• Antibody-producing B lymphocyte cells
• Different types of cells associated with cell-mediated immunity including T lymphocytes cells.
• White blood cells like Macrophages and Monocytes
• Components of the complement system
   

Human Immune Deficiency Virus (HIV-1 + HIV-2)  

Human Immune Deficiency disease needs no introduction.  From a Social Security standpoint, the claimant suffering from HIV infection must show a positive serology test.  Since HIV attacks the production of T lymphocyte production, this serology test is most often used to denote the seriousness of the condition.  Lowered T-Cell (T4) lymphocyte count (less than 200 or 14% or less) and an adequate description of the clinical findings associated with the disease are required for an allowance determination.  If the above findings are present, the claimant will probably receive an allowance determination from Social Security. 

A definitive diagnosis of HIV infection is documented by one or more of the following laboratory tests:

1.  Blood serum containing HIV antibodies via the ELISA test.

2.  Blood or spinal fluid specimen containing HIV antigens.

3.  Positive Polymerase chain reaction test (PCR).

If the claimant is serum negative for HIV but shows several of the secondary manifestations of this disorder, you may still have a fighting chance of winning benefits for your client.   In such a situation, you must attempt to document the HIV infection by medical history, clinical and laboratory findings that are consistent with the manifestations of the disease.  For example, a diagnosis of HIV infection will be accepted without definitive laboratory evidence if the claimant has an opportunistic disease such as toxoplasmosis of the lungs or brain.  Toxoplasmosis is a disease caused by a protozoan organism that only infects humans with seriously compromised immune systems.  Please note that before the actual diagnosis of HIV can be accepted by SSA, you must rule out any other disease states that might be causing the immune deficiency.

Evaluating a Potential HIV Case

When evaluating case that you suspect might be HIV, here are a few basic steps you should take:

1.  Taking the claimant's word that he has HIV is not enough.  You should immediately attempt to acquire copies of the claimant's medical documentation.  You should especially seek out any definitive serology (blood) test as listed above. This blood test alone will pretty much make the diagnosis. 

2.  Acquire a copy of the claimant's physical examination performed around the time of the onset of the disease.  HIV infection is often discovered as a result of findings in a physical examination.  For example, a claimant might visit his attending physician for an oral infection or because of persistent flu symptoms.  This examination can help you to establish the onset of the impairment.

3.  Acquire a copy of the claimant's doctor or nursing notes from follow-up visits.

4.  Acquire activities of daily living reports from friends or close acquaintances.  This information will help you to demonstrate the claimant's pattern of declining capabilities.

5.  Provide or request that Social Security order a current physical examination.  This action will establish the claimant's current physical state.  This step will not be required  if the claimant is being seen by his MD on a regular basis.

Identify those symptoms suffered by the claimant and discuss their restrictive aspects on the claimant's ability to perform work.  Also note and discuss any general symptoms the claimant may have, such as recurrent infections and chronic weakness.  If any of the secondary manifestations of HIV are present, there effect on the claimant's ability to perform work should also be mentioned.

There are several other important diseases of the immune system.  For additional information about diseases of the immune system and how they are evaluated by Social Security, see full discussion link.