20 CFR 416.1403 - Administrative actions that are not initial determinations. | Title 20 - Employees' Benefits | Code of Federal Regulations

§ 416.1403

Administrative actions that are not initial determinations.

(a) Administrative actions that are not initial determinations may be reviewed by us, but they are not subject to the administrative review process provided by this subpart and they are not subject to judicial review. These actions include, but are not limited to, an action about—

(1) Presumptive disability or presumptive blindness;

(2) An emergency advance payment (as defined in § 416.520(b) );

(3) Denial of a request to be made a representative payee;

(4) Denial of a request to use the expedited appeals process;

(5) Denial of a request to reopen a determination or a decision;

(6) The fee that may be charged or received by a person who has represented you in connection with a proceeding before us;

(7) Refusing to recognize, disqualifying, or suspending a person from acting as your representative in a proceeding before us (see §§ 416.1505 and 416.1545 );

(8) Denying your request to extend the time period for requesting review of a determination or a decision;

(9) Determining whether (and the amount of) travel expenses incurred are reimbursable in connection with proceedings before us;

(10) Denying your request to readjudicate your claim and apply an Acquiescence Ruling;

(11) Determining whether an organization may collect a fee from you for expenses it incurs in serving as your representative payee (see § 416.640a );

(12) Declining under § 416.351(f) to make a determination on a claim for benefits based on alleged misinformation because one or more of the conditions specified in § 416.351(f) are not met;

(13) Transition to eligibility for special SSI cash benefits ( § 416.262) in a month immediately following a month for which you were eligible for regular SSI benefits;

(14) Transition to eligibility for regular SSI benefits in a month immediately following a month for which you were eligible for special SSI cash benefits ( § 416.262 );

(15) The determination to reduce, suspend, or terminate your federally administered State supplementary payments due to a State-initiated mass change, as defined in § 416.1401, in the levels of such payments, except as provided in § 416.1402(n) ;

(16) Termination of Federal administration of State supplementary payments;

(17) Findings on whether we can collect an overpayment by using the Federal income tax refund offset procedure. (see § 416.583 );

(18) Determining whether we will refer information about your overpayment to a consumer reporting agency (see §§ 416.590 and 422.305 of this chapter );

(19) Determining whether we will refer your overpayment to the Department of the Treasury for collection by offset against Federal payments due you (see §§ 416.590 and 422.310 of this chapter );

(20) Determining whether we will order your employer to withhold from your disposable pay to collect an overpayment you received under title XVI of the Social Security Act (see part 422, subpart E, of this chapter);

(21) Determining when provisional benefits are payable, the amount of the provisional benefit payable, and when provisional benefits terminate (see § 416.999c );

(22) Determining whether to select your claim for the quick disability determination process under § 416.1019 ;

(23) The removal of your claim from the quick disability determination process under § 416.1019 ;

(24) Starting or discontinuing a continuing disability review; and

(25) Issuing a receipt in response to your report of a change in your earned income.

(26) Determining whether a non-attorney representative is eligible to receive direct fee payment as described in § 416.1517 of this part.

(b) We send some notices of actions that are not initial determinations:

(1) If you receive an emergency advance payment; presumptive disability or presumptive blindness payment, or provisional payment, we will provide a notice explaining the nature and conditions of the payments.

(2) If you receive presumptive disability or presumptive blindness payments, or provisional payments, we shall send you a notice when those payments are exhausted.

(3) If there is a termination of Federal administration of State supplementary payments.

[45 FR 52096, Aug. 5, 1980, as amended at 51 FR 8809, Mar. 14, 1986; 55 FR 1020, Jan. 11, 1990; 55 FR 4423, Feb. 8, 1990; 57 FR 23058, June 1, 1992; 59 FR 41405, Aug. 12, 1994; 59 FR 43039, Aug. 22, 1994; 59 FR 44928, Aug. 31, 1994; 62 FR 49440, Sept. 22, 1997; 66 FR 67081, Dec. 28, 2001; 68 FR 74184, Dec. 23, 2003; 70 FR 57146, Sept. 30, 2005; 71 FR 16461, Mar. 31, 2006; 71 FR 66859, 66867, Nov. 17, 2006; 72 FR 51178, Sept. 6, 2007; 76 FR 45194, July 28, 2011; 76 FR 80247, Dec. 23, 2011]

Title 20 published on 2012-04-01

The following are only the Rules published in the Federal Register after the published date of Title 20.

For a complete list of all Rules, Proposed Rules, and Notices view the Rulemaking tab.

2012-07-25; vol. 77 # 143 - Wednesday, July 25, 2012

77 FR 43492 - Expedited Vocational Assessment Under the Sequential Evaluation Process

GPO FDSys XML | Text

Additional Documents

type	regulations.gov
FR Doc.	2012-17934
RIN	0960-AH26
Docket No.	SSA-2010-0060

SOCIAL SECURITY ADMINISTRATION

Final rules.

These rules are effective August 24, 2012.

20 CFR Parts 404 and 416

Summary

We are revising our rules to give adjudicators the discretion to proceed to the fifth step of the sequential evaluation process for assessing disability when we have insufficient information about a claimant's past relevant work history to make the findings required for step 4. If an adjudicator finds at step 5 that a claimant may be unable to adjust to other work existing in the national economy, the adjudicator will return to the fourth step to develop the claimant's work history and make a finding about whether the claimant can perform his or her past relevant work. We expect that this new expedited process will not disadvantage any claimant or change the ultimate conclusion about whether a claimant is disabled, but it will promote administrative efficiency and help us make more timely disability determinations and decisions.

This is a list of United States Code sections, Statutes at Large, Public Laws, and Presidential Documents, which provide rulemaking authority for this CFR Part.

This list is taken from the Parallel Table of Authorities and Rules provided by GPO [Government Printing Office].

It is not guaranteed to be accurate or up-to-date, though we do refresh the database weekly. More limitations on accuracy are described at the GPO site.

United States Code

USC : Title 8 - ALIENS AND NATIONALITY

§ 1254a - Temporary protected status

USC : Title 31 - MONEY AND FINANCE

§ 3720A - Reduction of tax refund by amount of debt

U.S.C. : Title 42 - THE PUBLIC HEALTH AND WELFARE

§ 421 - Disability determinations

§ 421 note - Disability determinations

§ 423 note - Disability insurance benefit payments

§ 902 - Commissioner; Deputy Commissioner; other officers

§ 902 note - Commissioner; Deputy Commissioner; other officers

§ 1310 - Cooperative research or demonstration projects

42 USC § 1320a–6 - Adjustments in SSI benefits on account of retroactive benefits under subchapter II

42 USC § 1320a–8a - Administrative procedure for imposing penalties for false or misleading statements

42 USC § 1320b–17 - Cross-program recovery of overpayments from benefits

§ 1381 - Statement of purpose; authorization of appropriations

§ 1381a - Basic entitlement to benefits

§ 1382 - Eligibility for benefits

§ 1382a - Income; earned and unearned income defined; exclusions from income

§ 1382b - Resources

§ 1382c - Definitions

§ 1382d - Rehabilitation services for blind and disabled individuals

§ 1382f - Cost-of-living adjustments in benefits

§ 1382h - Benefits for individuals who perform substantial gainful activity despite severe medical impairment

§ 1382h note - Benefits for individuals who perform substantial gainful activity despite severe medical impairment

§ 1382j - Attribution of sponsor’s income and resources to aliens

§ 1382 note - Eligibility for benefits

§ 1383 - Procedure for payment of benefits

§ 1383b - Administration

§ 1383c - Eligibility for medical assistance of aged, blind, or disabled individuals under State’s medical assistance plan

USC : Title 48 - TERRITORIES AND INSULAR POSSESSIONS

§ 1681 note - Continuance of civil government for Trust Territory of the Pacific Islands; assistance programs; maximum fiscal year costs; reimbursement

USC : Title 49 - TRANSPORTATION

§ 1681 note

Statutes at Large

118 Stat. 493

Title 20 published on 2012-04-01

The following are ALL rules, proposed rules, and notices (chronologically) published in the Federal Register relating to 20 CFR 416 after this date.

2013-02-04; vol. 78 # 23 - Monday, February 4, 2013

78 FR 7968 - Revised Medical Criteria for Evaluating Respiratory System Disorders

GPO FDSys XML | Text

Additional Documents

type	regulations.gov
FR Doc.	2013-02165
RIN	0960-AF58
Docket No.	SSA-2006-0149

SOCIAL SECURITY ADMINISTRATION

Notice of proposed rulemaking.

To ensure that your comments are considered, we must receive them by no later than April 5, 2013.

20 CFR Parts 404 and 416

Summary

We propose to revise the criteria in the Listing of Impairments (listings) that we use to evaluate claims involving respiratory disorders in adults and children under titles II and XVI of the Social Security Act (Act). The proposed revisions reflect our program experience, advances in medical knowledge, and comments we received from medical experts and the public at an outreach policy conference and in response to an Advance Notice of Proposed Rulemaking (ANPRM).

2013-01-28; vol. 78 # 18 - Monday, January 28, 2013

78 FR 5755 - Change in Terminology: “Mental Retardation” to “Intellectual Disability”

GPO FDSys XML | Text

Additional Documents

type	regulations.gov
FR Doc.	2013-01522
RIN	0960-AH52
Docket No.	SSA-2012-0066

SOCIAL SECURITY ADMINISTRATION

Notice of proposed rulemaking.

To ensure that your comments are considered, we must receive them no later than February 27, 2013.

20 CFR Parts 404 and 416

Summary

We propose to replace the term “mental retardation” with “intellectual disability” in our Listing of Impairments (listings) that we use to evaluate claims involving mental disorders in adults and children under titles II and XVI of the Social Security Act (Act) and in other appropriate sections of our rules. This change would reflect the widespread adoption of the term “intellectual disability” by Congress, government agencies, and various public and private organizations.

2012-07-25; vol. 77 # 143 - Wednesday, July 25, 2012

77 FR 43492 - Expedited Vocational Assessment Under the Sequential Evaluation Process

GPO FDSys XML | Text

Additional Documents

type	regulations.gov
FR Doc.	2012-17934
RIN	0960-AH26
Docket No.	SSA-2010-0060

SOCIAL SECURITY ADMINISTRATION

Final rules.

These rules are effective August 24, 2012.

20 CFR Parts 404 and 416

Summary

We are revising our rules to give adjudicators the discretion to proceed to the fifth step of the sequential evaluation process for assessing disability when we have insufficient information about a claimant's past relevant work history to make the findings required for step 4. If an adjudicator finds at step 5 that a claimant may be unable to adjust to other work existing in the national economy, the adjudicator will return to the fourth step to develop the claimant's work history and make a finding about whether the claimant can perform his or her past relevant work. We expect that this new expedited process will not disadvantage any claimant or change the ultimate conclusion about whether a claimant is disabled, but it will promote administrative efficiency and help us make more timely disability determinations and decisions.

20 CFR 416.1403 - Administrative actions that are not initial determinations.

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