Pennsylvania Code › Title 55 - HUMAN SERVICES › Part II - Public Assistance Manual › Subpart K - Blind Persons › Chapter 451 - STATE BLIND PENSION › GENERAL PROVISIONS › Appendix A - PROCEDURE FOR DETERMINING VISUAL ACUITY

Current through Register Vol. 54, No. 28, July 13, 2024
The County Medical Consultant reviews the reports of all
						eye examinations and certifies finally to the degree of vision. The County
						Assistance Office sends to the County Medical Consultant all copies of the Form
						PA 40's of prior examination and other available pertinent information.
A County Assistance Office without a Medical Consultant
						contacts its Regional Office which will arrange for another County Medical
						Consultant to review reports of eye examinations and certify finally to the
						degree of vision.
I.
Authorizing examinations.
A.
Initial examination.
If an applicant for SBP appears to meet all other
						eligibility requirements, the County Office authorizes an opthalmologic
						examination for determining his degree of vision except in the following
						circumstances: both eyes are missing (the caseworker records his observation of
						this condition in the case record); or the Office for the Visually Handicapped
						has referred the person to the County Assistance Office and has submitted an OB
						401 (see II).
The applicant has a choice of examiner who is either a
						physician skilled in the diseases of the eye or by an optometrist.
If for any reason it is not possible to arrange for an
						examination, the County Office contacts the County Medical Consultant for
						advice. The County Office gives the name of the applicant's physician and any
						available medical data regarding the applicant's physical or mental
						condition.
Use of forms.
The County Assistance Office gives the applicant the
						following forms in an envelope addressed to the examiner:
a. Three copies of Form PA 40, Ophthalmologic Report. The
						examiner keeps one copy and returns two copies to the County Assistance
						Office.
b. One copy of Form PA 48, Authorization for Services and
						Supplies.
c. One envelope addressed to the County Board of
						Assistance to be used by the examiner for the return of the forms.
When the forms are returned to the County Assistance
						Office, the Form PA 40 is checked for completeness and conclusiveness, that the
						examiner has signed at least one copy and that his statement of visual acuity
						appears to agree with the recorded visual acuity. If the Form PA 40 is
						incomplete, inconsistent, or otherwise unsatisfactory, the form is returned to
						the examiner for amplification or clarification.
If the County Assistance Office is satisfied the Form PA
						40 is completed properly, the Form PA 259 is checked to see that the charges
						are in accordance with the fee authorized by the Form PA 48. A notation "report
						received" is then written in the upper right hand corner of the Form PA 48. The
						completed Form PA 48, Form PA 259, and Form PA 259-S are sent to the Office of
						the Comptroller, Harrisburg. Both copies of the Form PA 40 together with copies
						of any prior opthalmological reports and other information in the case record
						related to visual eligibility are forwarded to the County Medical Consultant
						for review and certification. If a trustee is being requested for the same
						client, the Form PA 50 is forwarded to the Office of Medical Programs, Bureau
						of Medical Assistance.
When the information is returned from the County Medical
						Consultant, the County Office forwards the second copy of the Form PA 40 to the
						Bureau for the Visually Handicapped District Office.
If the examiner has recommended treatment or surgery and
						the client is not receiving treatment, the County Assistance Office makes known
						to him the available resources for treatment.
B.
Reexamination.
The County Assistance Office authorizes a reexamination
						under the following conditions:
a.
Applicant or recipient.
Whenever the County Medical Consultant requests a
						reexamination.
b.
Recipient.
If the County Office believes that his vision may be
						better than at the time of his last examination.
However, the County Assistance Office does not authorize
						an immediate reexamination if the recipient has had treatment or surgery that
						may be the cause of improved vision, or has had a recent refraction. In such
						case, the County Assistance Office requests a written report from the Office
						for the Visually Handicapped District Office, if appropriate, or from the
						recipient's opthalmologist or clinic. If the County Assistance Office receives
						the report within one month from the date of request, it sends the report to
						the County Medical Consultant for review; this information without another
						examination may be adequate for a determination of visual eligibility. If the
						County Office learns that the report will not be forthcoming, or if the County
						Office has not received the report within one month, the County Office
						authorizes a reexamination by another examiner. When sending the Form PA 40 to
						the County Medical Consultant, the County Assistance Office informs the County
						Medical Consultant of its inability to get the report without
						examination.
When there is a sound basis for considering that the
						recipient's vision has improved to the point of visual ineligibility, the
						County Assistance Office not only takes appropriate action as stated above, but
						also suspends State Blind Pension until it receives final certification of the
						degree of vision from the County Medical Consultant.
c.
Reapplicant.
1. Former applicant or recipient who was found ineligible
						because of visual acuity, if he reapplies six months or more after the
						examination that was the basis of the decision of ineligibility. If less than
						six months have elapsed, the County Assistance Office may not authorize a
						reexamination without prior approval of the County Medical Consultant. To
						request approval, the County Assistance Office sends to the County Medical
						Consultant for review, any information indicating that the client's vision may
						be different from that shown on the last report.
2. Former recipient ineligible for reasons other than
						visual acuity if:
(a) five or more years have elapsed since last
						examination; or
(b) he has had eye treatment or surgery since his last
						examination; or
(c) there is some indication that his vision may be
						better than his last examination.
Copies of all prior Form PA 40's and OB 401's or their
						equivalent, in the case record are always submitted with a report of current
						examination, with a request for authorization of a reexamination, or with an
						inquiry as to the need for reexamination.
The Form PA 40's and the Form PA 48 are processed as
						described in "A" above.
II.
Ophthalmological reports from the Office for
						the Visually Handicapped.
State Blind Pension applicant.
If the Office for the Visually Handicapped District
						Office finds that a person to whom it is giving vocational rehabilitative
						service appears to be visually eligible for State Blind Pension, it will refer
						the person to the County Assistance Office for information on the State Blind
						Pension Program. The Office for the Visually Handicapped District Office will
						send the County Assistance Office an original, or a certified true copy, of the
						OB 401. A covering memorandum will state that the person has been referred
						because "his visual acuity with best correction is 3/60 or 10/200 or less." If
						the person applies for SBP and the County Assistance Office finds him eligible
						in all other respects, and the OB 401 is current, the County Medical Consultant
						may use this report as the basis for determining visual eligibility.
TThis appendix is cited in 55 Pa. Code §
													451.3 (relating to
						  requirements).