WAG 03-07-01: Establishing Blindness

PM 03-07-01

The Client Assessment Unit (CAU) completes determinations of blindness for:

  • AABD Medical applicants who are not receiving SSI or primary SSA benefits, and
  • AABD Cash applicants who have been denied SSI due to income.
  1. (FCRC) If the applicant does not have a current eye exam report available, make an appointment with an ophthalmologist. Notify the applicant of the appointment by letter.
  2. (FCRC) Send the ophthalmologist the following:
    • A letter confirming the appointment.
    • Report of Eye Examination (Form 51) with the following information completed:
      • case name, address, and number, and
      • information about prior eye care.
    • revised textreturn envelope addressed to the Family Community Resource Center for return of the completed Form 51.
    • Instructions for billing for the exam.
  3. (FCRC) When the completed Form 51 is received, send it to:

    Client Assessment Unit
    PO Box 19492
    Springfield, IL 62794-9492 

  4. (CAU) Completes and returns Form 51 showing:
    • the decision regarding the applicant's blindness;
    • a medical review date, if one is needed; and
    • a recommendation for corrective treatment.
  5. (FCRC) At approval, if CAU provides a medical review date, establish a control for a review of the client's blindness. Establish the control by entering code 156 DRD in Item 80 on Form 552 and the month and year the medical review is due under PERSONS.
  6. (FCRC) Upon receipt of the medical bill, prepare Invoice Voucher (Form C-13). Enter the client's name, case number, and a statement that the examination was done to determine AABD Cash or Medical eligibility due to blindness. Do not enter the amount of payment authorized.

    NOTE: The bill can be submitted on the ophthalmologist's own billing form or on Health Insurance Claims Form (Form 2360). 

  7. (FCRC) Attach the original copy of the bill to the C-13 and send to:

    Illinois Department of Healthcare and Family Services
    Bureau of Claims Processing - Pricing Unit
    PO Box 19106
    Springfield, IL 62794-9106