Glossary

AIDS Drug Assistance Program (ADAP)
ADAP pays for HIV/AIDS-related prescription drugs for individuals who are uninsured. To be eligible, individuals must be HIV+ and meet financial eligibility requirements.

AIDS Service Organizations (ASOs)

Americans with Disabilities Act (ADA)
The ADA is a federal law that protects the civil rights of individuals with disabilities, including people with HIV/AIDS. The ADA prohibits discrimination by employers of 15 or more employees.

Benefit Analyst
The LTD insurer's employee assigned to the client's (your) case. This is a data gathering and evaluation position.

Benefits
What you receive from the government or an insurance company based on your disability or need. Benefits may include cash/checks, food stamps, rent subsidy and health insurance coverage.

Case Manager
The person in contact with the client when a Benefits Analyst and the client agree that it may be time to return to work. It is important to emphasize that an HIV disability does not track the same way as a physical handicap. Sometimes Case Managers must be educated about HIV/AIDS and the resulting disability.

COBRA/OBRA

Disability
(As defined by the Social Security Administration)
"...a condition that is expected to last for at least a year (or result in death) and results in the inability to do the work for which you are suited. Disability programs give benefits when an individual is unable to work."

Disability
(According to the Americans with Disabilities Act — ADA)
"...one who has a physical or mental impairment that substantially limits one or more of the individual's major life activities, has a record of having a disability, or is perceived to have disability."

Earned Income
Usually refers to wages and salary. Earned income is payment received for your efforts or work that can be used to pay for food, clothing or shelter.

Entitlement
Another word for benefits.

ERISA

Extended Period of Eligibility (EPE)
For 36 months after a successful trial work period, if you are still disabled, you will be eligible to receive a monthly benefit without a new application for any month your earnings drop below $500.00

Functional Limitations
Functional Limitations as defined by the Americans with Disabilities Act of 1990 is described as a task or action that a person is unable to perform, or has difficulty performing because of the disability. There is a lack of consistency between the definitions of functional limitations and capabilities in the Americans with Disabilities Act (ADA) and the definitions in private insurance policies. Be sure to insist that the people you work with from insurance companies define their terms when they use these terms.

Impairment Related Work Expenses
A provision for SSI and SSD recipients which recognizes disability-related items and services (such as special transportation or adaptive devices) needed for an individual to work. Social Security recognizes the cost of these items and/or services and subtracts them from gross income when figuring countable earned income.

Long Term Disability Insurance (LTD)
Acronym, which stands for Long Term Disability and is found most often referring to a private disability insurance policy.

Long Term Disability Gap

Pre-existing Condition Clause

Medicaid
A health insurance program for individuals who cannot afford medical care. Medicaid is issued to everyone who receives SSI. Other individuals with limited income and high medical expenses may receive Medicaid based on income guidelines.

Medical
California’s version of Medicaid.

Medicare
A health insurance program for individuals who have received SSD for two years. Medicare includes Hospital Insurance (Part A) and Supplementary Medical Insurance (Part B).

Partial Disability
Some policies classify the disability of individuals able to work at a permanent part time position as a "Partial Disability."

People With HIV

Plan for Achieving Self Support (PASS)
A written plan that allows an SSI recipient to set aside or shelter some income and/or resources in order to attain a work goal (such as special training, tools or transportation). The specified income and/or resources are not counted in eligibility tests and do not reduce the SSI check. The PASS Plan must be approved in advance and monitored by the Social Security Administration.

Qualified Individual with a Disability
The term "qualified individual with a disability" means an individual with a disability who, with or without reasonable modifications to rules, policies, or practices, the removal of architectural, communication, or transportation barriers, or the provision of auxiliary aids and services, meets the essential eligibility requirements for the receipt of services or the participation in programs or activities provided by a public entity.

Qualified Medicare Beneficiary (QMB)
Program pays the $768 hospital-admission deductible, the $100 annual doctor-bill deductible and the 20 percent co-payment required for doctor and outpatient bills.

Qualified Working Disabled Individuals (QDWI)
If, after 45 months at work, your total monthly salary is below $2,832 this program will pay your Part A premium.

Reasonable Accommodations
Any change in a job or work environment that enables a disabled person to work.

Recurrent Disability
A Recurrent Disability clause allows the insured to return to employment previously held and resume coverage under the old group policy with no waiting period.

Residual Disability
If a policy includes a Residual Disability clause, the insured may be able to take a lower-paying job and the insurer would make up all or part of the salary difference between your employment salary and the disability income. In most cases there is no change in income for a specified period of time. In some cases, income actually increases.

Social Security Administration (SSA)
The federal agency that administers both SSD and SSI. Local offices are situated throughout the State.

Social Security Disability Insurance (SSDI)
Also referred to as SSD is the long-term disability insurance plan sponsored by SSA. SSD recipients have worked, paid taxes (FICA) and are disabled. SSD is granted to individuals regardless of income and/or resources. Recipients receive monthly checks on the third of every month. After receiving SSD for two years, individuals automatically receive Medicare.

Specified Low Income Medicare Beneficiary (SLIMB)
Program pays the $45.50 monthly premium for Medicare Part B (which covers doctor bills and outpatient care) that's automatically deducted from Social Security Disability Insurance (SSDI) checks.

Substantial Gainful Activity (SGA)
Social Security Law bestows a disability status not only on the individual who is conditionally disabled but also upon that individual’s inability to engage in any substantial gainful activity ("SGA") which exists in the national economy. Generally, monthly earnings of over $500 trigger Social Security to declare work to be disqualifying "SGA".
In situations where someone is working, or trying to work, over a period of several months, though, earnings as low as $200 monthly can considered to be "SGA" thereby affecting your monthly SSDI payment.

Summary Plan Description (Group Long-Term Disability)
The Summary Plan Description is an easy-to-understand overview of your group Long Term Disability Insurance Policy. The Summary Plan Description tells you what your policy does and does not cover, as well as eligibility requirements, prerequisites and qualifiers. Important references:
Residual Disability
Recurrent Disability
Allowance for Retraining or Vocational Rehabilitation
Trial Work Period
Partial Disability
Rehabilitation Plan(s)
Conversion Options

Supplemental Security Income (SSI)
Administered by SSA, SSI is given to disabled individuals who have limited income or resources. This includes people who did not pay into Social Security because they worked "off-the-books." Recipients receive Medicaid. Checks are paid on the first of each month.

Trial Work Period (TWP)
A Term of nine not necessarily consecutive months during which one can return to work without Social Security without impacting current Social Security Disability Insurance Benefits.

WIIA
Work Incentives Improvement Act

Other AIDS Resources
AIDS Clinical Trials Information Service
English and Spanish answers; video: Knowing Your Options
800.874.2572

AIDS in Prison Project
809 Westchester Ave., Bronx, NY 10455
Prisoners nationwide can call collect
718.674.0800

AIDS Research Center at Bastyr University
Alternative medicine
800.475.0135

AIDS Treatment Data Network (ATDN)
Treatments, assistance and more
800.734.7104

Body Positive Helpline
Medical information and referrals
800.566.6599

Boston Buyers Club
Fact sheets about nutrition and HIV
800.435.5586

CDC National HIV/AIDS Hotline
Information and referral services from the big gun
800.342.AIDS

CDC National HIV/AIDS Hotline Hearing-impaired
Other STDs
800.344.SIDA
800.243.7889
800.227.8922

CDC National Prevention Information Network
HIV, STD and TB info in English and Spanish
Hearing-impaired
800.458.5231
800.243.7012
Desert AIDS Project (Palm Springs)
medical care and comprehensive support services
760.323-2118
Direct Access Alternative Information Resources (DAAIR)
Free 90-page alternative-treatment booklet
888.951.5433

Gay and Lesbian National Hotline
HIV counseling service
800.843.4564

National HIV Telephone Consultation Service
For the pros only; give this number to your doc
800.933.3413

Project Inform Hotline
Answers to all treatment questions, from introductory to advanced.
Written materials mailed same day
800.822.7422

Rural Center for AIDS/STD Prevention
Prevention in the boonies
800.566.8644

Teenage AIDS Hotline
Teen peer counseling; Friday and Saturday nights,
6 pm-midnight EST
800.440.TEEN

Working Wonders (Cathedral City)
medical care and comprehensive support services
760.324.7586

Woman Alive's Voices With a Message Hotline
Female troubles, staffed by HlV-positive women.
Monday, Wednesday and Friday, 2 pm-9 pm EST
800.554.4876