Social Security benefits
for people with AIDS or ARC
Social Security and other public-benefit law is complex , and
eligibility requirements are detailed and sometimes conflicting
BY B R A D L E Y J. W O O D W O R T H , Esq.
Note: No two legal situations are the same. This
column discusses only general legal principles.
For specific advice, consult a qualified attorney.
possible. Claims filed after the disability date
may recognize the disability date retroactively
for the waiting period (up to twelve months
retroactive).
Supplemental Security Income
here are a variety of public benefits
SSI is available to persons who qualify as
available to persons diagnosed with
“
disabled”
and have demonstrated “ financial
AIDS or AIDS-Related Complex (ARC). This
need.” One does not have to have paid into the
column explains, in general terms, some of the
Social
Security system to qualify for this
potential benefits and their eligibility
benefit. There is no waiting period, but claims
requirements.
may take a long time to process. If the claim is
Public agencies have dealt with AIDS and
approved,
benefits range up to $354 per month
ARC claims for only a few years, so issues
and will be paid retroactively to the date of
filing the claim.
“ Financial need” means that one has $1,900
or less in assets after deducting exemptions such
as the value of one's home, and one car, worth
up to $4,500 if it’s needed for medical or
often come up for the first time. Agency proce­
employment reasons; there are also some other
dures and requirements can change rapidly, in
property exemptions. One may receive income
light of court rulings and lawsuits brought by
up to a variable maximum depending on the
applicants. One should consult a qualified
number of one’s dependents.
person for up-to-date information on public-
For example, a single person with no other
benefit programs. Unless one’s lawyer is a
income after qualifying for SSI could work and
specialist in Social Security and other public-
earn up to $793 before losing all benefits. An
benefit law — Legal Aid is a good source —
income of more than $300 at the time one ap­
one should check with specialized private
plies for SSI, however, would prevent one from
agencies, such as the Cascade AIDS Project
qualifying for benefits.
and Outside-In in Portland, that keep up to date
on benefit information.
Medical benefits: Medicare and Medicaid
There are two kinds of medical benefits in the
Disability
Social Security system. A person eligible for
Any person with a medical diagnosis of
SSDI is eligible for Medicare, but there is a
AIDS automatically qualifies as ‘ ‘disabled” for
two-year waiting period from the date of the
purposes of receiving Social Security or
first Social Security payment before Medicare
Supplemental Security Income.
coverage starts. Currently there is a move to
But if a person is diagnosed with ARC, or is
eliminate the waiting period for AIDS patients,
only HIV-positive, the case will be reviewed
but this change has not been finalized.
on an individual basis. To qualify as “ dis­
Medicaid benefits can begin immediately if
abled,” one must have a physical or mental
the applicant meets the same disability and
condition that is disabling (prevents one from
financial-need requirements to qualify for SSI.
working) and is expected to prevent one from
Persons who do not qualify as financially needy
working for a minimum of twelve months.
may still be eligible for Medicaid assistance if
Some ARC patients have successfully estab­
they have substantial medical bills.
lished a disability claim, but many ARC claims
are denied and one must pursue the sometimes-
Other programs
lengthy appeals process and be able to produce
Veterans and their dependents, if they have a
a substantial amount of medical evidence and
service-related disability, are eligible for a wide
employment documentation to verify one’s dis­
variety of benefits, including medical care and
disability income.
abled status.
It is advisable to consult a qualified lawyer or
Federally funded food-stamp programs are
community advocacy agency prior to applying
administered by the State Department of Social
Services.
for benefits. Such assistance can be useful in
assembling the necessary information. Evidence
General-assistance or welfare programs are
sometimes available, but single persons without
that one is capable of working at one’s present
job or another job almost always results in a
minor dependents usually do not qualify.
If one is fired from employment, one may be
claim denial. If one’s claim is denied and then
able to collect unemployment benefits if one is
appealed, the law provides that 25 percent of
able and available for work and has sufficient
the retroactive benefits may be withheld to pay
covered employment.
attorney fees. This provision is helpful because
Private insurance programs vary widely in
lawyers may take such cases on a contingency
their coverage, so one should be sure to know
basis, getting paid a fee only if the claim is
what one’s insurance covers. If one leaves one’s
approved.
employment, it may be possible to retain the
group medical insurance, convert to individual
Social Security Disability Income
coverage and pay the monthly insurance fees.
To be eligible for Social Security Disability
Income, the applicant must have worked and
Summary
paid into the Social Security system for 20 of
Social Security and other public-benefit law
the past 40 calendar quarters, and be disabled.
is complex, and eligibility requirements are de­
Persons becoming disabled before reaching age
tailed and sometimes conflicting. Persons who
22 may qualify if their parents have paid into
believe they may have a claim should consult a
Social Security. Persons not having paid the
qualified lawyer who specializes in these areas
minimum quarters still may be eligible for
or contact a community advocacy agency for
benefits and should inquire as to the
assistance and referral to other qualified sources
requirements.
of advice.
SSDI benefits range up to $822 per month,
Keep records of all claim activities and be
depending on the amount paid in to the plan.
prepared to pursue the claim through different
The maximum benefit is given to persons who
levels of appeals if it is denied initially.
•
have paid the maximum amount of Social
Security for 35 years.
Bradley J. Woodworth is a lawyer in private
There is a five-month waiting period from the
practice. He maintains an office in the Oregon
time disability begins before benefits can be
Trail Building in downtown Portland.
paid out. so claims should be filed as soon as
T
B a r b a r a G. Is a a c s , P h .D .
EMILY SIMON
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