[Listing of Impairments: Immune System] Page: 4 of 8
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ITA T
LISTING OF IMPAIRMENTS-CURRENTconditions manifested by individuals with
HIV infection. As in any case, consideration
must be given to whether an individual's
impairment(s) meets or equals in severity
any other listing in appendix 1 of subpart P
(e.g., a neoplastic disorder listed in 13.00ff).
Although 14.08 includes cross- references to
other listings for the more common manifes-
tations of HIV infection, other listings may
apply.
In addition, the impact of all impairments,
whether or not related to HIV infection,
must be considered. For example, individu-
als with HIV infection may manifest signs
and symptoms of a mental impairment
(e.g., anxiety, depression), or of another
physical impairment. Medical evidence
should include documentation of all physi-
cal and mental impairments, and the im-
pairment(s) should be evaluated not only
under the relevant listing(s) in 14.08, but
under any other appropriate listing(s).
It is also important to remember that indi-
viduals with HIV infection, like all other
individuals, are evaluated under the full
five-step sequential evaluation process de-
scribed in Section 404.1520 and Section
416.920. If an individual with HIV infec-
tion is working and engaging in substantial
gainful activity (SGA), or does not have a
severe impairment, the case will be decid-
ed at the first or second step of the sequen-
tial evaluation process, and does not re-
quire evaluation under these listings. For
an individual with HIV infection who is
not engaging in SG A and has a severe
impairment, but whose impairment(s) does
not meet or equal in severity the criteria of
a listing, evaluation must proceed through
the final steps of the sequential evaluation
process (or, as appropriate, the steps in the
medical improvement review standard) be-
fore any conclusion can be reached on the
issue of disability.
7. Effect of treatment. Medical treatment must
be considered in terms of its effectiveness in
ameliorating the signs, symptoms, and labo-
ratory abnormalities of the specific disorder,
or of the HIV infection itself (e.g. antiretro-
viral agents) and in terms of any side effects
of treatment that may further impair the
individual.
Response to treatment and adverse or ben-
eficial consequences of treatment may vary
widely. For example, an individual with
HIV infection who develops pneumonia or
tuberculosis may respond to the same anti-
biotic regimen used in treating individuals
without HIV infection, but another indi-
vidual with HIV infection may not re-
spond to the same regimen. Therefore,
each case must be considered on an indi-
vidual basis, along with the effects of
treatment on the individual's ability to
function.A specific description of the drugs or
treatment given (including surgery), dos-
age, frequency of administration, and a
description of the complications or re-
sponse to treatment should be obtained.
The effects of treatment may be temporary
or long-term. As such, the decision regard-
ing the impact of treatment should be
based on a sufficient period of treatment to
permit proper consideration.
8. Functional criteria. Paragraph N of 14.08
establishes standards for evaluating manifes-
tations of HIV infection that do not meet the
requirements listed in 14.08A-M. Paragraph
N is applicable for manifestations that are
not listed in 14.08A-M, as well as those
listed in 14.08A-M that do not meet the
criteria of any of the rules in 14.08A-M.
For individuals with HIV infection evalua-
ted under 14.08N, listing-level severity will
be assessed in terms of the functional limi-
tations imposed by the impairment. The
full impact of signs, symptoms, and labora-
tory findings on the claimant's ability to
function must be considered. Important
factors to be considered in evaluating the
functioning of individuals with HIV infec-
tion include, but are not limited to: symp-
toms, such as fatigue and pain; characteris-
tics of the illness, such as the frequency
and duration of manifestations or periods
of exacerbation and remission in the dis-
ease course; and the functional impact of
treatment for the disease, including the
side effects of medication.
As used in 14.08N, "repeated" means that
the conditions occur on an average of 3
times a year, or once every 4 months, each
lasting 2 weeks or more; or the conditions
do not last for 2 weeks but occur substan-
tially more frequently than 3 times in a
year or once every 4 months; or they
occur less often than an average of 3 times
a year or once every 4 months but last
substantially longer than 2 weeks. To meet
the criteria in 14.08N, an individual with
HIV infection must demonstrate a marked
level of restriction in one of three general
areas of functioning: activities of daily
living; social functioning; and difficulties in
completing tasks due to deficiencies in
concentration, persistence, or pace. Func-
tional restrictions may result from the im-
pact of the disease process itself on mental
or physical functioning, or both. This
could result from extended or intermittent
symptoms, such as depression, fatigue, or
pain, resulting in a limitation of the ability
to concentrate, to persevere at a task, or to
perform the task at an acceptable rate of
speed. Limitations may also result from the
side effects of medication.
When "marked" is used as a standard for
measuring the degree of functional limita-DI 34001.010A. (Cont.)
TN 4 6-9 3
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[Listing of Impairments: Immune System], chapter, 1993; (https://texashistory.unt.edu/ark:/67531/metadc948307/m1/4/: accessed June 5, 2024), University of North Texas Libraries, The Portal to Texas History, https://texashistory.unt.edu; crediting UNT Libraries Special Collections.