Effective Dates: 05/09/2013 - Present Previous | Next

TN 2 (10-08)

DI 26010.055 Completing Item 27 (Rationale) on the SSA-831 for Blindness Cases

A. Procedure for Title II cases

If the onset of statutory blindness occurred later than the established onset date for the disability shown in Item 15A,

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    Check “See Attached SSA-4268-U4/C4” in Item 27, and

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    Enter “Onset of statutory blindness established as of (date) (MM/DD/YY)” on the rationale (Form SSA-4268–U4/C4), or

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    For eCAT, enter the date of blindness and the onset date of disability on the Determination page as directed. The Determination section of the Disability Determination Explanation will explain the two onset dates.

1. Item 18A checked — All Disability Insurance Benefits (DIB) cases

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    Modify the rationale (SSA-4268-U4/C4) to support the determination that the statutorily blind claimant is not disabled for cash benefit purposes.

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    If the statutorily blind claimant has attained age 55, modify the rationale to address the criteria set out in DI 26005.001D., “Policy - Work Comparability Provisions for Blind DIB, CDB, and DWB Individuals - Age 55 and Older”.

2. Item 18B checked — Claimant has attained age 55

If the claimant engaged in noncomparable SGA in or after the first full month he or she is under a disability for cash benefit purposes based on the date in Item 18B, include a statement in the rationale identifying the month of noncomparable substantial gainful (SGA) (see DI 26005.001D., “Policy – Work Comparability Provisions for Blind DIB, CDB, and DWB Individuals Age 55 and Older).

EXAMPLES:

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    “Claimant engaged in noncomparable SGA in 03/04 and 07/04”; or

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    “Claimant engaged in noncomparable SGA from 03/04 on.”

NOTE: If the claimant did not engage in SGA in or after the month shown in Item 18B, no entry is required.

3. Allegation of visual impairment — DIB insured status is not met

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    Prepare a substantive determination on the issue of statutory blindness when the field office (FO) advises that the claimant does not meet the regular DIB insured status requirement (the 20/40 test or alternative for young wage earners) at the alleged onset date (AOD) or later, but does meet the fully insured status requirement at AOD or later and has alleged a visual impairment (regardless of severity).

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    Include a brief statement such as, “Claimant is not statutorily blind per Dr. (name) report of (date (MM/DD/YY)),” in the rationale (SSA-4628).

NOTE: You can decide this type of case on the basis of lack of severity (F1), because the only issue involves the legal definition of blindness. Even though the claimant may be severely disabled, visually or otherwise, the fully insured provision applies only to statutory blindness. It is not necessary to evaluate the claimant’s impairment beyond this point. The claimant’s visual impairment either meets or does not meet the legal definition of blindness.

B. Procedure for Title XVI cases

1. Disability is established

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    When a claimant with a visual impairment is found to be disabled but not statutorily blind, provide a statement in the personalized notice to this effect.

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    When the claimant is already a Title II disability beneficiary, also provide a statement in the personalized notice to indicate that disability was previously established for Title II purposes.

If you determine that the claimant is disabled in the month of filing but became statutorily blind in a later month, provide a statement in the personalized notice to indicate this and include the date the claimant became statutorily blind.

2. Previous Presumptive Disability (PD) or Presumptive Blindness (PB) determination

If you enter a rationale for a PD or PB determination, precede the DDS formal rationale with the heading “Formal Determination.”

REFERENCES:

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    DI 26516.001 - Background

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    DI 26516.005 - Issues Requiring Rationalization/Documentation in the Disability Decisionmaking Process

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    DI 26516.010 - Implementation of Simplified Decision Rationale Procedures

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    DI 26516.015 - Optional Use of a Decision Rationale

To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0426010055
DI 26010.055 - Completing Item 27 (Rationale) on the SSA-831 for Blindness Cases - 05/09/2013
Batch run: 01/15/2019
Rev:05/09/2013