Applying for disability with Glaucoma

First, a bit about the condition

Glaucoma is not just one eye disorder but a group of eye diseases, which cause a loss of retinal ganglion cells. The loss of retinal ganglion cells results in optic neuropathy, and the loss of visual fields. The danger of glaucoma lies in its gradual loss of visual fields over a long period of time.

Once visual fields have been damaged they can never be recovered, consequently untreated glaucoma may lead to blindness.

Studies indicate that African Americans and diabetics are about three times more likely to be affected by glaucoma. Asians are more likely to be affected by angle closure glaucoma. In fact, Inuits are twenty to forty times more likely than Caucasians to suffer from primary angle closure glaucoma. Even the use of drugs such as steroids can cause glaucoma.

Once of the most common myths about glaucoma is that although intraocular eye pressure is a risk factor for glaucoma, there is no certain threshold that will trigger glaucoma.

For instance, some individuals who have relatively low eye pressures may have nerve damage, while others may have extremely high eye pressure with no nerve damage from glaucoma. Consequently, regular eye exams are necessary to detect increases in eye pressure, and an ophthalmologist should monitor elevated eye pressure to prevent permanent optic nerve damage.

Filing for disability with Glaucoma

If you are applying for Social Security Disability or SSI on the basis of glaucoma, there are some things you will need to know to help your claim get approved.

Firstly, you have to either not be working or have reduced you earnings so that they are under the SGA limit. You can apply anytime, however your claim will be denied without a medical decision if you performing SGA.

Secondly, you must have a severe impairment that can be or is medically documented through objective medical evidence.

If both of these criteria are met, you should apply for Social Security Disability if you have glaucoma that causes severe restrictions to your ability to perform daily work activities including work activity.

Since glaucoma affects visual fields, Social Security uses impairment listing 2.03, Contraction of the visual field in the better eye, with:

A. The widest diameter subtending an angle around the point of fixation no greater than 20 degrees; OR

B. A mean deviation of '22 or worse, determined by automated static threshold perimetry. OR

C. Visual field efficiency of 20% or less as determined by kinetic perimetry.

Social Security will require certain testing to evaluate the affect severity of your glaucoma. Social Security will accept the results of:

A) Humphrey Field Analyzer that uses the white size III Goldmann stimuli and a 31.5 apostilb white background. The stimuli location must be no more than 6 degrees apart horizontally or vertically. Measurements must be reported on standard chart and include a description of the size and intensity of the test stimulus.

B) Humphrey 'SSA Test Kinetic' or Goldmann perimetry instead of the automated static threshold.

Because of limitations in this testing, this test is unable to detect limitations in the central visual field. If your visual disorder has progressed to the point of significant limitation in the central visual field, they will not use the automated kinetic perimetry to evaluate your visual field loss.

Social Security will not accept visual field screening tests, such as confrontation tests, tangent screen tests, or automate static screening tests to evaluate and determine if you impairment meets or medically equal a listing or to evaluation your residual functional capacity. However, Social Security will accept them if they are normal to determine if your glaucoma is severe when these tests are consistent with other medical evidence in your file.

From my experience as a disability examiner, we often had to order these tests for disability applicants due to the specific requirements used by Social Security to evaluate the severity of vision impairments. You should not be concerned, as the Social Security will pay for any kind of examination they need for their medical determination.

About the Author: Tim Moore is a former Social Security Disability Examiner in North Carolina, has been interviewed by the NY Times and the LA Times on the disability system, and is an Accredited Disability Representative (ADR) in North Carolina. For assistance on a disability application or Appeal in NC, click here.

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