The daily Nebraskan. ([Lincoln, Neb.) 1901-current, April 15, 1992, The SOWER, Page 14, Image 23

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    Brian Shetlito/DN
-♦
“Adequate medical care
goes on throughout the
condition. Legal assistance
is one of those things that
comes in and helps meet
other needs. ”
— John Milligan
attorney for Legal Services
of Southeast Nebraska
-♦
Lawyer says people with HIV and AIDS
face insurance problems, discrimination
By Roger Price
Many of the non-medical chal
lenges faced by people with HIV
or AIDS — discrimination,
health'insurance^md finances
— can be solved with the assistance of a
lawyer, a local attorney said.
John Milligan, an attorney for Legal
Services of Southeast Nebraska works
with several people with HIV or AIDS,
said, “People rate the need for an attor
ney well down the list” when they are
first diagnosed, but proper legal assis
tance can make it easier for people with
HIV or AIDS to obtain the services they
need.
One of the major
roles for an attorney
representing a person
with HIV or AIDS,
Milligan said, is to help
that person obtain
Social Security disabil
ity benefits.
The attorney, he
said, also helps with estate planning,
establishi ng a plan for medical treatment
once the patient is unable to care for
himself or herself and working with in
surance companies to ensure tne person
with HIV or AIDS gets maximum bene
fits.
Milligan said it was understandable
that legal services often are overlooked
when a person is first diagnosed as hav
ing HIV or AIDS.
“From my viewpoint, the first thing is
adequate medical treatment. I think that
is the primary concern. The legal part is
something that you run into after you
deal with the big issues. You have time to
reflect on how you need to have some
legal planning to help with other issues.
“Adequate medical care goes on through
out the condition. Legal assistance is one
of those things that comes in and helps
meet other needs."
Because getting disability benefits
from Social Security allows many
persons with HIV or AIDS to get
the services they need, Milligan
said, an attorney often can help the per
son qualify for benefits quicker because
the lawyer understands the process.
Qualifying for disability benefits can
be difficult for people with HIV or AIDS,
he said, because constant fatigue and
other conditions associated with the dis
ease require more subjective judgements.
The role of the attorney, ne said, is to
“facilitate obtaining information to help
the decision maker.
Frank Battistelli, deputy press officer
for the Social Security Administration,
said there are two programs which SSA
administers — Social Security Disability
Program and Supplemental Security
Income Program.
Only persons who have been employed
and paid into Social Security are eligible
for Social Security Disability, while Sup
plemental Security is l^sed solely on
need, he said.
Battistelli said that to qualify for ei
ther Social Security Disability or SSI, a
person must meet the legal definition of
being disabled. This requires that a per
son applying for disability benefits have
an impairment or combination of impair
ments that makes working impossible.
The impairment must last for at least one
year or result in death.
Even if people cannot perform the work
they once did, Battistelli said, they may
not qualify for disability benefits if they
can work in other jobs.
A person qualifying for disability bene
fits must not be able to perform any type
of work anywhere in the country, he said.
A person may qualify for one or both
disability programs, he said, and both
programs provide the person with a liv
ing stipend.
Milligan said being found disabled by
Social Security also allowed a person to
receive other benefits that were some
times more important than the actual
stipend.
“Being found disabled for many people
opens the doors to receiving a lot of other
associated benefits, specifically medical
care.”
Battistelli said qualifying for SSI, in
most states, also qualified the person tor
Medicaid health benefits.
People on just Social Security Disabil
ity qualify for Medicare benefits after
being in the program for two years, he
said.
However, Medicare is a limited health
insurance program while Medicaid cov
ers most health care expenses.
Battistelli said the Social Security
Administration looks at people with HIV
or AIDS just like it looks at people with
any other disability.
The Social Security Administration,
he said, recognizes that manv people with
HIV or AIDS who apply for disability
need the benefits as quickly as possible
and tries to approve those cases as quickly
as possible.
Mulligan said the Social Security
Administration had been responsive to
the needs of people with HIV or AIDS and
was changing its standards for dealing
with AIDS in response to recent research
and knowledge.
“They are making their standards more
realistic,” he said.
Before people with HIV or AIDS
reach the point that they apply
for disability benefits, Milligan
said, they face a variety of
workplace problems including discrimi
nation and coverage by company health
insurance policies.
Milligan said insurance companies had
become much more conservative in re
sponse to AIDS. He said some had begun
requiring physicals before people could
be added to a company policy and exclude
anyone who tests HIV-positive with or
without any symptoms of AIDS.
Other insurers, he said, entirely ex
elude or severely limit coverage for AIDS
and related illnesses.
There is “a concern financially on the
part of insurance companies and they do
treat these cases differently and approach
them differently,” he said.
Milligan questioned insurance compa
nies’ motives for handling AIDS differ
ently than other terminal illnesses.
“I guess the big question you have to
ask is, is there really a reasonable reason
why they should (treat HIV or AIDS
patients differently) other than a strictly
financial analysis.
In addition to insurance problems, he
said, persons with HIV or AIDS some
times face hostile workplaces.
In most of the cases Milligan has worked
with, he said the discrimination takes a
more subtle form.
“The employee is either treated differ
ently by co-employees or perceives being
treated differently by co-employees and
is basically forced with ‘wouldn’t it be
better for me to get out of thi s situation by
leaving my employment?’ Not an em
ployer coming in ana saying, ‘You’ve tested
HIV positive. You no longer can be em
ployed here.’
“It’s more subtle. It’s actions by em
ployers and co-employees that make
employment uuucuit.
Milligan said he was sure there were
cases of blatant discrimination against
persons with HIV or AIDS, but his office
had not seen any.
Another obstacle people with HIV or
AIDS face is finding employment, he said.
Like many other persons with physi
cal problems, he said people with AIDS
faced a dilemma when asked about their
health problems in a job interview.
If a person answers honestly that they
have HIV or AIDS he or she is less likely
to be hired, he said, but if that person lies,
he or she is can be fired if the employer
discovered they lied.
Milligan said there were laws prevent
ing employers from asking about health
firoblems unless they were directly re
ated to the job, but interviewers often
ask these auestions in an indirect way to
avoid breaking the law.
Milligan said there was the po
tential for people with HIV or
AIDS to face discrimination in
almost every aspect of their lives,
but one area where his office had become
involved was the county and state correc
tions systems.
Discrimination against persons with
AIDS is a more serious problem in jails
and prisons because the afflicted person
cannot leave the discriminatory situation,
he said.
Because confined people cannot get
away from the abuse, he said, “it is tne
responsibility of the administrators to
protect the person while still allowing the
person as much liberty as they can.
“It’s a big balancing test,” he said.
Some institutions segregate all people
who are HIV-positive away from the
genera] population, he said, but that situ
ation infringes on personal freedom.
“There are no clear-cut guidelines,” he
said.
Robert Whitson, medical administra
tor for the Nebraska Department of Cor
rections, said the state prisons did not
segregate people with HIV or AIDS from
the general population unless medical or
safety reasons dictated it.
Whitson said the only reasons a person
with AIDS would be taken out of the
general population would be for hospital
treatment or protection from threaten
ing inmates.
The other prisoners generally do not
know if another inmate has HIV or AIDS,
he said.
The state corrections system does test
all incoming prisoners for HIV, he said,
but has strict guidelines designed to keep
that information confidential.
There now are 10 prisoners in the
system who are HIV-positive, he said.
Whitson said there was one prisoner
who was telling everybody of his HIV
status, and that caused some problems
with other prisoners.
/\ny prisoner wno nas nad threats made
on his life for any reason is isolated in
protective custody, he said. No distinc
tion is made for people who are HIV
positive, he said.
In treating people with AIDS, Whitson
said, the prison system follows the latest
guidelines issued by the Centers for Dis
ease Control.
Sally Halford, Lancaster County cor
rections director, said the county jail didn’t
test prisoners for HIV, so employees and
other inmates were instructed to act as if
every inmate had an infectious disease.
“We tell inmates that if they follow the
Biidelines, they cannot contract AIDS,”
alford said.
The jail does not allow any sex between
inmates, any needles or drugs or any
tattooing, she said.
Halford said, rumors are a way of life
inside the jail, and “if somebody is being
harassed, you deal with that.”
Discrimination is major problem
for people with HIV or AIDS,
Milligan said, but as attitudes
about AIDS change, discrimina
tion will lessen.
Because AIDS was first thought of as a
gay man’s disease, he said, the nation’s
leaders were slow to deal with the epi
demic.
Now that attitudes are beginning to
change about the disease, Milligan said,
a wide population is beginning to press
for solutions to the problem.
“The first step is when people become
comfortable at least talking about a prob
lem,” he said.
“If nothing else, the politicians and
administrators are more willing to talk
about AIDS in general, and are more
willing to seriously consider the
viewpoints^* advocates.” .