Social Security & SSI Disability: Vision Loss & Blindness

Winning Your Vision Loss Or Blindness Case

Vision Loss And Blindness Medical Records And What Social Security Wants

Social Security will evaluate your disability and SSI application about vision loss and blindness with care to determine if you meet its disability rules. Vision loss or blindness can be caused by a variety of factors. The most common types of visual disorders, conditions, and impairments reviewed by Social Security are as follows -

1. Refractive errors including myopia (nearsightedness), hyperopia (farsightedness), presbyopia (inability to see close up), or astigmatism (distorted or blurred vision at any distance);
2. Cataracts;
3. Glaucoma;
4. Floaters (spots in your vision);
5. Cloudy vision;
6. Double vision;
7. Amblyopia (lazy eye);
8. Diabetic retinopathy;
9. Macular degeneration;
10. Retinal detachments;
11. Genetic disorders; and
12. Infections.

In evaluating your disability and SSI case, Social Security will need to determine the diagnostic basis of your vision loss and blindness which is a vision test. Any diagnosis will need to be done by an ophthalmologist.

Records of your medical treatment are especially important to Social Security because medical treatment produces medical records that tell Social Security about the nature of your vision loss or blindness. Treatment widely depends on the nature of your condition, and some vision loss is not correctable. The most frequent treatment is medications, and several types of surgeries to correct vision symptoms depending on the nature of your eye condition:

1. LASIK - It is done to treat nearsightedness, farsightedness, and astigmatism. A flap is created on the cornea so that the surgeon can gain access to the cornea and reshape it allowing more light to reach the retina.
2. PRK (photorefractive keratectomy) - This is the same surgery as LASIK except no flap is created, and instead access to the cornea is obtained by cutting away and discarding the epithelium (thin outer layer of the cornea). The epithelium then grows back.
3. LASEK (laser epithelial keratomileusis) - This is the same surgery as PRK except the epithelium is not discarded but rather put back over the cornea and allowed to reattach and heal.
4. AK (astigmatic keratonomy) - It is done to treat astigmtism. Non-laser incisions are made in the cornea to make it more rounded in shape.
5. RLE (refractive lens exchange) - It is done primarily to correct cataracts. However, it can also be performed to correct nearsightedness and farsightedness. The lens of the cornea is replaced with an artificial one.
6. Phakic Intraocular Lens Implant - A cornea lens is implanted into the eye without removing the natural lens.
7. PRELEX (presbyopic lens exchange) - Like a RLE, the corneal lens is replaced with an artificial one.
8. Vitrectomy - It is done to treat diabetic retinopathy. Blood leakage and scar tissue is removed from the eye.

Social Security will be highly concerned about your symptoms. The worse your vision loss and blindness symptoms, the more likely Social Security will find you disabled. Primary symptoms and limitations are a degree of vision loss. Secondary symptoms and limitations include excessive watery or dry eyes; floaters that come and go that may not be present at all vision tests; eye fatigue; eye pain; avoidance of bright or dim light; headaches; or eye fatigue with a need to rest your eyes for long periods (the most important secondary symptom).

Vision Loss And Blindness Social Security & SSI Listings

There are three listings for vision loss and blindness.

Loss of Central Visual Acuity - Adults can satisfy Adult Listing 2.02 if they have 20/200 vision or less. Children can satisfy Child Listing 102.02 if they have 20/200 vision or less, or they cannot take a visual test and one of -

1. A physical abnormality indicating vision less than 20/200,
2. An abnormal cerebral cortex which is expected to prevent vision better than 20/200,
3. A Leber's congenital amaurosis or achromatopsia, or
4. No response to a visually evoked response (VER) test which evaluates the optic nerve.

Contraction of Your Visual Field - Adult Listing 2.03 and Child Listing 102.03, requires you show -

1. Your widest diameter of vision is 20 degrees or less,
2. You have a mean deviation of 22 decibels or greater, or
3. Your visual field efficiency of 20 percent or less.

Loss of Visual Efficiency - Adult Listing 2.04 and Child Listing 102.04, requires you show -

1. Your visual efficiency is 20% or less, or
2. You have a visual impairment value of 1.00 or greater.

Statutory Blindness

Social Security defines two degrees or types of vision loss and blindness as "statutory blindness" which means you satisfy Listings 2.02/102.02 or 2.03/102.03. There are several special Social Security rules if you are statutorily blind - Statutory Blindness Rules.

Proving You Are Disabled

At Steps 3, 4, and 5 of the disability criteria, a finding of disability is almost exclusively made based on vision loss. It is difficult to be found disabled based on secondary symptoms. Vision loss is measured by vision testing. With other impairments, there are very few objective tests that so easily determine a degree of limitation, and therefore, Social Security must look at a variety of factors to determine condition severity. But with vision, the vision test basically shows it all.

At Step 3, you must meet or equal a listing.

At Step 4, you must show you cannot do your past relevant work due to your vision limitations. This is usually easy, because if you could do your past relevant work, you'd be doing it.

At Step 5, you must show you cannot do "other work." Because vision loss is a non-exertional impairment (it does not affect your ability to meet the strength demands of jobs), your "other work" job standard is that you must show you cannot do any work at all - an any-job standard. If you want to meet this any-job standard, your vision loss must be very close to the listing-level criteria, and in addition, you must have at least one other secondary symptom.

Compassionate Allowance Case

Some child visual impairment cases can count as a compassionate allowance case which is a medical condition that Social Security finds easily satisfies its disability requirements. Social Security expedites these types of cases - Expedited Cases.