[Listing of Impairments: Immune System] Page: 2 of 8
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LISTING OF IMPAIRMENTS-CURRENT
DI 34001.010A. (Cont.)
TN 4 6-93
ence with dressing and combing hair. Weakness
of anterior neck flexors may impair the ability
to lift the head from the pillow in bed. The
diagnosis is supported by elevated serum mus-
cle enzymes (creatine phosphokinase (CPK),
aminotransferase, aldolase), characteristic ab-
normalities on electromyography, and myositis
on muscle biopsy.
5. Undifferentiated connective tissue disorder
(14.06)- This listing includes syndromes with
clinical and immunologic features of several
connective tissue disorders, but that do not
satisfy the criteria for any of the disorders
described; for instance, the individual may have
clinical features of systemic lupus erythemato-
sus and systemic vasculitis and the serologic
findings of rheumatoid arthritis. It also includes
overlap syndromes with clinical features of
more than one established connective tissue
disorder. For example, the individual may have
features of both rheumatoid arthritis and sclero-
derma. The correct designation of this disorder
is important for assessment of prognosis.
C. Allergic disorders (e.g., asthma or atopic dermati-
tis) are discussed and evaluated under the appro-
priate listing of the affected body system.
D. Human immunodeficiency virus (HIV) infection.
1. HIV infection is caused by a specific retrovirus
and may be characterized by susceptibility to
one or more opportunistic diseases, cancers, or
other conditions, as described in 14.08. Any
individual with HIV infection, including one
with a diagnosis of acquired immunodeficiency
syndrome (AIDS), may be found disabled un-
der this listing if his or her impairment meets
any of the criteria in 14.08 or is of equivalent
severity to any impairment in 14.08.
2. Definitions. In 14.08,the terms "resistant to
treatment," "recurrent," and "disseminated"
have the same general meaning as used by the
medical community. The precise meaning of
any of these terms will depend upon the specif-
ic disease or condition in question, the body
system affected, the usual course of the disor-
der and its treatment, and the other circum-
stances of the case.
"Resistant to treatment" means that a condi-
tion did not respond adequately to an appro-
priate course of treatment. Whether a response
is adequate, or a course of treatment appropri-
ate, will depend on the facts of the particular
case.
"Recurrent" means that a condition that re-
sponded adequately to an appropriate course
of treatment has returned after a' period of
remission or regression. The extent of response
(or remission) and the time periods involved
will depend on the facts of the particular case.
"Disseminated" means that a condition is
spread widely over a considerable area or
body system(s). The type and extent of the
spread will depend on the specific disease.As used in 14.081, "significant involuntary
weight loss" does not correspond to a specific
minimum amount or percentage of weight loss.
Although, for purposes of this listing, an invol-
untary weight loss of at least 10 percent of
baseline is always considered significant, loss
of less than 10 percent may or may not be
significant, depending on the individual's base-
line weight and body habitus. (For example, a
7-pound weight loss in a 100-pound female
who is 63 inches tall might be considered
significant; but a 14- pound weight loss in a
200-pound female who is the same height
might not be significant.)
3. Documentation of HIV infection. The medical
evidence must include documentation of HIV
infection. Documentation may be by laboratory
evidence or by other generally acceptable
methods consistent with the prevailing state of
medical knowledge and clinical practice.
a. Documentation of HIV infection by defini-
tive diagnosis. A definitive diagnosis of HIV
infection is documented by one or more of
the following laboratory tests:
i. A serum specimen that contains HIV anti-
bodies. HIV antibodies are usually detected
by a screening test. The most commonly
used screening test is the ELISA. Although
this test is highly sensitive, it may yield false
positive results. Therefore, positive results
from an ELISA must be confirmed by a
more definitive test (e.g., Western blot, im-
munofluorescence assay).ii. A specimen that
serum specimen,
rebrospinal fluidcontains HIV antigen (e.g.,
lymphocyte culture, or ce-
(CSF) specimen).iii. Other test(s) that are highly specific for
detection of HIV (e.g., polymerase chain
reaction (PCR)), or that are acceptable
methods of detection consistent with the
prevailing state of medical knowledge.
When laboratory testing for HIV infection
has been performed, every reasonable ef-
fort must be made to obtain reports of the
results of that testing.
Individuals who have HIV infection or
other disorders of the immune system may
undergo tests to determine T-helper lym-
phocyte (CD 4) counts. The extent of im-
mune depression correlates with the level
or rate of decline of the CD4 count. In
general, when the CD4 count is 200/mm3
or less (14 percent or less), the susceptibili-
ty to opportunistic disease is considerably
increased. However, a reduced CD4 count
alone does not establish a definitive diag-
nosis of HIV infection, or document the
severity or functional effects of HIV
infection.
b. Other acceptable documentation of HIV
infection.
HIV infection may also be documented
without the definitive laboratory evidencei
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[Listing of Impairments: Immune System], chapter, 1993; (https://texashistory.unt.edu/ark:/67531/metadc948307/m1/2/: accessed June 9, 2024), University of North Texas Libraries, The Portal to Texas History, https://texashistory.unt.edu.; crediting UNT Libraries Special Collections.