In South Africa, persons too ill to work qualify for a disability grant (DG). The disability grant may have a disincentive effect, with ARV patients facing the dilemma of trading off the stable source of income in the form of the disability grant against their current and/or future health and adhering sub-optimally to treatment so as to not lose the grant. This paper employs longitudinal, panel data from two Free State cohorts of public sector ARV clients to determine how disability grant terminations may impact on virologic and immunologic treatment outcomes. Findings from the quantitative analyses suggest that the termination of access to a disability grant translates into poorer treatment outcomes, particularly in the first three months of ARV treatment. Social welfare officers and health care teams should therefore take particular care when deciding to refuse applications for social assistance early in the ARV treatment career.