360-5.2 Definitions. When used in this Part, unless otherwise expressly stated or
unless the context or subject matter requires a different interpretation, the following
mean:
(a) Blindness. Blindness for MA purposes is defined as the total lack
of vision or residual vision being no better than 20/200 in both eyes with best
correction, or restriction of the visual fields, or other factors which affect the
usefulness of vision as prescribed in the appropriate medical criteria published by the
department.
(b) Disability. Disability is the inability to engage in any
substantial gainful activity by reason of any medically determinable physical or mental
impairment which can be expected to result in death or has lasted or can be expected to
last for a continuous period of not less than 12 months.
(c) Disability review team. The disability review team must be composed
of a medical or psychological consultant and another person who is qualified to interpret
and evaluate medical reports and other evidence relating to an individual's physical or
mental impairments. As necessary, the other person also must be able to determine the
individual's capacity to perform substantial gainful activity. The review team must review
the medical report, which must include a diagnosis, and medical and non-medical evidence
sufficient to determine whether the individual's condition meets the definition of
disability.
(1) The medical report must include a
substantiated diagnosis, based either on existing medical evidence or upon current medical
examinations.
(2) The social history must contain sufficient
information to make it possible to relate the medical findings to the activities of the
person's occupation and to determine whether the individual is totally disabled.
(d) Substantial gainful activity. Substantial gainful activity is any
work of a nature generally performed for remuneration or profit, involving the performance
of significant physical or mental duties or a combination of both. Work may be considered
substantial even if performed part-time, and even if it is less responsible than the
individual's former work, and it may be considered gainful if it pays less than former
work. The application of this definition and of the amount of earnings that could result
in a finding or deeming of substantial gainful activity must be in accordance with
applicable federal regulations.
(e) Group I. This classification includes persons who show no
possibility of engaging in a useful occupation because they have permanent impairments
which are totally disabling and definitely irreversible.
(f) Group II. Individuals having permanent impairments which, while
totally disabling at the time of initial determination, are such that the conditions may
be arrested or a remission may occur, or for which therapeutic advances are occurring or
where rehabilitation is deemed feasible. Group II designation is limited to those persons
who are expected to show a change in physical or mental status or improved functioning
which will enable them to become capable of substantial gainful activity.