BASIC (03-86)

DI 21501.095 Iowa APTD/AB State Plan

A. Blindness

An applicant or recipient must have no vision, or, not more than 20/200 central vision acuity in the better eye with correcting glasses, or a field defect in which the peripheral field has contracted to an extent that the widest diameter of visual field subtends at an angular distance of no greater than twenty (20) degrees.

B. Permanent and total disability

1. Definitions

Disability means a permanent, total impairment of such severity that the individual requires assistance from another person in performing the normal activities of daily living.

Permanent disability means an impairment of major importance 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.

Total disability means an impairment so severe as to substantially preclude engagement in a useful occupation including homemaking.

The term “useful occupation” means productive activities which add to the economic wealth, or produce goods or services to which the public attaches a money value. “Homemaking” within the interpretation of useful occupation involves ability to carry on specified home management and decision-making responsibilities and to provide essential services within the home for at least one person in addition to one's self. Certain activities, although sometimes engaged in by disabled persons, are not considered as “useful occupations” for purposes of this program. These activities, which may or may not be remunerative, are:

  1. Hobbies.

  2. Activity which is essentially occupational therapy.

  3. “Made work,” available only because of the sympathy of others who assist in the work or purchase of the product.

  4. Work not normally considered a necessary occupation and which, if the individual ceased doing it, no one else would replace him.

  5. Work at home, provided it is part of a supervised training program of rehabilitation.

2. Requirement

To be considered permanently and totally disabled, the individual must require the attendance and/or supervision of another person on a daily and continuing basis but not necessarily on a full time basis, in order to perform one or more of the essential personal activities of daily living, namely personal hygiene (bathing, shaving, hair care, brushing of teeth, application of dressing, help with appliances), eating, dressing, toilet functioning, ambulating, communication and/or administering of medications prescribed on a continuing basis. There must be a demonstrated relationship between these and the disability.

Any person whose activities are so restricted that he is confined to bed, chair or wheelchair, or who requires considerable assistance in locomotion from others may be in need of help from another in essential activities of daily living.

Disability may exist from birth or be acquired during the lifetime of the individual. Impairments may exist singly or in combination. They may be obvious or they may be such that they can be revealed only by medical examination. The concepts of “permanent” and “total” should be evaluated separately in determining eligibility.

Permanence does not rule out the possibility of rehabilitation, or even recovery from the disability. The discovery of new drugs, surgical procedures and other advances in medical treatment may at some future time change a “permanent” situation. It is, therefore, to be defined in a practical manner rather than in an absolute sense. The term is not used in the sense of “everlasting” or “unchangeable” but in the sense of continuing as distinct from “temporary or transient.”

The terms “substantially precludes,” as used in the definition of total disability, relates to the extent to which an individual's permanent impairment has left him able to engage in the activities necessary to carry on specified responsibilities, such as those related to employment or homemaking. If an individual is able to engage in such activities well enough and with sufficient regularity to receive regular payment for his activity on a continuing basis, he is not precluded from engaging in “useful occupations” and cannot be found to be permanently and totally disabled.


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