolar disorder, psychosis and/or schizophrenia
• Opportunistic infections due to AIDS

Most people think your CD4 count will determine if you qualify for this benefit, but that is not true. Instead, Social Security relies on repeated symptoms of HIV or AIDS that limit your ability to work. The more you report the worst moments and days to your medical provider, the easier your claim for this benefit will be.

Alcohol and Drug Rules:

Before 1997, you could get SSDI or SSI if you had drug or alcohol issues. Now, if any substance use is mentioned in your medical notes, you should explain to your medical provider why you would still be unable to work even if you stopped using drugs or alcohol. For example, you may be using to self-medicate your symptoms or allow enough energy to go about your day.

Incarceration Rules:

You are not eligible for SSDI (as of January 1, 2005) or SSI if you have a felony warrant or are in violation of parole or probation. If you have one of these warrants that Social Security knows about, try and work with an advocate to get rid of the warrant. Otherwise, you may never be able to get this benefit or be cut off and owe Social Security back. Convictions have no effect on your ability to get this benefit.

Immigration Rules:

For SSDI, you have to show that you are lawfully residing in the U.S. (including any temporary status). For SSI, you have to show that you were lawfully residing before August 22, 1996, granted asylum, refugee, or withholding of deportation status, are a Cuban or Haitian entrant, or are an American Indian born abroad.

Some states have adopted state programs for immigrants who are not eligible for SSDI or SSI because of immigration status. Contact your county for more information.

Dependent and Spousal Benefits:

If you get SSDI, your spouse and/or your children may be eligible for income too. If your spouse gets SSDI, you and/or your children may be able to get some income.

SSDI and/or SSI are usually the highest paying public income sources so it is important to try and win your claim.

ADAP can pay for Food and Drug Administration (FDA)-approved medications. You may have no health insurance, be on Medicare, or have private insurance with co-pays for your medication. Each state has its own requirements and list of covered medications. Some states want proof that you are HIV+, but do not require that you be at a certain stage of the disease. Other states look at income only, but not assets. Contact your county or an AIDS service organization for more information.

This health insurance may come automatically with TANF or SSI. Some counties also provide Medicaid if you have limited income or resources. Contact your county or an AIDS service organization for more information.

You automatically qualify for Medicare after 24 months of SSDI payments. Up until recently, Medicare didn’t cover prescription drugs. Medicare laws are changing and some options are available to help with the cost of medications. Contact Medicare or an agency such as the Medicare Rights Center for more information. 

You should see if you can also get Medicaid to pay for your Medicare premiums and costs that Medicare does not cover. Check to see if you can get ADAP if you are not able to get Medicaid.

If you are unable to work due to symptoms of HIV, mental health, and/or other conditions, you are entitled to benefits.

• Be persistent with your applications, appeal any denials, and try to get an advocate or attorney to represent you through a local Legal Aid society, an AIDS service organization, or a private attorney’s office.
• Report all symptoms to your medical provider.
• Fight for what you deserve - the most income and health insurance that you and/or your family are allowed.
• See your medical provider as often as possible for the best medical treatment as well as support with your benefits claims.

The above information was supplied by Positive Resource Center (www.positiveresource.org), an agency that provides benefits counseling and employment services to HIV+ people in San Francisco.

1		AIDS Drug Assistance Program: http://www.atdn.org/access/index.html. 212-260-8868.
2		Medicare: http://www.medicare.gov. 800-MED-CARE.
3		Social Security Administration: http://www.ssa.gov.  800-772-1213.