DI 21501.090 Indiana APTD/AB State Plan
A. Blindness (Chapter III Section D)
1. Definitions used in determining visual eligibility
BA A person who has vision in the better eye with correcting glasses of 20/ 200 or less, or has a disqualifying field defect is considered blind within the meaning of the definition of blindness as established by Section 1 (o) of the Welfare Act, and is visually eligible for BA. The disqualifying field defect has been determined by the State board at 20 degree or less.
2. Restoration of eyesight — BA
In order to receive BA, an otherwise eligible applicant shall accept treatment recommended by the Supervising Ophthalmologist if: he is able-bodied and employable and such treatment will partially or wholly restore his eyesight; or he has an infectious eye condition that is endangering his eye health or that of other persons and if such condition can be eliminated by treatment.
If recommended eye treatment is refused, every effort should be made by the caseworker, the eye physician and other interested persons to encourage the applicant to undergo treatment. Consultation in such situations is available from the state department and the Supervising Ophthalmologist. If the applicant continues to refuse to accept the recommended treatment, the county department shall report this decision to the state department along with the recommendation to deny BA.
Upon the request of the county department and/or the applicant for BA, the recommendation for eye treatment may be waived upon the decision of the Supervising Ophthalmologist if the applicant is aged, unemployable, or fearful of surgery. This decision is based upon the medical and social factors in such situations.
B. Permanent and total disability (Chapter III Section E)
1. Definition of disability
In order to receive assistance as a disabled person, such person shall be determined to be disabled according to the definition in Section 82a of The Welfare Act which defines a disabled person as one who has a physical or mental impairment, disease, or loss which appears reasonably certain to continue throughout the lifetime of the individual without significant improvement and which substantially impairs his ability to perform labor or services or to engage in a useful occupation.
In determining whether a person is disabled, consideration shall be given to the existence of a permanent impairment or a combination of such impairments, which together with such factors as age, training, skills and work experience, result in total disability.
The term permanent means a physical or mental impairment of major importance or a combination of such impairments which medical determination indicates is likely to continue throughout the lifetime of the individual and is not likely to respond to any known therapeutic procedures. Permanent does not rule out the possibility of rehabilitation, or even recovery from the disability. The term is not used in the sense of being unchangeable but is used as distinct from temporary.
The finding of the permanence of the impairment shall be based on substantiating medical evidence and so documented that the State Supervising Physician will have sufficient information upon which to base a decision with reference to the permanence of the impairment without examining the patient.
The term total means the physical or mental impairment is such that the person is substantially impaired in his ability to perform labor or services or to engage in a useful occupation.
In this connection "substantially impaired" relates to the extent which the individual's impairment has left him able to engage in those activities necessary to carry on specified responsibilities, such as those related to employment or homemaking.
The length of time the total disability continues is not a factor because changes in the social situation may occur at any time.
If an individual is able to perform the essential activities of a useful occupation within his competence, such as holding a job or homemaking with sufficient regularity to receive regular payments for his own efforts or to carry homemaking responsibilities on a continuing basis for at least one person in addition to himself, such person is not considered to be substantially impaired in his ability to engage in a useful occupation.
“Within his competence” refers to the person's physical condition, mental capacity, emotional stress, education and work skills.
If there is question as to whether or not there is employment available to the applicant that is within his competence, clearance shall be made with the nearest Employment Security Division office.
2. Useful occupation
Useful occupation is defined as activity that demands the time and attention of the person for the ultimate benefit of others. The following are not considered as useful occupations: Hobbies; activity which is essentially occupational therapy; work made possible only by sympathy of others in assisting in the work or purchasing the product; work not normally considered a necessary occupation, and if the individual ceased doing it, no one else would replace him; work in a sheltered workshop; and work under an approved vocational rehabilitation plan. Income from any such activity shall be considered in the determination of need.
Homemaking is considered as a useful occupation when it involves the ability to carry out the responsibilities of home-management and decision-making and to provide essential services within the home for at least one person in addition to oneself. It is not an occupation which is carried on for pay such as would apply to domestics, maids, and housekeepers hired by other people.
The following activities are important to the adequate performance of the occupation of homemaking: shopping for food and supplies; planning and preparing meals; washing dishes; cleaning house (sweeping, mopping, dusting, moving furniture); making beds; and washing and ironing clothes. If the care of young children is within the homemaking responsibilities, the following activities are involved: lifting and carrying infants and when necessary, pre-school children; bathing and dressing young children; training and supervising children; and accompanying children to community activities, to sources of medical care, etc. Where more modern facilities are not used the following activities may be necessary to the maintenance of the home: carrying water; carrying fuel; and building fires.
A person performing some of the functions of a homemaker may meet the eligibility requirement of permanent and total disability if activities are restricted to the extent that the person may be permanently and totally disabled as defined in A and B above.
3. Treatment for restoration of physical or mental health
The disabled person is expected to cooperate in any recommended treatment plan which may partially or wholly restore his physical or mental health and thus lessen the extent of his dependency.
Refusal of Disabled Person to Accept Treatment: Assistance may be denied or discontinued to any disabled person who refuses treatment which has been approved by the State Supervising Physician for the restoration of physical or mental health.
If treatment is refused, every effort shall be made for a reasonable period of time by the caseworker, the physician, the family and other interested persons to encourage the disabled person to cooperate in the treatment plan. If the disabled person continues to refuse the recommended treatment, the county department shall report this and the reasons for the refusal to the state department.
Some of the factors to be considered in evaluating the refusal of the disabled person to submit to recommended treatment are whether:
the disabled person is unreasonable in his attitude;
he endangers the lives of others in his refusal;
religious beliefs or convictions hinder acceptance of treatment; and
fear if so great that it seems irresolvable.
No individual should be required to take treatment unless it can be demonstrated to be such that an average person would accept it.