Court: District Court, E.D. Washington; June 27, 2018; Federal District Court
Donald Henderson, a former serviceman, sustained permanent injuries in a military accident and qualifies for benefits from the Department of Veterans Affairs. The Government contests the amount of these benefits, alleging that Henderson was deceptive in obtaining them, specifically claiming he made a false statement regarding his visual impairment by submitting a diagnosis from Dr. Harshman that stated he was legally blind. To support its claims, the Government presented multiple witnesses over seven and a half days, who testified about their observations of Henderson's behavior during eye exams and casual interactions. However, Henderson contends that the Government did not provide adequate evidence to prove he intentionally made a false statement about his legal blindness.
The Court found in favor of Henderson, ruling that the Government did not meet its burden of proving that he knowingly and willfully made a false statement regarding the permanence or extent of his visual impairment. Consequently, the Court granted Henderson’s motion for acquittal under Fed. R. Crim. P. Rule 29, which allows a court to enter a judgment of acquittal if the evidence is insufficient for conviction. The Court emphasized that the inquiry must be whether a rational jury could find the essential elements of the crime beyond a reasonable doubt, and it noted that the jury's verdict deserves significant deference. Henderson had initially moved for acquittal after the Government's case-in-chief, and following the jury's decision, he reiterated this request for the three counts of conviction. The Court indicated that when it reserved judgment on the mid-trial motion, it would base its later decision on the evidence available at that time.
Defendant Donald Henderson faces multiple charges, including making a false statement to the VA (Count 3), theft from the SSA (Count 2), and theft from the VA (Count 4). The allegations stem from claims that he concealed the extent of his eye condition, keratoconus, to imply permanent blindness, and that he unlawfully took over $1,000 from both SSA and VA between 2011 and 2016. A jury acquitted him of Social Security fraud (Count 1) but convicted him on the other three counts after a trial lasting over seven days.
The Government acknowledges that Henderson was injured in a motorcycle accident in 1984 while in military service, resulting in a brief loss of consciousness and subsequent surgeries. Initially granted a 10% disability rating for finger injuries upon his honorable discharge in 1986, he later sought increased disability ratings, including for migraine headaches linked to the accident. His requests were denied in 1988 and 1991 due to a lack of reported head injury at discharge. However, after further medical evaluations and evidence submission, the VA granted him a 50% disability rating for migraines in 1993, recognizing the condition's debilitating impact on his work and quality of life.
In 1995, Mr. Henderson requested an increased disability rating for his migraine headaches, but the VA upheld his sixty percent total disability rating. Testimony indicated that the maximum disability rating for migraines under the VA schedule was fifty percent. In 1996, Mr. Henderson's wife submitted a statement supporting a new claim for disability related to anxiety, depression, and opioid dependence stemming from his migraine treatment, which led to the VA granting a thirty percent disability rating for these secondary symptoms. Consequently, Mr. Henderson's total disability rating was adjusted to seventy percent due to the VA's method of combining partial disabilities.
In April 1998, Mr. Henderson was diagnosed with keratoconus by optometrist Brett Hagen, and in February 2000, he sought disability compensation for this condition. The VA denied service-connection for keratoconus in March 2000 but allowed him to submit further medical evidence. By June 2001, the VA reassessed his conditions, increasing the disability rating for anxiety neurosis, PTSD, and major depressive disorder to fifty percent and for finger injuries to twenty percent.
On July 18, 2001, Dr. Alan Johnson examined Mr. Henderson, determining his visual acuity to be 20/80 in the right eye and 20/100 in the left, and noted severe keratoconus in the right eye and moderate in the left. By December 2001, Dr. Hagen reported that Mr. Henderson's best visual acuity was 20/60 in both eyes, leading to the revocation of his driver's license due to visual impairment. Dr. Hagen referred Mr. Henderson to ophthalmologist Christopher Sturbaum for potential contact lenses and corneal transplant evaluation. Dr. Sturbaum disagreed with previous assessments, labeling the keratoconus as mild and stating that visual predictions cannot be made solely on corneal topography. He suggested that Mr. Henderson's condition could lead to a visual acuity as poor as 20/80 and noted that his medications might impact his vision.
Dr. Sturbaum testified that optometrists and ophthalmologists typically do not treat traumatic brain injury (TBI) patients, as it falls outside their expertise. On January 8, 2002, the VA recognized Mr. Henderson's keratoconus as a service-connected condition, assigning it a thirty percent disability rating effective October 25, 2000. Consequently, the VA calculated Mr. Henderson's overall disability at ninety percent beginning on the same date. On February 11, 2002, VA optometrist Dr. Thomas Riley assessed Mr. Henderson's vision at 20/100 in both eyes, noting his vision fluctuated regularly. Dr. Riley monitored Mr. Henderson annually from 2002 to 2013, recording a decline in visual acuity to 20/400 the following year. Notably, Dr. Riley observed no progression of keratoconus during the initial assessment period. Mr. Henderson described his vision as "wildly" fluctuating in 2004, and Dr. Riley reported atypical behavior for keratoconus patients, such as bumping into walls.
On March 27, 2002, the VA granted Mr. Henderson "individual unemployability" benefits, acknowledging that his disabilities, while not totaling 100 percent, were severe enough to prevent him from working, effectively treating him as 100 percent disabled. Testimony indicated that the VA deemed Mr. Henderson's disability status permanent at that time. On July 5, 2002, VIST Coordinator Cheryl Sjoberg noted Mr. Henderson was likely legally blind but required a definitive diagnosis. Despite his vision impairment, he reported being independent in daily activities.
On August 27, 2002, Mr. Henderson applied for an increase in his VA disability benefits, citing his keratoconus and current vision of 20/400. He indicated difficulties with contact lenses and severe double vision, emphasizing the need for a higher disability rating based on his condition.
Mr. Henderson has requested an increase in his service-connected disability rating for keratoconus, a progressive eye disease that has resulted in him being classified as legally blind. He has lost his driver's license and submitted a cover letter with his VA benefits application, asserting that his condition is total and permanent. His most recent eye examination, conducted by Dr. Douglas Harshman, confirmed his legal blindness with a best-corrected visual acuity of 20/400 in both eyes, stating that this condition is not expected to improve. Despite the severity of his condition, the government did not call Dr. Harshman or VIST coordinator Cheryl Sjoberg to testify at trial.
Henderson also applied for Social Security benefits, claiming he became unable to work due to his worsening eye condition, and he enclosed Dr. Harshman's statement in his application. His disability claims were approved by the VA in September 2002 and by the SSA in February 2003, based on his assertions and Dr. Harshman's diagnosis.
In 2012, VA Special Agent Marcus Munn initiated an investigation into Mr. Henderson after receiving a tip regarding potential fraud. During his investigation, Agent Munn observed Mr. Henderson engaging in gardening activities and using public transportation, which raised questions about the legitimacy of his claimed disability. Additionally, Agent Munn discovered that Mr. Henderson had sent a thank you card and gift card to his VA dentist, indicating he was able to engage in normal activities despite his claimed legal blindness.
On November 27, 2012, VA Special Agent Jason Farrell, posing as the nephew of Mr. Henderson's dentist, accompanied Mr. Henderson to a shooting range where he observed Mr. Henderson actively engaging in shooting activities and locating ammunition in his garage. Agent Munn conducted covert surveillance of Mr. Henderson's residence from March 22, 2013, to June 11, 2013, capturing various activities, including driving, lawn maintenance, and receiving deliveries, all without the use of mobility aids. Agent Munn testified that he never observed Mr. Henderson using a cane or stick. Following this, a compensation and pension exam was scheduled for Mr. Henderson with Dr. Johnson, who documented Mr. Henderson's reports of double vision and conducted objective tests revealing corneal irregularities. Dr. Johnson noted that the severity of Mr. Henderson’s keratoconus had not significantly changed since 2001, describing it as moderate in one eye and severe in the other. He acknowledged overlaps between symptoms of traumatic brain injury (TBI) and keratoconus but did not link Mr. Henderson's vision issues to TBI or recent medications, as he had not reviewed all of Mr. Henderson's medical history. Additionally, the Government presented lay witness testimonies and expert analysis from SSA Program Expert Christine Vu, who stated that qualifying for Social Security disability benefits requires a continuous impairment lasting at least 12 months, which she argued Mr. Henderson did not meet, as evidenced by his functional capabilities.
The claimant does not utilize assistive aids like a cane or guide dog. The Defendant presented eleven witnesses, including Dr. William Hills, a neuro-ophthalmologist who diagnosed Mr. Henderson with traumatic brain injury (TBI) and keratoconus. Dr. Hills noted Mr. Henderson suffers from light-near dissociation, a neurologic condition linked to TBI. Utilizing a pupilometer, Dr. Hills observed objective abnormalities in Mr. Henderson's pupil reactivity. He indicated that Mr. Henderson's medications might cause vision-related side effects, such as double vision and dry eyes. Dr. Hills criticized the subjectivity of Snellen eye chart tests, highlighting that test results can be influenced by examiner persistence, testing conditions, and chart calibration. He assessed Mr. Henderson's baseline vision at 20/200, suggesting improved perception may only occur under perfect conditions. Although Mr. Henderson achieved 20/70 during testing, Dr. Hills deemed this level of acuity unsustainable. To illustrate Mr. Henderson's capabilities, Dr. Hills simulated impaired vision and successfully performed activities similar to those Mr. Henderson had done.
Additionally, Ms. Sjoberg's notes from a 2004 VA review indicated that Mr. Henderson rides a bicycle when his vision is better and manages household tasks independently. During her testimony, Ms. Sjoberg, who has 20/400 vision, confirmed she could see targets similarly to Mr. Henderson without glasses. The court's analysis centers on Count 3 regarding a false statement to the VA, which is critical to the case's outcome; if evidence for this count is insufficient, the related theft counts would also fail, as they depend on Mr. Henderson's alleged misrepresentation of his visual impairment to justify benefits received.
Count 3 of the superseding indictment charges Mr. Henderson with violating 18 U.S.C. § 1001 by allegedly concealing a material fact regarding his eye condition, keratoconus, by misrepresenting that it resulted in permanent blindness with a best corrected visual acuity worse than 20/200. The indictment and the Government's proposed jury instruction did not clarify how Mr. Henderson concealed this fact from the VA. During trial discussions, the Government argued that Mr. Henderson made a false statement by submitting a medical diagnosis from Dr. Harshman, which indicated he was legally blind due to a permanent condition. Throughout the proceedings, the Government's framing focused on this false statement rather than the concealment through a trick or scheme, which pertains to a different subsection of 18 U.S.C. § 1001.
The Ninth Circuit interprets 18 U.S.C. § 1001 to prevent the submission of false statements to federal agencies that induce reliance or action. To obtain a conviction for making a false statement, the Government must establish five elements: (1) a statement, (2) falsity, (3) materiality, (4) specific intent, and (5) agency jurisdiction. Specifically, for section (a)(1), the elements include: (1) a duty to disclose material information, (2) falsification or concealment through a trick or scheme, (3) the materiality of the concealed fact, (4) knowing and willful falsification or concealment, and (5) the fact being within the jurisdiction of the Executive Branch. Materiality is satisfied if the statement can influence agency decisions.
To prove the use of a "scheme, trick, or device," the Government must demonstrate the defendant engaged in an affirmative act to conceal information he was legally required to disclose; mere omissions do not suffice. The Court instructed the jury regarding Count 3, requiring them to find that Mr. Henderson made a false statement within the jurisdiction of the VA, acted willfully, and that the statement was material to the VA's activities. The jury must reach a unanimous decision on the specifics of the false statement and its date. The Court will evaluate each element the Government must prove beyond a reasonable doubt.
The jury was instructed to reach a unanimous decision on which statement(s) were false, yet no special verdict form or jury interrogatory was provided, leading to ambiguity regarding the basis of their verdict. During a hearing, the Government claimed that Mr. Henderson's false statements included Dr. Harshman's July 16, 2002 diagnosis and Mr. Henderson's submissions of this diagnosis for benefits. The Government positioned the diagnosis as the critical point separating legal from illegal disability benefits. However, the Court questioned whether Dr. Harshman's diagnosis could be considered Mr. Henderson's statement, as he merely submitted it in support of his claims.
The Court referenced a Fourth Circuit case where a medical diagnosis was accepted as a defendant's false statement, highlighting differences with the current case. In that precedent, there was clear evidence connecting the defendant's statements to the diagnosis, which was not present here. The Government did not provide testimony from Dr. Harshman or evidence about the examination questions or Mr. Henderson's responses, failing to establish a causal link between the diagnosis and any purported false statements by Mr. Henderson. The Court also noted that the wording of Dr. Harshman's diagnosis was ambiguous, undermining the Government's assertion that Mr. Henderson knowingly made a false statement based on it. Specifically, the reference to "this" in the diagnosis created uncertainty about what it pertained to, complicating the Government's argument of intentional deceit.
Keratoconus is established as a permanent, chronic, and irreversible condition that either progresses or remains stable, supported by expert testimony. Mr. Henderson consistently communicated to multiple examiners that his vision fluctuated daily. The Government's claim that Dr. Harshman's diagnosis of Mr. Henderson's visual acuity as "20/400 both eyes" implied permanent impairment is unsupported by evidence, as no optometrist would define visual acuity as a "condition." Mr. Henderson's documentation highlighted his current vision and explicitly requested a reevaluation of his disability status without claiming that his visual acuity was permanent. The Government's interpretation that "permanent" modifies "visual acuity" rather than "keratoconus" lacks backing. Furthermore, Count 3 of the indictment alleges Mr. Henderson claimed to be "permanently blind," yet no evidence substantiates this assertion. Dr. Harshman's note does not diagnose permanent blindness, and Mr. Henderson's statements refer to a "permanent condition" but not "permanent blindness." For the Government to prove falsity, it must demonstrate that Mr. Henderson knowingly submitted false information. The Government's approach at trial suggested an illogical dichotomy, asserting that either keratoconus solely caused Mr. Henderson's impairment or he was misleading about its severity, while also presenting evidence indicating keratoconus alone could not account for the level of impairment claimed.
Defendant's visual impairment claims were challenged, with the Government asserting that Mr. Henderson fabricated the extent of his condition. However, the Government did not provide sufficient evidence to support this claim, failing to establish a rule-out diagnosis that Mr. Henderson's impairment was solely due to keratoconus. Alternative explanations for his condition, such as traumatic brain injury (TBI), prescribed medications, and light-near dissociation, were presented. The Government's medical experts did not comprehensively review Mr. Henderson's extensive medical records before forming their opinions; for instance, Dr. Johnson, an optometrist, limited his review to specific eye clinic records and did not consider TBI as a contributing factor, despite acknowledging that TBI can lack physical symptoms. Dr. Sturbaum and Dr. Spitz, both ophthalmologists, also did not review significant portions of Mr. Henderson's medical history. Although the Government's witnesses diagnosed Mr. Henderson with visual impairments, they did not base their conclusions solely on his self-reports, as some evaluations included corneal topographies and physical exams. Disagreement arose among the experts regarding qualifications, particularly regarding Dr. Johnson's ability to assess the severity of keratoconus compared to Dr. Spitz. Ultimately, without evidence proving that other conditions besides keratoconus contributed to Mr. Henderson's impairments, there is insufficient basis to assert that he knowingly submitted false information for criminal liability. The Government acknowledged that Mr. Henderson had been partially disabled by keratoconus since 2000 and qualified for additional VA benefits due to migraine headaches.
Mr. Henderson is charged by the Government with making false statements regarding his vision, specifically claiming it was permanently 20/200 or worse due to keratoconus. However, the Government failed to present evidence showing he ever made such a claim. Instead, evidence indicates that Mr. Henderson consistently reported fluctuating visual acuity to his healthcare providers, who documented these fluctuations. Dr. Hills testified that such fluctuations are expected given Mr. Henderson's conditions, including traumatic brain injury (TBI). The Government's argument relied on inconsistent results from Snellen exams to assert that Mr. Henderson was not permanently 20/400, conflating "legally blind" from fluctuating acuity with "permanently blind." The Court clarified that these terms are not equivalent and emphasized that Mr. Henderson's condition is permanent but characterized by fluctuating acuity.
Furthermore, the Government's witnesses, including a VA investigator, speculated about Mr. Henderson's capabilities without adequate basis, noting that they expected overt signs of blindness when observing him gardening. The witness could not identify any signs of blindness during their observation. The evidence supports that Mr. Henderson did not misrepresent his condition and consistently communicated his fluctuating vision to the VA.
Agent Munn did not demonstrate qualifications to assess observable signs of legal blindness from a distance and did not define "overt sign of blindness." There was no evidence that Mr. Henderson, who claimed specific visual acuity for benefits, required assistive devices or exhibited signs such as falling or stumbling while working in his yard. The Government's VA ratings expert, Mr. David, expressed the opinion that Mr. Henderson did not qualify for disability due to his alleged blindness, based on medical evidence suggesting he could perform activities that a blind person typically could not. However, there was no evidence substantiating that individuals with the claimed vision issues could not perform those activities. Similarly, testimony from SSA expert Ms. Vu regarding expectations of assistive aids for statutorily blind individuals lacked adequate backing. The Government's argument relied on circumstantial evidence of Mr. Henderson's activities, implying malingering without expert testimony to support the notion that a legally blind person could not engage in such activities. The text emphasizes that expert testimony is necessary when the capabilities of a legally blind individual are beyond common knowledge, challenging the Government's reliance on lay assumptions without expert validation.
The Court ruled that many of the Government's proposed expert witnesses lacked the necessary expertise to support their conclusions regarding Mr. Henderson's vision claims. Testimony from Ms. Graham, a certified ophthalmic assistant, indicated uncertainty about the legal definition of blindness. The evidence presented by the Government, including observations of Mr. Henderson's activities from 2012 to 2013, was insufficient to prove that he falsely reported his vision between 2002 and 2016, failing to meet the standard for a rational jury to conclude beyond a reasonable doubt that he made a false statement or concealed material facts under 18 U.S.C. § 1001.
The Court also highlighted a lack of evidence regarding materiality, noting that the Government's assertion that Dr. Harshman's July 16, 2002 diagnosis constituted a false statement was undermined by the fact that the VA had already rated Mr. Henderson as permanently unemployable and was paying him at a 100 percent disability rate as of March 27, 2002. Consequently, the VA did not rely on Dr. Harshman's diagnosis or Mr. Henderson's statements in August 2002 for their decision, rendering these elements immaterial.
Regarding specific intent, which is essential for all counts of conviction, the Government's argument suggested that Mr. Henderson sought to gain increased benefits through a permanent disability claim. However, the absence of testimony from Dr. Harshman or the VA optometry intern and the lack of evidence showing that Mr. Henderson manipulated the diagnostic process or knowingly reported false information weakened the Government's case. Ultimately, there was no evidence that Mr. Henderson was aware of any misrepresentation in his reported diagnosis or that his actions constituted unlawful behavior.
Testimony from Mr. David, a Government witness, indicated that by March 2002, the VA had already classified Mr. Henderson as 100 percent disabled and individually unemployable. The Government argued that Mr. Henderson failed to report potential alternative causes for his vision impairment beyond keratoconus. However, there was no legal obligation for him to disclose all possible medical conditions affecting his impairment, nor was there evidence that he misrepresented his condition, especially given that he was entitled to rely on his VA doctor's diagnosis. Mr. Henderson was required to report any improvement in his condition, but the evidence suggested his condition remained unchanged.
The Government presented no proof that Mr. Henderson knowingly made false statements to obtain increased benefits. The lack of evidence would lead the jury to rely on speculation regarding his intent to misrepresent his visual impairment. Citing relevant case law, the Court determined that the evidence was insufficient to support a guilty verdict for Counts 2 (theft from the SSA) and 4 (theft from the VA) due to the absence of proved intent, which is essential under 18 U.S.C. 641. Consequently, the Court granted Mr. Henderson's motion for acquittal on all counts and acknowledged a request for a new trial should the acquittal be overturned.
A court can vacate any judgment and grant a new trial if necessary for justice, as stated in Federal Rule of Criminal Procedure 33(a). A district court's authority to grant a new trial is broader than its authority to grant a motion for judgment of acquittal, allowing the court to weigh evidence and assess witness credibility without favoring the original verdict. If the evidence heavily contradicts the verdict, indicating a potential miscarriage of justice, the court may set aside the verdict and order a new trial. This discretion should be exercised only in exceptional circumstances. In the case at hand, the court determined that the evidence significantly preponderates against the verdict, suggesting a serious miscarriage of justice, warranting a new trial if the acquittal ruling is overturned.
The testimony of VA Ratings Specialist Clinton David was permitted solely to discuss the VA disability ratings process as it pertained to Mr. Henderson. However, the defendant contends that David's testimony included impermissible vouching that violated due process. David provided extensive commentary on the VA's history, its ratings system, and his experiences, which the defendant argues was inappropriate. He described the government's commitment to veterans dating back to Abraham Lincoln and portrayed the VA's approach as non-adversarial, emphasizing the agency's loyalty to veterans over taxpayers.
Mr. David referenced the administrative process that led to the termination of Mr. Henderson's vision-related benefits, characterizing it as a "fraud case." The VA concluded this based on a "clear and unmistakable error standard," asserting that Mr. Henderson violated fraud regulations without explaining the meaning of that standard. The court found Mr. David's testimony prejudicial and potentially confusing to the jury regarding the significance of the benefits termination in relation to the Government's burden of proof for false statements.
The defendant seeks a new trial based on newly discovered evidence concerning the VA's fluctuating determinations of Mr. Henderson's individual unemployability status. Initially deemed unemployable in March 2002, the VA changed its determination in July 2015, then reinstated it in February 2018, only to revoke it again in May 2018, referencing the jury's September 2017 verdict as a basis for this decision. The VA's determinations were purportedly made using the same "clear and unmistakable error standard."
To qualify for a new trial based on newly discovered evidence, a defendant must meet five criteria, including that the evidence is newly discovered, material, and could likely lead to an acquittal. The May 1, 2018 VA decision revoking Mr. Henderson's unemployability status was issued on the same day the VA received the jury verdict, which it cited in its rationale, but it remains unclear how the VA obtained specific insights into the prosecution's case against Mr. Henderson.
The Court determined that a new trial is warranted based on four factors related to newly discovered evidence, specifically the May 1, 2018 VA determination, which was not available at the time of the September 2017 trial. This evidence is deemed material and not merely cumulative or impeaching. Although the likelihood of acquittal from the new evidence remains speculative, the VA's post-trial actions support the need for a retrial.
Additionally, the Court identified prosecutorial errors, noting that the Government's presentation of evidence was misleading, which was supported by numerous sustained objections from the defense during the trial. Despite the Court's reminders to the jury regarding the nature of closing arguments, the potential for jury confusion was significant.
The Court also highlighted that the Government improperly introduced the issue of Mr. Henderson's deservedness for VA benefits, which had been restricted prior to trial. After a thorough review of the trial evidence and new VA evidence, the Court concluded that the weight of the evidence did not support the jury's verdict, particularly regarding essential elements of the convictions.
Ultimately, the Court found insufficient evidence to uphold the convictions for Counts 2, 3, and 4, and thus granted Mr. Henderson's motion for acquittal on these counts.
The Court acknowledges the potential for a miscarriage of justice in Mr. Henderson's conviction, warranting a new trial if the acquittal ruling is vacated. Key orders include: granting the Defendant's Motion for Acquittal and two motions for a new trial, as well as acquitting the Defendant of Counts 2, 3, and 4, with a formal judgment of acquittal to be entered. The Court emphasizes the confusion surrounding the case, suggesting insufficient evidence to support the convictions under Federal Rule of Criminal Procedure 29. Relevant statutes cited include 42 U.S.C. § 408(a)(4), 18 U.S.C. § 1001(a)(1), and 18 U.S.C. § 641, each outlining serious criminal penalties for fraud and misappropriation of U.S. property. Additionally, the Court evaluated medical evidence regarding Mr. Henderson’s service-connected disabilities, determining that a 30 percent evaluation for keratoconus was justified based on active duty reports. The testimony of Ms. Sjoberg regarding the application for benefits was noted, along with a lack of corroborating documentation for a witness's assertion about Mr. Henderson's activities. The Court's analysis indicates a failure to meet the burden of proof required for the convictions.
The Court modified jury instructions by including a unanimity requirement and eliminating language concerning the jurisdiction of the Department of Veterans Affairs. During the Government's opening statement, Mr. Henderson was repeatedly alleged to have claimed he was "permanently blind." The Court overruled the Defendant's objection regarding this claim, based on the Government's assertion that Mr. Henderson provided medical evidence supporting his blindness to both the VA and SSA. However, at this point in the proceedings, the Court found no evidence confirming that Mr. Henderson explicitly stated he was "permanently blind."
In closing arguments, the Government contended that Mr. Henderson falsely represented his condition regarding keratoconus to both the VA and SSA, despite acknowledging his migraine compensation. The Government's Exhibit 9 indicated that the VA issued him a white cane in 2004 for identification purposes only, noting it was inadequate for support or mobility assistance. Testimony from Ms. Vu highlighted that the Social Security medical listing equates a visual acuity of 20/400 with disability, similar to an individual with no eyeballs. However, the Government emphasized that this regulatory classification does not provide evidence that someone legally blind due to keratoconus has the same limitations as someone without eyes, according to Dr. Harshman's diagnosis.
