Vision Problems | The Disability Benefits Podcast #35

In this episode, we cover what the disability benefits process looks like for vision and hearing impairments.

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Disclaimer: We are a non-attorney firm. Our company specializes in representation for Social Security disability claims and is not a law office. The information provided in this video is for general informational purposes only and does not constitute legal advice. For legal guidance specific to your situation, please consult a licensed attorney.

Transcript

SPEAKER_01 0:00

This coffee cup kind of matches my shirt, so I'm gonna go ahead and leave it up here.

SPEAKER_03 0:03

Yeah, it does.

SPEAKER_01 0:04

Today I choose happy. What's this one say? Oh, same thing. Okay.

SPEAKER_03 0:09

Today I choose sadness.

SPEAKER_01 0:12

It's a yin and yang coffee cup.

SPEAKER_03 0:15

Okay, are we good? All right. Well, I have a question about vision that I got from the audience, and I'll read the question and then I'll give a little bit of a preface before I get you to answer it.

SPEAKER_01 0:27

Alright.

SPEAKER_03 0:28

So this client says, I've been working for years while my vision has been steadily deteriorating. I'm going blind. Over the past year, it's been getting much harder to perform my job as my condition worsens. I have an appointment coming up to check my visual field. If I meet the blindness listing, I'll use that as my sign that it's time to quit. In that scenario, would you still recommend waiting several months before applying for SSDI? There's no cure or treatment for my condition. I'm 61 years old. And then they say, Thanks so much for all the helpful videos. Um so before before you answer that, um, and what we'll do is we'll answer this this person's question, and then we'll go into vision, and I also want to cover hearing because the way that they work is I think similar. Um so before before we get into that, um, this person says if they meet the listing. So just really quick, can you go over because we're gonna talk about vision listings and then um the RFC if they don't meet the listing, right? So before that though, what would it mean if this person meets the listing?

SPEAKER_01 1:35

Right. Well, there's two, there's visual acuity, you know, like if you you heard the old cliche, I have 20-20 vision. What that means is at 20 feet, you're seeing things that like they should be at 20 feet. And if you have 2040 vision, then you know, I'm 20 feet away, but it looks like I'm 40 feet away. And then if you have 2100, I'm 20 feet away, but it looks like I'm a hundred feet away. And then listings level is 2200. So you're 20 feet away, but it looks like 200. Your vision's horrible at that at that point. And this is best corrected vision, by the way. Um, so uh or they could they also call it best corrected binocular. So use them both your eyes, you know, if if your vision visual acuity with correction, you're wearing glasses, um is 2200, you meet a listing. The other one would be visual fields, and this is what the our uh audience member uh uh seems to have a problem with. And you just gotta think about that. Um you know our our eyes, we have you know, a field of vision. Like if we're I'm glad we're doing a video because I can actually put my hands out here like that. I can see, if I stare stare at you, I can see that I'm wiggling my hands right now. I'm looking at you, but that's my periphery. So uh there's a field of vision that eventually I can't see them anymore. But a somebody with a restricted field of vision that might be, you know, that everybody should be able to see this pretty easily, you know, without having to scan, you know, move your eyes or you know, twist your neck. So when your visual fields are compromised, it just means that um you can't see the full field. And what they n what normally happens is it's not it's not very uniform. That is, you know, if you think of visual field as a circle, and that's the way it's printed in medical records, it's kind of a circle. If you think about that way, it it doesn't just the circle doesn't just contract and get smaller and smaller. There's like a contraction here that you can't see here, and there's a contraction here and you can't see there. So um we'll probably need to edit that out.

SPEAKER_03 3:47

Nah. Continue.

SPEAKER_01 3:48

Yeah, okay. So the the visual fields they constrict, um, but they don't constrict uniformly to where a the the whole field gets smaller normally. It's usually uh there's a part of it. You you just you lose your your vision in that quadrant or in that section of the visual field. And when a certain percentage has actually been constricted, now it's kind of dangerous for you to do certain things, driving being the number one thing, you can't drive anymore, or you know, you're looking at something and you're not seeing the whole picture because your visual fields are constricted, and it's a percentage. Um, there's also a um a uh a factor that they use uh in the listings. So if if you meet the visual acuity fee uh listing, 2200 in your best corrected vision, or visual fields, which are there so constricted that there's a formula, but um I I don't know it offhand, but it's basically your your visual fields are constricted to the point where you don't see fully enough that you can just do regular work. You reading a page would be difficult for you because you're not seeing the whole page or you're not seeing the whole sentence. And you'd literally, you know, think about somebody reading like they're an old typewriter. You know, that's we we just don't do that. We do that with our eyes. And and with the visual fields, you can't do that. It's just um it's horrible, actually. So that's how they would um that's how they would uh uh factor those things, and that is basically the visual, you know, the visual listings, you know, visual acuity, visual fields.

SPEAKER_03 5:24

Yeah, and then one of the things that stands out about this question, aside from the the impairment that they're talking about, is they say over the past year it's been getting much harder to perform my job, and then they say if they meet the listing, they'll use that as their sign that it's time to quit. So this person's still working. And even though a listing is very matter-of-fact, it's not a matter-of fact if you're still working full-time. Um and we've talked about that before. Even if you are at a listings level, you meet a listing, if you're still working full-time, then they're not gonna move to that. Never get to you. I used to um I read this and I I thought of a person I used to work with, they had horrible vision, and it was so bad that they couldn't drive. And when they were looking at anything on their phone, they or they couldn't use their phone, they would use an iPad and they were looking really close. And I remember when he used to get to work and I was already there, and I would like I would see him walk in. He didn't know who I was until I was like five feet away. Yeah. So this guy had horrible vision, but I worked with him and he was full-time and he was good at his job, too. Yeah. And so if this guy, if he applied for disability, not only would he get denied, he would get denied without them even without social security even looking at his impairment.

SPEAKER_01 6:38

They'd never even request the medical records, much less look at them. Yeah.

SPEAKER_03 6:41

So to this person's point, um, they say they'll use that as if they meet the listing, they'll use that as a sign to to stop working. Um that is a way you can look at it. You you can't there's no reason to apply if you're still working full-time. If it gets to the point where that's preventing you from being able to work full-time, then that's when you would qualify. Um and then the thing at the the end here, well, the actual question that they ask is in that scenario, would you still recommend waiting several months before applying? And the answer is no. Absolutely there's no reason to wait if if you're disabled, you're unable to work, you're not going to be able to go back to work, there's no reason to wait to to uh file.

SPEAKER_01 7:19

Right. Yeah, and we've talked about this, and a lot of people think that we're just, you know, going used car salesman, you know, do this and do it quickly. Um no, we're not doing that, uh especially in this case. If if this person sounds like they're smart enough that they've actually read the listings, which you know, if you ever have difficulties with insomnia and you want to fall asleep quickly, pull up Social Security's listings, that'll put you to sleep. This person sounds like, you know, if I meet the listings and they're using Shop Talk, they've they've obvious obviously done some research. If you've done that amount of research and you know what the listing is and you know what your acuity is or you know what your visual fields are, the restrictions are um uh waiting is is why? You know, you you already know that you meet the listing, so you know, just go for it. Go for it. Yeah, you know, when you stop working. You know, if you meet the listing when you start stop working, um, first of all, if you provide them a medical record that shows your visual fields are constricted to the to the point to where you meet a listing, I don't ever like using the word quickly when I'm talking about Social Security, but as far as normal cases, regular cases, the most common cases go, this case would go forward pretty quickly. Yeah. You know, the the the lower levels would look at it, and if you provided medical records or if your your doctor weighed in on your case, um oh yeah, the the visual fields are this constricted. They they they do meet the listing. They're gonna allow the case.

SPEAKER_03 8:54

Yeah, no case is easy, but this would be easier. Yeah, and no case is quick, but this would be quicker. Exactly. Yeah. And they're 61 too. That I mean that definitely helps. Obviously, yeah. I think the with waiting to apply, a lot of people get tripped up because of the the 12-month eligibility and then the five-month waiting period. True. So the eligibility is that you have to be out of work or expected to remain out of work for at least 12 months. Right. A lot of people they they don't read the expected to be out of work and they think, okay, so I have to be out of work twelve months and then I can file. That's not true. If you think you're gonna be out of work that long, then go ahead and and file. Absolutely.

SPEAKER_01 9:32

Yeah, that that is the the operative word in that sentence, expected. You know. And so if you're you're expected if your condition is l is expected to last 12 consecutive months, um, then yeah, go ahead and file.

SPEAKER_03 9:45

Yeah, and then the five month waiting period, which is that when you stop working uh due to your health, you are not entitled to any kind of back pay for the first five months. That's right. Um, five month waiting period, and then you start accruing back pay. However, you don't have to wait five months to file. You can go ahead and just file and then get it get it out of the way. Yeah, very few cases are approved in under five months, but even if that did happen, then all that would mean is that there's no back pay. That's right. But you would still have the monthly benefit.

SPEAKER_01 10:13

Yeah, and I think we talked about this in maybe the last podcast or when when, you know, that there's several cases a year that we take that we don't take them and call them pro bono cases for free cases. Um, but they end up being that way. You know, they're can't usually usually cancer cases or terminal cases. Um uh and the case is one. Like I said, I I hesitate to use the word quickly when I'm talking about Social Security's processing, but the cases are won, relatively speaking, quickly in that five months. Um there's no back pay, no, no back pay, you know, as a representative. We don't get a fee. Um, but who cares? I mean, you need you need to get the case done. It's an easy error case that Social Security can approve, and uh and that's something that you know you don't have to worry about anymore. You know, you you that social security disability case is out of the way, you can work on getting better or tending to, you know, your conditions.

SPEAKER_03 11:09

Yeah, okay. Well, I think that answers that person's question. Let's um let's talk a little bit just about vision, and then like I said, I want to do hearing as well because I think there's a lot of the same concepts. Um, you know, with with vision, you meet with a specialist, they do testing, and then they're gonna give you your visual acuity numbers, um, etc. And then with your hearing, you're gonna meet with an an audiologist, right? Yep. And um they're gonna do testing to basically find the threshold of how loud does something need to be in order for you to hear it. Right. Um and those are similar. So assume and there's a listing for that as well for hearing, right? Absolutely, yeah. So assuming you don't meet the listing, so you're not maybe your vision is not 2200, maybe it's 2150, so it's really bad, but it doesn't actually it doesn't um qualify you um immediately, we'll say like it doesn't meet the list, or better way, it doesn't meet the listing. Right. What would um what would that case look like? What are what else would Social Security be looking for? What else should the client be trying to get together to prove disability if they don't meet the listing?

SPEAKER_01 12:13

Right. It's there are two, physically speaking, there are two aspects of an RFC, a residual functional capacity, and that's basically the rating that Social Security gives you. There's the exertional rating, which is, you know, you can do medium work, you can do light work, you can do sedentary work, and that's based on your lifting and carrying uh capacity, standing and walking capacity, and your sitting capacity. Everything else is the non-exertional limitations, and it's like postural limitations, climbing, uh balancing, stooping, crawling. And then you get to the special senses, you get to the the visual limitations, um, some hearing limitations, visual limitations, there would be a limitation in in uh far acuity, you don't see very well far away, or near acuity, um, where you don't see very well near field of vision, that is one of the the non-exertional limitations that are that is on in an RFC rating that they can give you. What we'd be looking at is kind of a real-world approach to how does this impact you? You don't meet a listing, you know, it's not gotten that bad yet. Either your your acuity, 150, you know, 2150 instead of 2200. 2150 is really bad though. Um so you don't meet a listing. Um the argument would likely be there's there's just no way that they're gonna be able to make it through an eight-hour work day with those visual limitations. They're gonna have problems um misseeing things. They're not gonna they're not gonna see things as they as they are until they get much closer. That's that's problematic. That's dangerous in a warehouse. Um so we we would argue that that it there would be just ab actual dangers in the workplace for somebody whose vision is that poor. I I'd say even somebody at that's 2100, which is you know, you're you're not listings level, but you're still having a real difficulty seeing things. Field of vision is even worse, and that is that's on the RFC form too. Field of vision um driving would become dangerous if your field is constricted to the point where you're periphery, you're not seeing somebody that's just past you, um, or you're not seeing somebody that you're passing. You know, once you get to a certain point, you know, you you can't see that. Um operating any kind of machinery again in a warehouse or on a construction site, um, you know, could you do that? Age would certainly come into play. You know, if you're 25-year-old and you have these kinds of conditions, there might be some work that you could do um uh at the uh a lighter or sedentary level. But then again, sedentary work, it's gonna require that you see pretty well because it's it's a desk job, so you're gonna be reading computer stuff and stuff like that. So the argument would be that even though they don't meet a listing, um their their acuity or their field of vision is so restricted that they would not be able to make it through an eight-hour work day without you know posing a danger to themselves or others or being able to do a job um as expected by an employer. So that's that's how I would argue that case. And we have them all the time, by the way. That's um that's one of the one of the things that a lot of people have, especially the older you get. Um I'm not wearing my readers, but I'm you know, I'm sure people have commented on how how I always wear my glasses on my on my uh shirt. Um you know, at my age, I need readers. You know, uh I literally, if I don't have readers on, I could not do my job. And there are people that readers don't help them. Yeah. My job is a sedentary job. You know, I meet I read medical records all day, I sit down at a desk all day, um I type on a computer all day, composing briefs and stuff like that. That's my job. That's a sedentary job. That's every sedentary job. You're an adjuster with an insurance company, you're working in a bank, um, you know, blah, blah, blah, blah, blah. You're using your eyes all the time. And, you know, if you need readers, no big deal. Yeah. But what if readers don't help you? What if your acuity is so bad that you really can't make out what that's saying on this, you know, form that I used to fill out, you know, in five minutes, and now I can't even navigate it because I can't see well enough. Yeah, that's you know, that is it's debilitating. And at a certain age, it's going to be disabling also.

SPEAKER_03 16:51

Yeah. And then they look at for hearing aids, they look at the same thing, right? So for for vision, if you if you can't see anything without your glasses, but then you put it on your glasses and you're completely fine. Well, then you can't say that you're disabled because social security would just tell you where your glasses are. Yeah, best c best corrected. That's right. With with hearing aids, is it is it the same thing? How does that work with I mean, glasses are not I mean, relatively, but they're not that expensive just to get glasses, but hearing aids are way more expensive. What about the client that says, I don't have hearing aids, I probably do need hearing aids, I can't afford hearing aids. That's a that's a trickier one.

SPEAKER_01 17:28

It's very tricky, and it would depend on the adjudicator. Yeah. Um, I would say most judges would look to see if there is, you know, some statement in the case record about from an audiologist or an ENT that, you know, this this person could could greatly benefit from hearing aids. Now there's a lot of doubt on whether you're disabled or not, because you know, if you had the hearing aids, and keep in mind Social Security doesn't care if if you even go to a doctor, they don't care um that you don't have transportation. They don't care that you don't have any money to to pay for an Uber or a taxi, they don't care about that. Yeah. They expect you to go. That's just the way it is. And it's kind of the same philosophy on you know, hearing aids. You know, if if if you had the money and you could get the hearing aids and your hearing would then significantly improve to the point where you could actually function in the workplace, they're probably going to find you not disabled. Yeah. So the hearing thing, we we didn't talk about the particulars of the listing. And and you're right, they do test you, they put headphones on you and they send beeps. But the beeps are at different frequencies, you know, so there's low low frequency, and then there's the middle frequency, which is like speech, and then there's high s high frequencies like um sizzles and um you know alarms and stuff like that. And they test you at different frequencies to see what is the decibel level, how loud does it have to be for you actually to hear certain certain things. Most people, when they're starting to lose their hearing, they're look they're losing the top end. So when somebody says s, it doesn't sound like s, it sounds like uh you know, you don't hear the sssss the the the sizzle in that top frequency, and that's usually what happens. How does that impact you in the workplace? Well, think about it. If there's dangerous machinery in a warehouse or you're on a construction site and you're not hearing things, because that's we we know something's behind us if we hear it. Um if communication is a problem that you're not hearing words clearly, um, and that's also part of the test, they call it the speech discrimination hearing. Okay, this this person is hearing is so bad that he's hearing about 50 percent of of what's being said, which is horrible hearing, by the way. Um so if you're if the speech discrimination is really low, the audio uh audio testing is really low, um, but you don't meet the listing, um then the way to argue that would be in a workplace, in any kind of workplace, this individual could not interact uh well enough due to speech difficulty. I'm not hearing 50% of what my boss just told me. Um or you know, I'm in a uh a warehouse that I hear noise, uh there's noise all the way, and therefore I can't make out that somebody is actually talking to me because the background noise it kind of meshes in with their speech, which by the way, that's one of the most common problems with hearing loss, is that the the ability to kind of push out that background noise and listen to what what's actually what you're wanting to listen to, it's almost impossible when you have a horrible hearing disorder. Everything is just the same and it's just inundating you and you just can't make things out. But if that was the case, then I would say not only is it debilitating, it's disabling. Yeah. That's how we'd argue that if it didn't meet the listing. Yeah. I think I answered that question.

SPEAKER_03 20:59

I mean Yeah, yeah. Yeah, I I well with the hearing aid thing, I just thought of that because I've never really thought about that before.

SPEAKER_01 21:05

Yeah, and it's the same thing as glasses, you're right. You know, best corrected vision, best corrected hearing. Um and that's what also they would do. An audiologist, the test is just like your vision test, if you've ever gone through there and they had they give you the little spoon to put over your eye when you're reading the Snellen chart. That's the one with the all the letters and stuff like that. Um when you're reading that, you know, let's check your left eye. Okay, now put that over your left eye, and let's check your right eye. You do that. They do the same exact thing with your ears, your headphones. They're they're basically gonna just they'll just mask one and they'll let's let's try the right ear first, and we're gonna hear that. Okay, well, they're gonna mask that one, and then you're just gonna get beeps in your left ear, and they're gonna be able to, okay, well, this is what you're hearing is in your left ear, and this is what you're hearing is in your right ear. Uh, this is your speech discrimination, you know, because we said this and you didn't get this, or you got most of it, or you know, whatever, and all that's gonna go. And then they're gonna stick air uh Uh help. They're gonna hearing aids. They're gonna stick that in your ear and they're gonna do the test again. And they're gonna find out if the hearing loss is helped by uh uh hearing aids, or if it's some kind of sensory neural um problem that goes deeper than just your ears, goes to your brain. People with tinnitus, you know, they think that's an ear problem. It's it's a brain problem, actually. Um and if you have tinnitus, you I can prove it to you. Put your hands over your ears and they're still buzzing. Yeah. You know, it's it's it's in your brain, it's not in your ears. But anyway, they'll put the the hearing aids on and then the headphones on again, and then they'll do the same test. What was the difference? You know, did it get better? Sometimes it doesn't get any better at all. And then they realize that the hearing loss is probably much deeper than just your ears. And um obviously that's horrible. Yes, it's virtually untreatable.

SPEAKER_03 23:04

Yeah, I think the main when I'm screening people and I'm talking to someone to see if we're gonna be able to help them with their case and their impairment is vision. The red flag that I get is they're talking to me about this for a while, and then I ask if they're still driving, and they're like, Yeah, I'm still driving. Yeah, it's like, well, that's really tough to say that you're so your vision's so bad that you can't work, but you're still comfortable driving.

SPEAKER_01 23:26

Yeah. Yeah, absolutely.

SPEAKER_03 23:28

Um I would I would imagine that's like one of the main pieces of evidence for vision.

SPEAKER_01 23:33

Absolutely, a hundred percent. Yeah, you know, that's a question that anybody who's watching this that has any kind of impairment, that is a question you are going to get in every single hearing. It doesn't matter if you got back problems, it doesn't matter if you have COPD, it doesn't matter if you have mental problems, vision, hearing. One of the questions that you're gonna get in a hearing, you know, do you have a driver's license? Do you drive? How frequently do you drive? When you drive, how far do you go? We're talking going to the quickie mart a mile away, or are we talking that, you know, I visit my my mom and she lives 20 miles away. Yeah. Um, you're gonna get those questions. And sure enough, if you answer, well, in our intake, if you answer that question that you're able to drive, it's like it's not really indicative of somebody who's disabled if you have vision impro impairments, but you're able to drive.

SPEAKER_03 24:22

Yeah, and then the on the flip side for me, that's so that's like the red flag. The green flag per se would be someone is 56 years old, they told me that they've drove they've driven a semi-truck for their entire life, and now they lost their license because they can't see anything. Their vision is so bad. That follows. That's that's a really again, it's not an easy case, but that's a straightforward case. That's a great case. Yeah.

SPEAKER_01 24:43

Yeah. I I would I would take a hundred out of a hundred of those. Absolutely. Yeah. Yeah.

SPEAKER_03 24:48

Okay. And as far as uh conditions go for vision loss, we see cataracts, glaucoma, um retinopathy. Ret yeah, retinopathy, common if you have diabetes. And that's another thing, too, is like we're we're really just talking about uh vision here, but if it's something like diabetic retinopathy, not always, but chances are the diabetes is doing is causing some other symptoms that you have. So social neuropathy, yeah. Yeah, they'll look at your vision problems, which is the retinopathy, but if you also have neuropathy, numbness in your hands or feet, maybe you're getting swelling in your hands or feet. Um that they'll look at the whole thing. Right. So and it's again, it's not it's not easy if you have all these things going on, but maybe it would be easier if it's his vision is really bad, but also he can't walk or stand at all. Um, all you know, all this stuff they work work together for the case. Absolutely. Cool. Okay, well, yeah, as far as vision and hearing goes, I don't think I have anything else I want to bring up. Um I'm glad we did an episode on that though.

SPEAKER_01 25:48

Excellent.

SPEAKER_03 25:49

Cool. If you have a question about your disability case, drop it in the comment section below, and we will do our best to answer it in the next episode.