Sightseeing. A periodic tour of CVI news, views and events.

Medical Eligibility When Applying for Social Security Benefits

SSI

As mentioned last month in the first installment of this series, disability benefits are available to those who can no longer work due to vision loss or impairment. These benefits - Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI) - each have their own technical requirements. You can read more about these programs in my previous post here: sightseeing/social_security/. In addition to the technical requirements explained there, applicants are required to meet certain medical criteria.

In order to qualify for SSDI or SSI benefits, an individual must first meet the SSA’s definition of disability. This definition is split into two parts, one for children and one for adults. These definitions are explained as follows.

1. Adults are considered disabled if they have a physical or mental impairment that has, or will, prevent them from engaging in substantial gainful activity (SGA) for at least one year. In 2014, SGA for statutorily blind individuals is set at $1800 per month. The monthly SGA amount for individuals with other types of impairments is set at $1,070.

2. Children under the age of 18 will be evaluated based on a separate definition of disability. The Social Security Administration (SSA) will consider a child to be disabled if they have a physical or mental condition that significantly impairs their ability to perform day-to-day activities.

It is important to note that there is no duration requirement for blindness under SSI, meaning that you will not need to be blind for a set amount of time before or after receiving benefits. Also of importance, SGA for blind individuals applies only to SSDI eligibility. SGA does not impact a blind applicant’s eligibility for SSI. To learn more about the different rules and requirements for blind applicants, visit the following page: http://www.ssa.gov/redbook/eng/blindrules.htm.

In addition to meeting the general definition of disability, an applicant will have to meet criteria specific to his or her particular condition. When evaluating your eligibility for disability benefits, the SSA will compare your condition to the requirements found in their official manual of disabling conditions, the Blue Book. Vision loss and impairment is evaluated under Blue Book section 2.00—Special Senses and Speech. Under this section, there are three listings that cover vision loss. It is important that you go over each of these listings to determine which listing is the closest match to your condition. These listings are:

• 2.02—Loss of Visual Acuity
• 2.03—Contraction of the Visual Field in the Better Eye
• 2.04—Loss of Visual Efficiency, or Visual Impairment, in the Better Eye

Note that these listings apply to adults. If you are applying for disability benefits on behalf of a child, you will need to consult the following listings instead:

• 102.02—Loss of Central Visual Acuity
• 102.03—Contraction of the Visual Field in the Better Eye
• 102.04—Loss of Visual Efficiency or Visual Impairment in the Better Eye

Although the Blue Book is conveniently located online, understanding the optometry terminology might prove to be a challenge. If you are having a hard time understanding the Blue Book requirements, you should start by scheduling an eye examination. At your examination, you can sit down with your doctor and discuss the SSA’s medical requirements and he or she will help you schedule the appropriate tests. If you do not meet a Blue Book listing, do not panic. You may still be able to qualify for disability benefits under something known as a medical vocational allowance. Essentially, this means that the SSA will evaluate your age, your abilities, and your previous work experience to determine if you are capable of holding a job. If it is determined that you cannot work, you will be awarded benefits.

For more information about Social Security Disability medical eligibility, visit the following page: http://www.disability-benefits-help.org/disabling-conditions/vision-loss-and-social-security-disability.

Stay tuned for the final blog post on Social Security benefits, where I will be discussing application preparation and submission.

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