DI 21501.075 Hawaii APTD/AB State Plan
A. Blindness — definition (3111)
When need is associated with blindness (blind), he must demonstrate through medical evidence that his central visual acuity is 20/200 or less in the better eye with correcting lenses or that the widest field subtends an angle no greater than 20 degrees.
B. Permanent and total disability
When need is associated with a disability (disabled), he must demonstrate through medical evidence that he has a physical or mental disabling condition which is permanent and total.
1. Definition of permanent impairment (3292)
Impairment refers to the physical, mental, organic, or functional damage that may occur at birth or result from disease or accident. One or more functional impairments may interfere with a person's faculties such as speech, reasoning, coordination or mobility.
Impairment is considered permanent if it is unlikely to improve and is likely to continue through the recipient's lifetime. “Permanence” does not mean everlasting. New drugs and other advances in medical treatment always are a potential for recovery. Vocational rehabilitation or recovery from the impairment is always a possibility.
Considered permanent are conditions not likely to respond to any known therapy; likely to remain static or become worse without therapy; for which treatment is unavailable or inadvisable; and for which the individual refuses treatment.
The following types of disability are frequently “permanent” according to the above definition of permanence, and any individual with one or more of them may be eligible for AABD (Disabled) if the extent of his disability is such that he can be considered “totally disabled.”
Paralysis (paraplegia, hemiplegia)
Amputation or loss of use of two or more extremities
Loss of vision which is disabling, but not such as to qualify the person for AABD (Blind)
Uncontrollable diabetes mellitus
Incontinence of urine or feces
Varicose veins of long standing with edema and ulceration
Cirrhosis of the liver, moderately advanced
Syphilis of central nervous system (i.e., Tabes Dorsalis, etc.)
Psychosis of long standing
Those whose mental capacity for self-direction is gone, as for instance, very low-grade feebleminded or those ex-patients of the State Hospital who are “able to adjust on a dependent level” only.
Refusal to pursue medical treatment shall disqualify the applicant for further economic assistance unless: His fears of medical treatment appear bona fide to the social worker; mental illness or mental deficiency precludes understanding of agency's requirements, or treatment is contrary to his religious beliefs.
2. Definition of totality of disability
Totality of disability refers to the extent the impairment has prevented or interfered with a person's use of his faculties, such as his senses, reasoning, or mobility. Disability is considered total if the individual cannot engage in either: A useful occupation which he is competent to perform such as regular gainful employment or homemaking or sufficient activity to meet his essential daily living needs without another person's help.
“Totality” does not mean absolutely. An individual must be totally disabled in relation to his normal activities and capabilities; his ability to carry out responsibilities of a job. The time during which he may be disabled is not a factor in determining totality.