What is Glaucoma?
Glaucoma is a progressive eye disease that results in damage to the optic nerve, and eventually causes permanent blindness. An estimated 3 million Americans currently have glaucoma, and around half of them aren’t aware of it - as up to 40% of vision can be lost before symptoms are present.
Glaucoma is the leading cause of preventable blindness in the U.S., and the overall leading cause worldwide. African Americans, Latinos, diabetics, and those who are middle-aged or elderly have a greater chance of experiencing glaucoma.
It is not always easy to detect if you have glaucoma as there aren’t necessarily any early warning signs and vision changes often take place gradually.
However, with any type of glaucoma you are likely to experience any of the following symptoms:
rainbow-colored halos around lights,
low vision, narrowed vision and blurred vision or blind spots,
eye pain or pressure.
What Causes Glaucoma?
Anyone can get glaucoma but increasing age is a risk factor. Also people who have diabetes are twice as likely to get glaucoma. Other risk factors include:
family history of glaucoma;
farsightedness or hyperopia;
high blood pressure and very low blood pressure;
long-term use of corticosteroids;
nearsightedness or myopia;
previous eye injury or surgery.
What affects the chances of getting glaucoma is based on intraocular eye pressure. All eyes produce a fluid called aqueous humor that nourishes them. This liquid flows through the pupil to the front of the eye.
When the eye is healthy, the fluid exits through the drainage canals which are found between the eye’s iris and cornea. When glaucoma is present resistance increases in the drainage canals which means the fluid has nowhere to go, so it accumulates in the eye which exerts pressure on your eye. Eventually, this higher than usual eye pressure could damage the optic nerve and lead to glaucoma.
Is Glaucoma a Disability?
Glaucoma can be considered a disability by the SSA if you meet the medical criteria outlined in the SSA’s Blue Book listings for vision loss. If you can prove that your glaucoma is so severe that you will be unable to work full time for at least 12 months, the SSA will consider your glaucoma a disability and you will be able to qualify for Social Security disability benefits.
In the Blue Book, which is the SSA's list of disabilities that qualify for SSD, glaucoma doesn’t have its own listing but there are three other listings related to blindness that your glaucoma can be assessed under. To prove that your glaucoma is a disability your vision loss needs to meet the following criteria:
- You have an MD of 22 decibels or more;
- You are unable to see more than 20 degrees to the right or left of a fixed point;
- The visual efficiency of your better eye is 20% or less with the use of glasses which is covered in listing 2.04;
- The remaining visual acuity in your better eye must be 20/200 or less which is covered in listing 2.02 in the Blue Book;
If your glaucoma doesn’t meet the criteria under any of the Blue Book’s listings, such as 2.02 and 2.04 you may still qualify by completing the Residual Functional Capacity (RFC) form. Your doctor will conduct certain eye tests which will show how your glaucoma affects your mobility and ability to go to work.
When you file your application you will need to provide all the results of eye exams to show you meet the requirements for disability benefits.
How to Qualify for Social Security Benefits with Glaucoma
Although there is no cure for glaucoma, getting early treatment can significantly slow down its progression. In some cases, it’s possible to get approved for Social Security disability benefits if you have glaucoma.
To qualify for disability for having glaucoma, you’ll need to meet certain criteria established by the Social Security Administration (SSA). But first, in order to be eligible for Social Security disability for any reason, you’ll need to be currently not working, with the expectation of being off work for at least a yea
The easiest way to get approved for Social Security due to glaucoma is to qualify under the SSA’s “Listing of Impairments.” These listings indicate a number of conditions for which the SSA has set forth specific standards that, if met, make the applicant eligible for benefits.
If you have glaucoma, you could be entitled to disability benefits under one (or more) of three separate listings. If your visual acuity (clearness and clarity) in your better eye is less than 20/200, you could meet listing 2.02.
You could also be approved based on listing 2.04, which requires that your visual efficiency (a combination of visual acuity and loss of peripheral vision) in your better eye is 20% or less, after correction (such as glasses). Listing 2.04 is based on loss of peripheral vision.
However, if your glaucoma doesn’t quite fall under one of these listings, you could still be eligible for Social Security disability. In order to be granted benefits, you’ll need to prove to the SSA that there is no job that you would be able to perform on a full-time basis (proving that you can’t do your previous work isn’t sufficient.)
The Financial Cost of Glaucoma
The annual cost of glaucoma to the U.S. health care budget is approximately $2.5 billion. Glaucoma is a preventable affliction, but awareness of its progressively negative effects is relatively low, especially amongst certain sections of the population.
Nationally, glaucoma affects the elderly and the Hispanic community disproportionally. The prevalence of glaucoma is predicted to increase by 28% by 2050, partly because of the aging population.
The cost of treating glaucoma is amplified because of its late detection. Advanced glaucoma can lead to blindness. Late diagnosis of glaucoma means the cost of treatment is increased as medical treatment is accompanied by the need for special equipment and support as eye sight deteriorates.
Early onset glaucoma can be detected quite easily by an ophthalmologist or eye doctor. Although glaucoma can rarely be reversed, it can be contained, or its deterioration slowed, by regular direct application of pressure reducing eye drops, oral medication or laser treatment.
As glaucoma is caused by high intraocular pressure, all treatment methods are aimed at reducing pressure.
If caught in its early stages, the cost of treating glaucoma may be as low as $620 a year, increasing to $2,500 a year for those with end stage disease, which can end in blindness.
To the cost of medical treatment alone should be added the cost of additional technology and support which are needed for the glaucoma patient to be able to complete average daily functions and move around.
This includes things like home modification, special transportation and a service dog. Costs increase exponentially if the disease advances. The cost to the U.S. annually includes social security benefits, loss of tax revenue and the cost of health care directly related to glaucoma.
Starting Your Application
To do this, it’s essential that you have records documenting consistent medical treatment, and that they not only include information such as your diagnosis and treatments, but also notes regarding how your glaucoma inhibits your ability to perform basic tasks.
To qualify under an impairment listing, your file could be required to contain specific test results. While the SSA will also consider your input as to what you can do, medical records are by far the most important piece of the puzzle.
After reviewing the evidence in your file, the SSA will establish what your limitations are – such as if you can’t operate machinery, read, or work with small objects. They will also consider other things, including your age, education level, and work history.
Based on all of these factors, they will determine whether or not there is any type of work that you can do. If they find that there is, your application for Social Security disability will be denied benefits.
Trial Work Period
Disabilities aren’t always permanent, or in the case of progressive diseases like glaucoma, treatment can allow a sufferer to return to work, albeit not necessarily the same job as before. If you are receiving SSD benefits, the Social Security Administration (SSA) allows disabled workers to work for 9 months in every period of 60 months without losing SSD payment privileges.
This is called a trial work period. Payments may be kept up during this period if the amount of remuneration during the trial work period is less than the substantial gainful activity (SGA) amount.
Payments may also be resumed without having to reapply for benefits if the trial work period ends due to an inability to maintain the pressure of the job due to the existing disability. The amount you are paid in SSD benefits will remain the same as before the trial work period as long as your income remains less than the SGA.
During the period of trial work, you must keep the SSA informed of your income, expenses and details of your employment. Failure to maintain this level of communication may mean your SSD benefit payments or eligibility for these payments is reduced or canceled.
Qualifying Through a RFC Form
Gaining SSD benefits as a result of meeting the exacting criteria of a listing in the SSA’s Blue Book is the primary route for those with advanced glaucoma, but it is not the only method. If you cannot meet the criteria under the Blue Book’s listings, such as 2.02 and 2.04 which are based on visual acuity, there is a chance that you may qualify by submitting a RFC form.
The Residual Functional Capacity (RFC) Form is not a compulsory requirement of the SSD application process, but is an optional qualification choice.
Remember that to obtain SSD benefits you must be able to prove that you are unable to work for at least the next 12 months. As glaucoma is a progressive disease, this is determined by just how far the deterioration in the retina and optic nerve has reached.
The RFC is a form, easily downloaded off the SSA’s website, which is best filled in by your physician, who is the best qualified to assess the status of your glaucoma and the ability or otherwise for you to continue working.
What you may not realize is that an adjudicator at the Disability Determination Services may use the information available on your file held with the SSA to fill in a RFC regardless, if this has not been done by your physician.
The RFC basically determines what sort of work you can or cannot do and the limitations of work you are able to carry out. By assessing the various actions that you are capable of it builds a detailed picture of your work ability that enables a judge together with your medical records to determine whether you are able to do any work at all and at what exertional level.
There are five exertional levels in the SSA classification system, which range from a “sedentary” work level requiring minimal movement right through “light,” “medium,” “heavy,” and “very heavy.”
Assuming that you cannot match any of the listing criteria in the Blue Book, an assessment of your RFC form together with other documentation may lead to a payment of SSD benefits under the medical vocation allowance.
Talk to a Social Security Lawyer
If you have glaucoma and you are thinking about applying for Social Security benefits, then you may want to seek the counsel of a Social Security lawyer or disability advocate.
They will be able to get all of your medical records and information in order, which helps give you the best chance of winning your case.