Social Security field offices send this report to the treating source of a child who alleges HIV infection in an SSI childhood disability claim. The source documents the diagnosis, HIV-related conditions and their effects on growth and function, so SSA can decide the claim and whether to begin presumptive disability payments while the final decision is pending. SSA-4814 is the adult version.
The child's treating pediatrician or other medical source completes the medical sections that follow the parent's release and signs with name and title; a physician, nurse or other acceptable hospital or clinic staff may sign. The parent or guardian signs the release when no SSA-827 is attached.
Download the current version from the source each time; forms change without notice.
Medical Report on Child with Allegation of Human Immunodeficiency Virus (HIV) Infection
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Both are Social Security medical reports for claimants alleging HIV infection, under the same OMB number. SSA-4814 is for adults, while SSA-4815 is for children and runs nine pages, adding the growth and functional effects that matter in a childhood SSI claim. Field offices apply the same four completion tests to both for presumptive disability.
SSA does not set a fixed number of days, but field offices include a return envelope to ensure speedy handling and can take the answers by phone instead. Because a completed report can support presumptive SSI payments for the child, a prompt reply can start benefits before the final decision.