This guide explains Social Security Disability Listings 2.02, 2.03, and 2.04, the vision impairment listings. These listings cover conditions such as cataracts, diabetic retinopathy, glaucoma, macular degeneration, retinitis pigmentosa, tunnel vision, optic nerve atrophy, and cortical visual impairment. The Listings are a set of medical criteria that, if you meet them, you automatically meet the medical requirements for applying for Social Security Disability.
2.02 Loss of Central Visual Acuity: Remaining vision in the better eye after best correction is 20/200 or less.
When you are wearing your glasses or contacts is your vision at 20/200 or worse in the better eye? Then you meet this listing. BUT there is more! Your vision can be significantly better than 20/200 and still meet this listing. If you read the SSA’s explanation of this listing you learn that so long as you can’t read any of the numbers or letters along the 20/100 line of your eye exam you still meet this listing. See Listing 2.00A5b. (https://www.ssa.gov/disability/professionals/bluebook/2.00-SpecialSensesandSpeech-Adult.htm)
The fine print explains that Listing 2.02 assumes your eye exam was taken with a Snellen eye chart. Here is an example of what a Snellen eye chart looks like:
Notice the big jump from 20/100 to 20/200? Other eye charts, such as the Bailey-Lovie or the Early Treatment Diabetic Retinopathy Study (ETDRS), have lines that measure visual acuity between these points!
Here is what a Bailey-Lovie test looks like:
Notice the 20/125 and 20/160 lines? Your vision could be as good as 20/125 and you would meet listing 2.02. What matters it that you can’t read any of the letters on the 20/100 line.
Eye exam results use special abbreviations for eyes with very low/no vision. If your eye exam reads CF (counts fingers), HM (hand movement), LP or LPO (light perception or light perception only), or NLP (no light perception) then your best-corrected vision is less than 20/200 for that eye.
2.03A Contraction of the visual field in the better eye, with the widest diameter subtending an angle around the point of fixation no greater than 20 degrees
You need a Humphrey Field Analyzer (HFA) 30-2, HFA 24-2, or an Octopus 32 test to meet this listing. We are going to focus on the Humphrey’s 30-2 since it is the most widely used test for measuring the visual field.
Here is what a Humphrey’s test results page looks like:
You know it’s a Humphrey’s 30-2 because it will say so on the test-results: I have highlighted that area of the form for you with a red box. What we care about for listing 2.03A in the large diagram on the middle/left with the crosshairs and all the numbers, known as the dB printout:
All of the numbers on the grid reflect the different dB (dB stands for decibel) values for the portion of the visual field tested. Decibels are a measure of the eye’s sensitivity to light. For Listing 2.03A, results less than 10 dB are non-seeing points. Results 10 dB and above are seeing points. The 30 degrees symbols on both sides of the chart indicate that we are looking at 30 degrees of the field of vision. The point of fixation (which is center point of the crosshairs on the graph) is the center point of the visual field.
You meet 2.03A if the widest diameter subtending an angle around the point of fixation is no greater than 20 degrees. To determine this, you box off all the values that are below 10 from those above 10:
The next step is to draw the longest line possible that goes through the point of fixation that is within the boxed-in area:
This line is the “widest diameter subtending an angle around the point of fixation.” We calculate the length of the line using the pythagorean theorem. The pythagorean theorem is A squared + B squared = C squared. Each number within the chart represents a square of your field of vision that is six degrees tall and six degrees wide. Looking at the leg of the triangle that runs left to right, it is 30 degrees long since the line is five numbers long and 6 + 6 + 6 + 6 + 6 = 30 . Looking at the leg of the triangle that runs up and down, it looks to be about 3 and ⅓ numbers long. 6 + 6 + 6 + 2 = 20. So the legs of our triangle are 30 and 20. 30 squared is 900. 20 squared is 400. 900 + 400 = 1300. The square root of 1300 is about 36, so the long side of the triangle that runs through the point of fixation is 36 degrees. The SSA requires an angle no greater than 20 degrees so this person does not meet listing 2.03A.
Please note that if your line is a decimal point above 20 the SSA will round down to 20. Also, in order for your test results to be valid on a Humphrey exam you need to have fixation losses not exceeding 20 percent or false positive errors and false negative errors exceeding 33 percent. Otherwise the SSA will determine the results of the exam are unreliable. Here is where you can find these scores on your exam results:
A more detailed discussion of how to calculate values for 2.03A can be found here: https://www.ssa.gov/OP_Home/rulings/di/01/SSR2007-01-di-01.html
2.03B Contraction of the visual field in the better eye, with: an MD of 22 decibels or greater, determined by automated static threshold perimetry that measures the central 30 degrees of the visual field
You need a Humphrey 30-2 test to see if you meet this listing. Here is where you find the information you are looking for on the test result page:
We know the test measures the central 30 degrees of the visual field because of the 30 degree symbols on the left and right of the dB printout . Here is a closer look at the MD findings:
MD stands for mean deviation, which is what the SSA is looking for for listing 2.03B. The dB value is -22.64 but in applying listing 2.03B we take the absolute value, which would be 22.64. Since their MD is above 22 dB this person meets the listing.
Please note to make sure your correct birthday is listed on the exam results; it plays an important factor in determining your MD result. Your birthday is listed in the top left corner of the exam results below your name.
2.03C, a visual field efficiency of 20 percent or less in the better eye, determined by kinetic perimetry
You need a kinetic perimetry test to see if you meet this listing. A kinetic perimetry test result looks like this:
Each eye on the chart has seven concentric circles around the center of the eye as well as eight principle meridians, which are the eight lines that meet in the center of the chart. Each principle meridian is designated by what degree of the circle it represents–0, 45, 90, 135, 180, 225, 270, and 315.
The SSA calculates the visual field efficiency percentage by adding the number of degrees you see along the eight principal meridians found on a visual field chart in your better eye and dividing by 5.
The diagram of the left eye has a visual field contracted to 30 degrees in two meridians (180 and 225) and to 20 degrees in the remaining six meridians. The visual efficiency percentage of this field is: (30 + 30 + 20 + 20 + 20 + 20 + 20 + 20) / 5 = 36 percent visual field efficiency.
The diagram of the right eye has a visual field contracted to 45 degrees on one meridian, 60 degrees on three meridians, 55 degrees on two meridians, 80 degrees on one meridian, and 85 degrees on one meridian. 45 + 60 + 60 + 60 + 55 + 55 + 80 + 85 = 500. 500 divided by 5 equals 100 percent visual field efficiency.
The SSA requires a visual field efficiency of 20 percent or less in the better eye so this person does not meet the listing.
2.04A Loss of visual efficiency, or visual impairment, in the better eye with a visual efficiency percentage of 20 or less after best correction
Listing 2.04A uses the data from listings 2.02 and 2.03C to see if you meet 2.04A. The SSA calculates your visual efficiency percentage by multiplying your visual acuity efficiency percentage by your visual field efficiency percentage and dividing by 100. Use the same method described above in 2.03C to determine your visual field efficiency percentage. Here is the graph you use to calculate your visual acuity efficiency percentage using your Snellen eye test score:
Snellen best-corrected score ————– Visual acuity efficiency (%)
20/16 ————————————- 100
20/20 ————————————- 100
20/25 ————————————- 95
20/30 ————————————- 90
20/40 ————————————- 85
20/50 ————————————- 75
20/60 ————————————- 70
20/70 ————————————- 65
20/80 ————————————- 60
20/100 ———————————— 50
For example, lets say you had a Snellen score of 20/100 (not enough to meet listing 2.02) and a visual field efficiency percentage of 25% (not enough to meet listing 2.03C). You convert the Snellen score to a 50% visual acuity efficiency using the chart above and multiply it by the 25% visual field efficiency percentage to get 1250. Divide 1250 by 100 to get 12.5%, which is enough to meet listing 2.04A.
Here is a graph showing the minimum values needed to meet this listing:
2.04B Loss of visual efficiency, or visual impairment, in the better eye with a visual impairment value of 1.00 or greater after best correction
Listing 2.04B uses the data from listings 2.02 and 2.03B to see if you meet 2.04B. The SSA calculates the visual impairment value by adding your visual acuity impairment value and your visual field impairment value to see if it is 1.00 or greater.
Here is the graph you use to calculate your visual acuity impairment value using your Snellen eye test score:
Snellen best-corrected score ——————— Visual acuity impairment value
20/16 ——————————————— 0.00
20/20 ——————————————— 0.00
20/25 ——————————————— 0.10
20/30 ——————————————— 0.18
20/40 ——————————————— 0.30
20/50 ——————————————— 0.40
20/60 ——————————————— 0.48
20/70 ——————————————— 0.54
20/80 ——————————————— 0.60
20/100 ——————————————– 0.70
You get your visual field impairment value by getting the absolute value of your MD (as discussed above for listing 2.03B) and dividing it by 22. So lets say your MD has a value of -18 dB (not enough to meet listing 2.03B) and your Snellen score was 20/80 (not enough to meet listing 2.02). We take the absolute value (absolute value means make it a positive number instead of a negative number) of your MD, which is 18. We divide 18 by 22, which is 0.81. Then we convert your Snellen score using the chart above to 0.60. We add them together to get a visual impairment value of 1.41. Listing 2.04B requires a value of 1.00 or greater, so a value of 1.41 would meet the listing.
Here is a graph showing the minimum values needed to meet this listing:
