DI 26510: Completion of Form SSA-831-C3/U3 -- Title II, Title XVI and Concurrent Claims
TN 10 (04-09)
A. Title II Disability Insurance Benefits (DIB)
For a complete discussion of "disability freeze" and completion of item 18, see Overview, DI 26010.001 and Item 18 (Case of Blindness) Procedure – Title II, DI 26010.025A.
Complete item 18 only in a Title II worker case where statutory blindness is established.
Do not complete this item where the established onset of disability entered in item 15A is earlier than the onset of statutory blindness. See Rationale, DI 26010.055 for the required entry for item 27.
Do not complete this item when "FZ" (Freeze) is shown in item 7 (Type Claim), and the individual has limited his/her application to a Freeze only.
B. Title II Disabled Widow(er) Benefits (DWB)
Do not complete Item 18 unless the field office (FO) has specifically requested a determination regarding statutory blindness.
NOTE: In these cases, the FO annotates Item 11: "A determination regarding statutory blindness is required; other impairments are not now a consideration."
Because of the higher SGA criteria for blind individuals effective 1978, the DDS may receive such cases involving visual impairments and earnings between the non-blind and blind SGA levels.
C. Title II Childhood Disability Benefits
Follow the DWB guidelines in DI 26510.025B in this section.
D. Title XVI
For a complete discussion on completing Item 18, see Item 18 (Case of Blindness) – Procedure Title XVI, DI 26010.025B.
Item 18A - Do not complete.
Item 18B – When the claimant is found to be statutorily blind, place an "X" in the box, and enter the date of filing (or protective filing date) or the exact date of onset if subsequent to the month of application.
If a date was entered in Item 18A for presumptive blindness, and it needs to be changed, draw a line through/delete that date and enter the correct onset date.
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