BASIC (09-08)

DI 24595.001 Expediting Claims Involving Human Immunodeficiency Virus (HIV) Infection

Citations:

Regulations—20 CFR 416.931, 416.932, 416.933, 416.934

A. Identify HIV infection cases

Identify cases involving HIV infection or acquired immune deficiency syndrome (AIDS) and expedite their handling.

B. How to identify HIV infection or AIDS cases

1. Paper case

The SSA-441 (Expedite Flag or the Terminal Illness (TERI) Flag) is attached to the case.

2. Electronic case

The TERI flag and a Special—A (AIDS Case flag) appears in the Flags indicator on the far left of the secondary title bar.

3. Other possible indicators

Other possible indicators include allegation of HIV infection by the claimant, diagnosis of HIV infection in the medical records, or SSA-4814-F5 (Medical Report on Adult with Allegation of Human Immunodeficiency Virus (HIV) Infection) or SSA-4815-F6 (Medical Report on Child with Allegation of Human Immunodeficiency Virus (HIV) Infection).

C. When the claimant alleges HIV infection but has no medical source

Order a consultative examination (CE) immediately (see DI 22510.005) if:

  • the disability determination services (DDS) receives cases flagged with an electronic or paper Form SSA-441 indicating “No Medical Source/CE needed”; and

  • there is no medical source.

D. When to make a Presumptive Disability (PD) finding

The DDS can make a finding of PD in an initial supplemental security income (SSI) claim at any time that the evidence is sufficient to establish a high degree of probability that the claimant alleging HIV or AIDS will be found disabled. See DI 23535.010, Disability Determination Services (DDS) Responsibilities in Presumptive Disability/Presumptive Blindness (PD/PD) Cases.

NOTE: If the DDS receives the SSA-4814-F5 or SSA-4815-F6, the DDS may be able to make a finding of PD based on the information in this form. For further information on the DDS responsibility in using these forms, see DI 23535.012.

Reference

DI 23020.045 - Terminal Illness (TERI) Cases


To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0424595001
DI 24595.001 - Expediting Claims Involving Human Immunodeficiency Virus (HIV) Infection - 04/06/2016
Batch run: 04/06/2016
Rev:04/06/2016