There are benefits and services which can help you if you are HIV-positive. Public Assistance (Welfare), the Division of AIDS Services (DAS), Supplemental Security Income (SSI), and Social Security Disability (SSD) are four of the government benefit programs for which you may be eligible. These benefits include a monthly allowance (food stamps and Medicaid are other benefits not covered here). This chapter cannot go into the full range of benefits available or even into all the aspects of these four programs. You may also want to read Chapters 12 and 13. The best way to find out about all the benefits and services to which you're entitled is to call an HIV service agency and get a case manager (see the "Resources" section). A good case manager will know about all the programs and benefits for which you are eligible, and help you with the application process.
New York City helps HIV-positive people who have certain symptoms and little or no income by giving higher welfare amounts for their rent (rent enhancement) and by providing benefits and services through a special unit of the City's Human Resources Administration (HRA) called the Division of AIDS Services (DAS).
Regular Public Assistance and Rent Enhancement for HIV-Positive People If you are HIV-positive but have no symptoms, you can get regular public assistance (PA) which provides cash assistance, food stamps, and Medicaid to people with little or no income. You can apply for PA at your local Income Support (IS) center. To find out where your local center is, call the HRA helpline at (718) 291-1900.
If you have no available money and are in an emergency situation, PA should give you an "immediate needs grant" (cash), and within five days you can get expedited food stamps. You may also be able to get emergency Medicaid and/or money to pay your back rent or utility bills.
If you move into a new apartment because you are homeless or have to leave where you are for health or safety reasons, PA will also pay the broker's fees, security deposit, and moving expenses. You must ask for these funds before you move. You also must show you can pay the rent in the future.
If you are HIV-positive and have certain symptoms (see the list at the end of this chapter) but do not have an AIDS diagnosis, you may be able to get extra money for rent ("enhanced rent") through a regular public assistance center. The amount you can get depends on how much your rent is and how much other money you receive each month. If you have no other income, you can get up to $480 in rent for one person plus $330 for each additional person in your household who is eligible for public assistance (whether or not they are HIV-positive), up to the actual amount of your rent. In order to get the rent enhancement, you must tell your public assistance caseworker that you want to receive it and ask that you be given an appointment with "HS Systems" (City doctor) to establish your medical eligibility for the program. Bring medical evidence with you when you go to see the doctor.
The Division of AIDS Services
If you have an AIDS diagnosis and you need financial assistance, you should apply for help from the Division of AIDS Services (DAS). You may also be able to receive DAS benefits without an AIDS diagnosis if your doctor says you need home care. The City created DAS so that people with AIDS or HIV would have a caseworker who could make referrals to support groups, medical providers, and other services, as well as guide clients through the entitlements process. Now there are so many new people that qualify for DAS, DAS can only assist you in getting the basic financial benefits for which you qualify, home care, and housing if you need it. For this reason, we strongly recommend that you get a case manager (through an HIV service organization) to guide you through the application process and get you hooked up with other programs. Again, see the "Resources" section for organizations that offer case management.
You qualify for DAS services if you are financially eligible for Medicaid and have an AIDS diagnosis, or if you are HIV-positive, have one of the diseases that appear on the list at the end of this chapter, and your doctor says that you need home care. The only way to apply for DAS is by writing, faxing, telephoning, or going in person to the DAS "serviceline," the office within DAS which accepts applications and determines eligibility. In order for DAS to decide whether you are eligible, your doctor must fill out a special form (called an "M11Q" form) which shows that you are medically eligible. This must be sent by fax, mailed, or hand delivered to the DAS Serviceline. (The walk-in address is 12 West 14th Street, 5th floor, New York, New York 10011, the mailing address is 11 West 13th Street, Intake, 5th floor, New York, New York 10011, Tel: (212) 645-7070, Fax: (212) 337-1647). Once your case has been accepted, you should be assigned a caseworker within a few days.
Your DAS caseworker is supposed to help you apply for benefits, including rent enhancement, food stamps, Medicaid, and the nutritional/transportation allowance of $193 per month which is only available to DAS clients. He or she can also help you to get home care if you need it or a hotel room if you need emergency housing. Your caseworker will gather all the forms for your public assistance application and send them to Income Support (welfare) for processing. Your caseworker is supposed to help you gather necessary documentation and must come to see you if you are too sick to go in to the office to apply for benefits. Your DAS caseworker must request any benefits for which you want to apply. The caseworker cannot decide whether you are eligible for a benefit.
If you already have an open public assistance "case," it is supposed to be transferred from your old center to DAS within ten days after your caseworker asks for the transfer. Your caseworker should ask for the transfer within two days of getting the case. Once the case is transferred, you should be "rebudgetted" so that you receive the additional nutrition/transportation allowance.
Being accepted as a DAS client is only the beginning of the process. It will probably take weeks before you start receiving benefits unless you have emergency needs. You should begin to receive benefits after 30 days if you have children (Aid to Families with Dependent Children, AFDC) or 45 days if you are single or do not have children (Home Relief, HR). In either case, you have the right to get food stamps and Medicaid within 30 days.
It will probably be a long and difficult process. Be persistent and advocate for yourself. Try to resolve problems with your caseworker first, but remember that if this doesn't work, you can go to their supervisor (see phone numbers at the end of this chapter). Take a friend for support whenever you have to go to DAS offices, and try not to personalize what happens. Do not confuse a case manager at an HIV service organization with your caseworker at DAS. Getting you into additional programs is more likely to happen if you have a case manager from an HIV service organization.
Supplemental Security Income (SSI) and Social Security Disability (SSD) Both Supplemental Security Income (SSI) and Social Security Disability (SSD) are federal programs for people who are disabled and unable to work full-time. The medical criteria used to determine if you are disabled is the same for both SSI and SSD. If you qualify, you will be sent a check every month. You cannot apply for these benefits through your DAS caseworker or at public assistance. You must apply with the Social Security Administration, a federal agency, which administers SSI and SSD. You can apply in person or by phone; call (800) 772-1213.
Recently, the Social Security Administration was sued because of the limited number of illnesses that could qualify an HIV-positive person as "disabled." As a result of this lawsuit, the SSA has changed the criteria HIV-positive people must meet to prove they are disabled. These rules are very different now than they were a few years ago. Many people think that because the definition of AIDS includes having less than 200 T-cells, they will qualify for SSI/SSD when their counts reach this level. THIS IS NOT THE CASE. In order to get disability benefits, you must have certain illnesses or conditions, and you may have to prove that you have difficulty doing daily activities. For more information about workshops that can help you apply for disability, see the "Resources" section. It is very important to make sure that the SSA has all the medical evidence about your condition. A report from your doctor is required.
If you apply and are not found eligible, you should ask for a "reconsideration" rather than submitting a new application. If SSA made a mistake, you will get benefits retroactively (back to when you applied for benefits or before). If your reconsideration is denied, you can request an administrative hearing.
Supplemental Security Income (SSI)
You are eligible for SSI if you are disabled and have income of less than $532 a month ($771.50 per month for a married couple who are both eligible for SSI). You are not eligible if you have more than the allowed amount of savings/assets ($2,000 for a single person; $3,000 for a couple). This does not include a burial fund. The income levels change every year. In 1994, in New York State, the amount of your SSI check was $532 for individuals living alone and $772 for married couples living only with each other. If you have a roommate and share living expenses, your check will be less.
Social Security Disability (SSD)
To qualify for SSD, you have to be disabled and have worked and paid FICA taxes for a certain number of years within the last decade. The number of years you must have worked varies by how old you are. The amount of your check will be based on a formula that considers your entire salary history. If the monthly amount is less than the SSI you would receive, SSI will supplement the amount, and you will get $20 more than you would on SSI.
The Social Security Administration keeps records of different jobs you have held and how much money you earned at each one of them. It is a good idea to call them at (800) 772-1213 as soon as you can and ask for your "earnings records," so you can correct them if they contain errors. They can also tell you how much you will get. SSD does not have income or savings limits.
Appealing a DAS Decision
Your first step should be to talk to your caseworker. If this doesn't help, speak to their supervisor, the Director of the site, or the Deputy Director who oversees several offices. If you're still not satisfied, you can call the Assistant Deputy Commissioner. (Numbers are listed in the "Resources" section.) Ask your caseworker for a copy of the "General Information for Applicants and Recipients of DAS" which tells you how to challenge a decision about your benefits. You can also request the two types of appeal explained below.
Appealing an Agency Decision
There are two kinds of appeals. An "Agency Conference" is an informal meeting to discuss your situation with agency staff. You can appear by yourself or be represented by a lawyer, a friend, a relative, or any person you choose. The next level of hearing is called a "Fair Hearing." It must be requested within 60 days of the decision you are appealing; 90 days for food stamp challenges. At this hearing, both sides present their positions before a hearing officer (an administrative law judge, not an agency staff person). The officer will notify you and the agency in writing of their decision. The agency must comply with this decision.
All of these programs can make a tremendous difference to you, but they only work if you know your rights and how to work the system to your advantage. Get a case manager, go to workshops about entitlements, and talk to other people with HIV. You should also get an advocate from a legal services office to help you if you are not receiving all the benefits to which you believe you are entitled.
Author Information: Lauren Shapiro, JD, is the Director of the HIV Unit of Brooklyn Legal Services Corp B. Cynthia Schneider, JD, is the Deputy Director of the HIV Unit of Brooklyn Legal Services Corp B.