BASIC (03-86)

DI 21501.115 Maine APTD/AB State Plan

A. Blindness — aid to the aged, blind or disabled

Blind applicant or recipient has in terms of ophthalmic measurement central visual acuity of 20/200 (can see on the eye examination chart at 20 feet what a person with normal vision can see at 200 feet) or less in the better eye with best correcting glasses, if he has 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; if the visual field effiency is reduced to 30% or less; or if in the opinion of the consulting ophthalmologist the visual field limitations encroach on the central visual axis sufficient to interfere with useful vision. Such a person has what is known as economic blindness which prevents the performance of ordinary activities for which eyesight is essential. For determining the visual field efficiency the amount of radial contraction in the eight principal meridians shall be determined, and the sum of these eight, divided by 420 (the sum the eight principal radii of the industrial visual field) multiplied by 100 will give the visual field efficiency of one eye in percent.

B. Permanent and total disability

Permanent and total disability is interpreted to mean that the individual has some permanent physical or mental impairment, disease or loss or combination thereof that substantially precludes him from engaging in useful occupations within his competence, such as holding a job.

1. Permanently

“Permanently” refers to a condition which is not likely to improve or which will continue throughout the lifetime of the individual; it may be a condition which is not likely to respond to any known therapeutic procedures, or a condition which is likely to remain static or become worse unless certain therapeutic measures are carried out, where treatment is unavailable, inadvisable, or is refused by the individual on a reasonable basis; “permanently” 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.

2. Totality

Totality of impairment is defined to mean that the individual has a physical and/or functional disability which substantially precludes him from:

  1. Engaging in a useful occupation existing in the community, such employment to be on a regular and predictable basis.

  2. Performing the essentials of homemaking for self and at least one other person.

The individual is measured against his usual role as indicated by the pattern in existence at the time of the eligibility determination. If the client has carried both roles—breadwinner and homemaker—he will be measured against his ability to function in his actual role at the time of application.

Totality is primarily determined from the content of the social study report which must reflect such factors as the applicant's age, education, work history, marital history, living conditions, health, and quality of interpersonal relationships.

These will reflect how this disability affects this person as well as providing indicators regarding the person's ability to function in the light of his permanent impairment.

3. Useful occupation

A useful occupation is one which if the individual were not performing on it, would require a replacement. It must constitute the production of goods or services to which the public attaches a money value and for which there must be a demand in the community. The following are examples of activities that would not be considered useful occupations:

  1. A job that is made for an individual out of sympathy or compassion, or which he is able to perform only because others provide more assistance or supervision than would be characteristic of a bona fide employment situation, or a market for his goods or services is created more on sympathy than intrinsic value received.

  2. A job that is part of occupational therapy prescribed and supervised by a physician.

  3. An activity which is in the nature of a hobby and does not provide a bona fide job opportunity from the standpoint of genuine economic demand and remuneration.

  4. Activity while it is in a part of an active Vocational Rehabilitation program constituting training and supervised by a rehabilitation agency.

4. Homemaking

An individual does not meet the test of totality with respect to homemaking if he is found able to perform without substantial assistance the essential elements