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Vision Loss and Social Security Disability

The American Foundation for the Blind (AFB) reports nearly 20.6 million adults in the U.S. have significant vision loss. This figure, from a 2012 survey conducted by the National Center for Health Statistics, includes individuals that have difficulty seeing, even with corrective lenses, as well as individuals who cannot see at all.

The Social Security Administration (SSA) considers “legal” or “statutory” blindness as a qualified disability. Legally blind individuals include people who have been blind since birth in addition to those that have experienced severe vision loss due to conditions like glaucoma, retinopathy, and traumatic injury, among others. In fact, the blind can qualify for disability and still continue to work while receiving monthly benefits, provided they meet all SSA requirements.

The Financial Costs of Blindness

People born blind usually learn to live and thrive in a world dominated by sighted individuals, but they still experience ongoing “adaptive living” expenses as working adults. These costs include transportation fees, home modifications, and expensive technologies that allow the blind to live independently and perform essential job duties.

Even the expense of a guide dog may be outside the grasp of a disabled worker. According to the Guide Dog Foundation, the cost of raising and training a single service animal is about $50,000. While some organizations provide dogs free of charge to the blind, these groups have limited resources and budgets. This means blind workers may wait months or years for a guide animal unless they’re able to afford to pay for training their own.

For people who lose their sight later in life, the costs of blindness include not only adaptive expenses like those mentioned above, but also astronomical medical bills. Patients and doctors frequently do all they can to retain or improve sight, using surgical procedure, medications, and other treatment methods. Bills add up quickly, particularly for patients that have lost their job and their health insurance along with it.

A decrease in average earnings or total loss of income from work after vision loss is common too, with workers often being unable to continue employment in their traditional field. A production worker who loses his sight, for example, cannot return to the production floor after a medical leave. Instead, he must learn new skills and eventually find a new job. Making ends meet in the mean time only adds stress to an already stressful life transition.

Disability benefits can provide financial support and access to occupational rehabilitation, in which workers are trained for new professions. Disability benefits can additionally be an ongoing source of financial support for blind workers, allowing them to continue employment while simultaneously receiving monthly disability payments.

Medically Qualifying for Disability Benefits through the Blue Book Listing

The SSA maintains standard listings that outline what constitutes disability with various health conditions. These listings appear in a manual that’s call the “Blue Book.” The Blue Book is accessible online, via the SSA’s website, for you and your doctor to consult. Your doctor can help you understand the complex medical language and the SSA’s severity level requirements for qualifying for disability with blindness or vision loss.

SSA disability examiners are the people who review claims for benefits. They use the listing in the Blue Book to compare with your medical records to determine eligibility for benefits. To qualify for disability benefits, your vision loss or blindness must meet one of the following listings:

  • Loss of central visual acuity (2.02) – this listing covers loss in your central field of vision and requires you see no better than 20/200 in your better eye.
  • Contraction of the visual field in the better eye (2.03) – you can qualify under this listing if you have a shrinking field of vision. Your doctor must measure your vision with specific tests and must record what you’re able to see when you’re focusing on a fixed point. This listing requires reports of your visual field, which is the distance in all directions from the fixed point on which you’re focused. That diameter must be no greater than 20 to 30 degrees. In others words, your visual field must be very narrow.
  • Loss of visual efficiency, or visual impairment (2.04) – this listing covers issues that cause blurry or unfocused vision or an absence of vision (total blindness). To qualify, you must have vision in your better eye that is no greater than 20/200 when wearing corrective lenses.

Medically Qualifying for Disability through an RFC Analysis

The SSA reviews blindness or severe vision loss under strict rules of medical eligibility. To prove you’re disabled without meeting a listing means you must show your decreased vision or blindness prevents you from working in any job. This is done through a “residual functional capacity” analysis or RFC.

In an RFC, the SSA looks at your functional limitations, like your inability to drive, read, shop for food, or get around in unfamiliar locations. These limitations in your everyday life help the SSA understand how you’d be limited in performing specific kinds of job duties.

During an RFC, the SSA also looks at your age, job skills, and education level. As a person with severe vision loss that doesn’t meet a Blue Book listing, you’re more likely to be approved through an RFC analysis under certain circumstances:

  • If you have a medical condition that causes progressive vision loss. While your vision may not meet a disability listing now, the SSA can see from your diagnosis that your vision will continue to worsen, eventually reaching the severity level noted in the Blue Book.
  • If you are older and have a lower level of education or limited transferable job skills. For example, if you are 55 years old, did not go to college, and have worked your entire life as a bus driver, then your loss of vision likely means you cannot find work in a different field. If however, you’re a teacher who holds a master’s degree and are relatively young, then you may not be approved through an RFC because the SSA will believe that you should be capable of finding gainful employment despite your vision issues.

Qualifying through an RFC means you’re granted a “medical vocational allowance.” This essentially means the SSA believes you cannot work in any job due to your functional limitations.

How to Apply for Benefits with Blindness

You can apply for Social Security Disability Insurance (SSDI) online via the SSA’s website or you can submit your application at your local SSA office. If you apply for Supplemental Security Income (SSI) however, you must do so through an interview process with an SSA representative and this is usually done at the local office.

No matter how you apply or which program you’re applying for, you will need to have a lot of information readily available, including:

  • Your work history and details of your education and job training
  • Medical records or at least accurate contact information for all your healthcare providers, including your primary care doctor, specialists, and therapists or life skills educators
  • Financial records, including bank statements, paystubs, and information on any other forms of benefits you currently receive

Your medical documentation is essential to proving your disability whether you qualify under a disability listing or through an RFC. Specific records that the SSA requires for visually impaired and blind applicants may include:

  • Snellen method or similar visual acuity tests, which measures how well a patient can see objects based on distance and location in relation to the central field of vision
  • Automated static threshold perimetry or kinetic perimetry exams, which document shrinking or contraction of the central field vision over time
  • Humphrey Field Analyzer visual field tests, which documents central and peripheral vision when a patient is focused on a fixed point

Your doctor can help you understand whether your medical records meet the SSA’s requirements. He or she can also determine any gaps in your medical documentation and fill in those gaps by completing evaluations according to SSA documentation standards.