Meds, Mind, Body & Benefits > Insurance, Benefits Programs & HIV

Anyone Kicked Off Of SSDI?

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JR Gabbard:

--- Quote from: ademas on August 04, 2007, 10:30:04 AM ---
 I know it says they reviewed my claim, but it just seems weird that it seemed entirely about the Work Activity Report.



--- End quote ---

For all practical purposes, once you have an SSDI disability determination, you are totally and permanently disabled.  The only factor that affects your continuing eligibility for SSDI is whether you are actually working and earning more than $860 per month (SGA).  That's why they used to lead with the Work report.  If you're not working, your disability continues.  If you are working, they check your medical eligibility.

If you do return to work, you will still draw your regular benefit for 12 months (9 TWP + 3 grace).  For the next 3 years, you are eligible for your benefit for any month in which you do not earn SGA (substantial gainful activity, currently ~$860).  All you have to do is let 'em know.

Furthermore, ( ;D ), during the first 5 years after you return to work, if you become too sick to work due to the same condition (HIV infection), all you have to do is submit a special application--no medical review.  They used to call it Easy-on.

It works this way because your disabling condition is HIV infection.  The infection must have seriously damaged your immune system, as shown by the symptoms you have, and OIs you've had.  But, the OIs are not the disabling condition, the underlying HIV infection is; so recovering from an OI does not change your status to "no longer disabled."  Neither does an undetectable VL and rising CD4 count, since you are still at risk of new OIs.

It is nearly a certainty that your physician either does not know this, does not get this, or does not accept this.  It falls to you to insist that they get it right.  HIV infection is the disabiling condition, not the OIs.

Physicians also don't understand that there is a difference between a medical diagnosis of "disabled," and a legal determination that one is disabled and entitled to benefits.  They absolutely determine the former.  But their contribution to the legal determination is in making a good diagnosis, and ordering the right tests.  Their negative opinion is sometimes considered, but it can usually be argued against if the facts support disability.  Docs are given deference, but it is a far cry from the treatment they receive within their own community (clinics and hospitals).  They don't get it, and they don't want to hear it. 

So you have to stick up for yourself.  If you aren't working, you need to be on benefits.  If you are working, you don't need them any more.  If your doc doesn't support this, why not?  Does s/he have your best interest in mind?

It is very frustrating for me personally, because the last 5 docs I've seen got sacked (by me) for some various display of stupidity or ignorance regarding AIDS disability (which complicated my access to needed benefits), and professionally because I see the damage that is done to folks when benefits are lost.

The above applies to SSDI only.  SSI has different rules on when you are disabled.  LTDs vary with each particular policy. 

Since everything after "Physicians" a couple of paragraphs back is a complete hijack of this thread, I have copied and posted this onto my blog (link below).  If you want to respond to the "My doctor doesn't get it" idea, please don't hijack this  thread--you can comment there, or start a new thread. 

J.R.E.:
Thanks for starting this thread. It's been very informative, and thanks gabbardjr, for you input .
 I learned a little more tonight !!


Ray

randym431:
Yes!!! A very good thread. I always thought it would be nice to "retire" with things still going good, on the meds. Guess thats out...
As to change in the future for people doing well on the meds and SDI, guess it all depends on who is elected in 2008, in part at least.
Talk about a double edged sword.
I have done excellent on meds, and actually feel better than I did before hiv in the first place (go figure).
Numbers are as a "normal" person in the last checks and I switched to ever four months now (from three month checks).
The doc said whats the point, and saves me a little on out of pocket co-pays. I'm even thinking every 6 months, if I can get them to agree. Why not?
And all too often, I just wish these meds would have been available to so many that never had them as an option. I'd LOVE to have a time machine.

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