Re-entry to work after disability requires careful management. It's a major financial transition with many ramifications - where many things can go awry.

In one case someone was called to help out his old employer off-the-books; while he was there he got a call from the insurer asking him if he was back at work! Yet budding photographers and writers are stifling their creative genius out of an exaggerated fear that they will be "found out" - that their avocation will be mistaken for a new vocation.

Others have founded nonprofit organizations that demand far more than any job - who openly continue their disability benefits because they are working at their own pace, in their own way, without salary. Another person is mothering his old research project towards completion - while he's on disability; he's able to do that simply because he shows up when his health permits, he naps when he wants, and he exits when his physical needs are greater than his creative needs.

The key is that paid work demands consistent performance, day-in, day-out - something that's often not possible with HIV and especially not possible with the side-effects and requirements of the new drugs. Paid work and volunteering are not the same.

Re-entering the workforce is a shock after being out several years. The world of work changes in but a few years - especially high-tech fields. The world of work has become awfully mean and demanding in the 1990s. The 90s have seen organizations downsize & disappear and specialties & skills subside in short periods of time. Personal life seems to have gone out the window. Employers are demanding 110% of an employee's time. These trends don't dictate staying on disability but they do imply preparing carefully for the demands of new work. People on disability usually need new training before working again.

This is particularly true since it is highly likely that any work obtained will be unlike work done before. "Back to work" is a misnomer - because life moves forward. We rarely return easily to any earlier stage of development or line of work. People on disability aren't put on ice. They grow, they age, they reflect. They often come to appreciate other things of value in life than money-making; they come to realize that life's needs can be very few and the highest wants don't necessarily require money; they move on to new interests. Disability has a way of accelerating one's learning curve about goals, values, and what's the best way to deploy one's time.

The best approach is to use the career centers and extensive computerized testing programs most universities offer which often can be accessed free-of-charge. Turning to such resources should be a first step when news turns good. Using disability to train for new skills may be the best practical manifestation of optimism and hope.

Government programs exist which pay the educational fees and retraining expense of people on disability; these are usually run through the states. There are programs where even people on welfare can put money aside tax-free to start a business - while continuing to receive benefits.

Beware of re-entering the workforce at a low level - people tend to get pegged where they start. It's far better to learn a new trade, adopt new interests, get the necessary capital, and take the time required to thoroughly plan what role career is going play in this new stage of life.

Just as disability was far more livable with good benefits, work will be more successful if it's both satisfying and fairly-paid. Disability doesn't have to be a setback. It can be a timeout for getting reacquainted with oneself and re-entering the workaday world on a new footing. Getting back to work takes work.