Jon thinks he's getting his monthly group disability check -but he's also getting a note tucked inside saying this is his last check. Abby gets called by her disability insurer suggesting jobs she can do. Tony gets a visit from his disability plan's agent - who asks about how he spends his day.

And Chico's insurer tells him they don't accept what his psychiatrist says - and offers a buyout of his benefits.

Welcome to disability benefit hell! After many false warnings and much media hype, we have recently started to see these scary scenarios actually materialize with insurers.

Traditionally it's been left to claimants to decide when to return to work. Social security in fact contemplates no present changes because they realize the new drugs' performance is spotty- and because their policies are subject to extensive scrutiny.

These incidents are occurring only with group and private disability insurers. Nearly all cases handled so far have been settled in the insured's favor - without having to go to court.

There has been no wholesale dumping of claimants back into the workforce. Yet the pattern emerging is almost as if the insurer sare trying several approaches to test the waters.

To buy time for healing and for important back to workdecisions people with HIV and other life-threatening illnesses might consider these pre-emptive actions before they get a letter, call, summons, or visit. Don't panic! There's much that can be done to correct or to prevent such incidents.

• Start with a running list of symptoms past and present - concrete and detailed. This is the time to tally - not discount - what has happened over time. Past problems might recur.
  
• Keep a bad news diary, noting anything that occurs that could get in the way of being able to work. This is also a good treatment tool - to spot things before they loom large.
  
• If a symptom occurred once or might likely occur, write it down. There is often no room in some of today's lean & mean 90s jobs for even small symptoms.
  
• Since today's jobs seem to require 110% capacity, cite any problems with concentration, persistence, pace, memory, or irritability.
  
• Use incidents to illustrate the impact of the symptoms - especially if they were embarrassing or disruptive. At the least this database of symptoms can be used as a basis for later accommodations at work.
  
• Don't focus on diagnoses - list individual symptoms instead. Symptoms - not diagnoses - are what impact work.
  
• Report the news. Let your physician take care of labelling and explaining it.
  
• Low or high lab results don't always tell the true story about the ability to work. This is why t-cell counts no longer define AIDS for social security benefits. Beware of attaching too much importance to lab measures - leave that to the physician.
  
• Get your physician involved in the protection of your benefits. Give a copy of the invaluable detail from your latest bad news diary pages - asking that they be added to the medical record or at least commented on in the record.
  
• If there were symptoms since the last visit don't discount them by saying "I'm fine." Part of the job of being disabled is meticulous record keeping - and the record that counts most is the medical record. This is the one occasion where complaints count - especially if they're repeated - even if you've voiced them endless times before.
  
• Get a complete copy of the medical record. If symptom and incident reporting are spotty or unclear, ask the physician to correct the record with a summing up statement.
  
• If there is a form to be filled out, make a special appointment just for that. Discuss the importance of records and official statements with your physician. Don't rush things.

Income protection is a treatment tool.

• Know your policy - they're all unique. What's its definition of disability? Is the basis your own occupation - or any occupation? Remember, both should be appropriate to your experience and training - and you can hold your insurer to what your policy says.
  
• List potential job tasks appropriate to these definitions of disability. Then match the tasks against the symptoms list.

The result will be a database of reference facts in responding to insurers.

• Some insurers are shifting from a short statement from the insured and a confirmation from the attending physician confirming total disability to lengthy questionnaires. Treat this as an excellent opportunity to spell out in concrete detail incidents illustrating disabling symptoms that have occurred.
  
• Insurers are sending claims adjusters out to see how the insured is functioning in daily life. With a friend present, use this visit to present your disabling symptoms & incidents in full detail.
  
• Know that in interviews you can say "I don't know", "I'm not sure," or "I'd have to think about that". You can also take time out, simply don't answer, or stop the interview at any time if you're tired.
  
• Report harassment incidents to your support organization - and make sure you're part of a support group during this difficult period.
  
• Get testimonials from organizations where you have volunteered, as well as friends and family, confirming your symptoms.
  
• Get a professional to coach you on defensive actions like these - from your AIDS organization or a financially or legally trained person experienced in responding to insurers.
  
• Insurers are not alike. Check out your insurer's reputation. Some smaller companies may aggressively cancel benefits simply to "shake the tree." If you're armed with consistent, clear records and have taken some of the actions outlined here to renew and reinforce your claim, they're more likely to back off - suspecting they'd lose in court.
  
• Remember that insurer bureaucracies need paper justification to continue benefits - especially with all the hype over the new drugs and pressures to increase profitability. Give them understandable data, clearly focused on your dis-ability to do work.
  
• If you want to try working, consider pursuing part-time or residual disability benefits first - if your plan has them.

Major insurers may act supportively if a return to work is attempted and if you do this with professional help - and you may forestall a discontinuance based in ignorance.

Above all, don't give in or give up. If you're not ready for work, defending your benefits is your #1 job. If you need help, ask for it. If you stand fast you're not only helping yourself, you're helping others less able to defend themselves.

By these actions we educate insurers to the fact that HIV disease and treatments are complex - and that people with life-threatening illness need the protection and income support that disability benefits provide.