How Poor Does a Child's Vision Have to Be to Qualify for Disability Benefits?

The Social Security Administration (SSA) has strict requirements for determining whether a child with poor eyesight can receive Supplemental Security Income (SSI) disability benefits. In addition to meeting the medical definition of blind or disabled, your family income and assets have to meet SSI's income and resource limits.

Social Security's Basic Definition of Blindness

The most straightforward way to receive disability benefits for a child (aged 18 and younger) with low vision is to meet the SSA's definition for blindness. The SSA defines blindness as having 20/200 vision or less in the better eye when using corrective glasses (or contact lens). That means that your child would be able to only see at 20 feet what a normal person would see at 200 feet. (In contrast, normal vision is usually calculated at 20/20.) It does not matter if one of your child's eyes has 20/400 vision if your child has good vision in the other eye -- your child would not meet the SSA's definition of blindness.

You will need to submit medical records to the SSA indicating your child's best corrective vision. An optometrist or ophthalmologist can test your child's eyesight.

If your child does meet the SSA's definition of blindness, then your child will be presumed disabled; the SSA does not require that you prove the cause of the child's blindness or show how your child's low vision affects his or her schooling or functioning.

Other Ways to Prove Your Child's Low Vision Causes a Disability

If your child does not meet the SSA's definition for blindness -- either because his or her problem is not with central acuity (vision) or because his or her eyesight is better than 20/200 in the better eye -- following are three additional ways by which your child can receive disability benefits:

• Your child meets or equals the childhood vision listing in the SSA's listing of impairments.
• Your child qualifies under the Compassionate Allowances Program.
• Your child has severe limitations in the six domains of functioning.

These methods will be discussed below. In addition to submitting the medical evidence requested by the SSA, you will also need to show your child's condition has lasted for at least one year.

Qualifying for Benefits under the Listing of Impairments

The Childhood Listing of Impairments states which medical conditions are serious enough to cause significant limitations in a child's daily functioning and cause a child to be disabled. The SSA's requirements are very technical; you can ask your child's optometrist or ophthalmologist if your child would meet one of the following listings.

Childhood Listing 102.03 is describes the requirements for getting disability benefits for decreased peripheral vision ("contraction of visual field"). This listing requires that your child have medical proof of one of the following from your doctor's testing:

• The largest angle around a fixated point is not more than 20 degrees.
• A mean deviation (MD) of at least 22 decibels determined by automated static threshold perimetry.
• A visual field efficiency of not more than 20%, shown through the use of kinetic perimetry.

Childhood Listing 102.04 is titled Poor Visual Efficiency; this is a combination of poor peripheral vision and poor central acuity. To meet this listing, your child must have a field of vision ratio of not more than 20% or a vision deficiency value of 1.00 or more after corrective measures are used.

Childhood Listing 102.02(B) is for children who aren't able to participate in standard vision testing. In this case, your child could be considered disabled if medical findings show the better eye is unable to fixate or follow objects and one of the following is true:

• Irregular anatomical findings indicate a vision level of 20/200 or less in the better eye.
• Irregular neuroimaging showing some injury to the cerebral cortex, which would likely lead to a vision level of 20/200 or less in the better eye.
• An electroretinogram (ERG) revealed Leber's congenital amaurosis or achromatopsia in the better eye.
• There is no reaction to visual evoked response (VER) testing in the better eye.

Childhood Vision and Compassionate Allowances

The SSA created the Compassionate Allowances Program to create a fast-track way for children and adults with serious conditions to be paid Social Security disability benefits. Many of these disorders are quite rare, but there are two disorders on the list that relate to childhood blindness.

First, your child can qualify for benefits if she or he has been diagnosed with Bilateral Optic Atrophy (BOA) for infants. BOA is a disorder that causes reduced vision in both eyes by attacking the optic nerve.

Second, your child can qualify for benefits if she or he has been diagnosed with Bilateral Retinoblastoma. This condition affects infants and toddlers. The most common characteristic of Bilateral Retinoblastoma is the whitening of a child's pupils.

If your child has been diagnosed with one of these conditions, you should note on your application that your child qualifies for the Compassionate Allowance Program.

Evaluating Your Child's Daily Functioning

Finally, if your child doesn't qualify through a childhood listing or through the Compassionate Allowances Program, the SSA will continue to assess your child's eligibility for disability benefits by considering six domains of functioning. To be found disabled, your child must be "markedly" limited in two categories of functioning or extremely limited in one category of functioning. The SSA will evaluate your child's medical files to determine whether any daily activities are affected by his or her poor vision despite the use of corrective glasses or lenses.

For example, one of the domains of functioning is moving your body and moving objects. In this domain, your child would be functionally limited if his eyesight prevented him from picking up and manipulating small items, or from doing such activities as catching and hitting a ball. Whether the limitation is marked or extremely limited depends on whether the child is altogether prevented from doing the activity, and how much help the child needs from others during the day. The SSA will also consider the age of the child in determining whether the limitation is marked or extremely limited. Older children from age 6 to age 12 are still considered to be developing the skills to catch balls, while children over age 12 are expected to be able to play a variety of sports on a more advanced level. As such, a 13-year old who struggles daily with hitting balls, writing, and light sensitivity due to his eye disorder would likely be considered to be extremely limited in this domain. This would be sufficient to receive disability benefits.

Likewise, the SSA will evaluate your child's activities under the domain of interacting with others. If your child is not socially accepted by her peers because of her poor eyesight or her appearance due to her eyesight, then she could be markedly limited in this domain.

For more information on how the SSA assesses the rest of the domains, see our article on when a child has disabling limitations in functioning.