The Social Security Administration's HIV rule, published December 2, 2016, distinguishes an absolute CD4 count from a CD4 percentage. In this December 4 weekend explanation, the distinction concerns disability adjudication, not treatment. SSA declined to add a percentage equivalent to an absolute count of 50 cells per cubic millimeter or less because it found no precise correlation. [2016-28843][2014-04124]

Adult listing 14.11F uses that absolute count of 50 or less, with applicable documentation requirements. The separate 14.11G pathway uses an absolute count below 200 or a percentage below 14, together with either body mass index below 18.5 or hemoglobin below 8.0 grams per deciliter. For that combined pathway, the measurements need not have been taken on the same date. [2016-28843][2014-04124]

Documentation also changed during rulemaking. The February 26, 2014 proposal contemplated definitive laboratory documentation and removal of older general CD4 guidance. The final rule retained guidance for non-definitive documentation instead. Comparing the two establishes a substantive change in the agency's design, not independent medical corroboration or an individual's eligibility. [2016-28843][2014-04124]

The final revisions cover adult and child HIV listings and immune-disorder functional guidance, with effectiveness specified for January 17, 2017. The adult numerical pathways summarized here should not be generalized to every child or every listing. Their logical structure matters: an alternative between two CD4 measures within one pathway is not permission to replace a different pathway's absolute-count threshold. The sources explain an adjudicative framework, not a self-diagnosis or benefit calculator. [2016-28843][2014-04124]

Source documents

  1. Revised Medical Criteria for Evaluating Human Immunodeficiency Virus (HIV) Infection and for Evaluating Functional Limitations in Immune System Disordershttps://www.govinfo.gov/content/pkg/FR-2016-12-02/html/2016-28843.htm
  2. Revised Medical Criteria for Evaluating Human Immunodeficiency Virus (HIV) Infection and for Evaluating Functional Limitations in Immune System Disordershttps://www.govinfo.gov/content/pkg/FR-2014-02-26/html/2014-04124.htm