TN 43 (12-13)

DI 11005.070 Field Office Title II and Title XVI Disability Claims for Blindness and Visual Impairment Allegations

CITATIONS:

Social Security Act, Sections 216(i) and 1614(a)(2) and
Regulations 20 CFR § 404.1581 through 404.1586 and 416.981 through 416.986

A. Definition of statutory blindness

Statutory blindness under both Title II and Title XVI:

  • Means a central visual acuity of 20/200 or less in the better eye with the use of a correcting lens.

  • Considers an eye that has a limitation in the field of vision where the widest diameter of the visual field extends to an angle no greater than 20 degrees as having a central visual acuity of 20/200 or less.

B. Statutory blindness duration requirement

The 12-month duration requirement to find disability does not apply to the following types of claims:

  • Title II statutory blindness, age 55 or older, or

  • Statutory blindness under Title XVI.

NOTE: A Title II stat blind claimant can be entitled to a period of disability (not cash benefits) if their blindness or visual impairment condition has lasted for at least 5 full calendar months; see DI 10105.001.

C. Visual impairment alleged

During the application process, it is important for the field office (FO) to be aware that:

  1. 1. 

    The claimant may not specifically state that he or she is blind but may allege another type of visual impairment.

  2. 2. 

    The claimant may request a special notice option (SNO); see SNO options in NL 01001.010.

  3. 3. 

    Certain visual impairments, based on severity, may meet the definition of blindness. See chart below for examples.

The following table provides examples of visual impairment allegations:

Adult

Child

Cataracts

Congenital cataracts

Diabetic retinopathy

Cortical visual impairment

Glaucoma

Glaucoma

Macular degeneration

Optic nerve atrophy

Retinitis pigmentosa

Retinopathy of prematurity

Tunnel vision

 

D. When to request a statutory blindness determination

The FO will forward the disability claim to the Disability Determination Services (DDS) for a stat blind determination when the claimant alleges blindness or a visual impairment and:

  • Meets only fully insured status;

  • Performs above the non-blind substantial gainful activity (SGA) limit but below the blind SGA limit (for SGA earning limits, refer to DI 10501.015);

  • Performs above the blind SGA limit and elects to file for a Title II disability freeze only (for blind SGA limits, refer to DI 10501.015);

  • Files for Title II Disabled Widow(er)’s Benefits (DWB) or Childhood Disability Benefits (CDB) and performs above the non-blind SGA allowable limit but below the blind SGA limit;

  • Files a Title XVI disability application. No SGA limitation applies to Title XVI disability claim based on blindness;

  • Is currently eligible for Title XVI as a blind individual (BI), blind spouse (BS), or blind child (BC) and files for Title II disability benefits. Due to the stat blind duration and medical requirements for Title II, do not apply collateral estoppel; or

  • Is currently entitled to Title XVI and requests a category change to receive a higher federal payment or a higher state supplementary payment. (For information on multicategory claims, see SI 00501.300 and DI 26005.005.)

IMPORTANT: Do not use the non-medical complete (NMC) function for Title II claims when the claimant alleges blindness or a visual impairment. Thoroughly review the SSA-831 Disability Determination and Transmittal form for blind onset determinations.

NOTE: DDS develops impairment allegations in all disability claims and can make a stat blind determination for a claimant that may not fall into any of the situations listed in DI 11005.070D (in this section). These situations are unique because the non-medical factors (insured status, SGA level, Title XVI category change) are dependent on whether DDS determines the claimant is stat blind, regardless of any other impairment. For Title XVI presumptive blindness provisions, see DI 11055.230.


To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0411005070
DI 11005.070 - Field Office Title II and Title XVI Disability Claims for Blindness and Visual Impairment Allegations - 01/08/2014
Batch run: 10/28/2024
Rev:01/08/2014