TN 12 (06-14)

DI 25501.380 Establishing the Established Onset Date (EOD) of Statutory Blindness in Title II Disability Insurance Benefits (DIB) Claims

A. Policy for establishing the EOD of statutory blindness

1. Disability freeze based on statutory blindness

A qualified DIB claimant who meets the insured status requirement (blind or non-blind) and is statutorily blind is entitled to a freeze, regardless of whether he or she is performing substantial gainful activity (SGA). A freeze is a period of disability during which we “freeze” a claimant’s earnings record. This means a statutorily blind claimant performing SGA can be entitled to a freeze period, but not for monthly benefits. A freeze period preserves the claimant’s insured status and prevents the loss of future retirement or disability benefits. The freeze period also protects the claimant’s primary insurance amount (PIA) used to calculate the monthly benefit amount payable to a claimant.

For more information on a Title II disability freeze, see DI 10105.005. For more information on Childhood Disability Beneficiary (CDB) and Disabled Widow(er) Benefits (DWB) freeze exceptions, see DI 26001.010C.

2. Insured status, statutory blindness, and EOD

For the purposes of a freeze period based on statutory blindness, the EOD is the date the medical evidence shows, or we can make reasonable medical inference, the claimant’s visual disorder meets the definition of statutory blindness. However, it cannot be earlier than the date the person first meets insured status.

To establish the EOD, a claimant must meet insured status requirements at the time the medical evidence supports a finding of statutory blindness. For either DIB cash benefits or a disability freeze based on statutory blindness without cash benefits, the claimant must be fully insured, but does not need to meet the regular DIB insured status requirement (the 20/40 test or alternative for young workers).

REMINDER: You can establish the EOD for a Title II DIB disability freeze based on statutory blindness even if the claimant is performing above the statutory blindness SGA threshold. No cash benefits are payable, however, until work drops below the statutory blindness SGA threshold.

NOTE: While you cannot establish the EOD before the DFI, you may consider the period before the DFI to determine if the claimant’s condition meets the 12-month duration requirement.

3. EODs for claimants who are both statutorily blind and disabled

We may establish a disability (non-blind) EOD prior to a statutory blindness EOD. In this situation, we establish two EODs, one for disability and one for blindness. The disability may be based on:

  • a visual disorder that did not (or did not yet) meet the statutory definition of blindness but nevertheless resulted in a disability,

  • a visual disorder in combination with another impairment or impairments, or

  • another impairment(s) that does not affect vision.

NOTE: A claimant must meet insured status and other eligibility requirements for us to establish an EOD for a Title II (non-blind) DIB claim.

For DIB non-blind disability EOD instructions, see DI 25501.300.

4. Two EODs for Title II DIB blind claimant who engaged in blind SGA

For a claimant who engaged in SGA despite statutory blindness, we establish two EODs:

  • The first date marks the medical onset of statutory blindness. This is the date we establish the disability freeze based on statutory blindness.

  • The second date marks the date the claimant ceased to engage in blind SGA and is eligible to receive Title II payments. This is the adjusted blind onset date (ABOD) and it controls the start of the 5-month waiting period and date of entitlement (DOE) to DIB.

NOTE: For DWB and CDB freeze exceptions, see DI 26001.010C.

B. Component roles for establishing the EOD for statutory blindness

When the field office (FO) identifies a Title II DIB claim with possible blindness entitlement (i.e., allegation of blindness or a visual impairment):

1. FO roles

The FO:

  1. documents insured status dates and technical information in the Electronic Disability Collect System (EDCS) or on the Disability Report—Field Office (Form SSA-3367), in item 4: Reason for Potential Onset Date, item 5: Explanation for Potential Onset Date, and item 6: Miscellaneous Information. See detailed instructions in DI 81010.025 and DI 11005.045.

  2. develops work issues on an SSA-820-BK or SSA-821-BK and work determinations on the SSA-823.

  3. establishes the freeze and then considers SGA to determine if and when monthly benefits are payable.

  4. forwards the claim to the disability determination services (DDS) regardless of any SGA determination, unless:

    • the claimant was not fully insured (i.e., does not have statutory blind insured status) and the case is technically denied by the FO, or

    • statutory blindness was established in a prior claim but benefits ceased due to SGA. If work again drops below SGA, a new medical determination is not required. In this situation, the FO forwards the case to the processing center (PC) for DIB attainment processing per DI 13010.135.

For detailed FO information on statutory blindness, see:

DI 11005.070 Field Office Title II and Title XVI Disability Claims for Blindness and Visual Impairment Allegations,

DI 11005.071 Title II Statutory Blindness Insured Status and Freeze Development

DI 11005.072 Field Office Disability Claims Process of Statutory Blind Allowances

2. DDS roles

The DDS:

  • requests blind SGA development from the FO if not already provided

  • establishes the EOD for statutory blindness, if the DDS determines the claimant is statutorily blind only

  • establishes two EODs - one EOD for the non-blind disability and a second EOD for statutory blindness, if the claimant becomes disabled before becoming blind (see DI 25501.380A.3., in this section).

  • establishes two EODs if the claimant engaged in SGA despite statutory blindness – one EOD for medical onset of statutory blindness to establish a freeze and a second EOD for when the claimant ceased to engage in blind SGA and became eligible to receive Title II payments (see DI 25501.380A.4., in this section).

C. Component instructions for establishing the EOD for statutory blindness

1. FO instructions

In cases with potential Title II DIB blindness entitlement, the FO will:

  • make SGA determinations using the SGA threshold amounts for blind persons (see DI 10501.015); and

  • respond within 24 hours to DDS assistance requests (AR) for clarification of any technical information needed for adjudication (see DI 81010.100B and DI 10005.010B.2);

  • clearly document the blind insured status information (DFI/DLI) on the EDCS 3367 or SSA-3367 (see details in DI 11005.045B.1.e., Item 5: Explanation for Potential Onset Date, when applicable.)

ATTENTION: It is extremely important that the FO provide the blind insured status and disability insured status information in certain situations if the claimant alleges blindness or a visual impairment. Failure to do so could lead to decisional errors due to erroneous blind DLI information or nonexistent disability insured status information. For detailed instructions on when to document blind insured status dates, see DI 11005.071A.2.

2. DDS instructions

IMPORTANT: Be alert of the need to clarify any missing, ambiguous, or clearly inaccurate insured status or SGA information that could affect potential entitlement. If the claimant has any earnings, the DDS needs to ask the FO for the blind insured status and SGA information in order to make an accurate determination.

The DDS will:

  • contact the FO (by phone or an AR) for blind insured status (DFI/DLI) or SGA information if not already provided by the FO;

  • verify that the SGA determination used the blind SGA threshold limits to determine possible entitlement to cash benefits;

  • verify the blind insured status (DFI/DLI) with the FO if the provided DLI is in the past;

  • establish the date the claimant met the criteria for statutory blindness (meets Listing 2.02 or 2.03A);

  • establish the non-blind disability EOD if you determine disability is established prior to the date the claimant was found statutorily blind; and

  • complete form SSA-831 following the instructions in DI 26010.001 through DI 26010.070.

ATTENTION: Do not complete Item 18 of Form SSA-831 when the onset date of disability entered in Item 15A is earlier than the onset of statutory blindness.

NOTE: A disability DLI cannot be more than 5 years in the future, but a blind DLI may be at full retirement age, thus, years in the future.

D. References


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DI 25501.380 - Establishing the Established Onset Date (EOD) of Statutory Blindness in Title II Disability Insurance Benefits (DIB) Claims - 07/29/2016
Batch run: 07/29/2016
Rev:07/29/2016