SSR 18-2p: Titles II and XVI: Determining the Established Onset Date (EOD) in Blindness Claims

Effective Date: October 2, 2018 Federal Register,

vol. 83, No. 191, page 49621 .

POLICY INTERPRETATION RULING

We are providing notice of SSR 18-02p which rescinds and

replaces the following sections of SSR 83-20 : “Titles

II and XVI: Onset of Disability,” – (1) “Title II:

Blindness Cases,” and (2) “Title XVI—Specific

Onset is Necessary,” as it applies to blindness claims. Concurrently,

we published a separate SSR, SSR 18-01p ,

“Titles II and XVI: Determining the Established Onset Date (EOD) in

Disability Claims,” which rescinded and replaced all other parts

of SSR 83-20 .

Therefore, as of October 2, 2018, the date this SSR was published in the Federal Register , SSR 83-20 is

completely rescinded and replaced by SSR 18-01p and

SSR 18-02p.

Purpose: This SSR explains how we determine the

EOD in blindness claims under titles II and XVI of the Social

Security Act (Act).

Citations: Sections 216 , 220 , 223 , 1602 , 1611 , and 1614 of the Act, as amended; P.L. 108-203, 118 STAT. 535; 20 CFR 404.110 , 404.130 , 404.303 , 404.315 - .316 , 404.320 - .321 , 404.335 - .336 , 404.350 - .351 , 404.1505 , 404.1510 , 404.1512 , 404.1572 , 404.1581 - .1584 , 416.202 , 416.305 , 416.912 , 416.981 - .984 .

Policy Interpretation:

To be entitled to disability insurance (DI) benefits

under title II of the Act or eligible for Supplemental

Security Income (SSI) payments under title XVI of the Act

based on blindness, a claimant must file an application,

meet the relevant statutory definition(s), and satisfy the

applicable non-medical requirements. If we find that a

claimant meets the relevant statutory definitions and meets

the applicable non-medical requirements during the period

covered by his or her application, we then determine the

claimant’s EOD. The EOD is the earliest date that the

claimant meets both the relevant definitions and non-medical

requirements during the period covered by his or

her application.

Outline

ts. If we find that a

claimant meets the relevant statutory definitions and meets

the applicable non-medical requirements during the period

covered by his or her application, we then determine the

claimant’s EOD. The EOD is the earliest date that the

claimant meets both the relevant definitions and non-medical

requirements during the period covered by his or

her application.

Outline

- What is the EOD? What is the statutory definition of

blindness? What are the statutory definitions of

disability for blind claimants and when do they apply? What is the statutory definition of

disability for a title II blind claimant who is younger

than 55? What is the statutory definition of

disability for a title II blind claimant who is age 55

or older? What are the non-medical

requirements?

- What are some special considerations

related to the EOD? What if a claimant meets all the

requirements for DI benefits or SSI payments based on blindness and based on

another impairment? What happens when a claimant applies

for DI benefits under title II and meets the statutory definition

of blindness, but continues to work?

- When is this SSR applicable?

What is the EOD?

- What is the statutory definition of

blindness?

- What are the statutory definitions of

disability for blind claimants and when do they apply? What is the statutory definition of

disability for a title II blind claimant who is younger

than 55? What is the statutory definition of

disability for a title II blind claimant who is age 55

or older?

- What are the non-medical

requirements?

What is the statutory definition of

blindness?

What are the statutory definitions of

disability for blind claimants and when do they apply?

- What is the statutory definition of

disability for a title II blind claimant who is younger

than 55?

- What is the statutory definition of

disability for a title II blind claimant who is age 55

or older?

at are the non-medical

requirements?

What is the statutory definition of

blindness?

What are the statutory definitions of

disability for blind claimants and when do they apply?

- What is the statutory definition of

disability for a title II blind claimant who is younger

than 55?

- What is the statutory definition of

disability for a title II blind claimant who is age 55

or older?

What is the statutory definition of

disability for a title II blind claimant who is younger

than 55?

What is the statutory definition of

disability for a title II blind claimant who is age 55

or older?

What are the non-medical

requirements?

What are some special considerations

related to the EOD?

- What if a claimant meets all the

requirements for DI benefits or SSI payments based on blindness and based on

another impairment?

- What happens when a claimant applies

for DI benefits under title II and meets the statutory definition

of blindness, but continues to work?

What if a claimant meets all the

requirements for DI benefits or SSI payments based on blindness and based on

another impairment?

What happens when a claimant applies

for DI benefits under title II and meets the statutory definition

of blindness, but continues to work?

When is this SSR applicable?

Discussion

I. What is the EOD?

For title II blindness claims, the EOD is the earliest

date that the claimant meets the statutory definitions of

blindness and disability [1] and the applicable non-medical requirements [2] for entitlement to benefits during the

period covered by his or her application. For title XVI

blindness claims, the EOD is the earliest date that the

claimant meets the statutory definition of blindness [3] and the applicable non-medical

requirements [4] for

eligibility for SSI payments during the period covered by

his or her application.

A. What is the statutory definition of

blindness?

titlement to benefits during the

period covered by his or her application. For title XVI

blindness claims, the EOD is the earliest date that the

claimant meets the statutory definition of blindness [3] and the applicable non-medical

requirements [4] for

eligibility for SSI payments during the period covered by

his or her application.

A. What is the statutory definition of

blindness?

Titles II and XVI of the Act define blindness as central

visual acuity of 20/200 or less in the better eye with the

use of a correcting lens. We consider an eye to have a

central visual acuity of 20/200 or less when it has a

limitation in the fields of vision such that the widest

diameter of the visual field subtends an angle no greater

than 20 degrees. [5] Under

title XVI of the Act, an individual may also be considered

blind if he or she: (1) was found blind under a State plan

approved under title X or XVI of the Act as in effect for

October 1972; (2) received aid under that plan because of

blindness for December 1973; and (3) continues to be blind

as defined under that plan. [6]

B. What are the statutory definitions of

disability for blind claimants and when do they apply?

A claimant who seeks DI benefits under title II

based on blindness must show that he or she meets the

statutory definition of blindness as well as the statutory

definition of disability during the period under

consideration. [7] A claimant

who seeks SSI payments under title XVI based on blindness

need only show that he or she meets the statutory

definition of blindness during the period under

consideration. [8] Title II of

the Act defines disability differently for those who are

younger than age 55 and those who are age 55 or older.

1. What is the statutory definition of

disability for a title II blind claimant who is

younger than 55?

ments under title XVI based on blindness

need only show that he or she meets the statutory

definition of blindness during the period under

consideration. [8] Title II of

the Act defines disability differently for those who are

younger than age 55 and those who are age 55 or older.

1. What is the statutory definition of

disability for a title II blind claimant who is

younger than 55?

For claimants who meet the statutory definition

of blindness during the period under consideration and are

younger than age 55, the Act defines disability as the

inability to engage in any substantial gainful activity

(SGA) [9] by reason of any

medically determinable physical or mental impairment which

can be expected to result in death or which has lasted or

can be expected to last for a continuous period of not less

than 12 months. [10]

2.What is the statutory definition of

disability for a title II blind claimant who is age

55 or older?

For claimants who meet the statutory definition

of blindness during the period under consideration and are

age 55 or older, the Act defines disability as the

inability by reason of such blindness to engage in SGA

requiring skills or abilities comparable to those of any

gainful activity in which the claimant has previously

engaged with some regularity and over a substantial period

of time. [11]

C. What are the non-medical requirements?

A claimant is not entitled to DI benefits or eligible

for SSI payments based on blindness unless he or she meets

the applicable non-medical requirements. The non-medical

requirements—such as the insured status requirements

under title II and the income and resource limitations

under title XVI—vary based on the type(s) of claim(s)

the claimant filed. To illustrate, we identify below the

most common types of claims and some of the regulations

that explain the non-medical requirements for that type of

claim.

ble non-medical requirements. The non-medical

requirements—such as the insured status requirements

under title II and the income and resource limitations

under title XVI—vary based on the type(s) of claim(s)

the claimant filed. To illustrate, we identify below the

most common types of claims and some of the regulations

that explain the non-medical requirements for that type of

claim.

- DI Benefits: 20 CFR 404.315 , 404.316 , 404.320 , 404.321 ; Disabled Widow(er)’s Benefits (DWB): 20 CFR 404.335 , 404.336 ; Childhood Disability Benefits (CDB): 20 CFR 404.350 , 404.351 ; and SSI: 20 CFR 416.202 , 416.305 .

DI Benefits: 20 CFR 404.315 , 404.316 , 404.320 , 404.321 ;

Disabled Widow(er)’s Benefits (DWB): 20 CFR 404.335 , 404.336 ;

Childhood Disability Benefits (CDB): 20 CFR 404.350 , 404.351 ; and

SSI: 20 CFR 416.202 , 416.305 .

II. What are some special considerations related to the EOD?

A. What if a claimant meets all the requirements for

DI benefits or SSI payments based on blindness and based on

another impairment?

If a claimant meets all the requirements for entitlement

to DI benefits or eligibility for SSI payments based on

blindness, and also meets all the requirements for

entitlement to DI benefits or eligibility for SSI payments

based on another impairment, we will establish two EODs.

One EOD will be for the first date the claimant meets all

the requirements for entitlement to DI benefits or

eligibility for SSI payments based on blindness, and the

other will be for the first date the claimant meets all the

requirements based on the other impairment. The EOD for the

other impairment may be before or after the EOD for

blindness.

B. What happens when a claimant applies for DI

benefits under title II and meets the statutory definition

of blindness, but continues to work?

or

eligibility for SSI payments based on blindness, and the

other will be for the first date the claimant meets all the

requirements based on the other impairment. The EOD for the

other impairment may be before or after the EOD for

blindness.

B. What happens when a claimant applies for DI

benefits under title II and meets the statutory definition

of blindness, but continues to work?

If a claimant applies for DI benefits under title II and

meets the insured status requirements [12] and the statutory definition of

blindness, but continues to work (even at the SGA level),

we may establish a period of disability for him or her. A

period of disability must last for at least five

consecutive, full calendar months. [13] If we establish a period of disability,

we “freeze” the claimant’s earnings

during that period and will not use them to compute cash

benefits (unless it advantages the claimant) or to

determine whether the claimant still has insured

status. [14] However, a period

of disability, or disability freeze, does not automatically

entitle the claimant to monthly cash benefits. [15] To be entitled to monthly cash

benefits, the claimant must still meet the statutory

definitions of blindness and disability and the applicable

non-medical requirements during the period covered by his

or her application.

For purposes of determining the EOD, if we find that the

claimant meets the insured status requirements and the

statutory definition of blindness, but he or she is

performing SGA, we will establish up to two dates. First,

we will establish a disability freeze date, which is the

date the claimant first met the insured status requirements

and the statutory definition of blindness. If the claimant

later stops working or his or her work is no longer SGA, we

will establish a second date called the “adjusted

blind onset date” (ABOD)

but he or she is

performing SGA, we will establish up to two dates. First,

we will establish a disability freeze date, which is the

date the claimant first met the insured status requirements

and the statutory definition of blindness. If the claimant

later stops working or his or her work is no longer SGA, we

will establish a second date called the “adjusted

blind onset date” (ABOD). The ABOD is the date the

claimant stopped performing SGA and became entitled to

monthly cash benefits under title II of the Act, subject to

a five-month waiting period.

The five-month waiting period begins with the first full

month that the claimant does not perform SGA. However, if

the claimant is age 55 or older and performing SGA, we

consider how the claimant’s work activity compares

with work he or she did in the past. [16] We consider work to be non-comparable if

it requires skills and abilities that are less than or

different from those the claimant used in the work he or

she did in the past. [17] If

the claimant is age 55 or older and performing “non-comparable”

SGA, we will count the months the

claimant performs “non-comparable” SGA in the

waiting period if they also fall within the period of

disability.

We cannot establish a disability freeze for DWB or CDB

claimants under title II of the Act. There is also no

freeze equivalent for SSI claimants under title XVI of the

Act. However, to be eligible for SSI payments based on

disability under title XVI, a claimant need only meet the

statutory definition of blindness and the applicable non-medical

requirements. Thus, a claimant seeking SSI payments

based on blindness need not show that he or she is unable

to perform SGA, but if the claimant is working, we will

consider his or her earnings under the income and resource

rules of title XVI of the Act

based on

disability under title XVI, a claimant need only meet the

statutory definition of blindness and the applicable non-medical

requirements. Thus, a claimant seeking SSI payments

based on blindness need not show that he or she is unable

to perform SGA, but if the claimant is working, we will

consider his or her earnings under the income and resource

rules of title XVI of the Act. [18] When a claimant’s income or

resources exceed the Act’s limitations, he or she is

ineligible for SSI payments under title XVI because he or

she does not meet the applicable non-medical

requirements, [19] even though

the claimant meets our statutory definition of

blindness. [20]

III. When is this SSR applicable?

This SSR is applicable on October 2, 2018.

We will use this SSR beginning on

its applicable date. We will apply this SSR to new

applications filed on or after the applicable date of the

SSR and to claims that are pending on and after the

applicable date. This means that we will use this SSR on

and after its applicable date in any case in which we make

a determination or decision. We expect that Federal courts

will review our final decisions using the rules that were

in effect at the time we issued the decisions. If a court

reverses our final decision and remands a case for further

administrative proceedings after the applicable date of

this SSR, we will apply this SSR to the entire period at

issue in appropriate cases when we make a decision after

the court’s remand.

[1] 42

U.S.C. 416(i)(1)(B) (defining blindness), 423(d)(1)(A) (defining

disability for blind individuals younger than age 55), 423(d)(1)(B)

(defining disability for statutorily blind individuals age 55 and

older); 20 CFR 404.1581 (defining blindness), 404.1582 (explaining

how we determine a period of disability based on blindness), 404.1583 (explaining how we determine disability for blind persons who are age

55 or older).

ining blindness), 423(d)(1)(A) (defining

disability for blind individuals younger than age 55), 423(d)(1)(B)

(defining disability for statutorily blind individuals age 55 and

older); 20 CFR 404.1581 (defining blindness), 404.1582 (explaining

how we determine a period of disability based on blindness), 404.1583 (explaining how we determine disability for blind persons who are age

55 or older).

[2] See, e.g., 20 CFR 404.315 , 404.316 , 404.320 , 404.321 (setting forth some of the non-medical

requirements for title II DI benefits), 20 CFR 404.335 , 404.336 (same

for title II disabled widow(er) benefits (DWB)), 20 CFR 404.350 , 404.351 (same for title II childhood disability benefits (CDB)).

[3] 42 U.S.C. 1381a

(“every aged, blind , or disabled individual who is determined

. . . to be eligible on the basis of his income and resources shall,

in accordance with and subject to the provisions of this title, be paid

benefits by the Commissioner of Social Security”) (emphasis added),

1382(a) (defining an eligible individual), 1382c(a)(2) (defining blindness); 20 CFR 416.981 (defining blindness), 419.982 (explaining when we will

consider an individual to be blind based on a State plan).

[4] See, e.g. , 20 CFR 416.202 , 416.305 (setting forth some of the non-medical requirements for title XVI SSI

payments).

[5] 42

U.S.C. 416(i)(1)(B), 1382C(a)(2); 20 CFR 404.1581 , 416.981 .

[6] 42 U.S.C. 1382c(a)(2); 20 CFR 416.982 .

[7] 42 U.S.C. 423(d)(1)(A), (B); 20 CFR

404.1512(a) , 404.1582 , 404.1583 .

laining when we will

consider an individual to be blind based on a State plan).

[4] See, e.g. , 20 CFR 416.202 , 416.305 (setting forth some of the non-medical requirements for title XVI SSI

payments).

[5] 42

U.S.C. 416(i)(1)(B), 1382C(a)(2); 20 CFR 404.1581 , 416.981 .

[6] 42 U.S.C. 1382c(a)(2); 20 CFR 416.982 .

[7] 42 U.S.C. 423(d)(1)(A), (B); 20 CFR

404.1512(a) , 404.1582 , 404.1583 .

[8] 42 U.S.C. 1381a

(“ every aged, blind , or disabled individual who is

determined . . . to be eligible on the basis of his income and resources

shall, in accordance with and subject to the provisions of this title, be

paid benefits by the Commissioner of Social Security”) (emphasis added),

1382(a) (defining an eligible individual); 20 CFR 416.912 (providing

that, in general, a claimant must prove to us that he or she is blind), 416.981 (defining blindness), 416.982 (explaining when we will consider

an individual to be blind based on a State plan).

[9] 20 CFR 404.1510 (defining SGA as significant and productive physical or mental duties done

(or intended) for pay or profit), 404.1572 (providing further details

about what we mean by SGA); see also 42 U.S.C. 423(d)(4)(A), 20 CFR 404.1584 (collectively describing how to calculate SGA for claimants

who meet the statutory definition of blindness).

[10] 42 U.S.C. 423(d)(1)(A).

[11] Id. at (d)(1)(B).

[12] 20 CFR 404.110 (describing how we determine fully insured status and explaining that

an individual needs at least six quarters of coverage but not more than

40 quarters of coverage to be fully insured),

[13] 20 CFR 404.320(a) ,

collectively describing how to calculate SGA for claimants

who meet the statutory definition of blindness).

[10] 42 U.S.C. 423(d)(1)(A).

[11] Id. at (d)(1)(B).

[12] 20 CFR 404.110 (describing how we determine fully insured status and explaining that

an individual needs at least six quarters of coverage but not more than

40 quarters of coverage to be fully insured),

[13] 20 CFR 404.320(a) ,

(b)(4) (explaining that “[a] period of disability is a continuous

period of time during which you are disabled” and that one of the

requirements to be “entitled to a period of disability ... [is

that a]t least 5 consecutive months go by from the month in which [the

claimant's period of disability begins and before the month in which it

would end”].

[14] 42 U.S.C. 420; 20 CFR 404.1582 .

[15] 20 CFR

404.1582 .

[16] 20 CFR

404.1584(c) .

[17] Id.

[18] 20 CFR

416.983(b) , 416.984 .

[19] 20 CFR 416.202(c) , (d)

(explaining that to be eligible for SSI payments, a claimant may not

have “more ncome than is permitted” or “more resources

than are permitted”).

[20] 20 CFR 416.984 .