Alaska AB 3 Review Report on Aid to the Blind

Alaska's Adult Public Assistance program pays cash benefits to people who are blind, and the Division of Public Assistance uses this report to decide whether an applicant meets the program's definition. The examining eye specialist or physician reports central visual acuity, any visual field restriction, and the nature, severity and effect of the impairment. A state medical review officer then records the decision.

Who completes it

An ophthalmologist, optometrist or physician completes the whole report and attaches a current medical evaluation. The decision section is completed by the state's medical practice review officer, not the examiner.

Submitting and payment

How to submit it
Return the completed report, with the attached medical evaluation, to the Division of Public Assistance.

Good to know

  • The blindness standard is central visual acuity of 20/200 or less or a restricted visual field, so measured acuity and field results belong on the report.
  • The form calls for a current medical evaluation to be attached to the completed report before it goes back to the Division of Public Assistance.
  • The companion AD 2 Preliminary Examination for Interim Assistance covers applicants whose SSI disability claim is still pending.
  • The current edition is AB 3 (06-3036), revised July 2022, and it is a fillable PDF.

Get the official form

Download the current version from the source each time; forms change without notice.

Review Report on Aid to the Blind

How this list is checked

A form is listed only after its name and number were confirmed on the issuing agency’s or insurer’s own website, or in the form itself. Each entry links to that source. The list was last checked in October 2026. Forms and their requirements change without notice, so check the official page for the current version before you complete one.

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Frequently asked questions

What vision loss qualifies for Alaska Aid to the Blind?

The AB 3 asks whether the patient meets the program's blindness definition: central visual acuity of 20/200 or less, or a restricted visual field. The examiner reports the findings and the nature and severity of the impairment, and the state's medical practice review officer makes the decision on the form.

Who can complete the Alaska AB 3?

An ophthalmologist, optometrist or physician who examined the patient. They complete the whole report, describe the nature and severity of the impairment and its effect on the patient, and attach a current medical evaluation before the report is returned to the Division of Public Assistance.