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Do I Qualify For Disability Insurance Benefits If I Have HIV AIDS?

CaveyLaw.com > Practice Areas  > Long Term Disability & ERISA Lawyer  > Long Term Disability Disabling Conditions > Do I Qualify For Disability Insurance Benefits If I Have HIV AIDS?

More than 980,000 cases of AIDS have been reported in the United States. Each year more than 40,000 men and woman are diagnosed.

Disability insurance companies don’t always make it easy for policyholders who have HIV AIDS to get the disability benefits they deserve. There are many reasons carriers deny claims.

How Disability Carriers View HIV AIDS Disability Claims

Disability carriers often argue that the pre-existing condition clause in your policy excludes coverage, or that benefits are limited under the subjective limitation clause. Pain, fatigue and diarrhea are the most disabling symptoms, but they are subjective complaints. Carriers routinely dispute them.

It is not uncommon for policyholders to have had HIV AIDS for years and not been disabled.  You will have to overcome the carrier’s argument that you have been working with these problems for years and nothing has changed.  It is crucial that your medical records develop the progression of your symptoms.

Carriers also may argue that treatment will allow you to continue to work so you couldn’t possibly be disabled.

As a result, many disability claims for HIV AIDS are denied. And carriers have other reasons to deny claims. The disability insurance company will say:

(1) There is no objective basis of the HIV AIDS diagnosis,

(2) There is no objective basis for the restrictions and limitations assigned by your physician, or

(3) There is no causal relationship between your HIV AIDS and/or your restrictions and limitations, and your inability to do your own or any occupation.

It takes detailed planning and preparation to be successful in an HIV AIDS claim.

Nancy Cavey, who has 35 years experience handling disability cases, has successfully represented many policyholders with HIV AIDS. She overcomes a claims denial by working closely with you and your physician.

She often employs a vocational expert to address the disability carrier’s argument that you have been able to work for years, or that there is no vocational reason you can’t work in your own or any occupation, despite your inability to come to work each day.

She offers a free initial consultation and welcomes the opportunity to speak with you about your disability claim.

HIV/AIDS and Disability

HIV, or human immunodeficiency virus, attacks the immune system and causes the person to become sick with infections their body normally would fight off.  AIDS, or acquired immune deficiency syndrome, is the most advanced stage of the HIV disease.

The first stage of HIV can include swollen glands in the throat, armpit, or groin with slight fever, headaches, fatigue and muscle aches that last several weeks. There are usually no symptoms for an average of 10 years.

If HIV develops into AIDS, the symptoms can include:

  1. Thrush,
  2. Recurring vaginal yeast infections and chronic pelvic inflammatory disease,
  3. Severe and frequent infections,
  4. Extreme tiredness with headache, light-headedness, and dizziness,
  5. Rapid weight loss,
  6. Bruising,
  7. Frequent diarrhea,
  8. Frequent fevers and night sweats,
  9. Swelling and hardening of throat, armpit and groin glands,
  10. Deep and dry cough,
  11. Shortness of breath,
  12. Growths on skin or in the mouth,
  13. Unexplained bleeding,
  14. Skin rashes,
  15. Severe numbness and/or pain in the hands or feet,
  16. Loss of muscle control, strength and reflex, and
  17. Confusion, personality changes and changes in cognition.

The progression of the disease and these symptoms must be fully developed in your medical records. You should provide your physician with a history of how your symptoms have changed and how those symptoms have interfered with your ability to do the material and substantial duties of your own occupation or any occupation. Don’t forget to tell your physician about all the side effects of medication you have and how it makes it difficult for you to work.

How To Win Your HIV AIDS Disability Claim

The development and progression of your HIV AIDS must be documented in your medical records together with information about how your symptoms impact your ability to function at home and at work. You can’t just stop working and claim disability if your medical records don’t document how your symptoms have become disabling.

You must get treatment from a specialist, because carriers also will argue that your physician isn’t qualified to render opinions in your claim or that you aren’t getting the right type of treatment.

If your physician doesn’t support your claim, it is time to change physicians.

How Do I Get The Disability Insurance Benefits I Deserve?

HIV/AIDS can interfere with your daily activities and with your ability to work. If you no longer can work because of HIV/AIDS or your doctor has told you to apply for disability benefits, you should take steps before you apply:

  1. Obtain a copy of your disability policy. See how it defines “disability,” “occupation” and “self-reported conditions.” You’ll need to understand what you have to prove and if there are limitations in your coverage.
  2. Obtain a copy of your medical records. Review them to see if there is an objective basis for your diagnosis, what your records say about your report of symptoms and your restrictions and limitations.
  3. Obtain a copy of your personnel file to see if your HIV/AIDS has affected your work performance.
  4. Obtain a copy of your job description. Create your own description of your physical duties with an explanation of how your symptoms impact your ability to do your occupation.
  5. Provide your doctor with the occupational description. Ask your doctor to prepare a report that explains the objective basis for your diagnosis, the objective basis of your restrictions and limitations, and the objective reasons you can’t perform some or all of the material and substantial duties of your occupation.
  6. Prepare an HIV/AIDS disease diary that explains and gives examples of how your symptoms interfere with your ability to do things on a daily basis and the side effects of your medication.
  7. Hire Nancy Cavey to help you file your initial application. The application process is confusing and designed so you and your physician make mistakes that can result in a delay or even a denial of your benefits. Ms. Cavey knows how to prepare and file a winning shock and awe disability application that leaves the carrier little reason to question your claim.
  8. Hire Nancy Cavey to help you appeal a wrongful denial or termination of your disability benefits. Disability carriers are in the business of collecting premiums and not paying disability benefits. They’ll use any reason to deny your claim. The odds of getting your benefits on appeal are greater when you are represented by an experienced ERISA/private ID policy disability attorney.

Contact Disability Attorney Nancy L. Cavey, Who Can Help You Regardless of Where You Live

HIV/AIDS can make it difficult, if not impossible, to work. You owe it to yourself and your family to get help today! Nancy Cavey can review your policy and your medical records, and explain to you what your policy says and how to get your disability benefits.  Call today for a free consultation at 727-894-3188.