A Guide to Fiscal Year 1991 Federal Funding for HIV Disease: How Dollars are Spent How to Access Them

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The Social Security Administration (SSA) administers a national program of contributory social insurance whereby employees, employers, and the selfemployed pay contributions which are pooled in
special trust funds. When earnings cease or are
reduced because the worker retires, dies, or becomes
disabled, monthly cash benefits are paid to replace
part of the earnings the family has lost.
The principle functions of the SSA include:
research and recommendations oriented to the problems of poverty, and health care for the blind, aged,
disabled; the long-range planning, design and
development of SSA administrative plans; maintaining statistics and records necessary to SSA program
implementation; policy guidance for the administration of the retirement, survivors, and disability insurance (SSDI) programs, as well as the supplemental
security income (SSI) program. In addition, the SSA
maintains 10 regional offices nationwide, 6 program
service centers, and more than 1,300 local offices to
direct and implement program operations.
The SSA administers two disability programs; the
definition of disability is the same for both. The Social
Security Disability Insurance (SSDI) program (Title
II) provides monthly benefits to people who have
worked long enough and recently enough under
Social Security. The Supplemental Security Income
(SSI) program provides payments to people who are
65 of older, blind, or disabled (including children) and
who have limited income resources. Most SSI recipients also qualify for Medicare.
In FY '91, the SSA HIV appropriated budget for
both disability programs is $305,000,000.
Social Security Disability Insurance
To be eligible for Social Security Disability Insurance (SSDI) an individual must: have paid into the
fund enough years for coverage (approximately one
half of the number of years since age 21); be medically disabled; and not be working-or working, but
earning less than the substantial gainful activity level.
Under the SSDI program, a worker who becomes
disabled must wait 5 months after disability begins
before receiving disability benefits. (Disabled
children, widows and widowers are subject to different rules.)
The procedures followed in disability determinations are specified by regulation and constitute a sequential evaluation process. First, it is determined
whether an individual is engaging in "substantial gainful activity" and, if not, whether he or she has a severe
impairment. If so, the individual's impairment is compared with the Listing of Impairments which sets
forth, for each major body system, the measurable
standards of impairment severe enough to prevent
a person from doing any gainful activity. If the impairment does not "meet or equal" one of the listed
impairments, the case is further evaluated to determine the individual's residual functional capacity
(RFC). It is then determined if the individual has the
ability to work at a past occupation in light of the
evaluation of RFC. If not, a determination is made
as to the ability to do any other work in the national
economy.
Under current SSA policy, any individual who: 1)
has a documented diagnosis of AIDS manifested by
one or more diseases indicative of AIDS, as defined
by the CDC case definition of AIDS, 2) is not working, and 3) meets other requirements for entitlement,
will be found to meet or equal the Listing of Impairments. If a determination of disability cannot be
made on medical grounds alone, the claim is individually evaluated through the remainder of the
sequential evaluation process.
A Disability Determination Service (DDS) in each
state evaluates disability claims for all Social Security

@1991 ASAP

Reproduction By Permission Only

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~1991 ASAP Reproduction By Permission Only 83