TN 5 (06-15)

DI 28005.090 Continuing Disability Review (CDR) Evaluation Process in Cases Involving Statutory Blindness

A. Introduction to the evaluation process for statutory blindness

The CDR evaluation process applies the medical improvement review standard (MIRS) in determining whether an individual is still blind. For information on the CDR evaluation process, see DI 28005.005. Where appropriate, the flexibility principle in DI 28005.005B applies. Actions after a finding that blindness ended is discussed in DI 28005.090C.5. in this section

B. Statutory blindness background

1. Blindness listing

The statutory blindness listing provisions have not changed in many years. DI 28005.090C.4. in this section, usually involves consideration of the same listing section as DI 28005.090C.2. in this section.

2. MIRS and Title XVI blindness

The MIRS provisions of the 1984 Amendments did not initially apply to Title XVI blindness cases. However, P.L. 99-643 resulted in the MIRS principles applying to these cases beginning July 1, 1987.

C. Step-by-step CDR evaluation of statutory blindness

1. Is there medical improvement (MI) (decreased severity)?

Decide whether MI occurred in the individual's blindness

  • If MI did occur, go to step 2.

  • If MI did not occur, go to step 3.

2. Is MI related to the ability to work?

Decide whether MI is related to ability to work. For consideration of prior listings, see DI 28015.050.

  • If MI is not related to ability to work, go to step 3.

  • If MI is related to ability to work, go to step 4.

3. Is there an exception to MI?

Decide whether an exception to MI applies.

  • If one of the Group I exceptions applies, go to step 4.

  • If one of the Group II exceptions applies with respect to the individual's blindness, find that blindness ended, and go to step 5.

4. Does the blindness meet a listing?

Decide whether the impairment currently meets the statutory blindness requirements of the Listing of Impairments (Listing 2.02 or 2.03A).

  • If so, find that blindness continues.

  • If not, find that blindness ended, and go to step 5.

5. Disability consideration

If blindness ended, determine whether the individual is disabled by applying DI 28005.005.

  • If not disabled, the usual cessation procedures apply.

  • "If still disabled, DIB entitlement will continue for statutorily blind beneficiaries who only meet "Fully Insured" status for blindness only (i.e., do not meet 20/40 or Special Insured status), and are subsequently determined no longer stat blind but are still disabled (i.e., have a non-blind impairment). This also applies to the Title II portion of concurrent Title II and Title XVI cases involving "Fully Insured" status for blindness only.

D. Allegations of blindness

To determine whether to develop the blindness issue in cases where blindness is alleged but is not established, and disability continues on a basis other than blindness, follow the instructions in DI 26001.010 and DI 26005.005.

E. References