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Aching & Disability Benefits |
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By John S. James
Some of the treatments discussed are: Non-opioid pain medications: Elavil (amitriptyline), Norpramin (desipramine), Pamelor (nortriptyline), Tofranil (imipramine), Mexitil (mexiletine hydrochloride), Neurontin (gabapentin), Ultram (tramadol), Dilantin (phenytoin), Klonopin (clonazepan), Tegretol (carbamazepine), Catapres (clonidine), and Lioresal (baclofen). Non-steroidal anti-inflammatory drugs including aspirin, acetaminophen, ibuprophen, and naproxen. Topical medications: capsaicin (Zostrix, Zostrix H.P., Axsain, or Capsin); EMLA (lidocaine and prilocaine), and cream preparations containing non-steroidal anti-inflammatory drugs.
Miscellaneous drugs: Ketamine (including a topical form which can be prepared by a compounding pharmacy); immune- suppressive drugs; IVIG (intravenous immune globulin). Other medical treatments: TENS (transcutaneous electrical nerve stimulation) gets several pages of discussion. (We believe that TENS deserves more attention because of its potentially low cost and simplicity.) Other treatments: include acupuncture, physical therapy, relaxation and meditation training, massage and similar therapies, and magnets. Nutrients: including vitamins A, vitamins B1, B2, B3, B5, B6, and B12, biotin, folic acid, inositol, choline, vitamins C and E, and minerals (selenium, magnesium, chromium, zinc).
A chapter on Coping includes exercise, arranging for comfort during sleep, finding comfortable shoes, and miscellaneous hints on clothing and other items. For More Information on Neuropathy
Disability Benefits: New Law will Help Disabled Return to Work By John S. James
We asked benefits expert Tom McCormack of T2CANN (Title II Community AIDS National Network) to outline some of the provisions of this legislation, the Ticket to Work and Work Incentives Improvement Act of 1999 (a bipartisan law which was signed by President Clinton on December 17, 1999). He noted that the most important changes will need approval by each state. But three which will apply to all states are:
If they cannot afford that, the welfare department's QWDI program can pay for them if they earn under $2832 monthly; welfare's SLIMB/QI program can also pay the $45.50 monthly Part B premiums (which come due after only 12 months back at work) for those earning under $1939. For an explanation of the unusual rules on how to use these programs, see "Keep Your Medicare in Force As You Go Back to Work--What to Do and How to Do It" by Thomas P. McCormack, AIDS Treatment News #313, February 19, 1999.]
A very important provision will require a decision to participate by each state. Alaska, California, Iowa, Massachusetts, Minnesota, Nebraska, Oregon, South Carolina, Vermont, and Wisconsin already give Medicaid to working, still-fully-disabled persons earning up to about $43,000, under the old law (all states could do so if they chose to). The new law will allow all states to cover them but also cover the formerly disabled (those who were disabled under Social Security, but then were ruled no longer disabled during a review--but who are still likely to have special medical needs) and some but not all states can also cover the pre-disabled (those who have medical conditions which could later result in disability, such as those who are "only" HIV+). Also, the new law will allow states to have even higher income and asset levels for these programs. [Note: Unfortunately the new law does not affect private disability insurance. With private insurance, it can be difficult to return to work without permanently losing disability insurance--a serious problem if it turns out that one is unable to continue working. "Almost all cases involving private disability insurance must be individually pre-negotiated," according to McCormack, "building on whatever rudimentary provisions the policy might have on return-to-work and vocational rehabilitation issues--to develop a workable work-return plan that includes protection for continued benefits, or the reinstatement of benefits, should the work effort collapse because of medical problems. This can only be done case-by-case for each individual by expert attorneys or other skilled benefits advocates, because policy provisions are so different."] For more in-depth information, request a summary of the new law, an advocacy kit for getting your state to add Medicaid coverage of the disabled (including the "pre-disabled" and the "ex-disabled"), and a copy of "Returning to Work and Keeping Medicare and Medicaid" from Tom McCormack, tomxix@ix.netcom.com Also, attorneys and other benefits advocates can subscribe to a free non-profit email discussion group on benefits and other legal issues. To subscribe, send a message to: HIV-Law-Approval@Web-Depot.COM; you will receive a brief questionnaire which must be returned for your subscription to be approved. AIDS Treatment News Published twice monthly Subscription and Editorial Office: P.O. Box 411256 San Francisco, CA 94141 800/TREAT-1-2 toll-free U.S. and Canada 415/255-0588 regular office number Fax: 415/255-4659 E-mail: aidsnews@aidsnews.org
Editor and Publisher: John S. James Associate Editor: Tadd T. Tobias Reader Services: Tom Fontaine and Denny Smith Operations Manager: Danalan Richard Copeland Statement of Purpose: AIDS Treatment News reports on experimental and standard treatments, especially those available now. We interview physicians, scientists, other health professionals, and persons with AIDS or HIV; we also collect information from meetings and conferences, medical journals, and computer databases. Long-term survivors have usually tried many different treatments, and found combinations which work for them. AIDS Treatment News does not recommend particular therapies, but seeks to increase the options available. Subscription Information: Call 800/TREAT-1-2 Businesses, Institutions, Professionals: $270/year. Includes early delivery of an extra copy by email. Nonprofit organizations: $135/year. Includes early delivery of an extra copy by email. Individuals: $120/year, or $70 for six months. Special discount for persons with financial difficulties: $54/year, or $30 for six months. If you cannot afford a subscription, please write or call. Outside North, Central, or South America, add air mail postage: $20/year, $10 for six months. Back issues available. Fax subscriptions, bulk rates, and multiple subscriptions are available; contact our office for details. Please send U.S. funds: personal check or bank draft, international postal money order, or travelers checks. ISSN # 1052-4207 Copyright 2000 by John S. James. |
Numb Toes and Aching Soles: Coping with Peripheral
Neuropathy, by John A. Senneff, discusses dozens of different
treatments which people are using for peripheral neuropathy,
a poorly-understood condition causing loss of sensation,
weakness, or pain, most often in the feet or hands. Millions
of Americans have peripheral neuropathy; about half the cases
are caused by diabetes. Many people with HIV also have
peripheral neuropathy, either caused by the illness itself,
or by some of the drugs used in its treatment. While Mr.
Senneff's book is not specific to HIV, what has been learned
about how to relieve neuropathy due to diabetes or other
causes may be helpful for persons with HIV as well.
Opioid drugs: morphine, codeine, Dilaudid (hydromorphone),
Demerol (meperidine), Dolophine (methadone), (Sublimaze
(fentanyl), OxyContin (oxycodone), and MS Contin (morphine
sulfate). The book includes a discussion of the problem of
under-prescribing of narcotic pain medications because of
fear of addiction, which research has found to be very
unlikely when these drugs are used for relief of pain.
An important new law will help disabled persons return to
work without losing medical benefits, and correct some other
disincentives to returning to work after being disabled.
However, this complex law is not effective yet; different
parts will be phased in over the next few years, and some
provisions will depend on decisions by each state.
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