Public Benefits and HIV

Table of Contents

• Introduction
• What Are Benefits?
• Income Benefits
• Health Benefits
• Taking Care of Yourself

Introduction

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

What Are Benefits?

Benefits are a form of government assistance that may provide you with monthly income, health insurance, food stamps, or help paying your rent or home mortgage. Benefits are important because they can increase your access to housing, health care, medication, methadone maintenance (drug treatment), in-home support services, food, job training, and assistance finding a job. If you are not working or if you are working and earning a limited income, benefits may be available to you so that you can provide for your 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 is important to know that you may qualify for benefits that can act as a safety net and help improve your quality of life if you are unable to work or earn a limited income.

Income Benefits

1. County or General Assistance

This benefit may be available through your county and is usually based on financial need. You have to have limited money in order to be eligible for county assistance. Counties may also require rent receipts, volunteer work, job 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 (meet the requirements that enable you to qualify) for any of the other programs listed below. Contact your county for more information.

2. State Disability Insurance

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 health care provider or psychologist has to certify that you cannot do your regular job due to a disability, such as HIV-related fatigue. It pays about 55 percent of the income you earned before your disability (pre-disability income) and is not taxed (unless it is a substitute for unemployment insurance benefits). Contact the Employment Development Department in one of these states.

3. TANF (Temporary Assistance for Needy Families)

This used to be called AFDC (Aid to Families with Dependent Children), but since 1997 it has been called TANF. The Office of Family Assistance, which is a part of the US Department of Health and Human Services (DHHS), manages the TANF and tribal TANF programs. States receive monies from the federal government to distribute to their residents. Because states give out the assistance, the rules for qualifying vary by state. Single parents, pregnant women, 2-parent families in which one or both parents are disabled, and some other family situations may qualify you for TANF. Income and resource limits, as well as time limits (usually 5 years) and work requirements, apply. SSI benefits may affect eligibility. To find help for your family, go to this website and enter your state of residence.

If you are an eligible single parent, you may be able to 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 state for more information. If you are unable to work after five years, you probably want to apply for Social Security Disability.

4. SNAP (Supplemental Nutrition Assistance Program)

SNAP is a federal program, formerly known as the Food Stamp Program that helps low-income families buy food. It is intended for people who are working for low wages, working part time, unemployed, receiving public benefits, elderly or disabled, or homeless. You can apply at your local welfare or Social Security office. To find your local SNAP office, go to SNAP's local office locator website or look for listings in your phone book under "public assistance," "social services," or "food stamps."

5. Social Security Disability

There are two relevant programs, Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI). You can get SSDI if you have a fairly long formal work history. SSDI is not a need-based program and has no asset limit. The amount you get is based on your work history; maximum benefits are $2533 per month in 2013. After you have received SSDI for 24 months you are automatically entitled to Medicare coverage.

You can get SSI if you have limited income and assets and do not qualify for SSDI. People who qualify for SSI may also receive assistance through Medicaid and food stamps (SNAP). Some people get both SSI and SSDI if their SSDI is less than the SSI limit (the federal SSI rate is $710/month for an individual in 2013, although most states pay more).

a. Medical Rules: According to Social Security, you are considered disabled when, due to a medically documented physical condition, you are unable to engage in substantial gainful work activity. You will be found disabled if you meet the following criteria:

• You cannot do work that you did before;
• Social Security decides that you cannot adjust to other work because of your medical condition(s); and
• Your disability has lasted or is expected to last for at least one year or to result in death.

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

• Fatigue
• Persistent diarrhea
• Recurrent 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
• Trouble thinking, concentrating, or remembering
• Opportunistic infections

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 decision is based on functional skills and abilities, taking into account how much work you can do. A person does not have to have AIDS; HIV symptoms may be enough. The more you report the worst moments and days to your medical provider, the easier your claim for this benefit will be.

b. Alcohol and Drug Rules: People who use drugs or alcohol are not prohibited from receiving SSI, as long as drug addiction or alcoholism is not their primary disability. However, in practice, judges and hearing officers who decide SSI cases may be less willing to give benefits to people with substance abuse problems.

If any substance use is mentioned in your medical notes, you should explain to your medical provider that you would still be unable to work even if you stopped using drugs or alcohol. For example, you may be using substances to deal with your symptoms or give yourself enough energy to go about your day. It is important to make sure the judge or hearing officer does not think that that substance abuse is your primary disability.

c. Incarceration Rules: You are not eligible for SSDI 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. However, regular disability benefits are not paid for the months a person is incarcerated (although under certain circumstances beneficiaries may still receive money).

d. Immigration Rules: For SSDI, you have to show that you are lawfully residing in the US (including any temporary status). For SSI, you have to show that you were lawfully residing in the US before August 22, 1996, have been granted asylum, are a refugee, are having your deportation withheld, are a Cuban or Haitian entrant, or are an American Indian born abroad.

It is important to know that, even if you are a Lawfully Admitted for Permanent Residence (LAPR), if you entered the US after August 22, 1996, you may not qualify for SSI for the first five years as a LAPR, even if you have 40 quarters of qualified earnings.

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.

e. Dependent and Spousal Benefits: If you get SSDI, your spouse and/or your children may be eligible for income too. Likewise, 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.