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You will be disabled under listing 9.08C if you are diagnosed with diabetes mellitus and retinitis proliferans. Your visual impairment will be evaluated under the criteria in listings 2.02, 2.03, or 2.04 which provide:
Listing 2.02 Loss of Visual Acuity. Remaining vision in the better eye after best correction is 20/200 or less.
Listing 2.03 Contraction of the Visual Field in the Better Eye.
A. The widest diameter subtending an angle around the point of fixation no greater than 20 degrees;
B. A mean deviation of -22 or worse, determined by automated static threshold perimetry as described in 2.00A6a (v);
C. A visual field efficiency of 20 percent or less as determined by kinetic perimetry (see 2.00 A7b).
Listing 2.04 Loss of Visual Efficiency.
Visual efficiency of the better eye of 20 percent or less after best correction (see 2.00A7c).
Diabetes mellitus is a major cause of various degrees of blindness and produces diabetic retinopathy (see Figures 3 – 7 below). In advanced proliferative diabetic retinopathy (retinitis proliferans) there is excessive new blood vessel growth in the retina (“neovascularization”). Advanced proliferative diabetic retinopathy can affect both visual acuity (sharpness of vision; ability to distinguish letters and numbers at a given distance) and peripheral vision (the ability to see objects at the edge of the visual field). Proliferative retinopathy can lead to a detached retina and bleeding into the retina or the vitreous humor that fills most of the eye. The vitreous humor is the gel-like clear substance between the lens and the retina.
Eventually proliferative retinopathy can lead to scarring and loss of peripheral vision. Proliferative retinopathy is treated with laser surgery in which small burn holes are placed in the retina to stop the advancement of the disease. It is not always successful.
Small pinpoint hemorrhages in the retina are an early form of diabetic retinopathy and do not necessarily impair vision. Visual acuity can fluctuate in diabetics who have poorly controlled blood glucose levels even when they don’t have much retinal damage. This fluctuation will correct itself when the diabetes is adequately controlled. However, macular edema (swelling) and progressive retinopathy can result in unstable acuities quite apart from blood glucose levels.
If you have proliferative retinopathy, the Social Security Administration should measure your visual fields, unless there is a good reason to think they are not affected, such as a statement from your treating ophthalmologist that visual fields were measured and are not affected. If you have proliferative retinopathy, you can have a significant visual field deficit even if you have normal visual acuity. Treating physician statements about visual field status without actual testing are nothing but guesses and should not be used to disallow a claim.
We handle SSI and Social Security disability cases in these Minnesota counties and communities: Counties: Hennepin County, Ramsey County, Anoka County, Carver County, Scott County, Dakota unty. Communities: Minneapolis, St Paul, Bloomington, Eagan, St Louis Park, Eden Prairie, Maple Grove,Brooklyn Park, Roseville, Woodbury, Hastings, Duluth, Alexandria, Brainerd, Rochester, St. Cloud, Mankato.