Program Operations Manual System (POMS)
TN 5 (08-94)
DI 10515.010 Processing Claims of Blind Persons Involving Work in 1978 or Later
A. Disability (DIB) claims
The usual instructions apply for handling cases of alleged visual impairment under title II. Develop the work issues, make a determination as to SGA in accordance with the usual instructions and the amended dollar criteria, and forward the case to the disability determination services (DDS) for a determination as to statutory blindness.
If the DDS finds that the individual is not statutorily blind, but does have a disabling impairment, reevaluate the work activity under the substantial gainful activity (SGA) earnings guidelines for nonblind persons.
When the case is returned to the field office (FO) with the DDS' determination as to blindness and/or disability, be guided by the general instructions in DI 11010.170.
If SGA is established under either the earnings guidelines for nonblind persons or those for blind persons, the FO makes the SGA determination, and prepares the SSA-831-U3.
NOTE: See DI 10501.025 for the possibility of establishing disability for payment purposes even when current work activity is SGA. Also, see DI 10501.055 ff and DI 11010.145 for the possibility of a finding of a unsuccessful work attempt (UWA).
B. Disabled widows benefits (DWB) and childhood disability benefits (CDB) claims
If work activity in 1978 or later is involved in a DWB or CDB claim, be alert for indications and allegations of visual impairment. DDS determinations as to statutory blindness may become necessary in these cases, or which a finding of statutory blindness previously had no significance, in order to determine which earnings guidelines must be applied to the evaluation of work activity.
Do not routinely forward all DWB and CDB claims involving work activity and alleged visual impairment to the DDS for determinations as to statutory blindness. It will be necessary first for the FO to evaluate the individual's work activity under the earnings guidelines for nonblind persons as well as those for blind persons, and to prepare SGA determinations under both of these SGA tests.
On the basis of the conclusions reached in these SGA determinations, it may or may not be necessary to forward the claim to the DDS for a disability determination. See the discussion below for further instructions.
NOTE: See DI 10501.025 for the possibility of establishing disability even when current work activity is SGA. Also, see DI 10501.055 ff. and DI 11010.175 for the possibility of a finding of a UWA.
Cases for FO determination of denial or cessation
If it is determined that an under-age-55 CDB or DWB claimant or beneficiary who alleges visual impairment is engaging in SGA based on the applicable SGA earnings amount for statutory blindness, it is not necessary to forward the claim to the DDS for a determination as to the medical issue of blindness. Prepare a determination of SGA and make the decision of denial or (if appropriate) cessation in these cases. (If the claimant's or beneficiary's earnings are later reduced to the range between the separate SGA levels for nonblind and blind persons, the medical issue of statutory blindness must be determined by DDS; if earnings are later reduced below the SGA level for nonblind persons, the disability issue must be determined by the DDS. This issue may arise in either a reapplication or reopening situation.
Cases for DDS determination not requiring a finding as to statutory blindness
If the under-age-55 CDB's or DWB’s work activity is not SGA under the guidelines for both nonblind and blind persons, a DDS determination as to statutory blindness is not necessary; a regular determination of disability will be sufficient to protect the individual's interests. Send these cases to the DDS and indicate in the SSA-831-U3 remarks section: “Work activity is not SGA under either test (blind or nonblind); statutory blindness is not now a factor.”
Cases for DDS determination requiring a finding as to statutory blindness only
If the under-age-55 CDB's or DWB’s work activity is SGA under only the SGA test for nonblind persons, a DDS determination of disability as to statutory blindness will be necessary in order to protect the individual's interests. Send these cases to the DDS and indicate in the SSA-831-U5 “Work activity is SGA under the test for nonblind persons; a determination as to statutory blindness only is required — other impairments are not now a consideration.”
Cases for DDS determination requiring findings as to statutory blindness and work comparability
If an age-55-or-older CDB or DWB claimant or beneficiary alleges a visual impairment and his or her earnings are more than the earnings amount permitted blind persons under the SGA test, a DDS finding as to statutory blindness and an evaluation of the individual's work under the comparability provisions (per DI 10515.015) will be necessary.