DI 21501.070 Georgia APTD/AB State Plan
A. Blindness — degree of blindness (2.a.)
A person shall be considered blind for the purposes of receiving Aid to the Aged, Blind, or Disabled, whose vision, with correcting glasses, is so defective as to prevent the performance of activities for which eyesight is essential. The following broader definition of blindness is also included in the State's definition of blindness.
In terms of ophthalmic measurement, central acuity of 20/200 or less in the better eye with correcting glasses is generally considered as economoic blindness. A field defect in which the peripheral field has contracted to such an extent that the widest diameter of visual field subtends at an angular distance of no greater than 20 degrees may be considered equally disabling.
B. Permanent and total disability
1. Definition of permanent and total disability (3a.)
According to Georgia Law, a permanently and totally disabled person is a person, “who has a medically demonstrable disability which is permanent and which renders him incapable of performing any gainful occupation within his competence.” This definition of permanent and total disability contains three essential criteria:
The disability must be medically demonstrable. The term medically demonstrable means that the person's disability must be verifiable and substantiated by medical findings. In other words, the Medical Eligibility Section must base its decision on the medical data which is provided by the client's physician and/or from other medical sources. A physician's statement that a client is permanently and totally disabled is considered insufficient evidence unless it is substantiated by medical and clinical data.
The disability must be permanent. The factor of permanency refers to a serious physical or mental impairment, or disease which is not likely to improve or which will continue throughout the lifetime of the individual.
Permanent disability is a condition which is not likely to respond to any known therapeutic procedures, or a condition which is likely to remain static or to become worse unless certain therapeutic measures are carried out. Permanent disability does not rule out the possibility of vocational rehabilitation or even possible recovery in light of future medical advances or changed prognosis. In this sense the term refers to a condition which continues indefinitely, as distinct from one which is temporary or transient.
The disability must be total to the extent that it prevents performance of gainful occupations within the disabled person's competence. The factor of totality involves considerations in addition to those verified through the medical findings. These include, but are not limited to, such considerations as age, training, skills, work experience and the extent to which these factors prevent the performance of gainful occupations within the disabled person's competence.
An individual's total disability would usually be tested in relation to his ability to engage in remunerative employment. The ability to keep house or to care for others would be the appropriate test for individuals such as housewives who were engaged in this occupation prior to the disability and do not have a recent history of gainful employment well enough and with sufficient regularity to receive regular payments on a continuing basis, he is not considered to be totally disabled.
All of these factors must be substantiated in order to make a determination of permanent and total disability, and the absence of any one of these factors would render the person ineligible.
2. Criteria of permanent and total disability (3.b.)
Any applicant/recipient meeting one of the two criteria given in the following paragraphs may be found to be totally disabled to perform a gainful occupation even though he may receive some remuneration through work-related activities.
A gainful occupation is one which is remunerative, performed regularly, and performed without unusual assistance from others.
Inability to Perform the Essential Activities of Daily Living: It is recognized that some severely disabled persons may achieve some semblance of engaging in a gainful occupation because of supreme motivation and effort, or because friends or relatives assist them in various ways. A person, for instance, may be bedridden, unable to leave his home, and require the help of others to meet the needs of daily living. Yet this person may engage in remunerative and productive events such as knitting or selling products via the telephone. The Medical Eligibility Section will consider the following criteria in determining permanent and total disability in such situations, and if the individual meets one or more of these criteria he may qualify for aid to the Disabled.
Is the applicant/recipient able to engage in remunerative activity because family, friends, or neighbors help in unusual ways, such as running errands, providing working materials or creating a market for him? Is this assistance based more on sympathy and compassion than it is on any profit which may be realized by those who assist?
Inability to Engage in Remunerative Work on a Predictable Basis: In order to determine whether the individual meets this criterion medical evidence must show that the disability precipitates periodic and unpredictable, incapacitating episodes of such intensity that the individual is unable to engage in useful occupations on a predictable basis. Among such incapacitating episodes are attacks of pain, shortness of breath, extreme dizziness, or unusual exhaustion.
3. Suggestions for determining whether a person's disability prevents him from engaging in gainful occupations within his competence
The fact that a person is employed or is performing housekeeping tasks, by itself, does not automatically render him ineligible for Aid to the Disabled.
Disability as Distinguished from Unemployment: The worker should be careful not to confuse disability with unemployment. It is conceivable that needy, unemployed persons may request assistance for reasons unrelated to disability such as seasonal unemployment or layoff from a job. They may even have minor health problems which have not prevented them from working in the past. Such persons should be considered as unemployed rather than permanently and totally disabled.
Mental Disorder: Persons who are unable to engage in gainful employment or perform the duties of housekeeping due to severe mental illness (psychosis, severe psychoneurosis, and severe mental deficiency) are considered permanently and totally disabled. The condition must be diagnosed by a physician, psychiatrist or psychologist and the disability must be of a permanent nature that is not likely to respond to any available treatment.
Sheltered Workshop Situations: Unusual or sheltered work situations in which the applicant/recipient would not be able to do the same type work in the competitive market without special consideration to his particular physical and/or mental condition shall not be considered the same as able-bodied employment.
Two Aid to the Disabled applicants, for instance, may suffer from equally severe arthritis. One client's application may be denied because his disability is not total and the other's application may be approved with no qualifying conditions. The first application was denied because the client had a high school education, was a trained clerk, and had a stable work history. The second application was approved because the client was illiterate, socially deprived, and had an unstable work history consisting of manual labor. On the basis of this social information the Medical Eligibility Section determined that one client's disability did not prevent him from working in occupations within his competence and that the other client's disability did in fact prevent him from working in occupations within his competence.