20 CFR 416.920a - Evaluation of mental impairments.
(a)General. The steps outlined in §§ 416.920 and 416.924 apply to the evaluation of physical and mental impairments. In addition, when we evaluate the severity of mental impairments for adults (persons age 18 and over) and in persons under age 18 when Part A of the Listing of Impairments is used, we must follow a special technique at each level in the administrative review process. We describe this special technique in paragraphs (b) through (e) of this section. Using this technique helps us:
(1) Identify the need for additional evidence to determine impairment severity;
(2) Consider and evaluate functional consequences of the mental disorder(s) relevant to your ability to work; and
(3) Organize and present our findings in a clear, concise, and consistent manner.
(b)Use of the technique.
(1) Under the special technique, we must first evaluate your pertinent symptoms, signs, and laboratory findings to determine whether you have a medically determinable mental impairment(s). See § 416.921 for more information about what is needed to show a medically determinable impairment. If we determine that you have a medically determinable mental impairment(s), we must specify the symptoms, signs, and laboratory findings that substantiate the presence of the impairment(s) and document our findings in accordance with paragraph (e) of this section.
(2) We must then rate the degree of functional limitation resulting from the impairment(s) in accordance with paragraph (c) of this section and record our findings as set out in paragraph (e) of this section.
(c)Rating the degree of functional limitation.
(1) Assessment of functional limitations is a complex and highly individualized process that requires us to consider multiple issues and all relevant evidence to obtain a longitudinal picture of your overall degree of functional limitation. We will consider all relevant and available clinical signs and laboratory findings, the effects of your symptoms, and how your functioning may be affected by factors including, but not limited to, chronic mental disorders, structured settings, medication, and other treatment.
(2) We will rate the degree of your functional limitation based on the extent to which your impairment(s) interferes with your ability to function independently, appropriately, effectively, and on a sustained basis. Thus, we will consider such factors as the quality and level of your overall functional performance, any episodic limitations, the amount of supervision or assistance you require, and the settings in which you are able to function. See 12.00C through 12.00H of the Listing of Impairments in appendix 1 to subpart P of part 404 of this chapter for more information about the factors we consider when we rate the degree of your functional limitation.
(3) We have identified four broad functional areas in which we will rate the degree of your functional limitation: Understand, remember, or apply information; interact with others; concentrate, persist, or maintain pace; and adapt or manage oneself. See 12.00E of the Listing of Impairments in appendix 1 to subpart P of part 404 of this chapter.
(4) When we rate your degree of limitation in these areas (understand, remember, or apply information; interact with others; concentrate, persist, or maintain pace; and adapt or manage oneself), we will use the following five-point scale: None, mild, moderate, marked, and extreme. The last point on the scale represents a degree of limitation that is incompatible with the ability to do any gainful activity.
(d)Use of the technique to evaluate mental impairments. After we rate the degree of functional limitation resulting from your impairment(s), we will determine the severity of your mental impairment(s).
(1) If we rate the degrees of your limitation as “none” or “mild,” we will generally conclude that your impairment(s) is not severe, unless the evidence otherwise indicates that there is more than a minimal limitation in your ability to do basic work activities (see § 416.922).
(2) If your mental impairment(s) is severe, we must then determine if it meets or is equivalent in severity to a listed mental disorder. We do this by comparing the medical findings about your impairment(s) and the rating of the degree of functional limitation to the criteria of the appropriate listed mental disorder. We will record the presence or absence of the criteria and the rating of the degree of functional limitation on a standard document at the initial and reconsideration levels of the administrative review process, or in the decision at the administrative law judge hearing and Appeals Council levels (in cases in which the Appeals Council issues a decision). See paragraph (e) of this section.
(3) If we find that you have a severe mental impairment(s) that neither meets nor is equivalent in severity to any listing, we will then assess your residual functional capacity.
(e)Documenting application of the technique. At the initial and reconsideration levels of the administrative review process, we will complete a standard document to record how we applied the technique. At the administrative law judge hearing and Appeals Council levels (in cases in which the Appeals Council issues a decision), we will document application of the technique in the decision. The following rules apply:
(1) When a State agency medical or psychological consultant makes the determination together with a State agency disability examiner at the initial or reconsideration level of the administrative review process as provided in § 416.1015(c)(1) of this part, the State agency medical or psychological consultant has overall responsibility for assessing medical severity. A State agency disability examiner may assist in preparing the standard document. However, our medical or psychological consultant must review and sign the document to attest that it is complete and that he or she is responsible for its content, including the findings of fact and any discussion of supporting evidence.
(2) When a State agency disability examiner makes the determination alone as provided in § 416.1015(c)(3), the State agency disability examiner has overall responsibility for assessing medical severity and for completing and signing the standard document.
(3) When a disability hearing officer makes a reconsideration determination as provided in § 416.1015(c)(4), the determination must document application of the technique, incorporating the disability hearing officer's pertinent findings and conclusions based on this technique.
(4) At the administrative law judge hearing and Appeals Council levels, the written decision must incorporate the pertinent findings and conclusions based on the technique. The decision must show the significant history, including examination and laboratory findings, and the functional limitations that were considered in reaching a conclusion about the severity of the mental impairment(s). The decision must include a specific finding as to the degree of limitation in each of the functional areas described in paragraph (c) of this section.
(5) If the administrative law judge requires the services of a medical expert to assist in applying the technique but such services are unavailable, the administrative law judge may return the case to the State agency or the appropriate Federal component, using the rules in § 416.1441 of this part, for completion of the standard document. If, after reviewing the case file and completing the standard document, the State agency or Federal component concludes that a determination favorable to you is warranted, it will process the case using the rules found in § 416.1441(d) or (e) of this part. If, after reviewing the case file and completing the standard document, the State agency or Federal component concludes that a determination favorable to you is not warranted, it will send the completed standard document and the case to the administrative law judge for further proceedings and a decision.
Title 20 published on 20-Dec-2017 04:12
The following are ALL rules, proposed rules, and notices (chronologically) published in the Federal Register relating to 20 CFR Part 416 after this date.
GPO FDSys XML | Text type regulations.gov FR Doc. 2017-15493 RIN 0960-AI06 Docket No. SSA-2017-0021 SOCIAL SECURITY ADMINISTRATION Final rule. This final rule is effective July 25, 2017. 20 CFR Parts 404 and 416 We are extending for six months our rule authorizing attorney advisors to conduct certain prehearing proceedings and to issue fully favorable decisions. The current rule is scheduled to expire on August 4, 2017. In this final rule, we are extending the sunset date to February 5, 2018. We are making no other substantive changes.
GPO FDSys XML | Text type regulations.gov FR Doc. 2017-06023 RIN 0960-AH51 Docket No. SSA-2012-0035 SOCIAL SECURITY ADMINISTRATION Final rules; correction. Effective March 27, 2017. 20 CFR Parts 404 and 416 We published a document in the Federal Register on January 18, 2017, that revises our rules. That document inadvertently contained technical errors. This document amends and corrects the final rules.
GPO FDSys XML | Text type regulations.gov FR Doc. 2017-00455 RIN 0960-AH51 Docket No. SSA-2012-0035 SOCIAL SECURITY ADMINISTRATION Final rules. These final rules are effective on March 27, 2017. 20 CFR Parts 404 and 416 We are revising our medical evidence rules. The revisions include redefining several key terms related to evidence, revising our rules about acceptable medical sources (AMS), revising how we consider and articulate our consideration of medical opinions and prior administrative medical findings, revising our rules about medical consultants (MC) and psychological consultants (PC), revising our rules about treating sources, and reorganizing our evidence regulations for ease of use. These revisions conform our rules to the requirements of the Bipartisan Budget Act of 2015 (BBA), reflect changes in the national healthcare workforce and in the manner that individuals receive medical care, and emphasize the need for objective medical evidence in disability and blindness claims. We expect that these changes will simplify our rules to make them easier to understand and apply, and allow us to continue to make accurate and consistent disability determinations and decisions.
GPO FDSys XML | Text type regulations.gov FR Doc. 2016-30103 RIN 0960-AH71 Docket No. SSA-2014-0052 SOCIAL SECURITY ADMINISTRATION Final rule. This final rule will be effective on January 17, 2017. However, compliance is not required until May 1, 2017. 20 CFR Parts 404, 405 and 416 We are revising our rules so that more of our procedures at the hearing and Appeals Council levels of our administrative review process are consistent nationwide. We anticipate that these nationally consistent procedures will enable us to administer our disability programs more efficiently and better serve the public.
GPO FDSys XML | Text type regulations.gov FR Doc. 2016-25565 RIN 0960-AH94 Docket No. SSA-2016-0014 SOCIAL SECURITY ADMINISTRATION Final rule. This final rule is effective October 24, 2016. 20 CFR Parts 404 and 416 We are extending, until December 28, 2018, the expiration date of our disability examiner authority (DEA) rule, which authorizes State agency disability examiners to make fully favorable determinations without the approval of a State agency medical or psychological consultant in claims that we consider under our quick disability determination (QDD) and compassionate allowance (CAL) processes. This is our last extension of this rule because we will phase out the use of DEA during the extension period under section 832 of the Bipartisan Budget Act of 2015 (BBA). This extension provides us the time necessary to take all of the administrative actions we need to take in order to reinstate uniform use of medical and psychological consultants. The current rule will expire on November 11, 2016. In this final rule, we are changing the November 11, 2016 expiration or “sunset” date to December 28, 2018, extending the authority for 2 years and 1 month. This is the final extension of our DEA rule. On December 28, 2018, at the conclusion of this extension, the authority for this test will terminate. We are making no other changes.
GPO FDSys XML | Text type regulations.gov FR Doc. 2016-24873 RIN 0960-AH66 Docket No. SSA-2014-0016 SOCIAL SECURITY ADMINISTRATION Final rules. These final rules will be effective November 16, 2016, except for the amendments to §§ 404.1592c and 416.999a, which will be effective April 17, 2017. 20 CFR Parts 404 and 416 These rules finalize the rules we proposed in our notice of proposed rulemaking (NPRM), published on May 11, 2016. In these rules, we remove some of the requirements for evaluation of an unsuccessful work attempt (UWA) that lasts between 3 and 6 months, allow previously entitled beneficiaries to apply for expedited reinstatement (EXR) in the same month they stop performing substantial gainful activity (SGA), and provide that provisional benefits will begin the month after the request for EXR if the beneficiary stops performing SGA in the month of the EXR request. These changes will simplify our policies and make them easier for the public to understand.
GPO FDSys XML | Text type regulations.gov FR Doc. 2016-22908 RIN 0960-AF69 Docket No. SSA-2007-0101 SOCIAL SECURITY ADMINISTRATION Final rules. These rules are effective January 17, 2017. 20 CFR Parts 404 and 416 We are revising the criteria in the 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). The revisions reflect our program experience, advances in medical knowledge, recommendations from a commissioned report, and public comments we received in response to a Notice of Proposed Rulemaking (NPRM).
GPO FDSys XML | Text type regulations.gov FR Doc. 2016-22909 RIN 0960-AH92 Docket No. SSA-2016-0015 SOCIAL SECURITY ADMINISTRATION Final rules. These final rules will be effective on November 2, 2016. 20 CFR Parts 404 and 416 In accordance with section 812 of the Bipartisan Budget Act of 2015 (BBA section 812), these rules explain how we will address evidence furnished by medical sources that meet one of BBA section 812's exclusionary categories (excluded medical sources of evidence) as described below. Under these new rules, we will not consider evidence furnished by an excluded medical source of evidence unless we find good cause to do so. We identify five circumstances in which we may find good cause. In these rules, we also require excluded medical sources of evidence to notify us of their excluded status under section 223(d)(5)(C)(i) of the Social Security Act (Act), as amended, in writing each time they furnish evidence to us that relates to a claim for initial or continuing benefits under titles II or XVI of the Act. These rules will allow us to fulfill obligations that we have under BBA section 812.
GPO FDSys XML | Text type regulations.gov FR Doc. C1-2016-13275 RIN 0960-AF58 Docket No. SSA-2006-0149 SOCIAL SECURITY ADMINISTRATION 20 CFR Parts 404 and 416
GPO FDSys XML | Text type regulations.gov FR Doc. 2016-21358 RIN 0960-AH51 Docket No. SSA-2012-0035 SOCIAL SECURITY ADMINISTRATION Notice of proposed rulemaking (NPRM). To ensure that we consider your comments, we must receive them by no later than November 8, 2016. 20 CFR Parts 404 and 416 We are proposing several revisions to our medical evidence rules. The proposals include redefining several key terms related to evidence, revising our list of acceptable medical sources (AMS), revising how we consider and articulate our consideration of medical opinions and prior administrative medical findings, revising who can be a medical consultant (MC) and psychological consultant (PC), revising our rules about treating sources, and reorganizing our evidence regulations for ease of use. These proposed revisions would conform our rules with the requirements of the Bipartisan Budget Act of 2015 (BBA), reflect changes in the national healthcare workforce and in the manner that individuals receive primary medical care, simplify and reorganize our rules to make them easier to understand and apply, allow us to continue to make accurate and consistent decisions, and emphasize the need for objective medical evidence in disability and blindness claims.
GPO FDSys XML | Text type regulations.gov FR Doc. 2016-19384 RIN 0960-AH63 Docket No. SSA-2013-0044 SOCIAL SECURITY ADMINISTRATION Notice of proposed rulemaking. To ensure that your comments are considered, we must receive them no later than October 17, 2016. 20 CFR Parts 404 and 416 We propose to revise our rules of conduct and standards of responsibility for representatives. We also propose to update and clarify procedures we use when we bring charges against a representative for violating our rules of conduct and standards of responsibilities for representatives. These changes are necessary to better protect the integrity of our administrative process and further clarify representatives' currently existing responsibilities in their conduct with us. The changes to our rules are not meant to suggest that any specific conduct is permissible under our existing rules; instead, we seek to ensure that our rules of conduct and standards of responsibility are clearer as a whole and directly address a broader range of inappropriate conduct.
GPO FDSys XML | Text type regulations.gov FR Doc. 2016-16265 RIN 0960-AH71 Docket No. SSA-2014-0052 SOCIAL SECURITY ADMINISTRATION Notice of proposed rulemaking (NPRM). To ensure that your comments are considered, we must receive them no later than August 11, 2016. 20 CFR Parts 404, 405 and 416 We propose to revise our rules so that more of our procedures at the administrative law judge (ALJ) and Appeals Council levels of our administrative review process are consistent nationwide. We anticipate that these nationally consistent procedures will enable us to administer our disability programs more efficiently and better serve the public.
GPO FDSys XML | Text type regulations.gov FR Doc. 2016-14974 RIN 0960-AI02 Docket No. SSA-2016-0019 SOCIAL SECURITY ADMINISTRATION Final rule. This final rule is effective June 24, 2016. 20 CFR Parts 404 and 416 We are extending for one year our pilot program that authorizes the agency to set the time and place for a hearing before an administrative law judge (ALJ). Extending the pilot program continues our commitment to improve the efficiency of our hearing process and to maintain a hearing process that results in accurate, high-quality decisions for claimants. The current pilot program will expire on August 12, 2016. In this final rule, we are extending the effective date to August 11, 2017. We are making no other changes.
GPO FDSys XML | Text type regulations.gov FR Doc. 2016-13744 RIN 0960-AH92 Docket No. SSA-2016-0015 SOCIAL SECURITY ADMINISTRATION Notice of proposed rulemaking (NPRM). To ensure that we consider your comments, we must receive them by no later than August 9, 2016. 20 CFR Parts 404 and 416 In accordance with section 812 of the Bipartisan Budget Act of 2015 (BBA section 812), we propose to revise our rules to explain how we would address evidence furnished by medical sources that meet one of BBA section 812's exclusionary categories (statutorily excluded medical sources). Under this proposed rule, we would not consider evidence furnished by a statutorily excluded medical source unless we find good cause to do so. We propose several circumstances in which we would find good cause, and we also propose to require statutorily excluded medical sources to notify us of their excluded status when they furnish evidence to us. These rules would allow us to fulfill obligations that we have under the Bipartisan Budget Act of 2015 (BBA).
GPO FDSys XML | Text type regulations.gov FR Doc. 2016-13275 RIN 0960-AF58 Docket No. SSA-2006-0149 SOCIAL SECURITY ADMINISTRATION Final rule. These final rules are effective October 7, 2016. 20 CFR Parts 404 and 416 We are revising 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 revisions reflect our program experience and advances in medical knowledge since we last comprehensively revised this body system in 1993, as well as comments we received from medical experts and the public.
GPO FDSys XML | Text type regulations.gov FR Doc. 2016-10932 RIN 0960-AH66 Docket No. SSA-2014-0016 SOCIAL SECURITY ADMINISTRATION Notice of proposed rulemaking. To ensure that your comments are considered, we must receive them no later than July 11, 2016. 20 CFR Parts 404, 411, and 416 We propose to remove some of the requirements for evaluation of an unsuccessful work attempt (UWA) that lasts between 3 and 6 months. We also propose to allow previously entitled beneficiaries to apply for expedited reinstatement (EXR) in the same month they stop performing substantial gainful activity (SGA). Provisional benefits will begin the month after the request for EXR if the beneficiary stops performing SGA in the month of the EXR request. These changes would simplify our policies and make them easier for the public to understand.
GPO FDSys XML | Text type regulations.gov FR Doc. 2016-02267 RIN 0960-AH64 Docket No. SSA-2013-0061 SOCIAL SECURITY ADMINISTRATION Final rule. Effective Date: This final rule is effective February 5, 2016. 20 CFR Parts 404 and 416 This final rule adopts the notice of proposed rulemaking (NPRM) that we published in the Federal Register on October 21, 2015. This final rule revises our rules regarding returning evidence at the Appeals Council (AC) level. Under this final rule, the AC will no longer return additional evidence it receives when the AC determines the additional evidence does not relate to the period on or before the date of the administrative law judge (ALJ) decision.
GPO FDSys XML | Text type regulations.gov FR Doc. 2015-27692 RIN 0960-AH74 Docket No. SSA-2014-0081 SOCIAL SECURITY ADMINISTRATION Advance notice of proposed rulemaking; extension of the comment period. The comment period for the advanced notice of proposed rulemaking published on September 14, 2015 (80 FR 55050), is extended. To ensure that your written comments are considered, we must receive them on or before December 14, 2015. 20 CFR Parts 404 and 416 On September 14, 2015, we published in the Federal Register an advanced notice of proposed rulemaking (ANPRM) regarding Vocational Factors of Age, Education, and Work Experience in the Adult Disability Determination Process and solicited public comments. We provided a 60-day comment period ending on November 13, 2015. We are extending the comment period to December 14, 2015. Our extension of the comment date accommodates and facilitates public comments we expect in response to the National Disability Forum we are sponsoring on Friday, November 20, 2015. During the forum, we are hosting a moderator-led discussion entitled: The Realities of Work for Individuals with Disabilities: Impact of Age, Education, and Work Experience (for information on the forum see the SUPPLEMENTARY INFORMATION section).
GPO FDSys XML | Text type regulations.gov FR Doc. 2015-26747 RIN 0960-AH64 Docket No. SSA-2013-0061 SOCIAL SECURITY ADMINISTRATION Notice of proposed rulemaking (NPRM). To ensure that we consider your comments, we must receive them by no later than November 20, 2015. 20 CFR Parts 404 and 416 We propose to amend our regulations by revising our rules regarding the return of evidence at the Appeals Council (AC) level. Our current rules state that the AC will return to the claimant additional evidence it receives when the AC finds the evidence does not relate to the period on or before the date of the administrative law judge's (ALJ) hearing decision. We are proposing these revisions to give the AC discretion in returning additional evidence that it receives when the AC determines the additional evidence does not relate to the period on or before the date of the ALJ decision.
GPO FDSys XML | Text type regulations.gov FR Doc. 2015-26488 RIN 0960-AH77 Docket No. SSA-2015-0011 SOCIAL SECURITY ADMINISTRATION Final rule. This final rule is effective October 19, 2015. 20 CFR Parts 404 and 416 We are extending the expiration date of our rule that authorizes State agency disability examiners to make fully favorable determinations without the approval of a State agency medical or psychological consultant in claims that we consider under our quick disability determination (QDD) and compassionate allowance (CAL) processes. The current rule will expire on November 13, 2015. In this final rule, we are changing the November 13, 2015 expiration or “sunset” date to November 11, 2016, extending the authority for 1 year. We are making no other substantive changes.
GPO FDSys XML | Text type regulations.gov FR Doc. 2015-22839 RIN 0960-AH74 Docket No. SSA-2014-0081 SOCIAL SECURITY ADMINISTRATION Advance notice of proposed rulemaking. To be sure that we consider your comments, we must receive them no later than November 13, 2015. 20 CFR Part 404 and 416 We are soliciting public input about how we should consider the vocational factors of age, education, and work experience in adult disability claims under titles II and XVI of the Social Security Act (Act). There have been significant changes in technology use and workforce demographics since we first adopted our vocational factor regulations in 1978. We are requesting public comments, along with any supporting data, to assist in our efforts to streamline, simplify, and ensure the ongoing relevance of our disability determination programs.
GPO FDSys XML | Text type regulations.gov FR Doc. 2015-16397 RIN 0960-AH75 Docket No. SSA-2015-0010 SOCIAL SECURITY ADMINISTRATION Final rule. This final rule is effective July 2, 2015. 20 CFR Parts 404 and 416 We are extending for one year our pilot program that authorizes the agency to set the time and place for a hearing before an administrative law judge (ALJ). Extending of the pilot program continues our commitment to improve the efficiency of our hearing process and to maintain a hearing process that results in accurate, high-quality decisions for claimants. The current pilot program will expire on August 10, 2015. In this final rule, we are extending the effective date to August 12, 2016. We are making no other substantive changes.
GPO FDSys XML | Text type regulations.gov FR Doc. 2015-13768 RIN 0960-AH83 Docket No. SSA-2015-0017 SOCIAL SECURITY ADMINISTRATION Final rule. This final rule is effective June 5, 2015. 20 CFR Parts 404 and 416 We are extending for 2 years our rule authorizing attorney advisors to conduct certain prehearing procedures and to issue fully favorable decisions. The current rule will expire on August 7, 2015. In this final rule, we are extending the sunset date to August 4, 2017. We are making no other substantive changes.
GPO FDSys XML | Text type regulations.gov FR Doc. 2015-08185 RIN 0960-AG28 Docket No. SSA-2011-0081 SOCIAL SECURITY ADMINISTRATION, 20 CFR Parts 404 and 416 Final rule. This rule is effective June 12, 2015. 20 CFR Part 404 This rule adopts, with one change, the rule for evaluating growth disorders in children we proposed in a notice of proposed rulemaking (NPRM) published in the Federal Register on May 22, 2013. Several body systems in the Listing of Impairments (listings) contain listings for children based on impairment of linear growth or weight loss. We are replacing those listings with new listings for low birth weight (LBW) and failure to thrive; a new listing for genitourinary impairments; and revised listings for growth failure in combination with a respiratory, cardiovascular, digestive, or immune system disorder. These revisions reflect our program experience, advances in medical knowledge, and comments we received from medical experts and the public.
GPO FDSys XML | Text type regulations.gov FR Doc. 2015-05921 RIN 0960-AH53 Docket No. SSA-2012-0068 SOCIAL SECURITY ADMINISTRATION Final rule. This rule is effective April 20, 2015. 20 CFR Parts 404, 405, and 416 We are clarifying our regulations to require you to inform us about or submit all evidence known to you that relates to your disability claim, subject to two exceptions for certain privileged communications. This requirement includes the duty to submit all evidence that relates to your disability claim received from any source in its entirety, unless you previously submitted the same evidence to us or we instruct you otherwise. We are also requiring your representative to help you obtain the information or evidence that we require you to submit under our regulations. These modifications to our regulations will better describe your duty to submit all evidence that relates to your disability claim and enable us to have more complete case records on which to make more accurate disability determinations and decisions.
GPO FDSys XML | Text type regulations.gov FR Doc. 2014-30921 RIN 0960-AH21 Docket No. SSA-2010-0025 SOCIAL SECURITY ADMINISTRATION Final rules. These rules are effective February 5, 2015. 20 CFR Parts 404 and 416 We are adopting, with two revisions, our interim final rules that implemented amendments to the Social Security Act (Act) made by the Social Security Disability Applicants' Access to Professional Representation Act of 2010 (PRA). The interim final rules made permanent the direct fee payment rules for eligible non-attorney representatives under titles II and XVI of the Act and for attorney representatives under title XVI of the Act. They also revised some of our eligibility policies for non-attorney representatives under titles II and XVI of the Act. Based on public comment and subsequent inquiries, we are revising our rules to clarify that an eligible non-attorney representative's liability insurance policy must include malpractice coverage. We are also reaffirming that a business entity legally permitted to provide the required insurance in the States in which the non-attorney representative conducts business must underwrite the policies.
GPO FDSys XML | Text type regulations.gov FR Doc. 2014-20535 RIN 0960-AH69 Docket No. SSA-2014-0045 SOCIAL SECURITY ADMINISTRATION Final rule. This final rule is effective August 28, 2014. 20 CFR Parts 404 and 416 We are extending the expiration date of our rule that authorizes State agency disability examiners to make fully favorable determinations without the approval of a State agency medical or psychological consultant in claims that we consider under our quick disability determination (QDD) and compassionate allowance (CAL) processes. The current rule will expire on November 14, 2014. In this final rule, we are changing the November 14, 2014 expiration or “sunset” date to November 13, 2015, extending the authority for 1 year. We are making no other substantive changes.
GPO FDSys XML | Text type regulations.gov FR Doc. 2014-16782 RIN 0960-AH67 Docket No. SSA-2014-0034 SOCIAL SECURITY ADMINISTRATION Final rule. This final rule is effective July 18, 2014. 20 CFR Parts 404 and 416 We are extending for one year our pilot program that authorizes the agency to set the time and place for a hearing before an administrative law judge (ALJ). Extending the pilot program continues our commitment to improve the efficiency of our hearing process and provide accurate, high-quality decisions for claimants. The current pilot program will expire on August 9, 2014. In this final rule, we are extending the expiration date to August 10, 2015. We are making no other substantive changes.
GPO FDSys XML | Text type regulations.gov FR Doc. 2014-14914 RIN 0960-AH02 Docket No. SSA-2009-0027 SOCIAL SECURITY ADMINISTRATION Final rules. These final rules are effective June 26, 2014. 20 CFR Part 416 This final rule adopts, without change, the final rule with request for comments we published in the Federal Register (76 FR 41685) on July 15, 2011. We are revising our regulations to reflect our use of electronic case processing at the initial and reconsideration levels of our administrative review process. We are not changing the requirement that State agency medical and psychological consultants must affirm the accuracy and completeness of their findings of fact and discussion of the supporting evidence, only the manner in which they may provide the required findings and affirmation. This revision will improve our efficiency by increasing our use of electronic resources.
GPO FDSys XML | Text type regulations.gov FR Doc. 2014-14793 RIN 0960-AH37 Docket No. 2011-0056 SOCIAL SECURITY ADMINISTRATION Final rules. These final rules are effective July 25, 2014. 20 CFR Parts 404, 405, and 416 These final rules explain how a claimant may object to appearing at a hearing via video teleconferencing, or to the time and place of a hearing. These final rules adopt, with further clarification regarding our good cause exception, the notice of proposed rulemaking (NPRM) that we published in the Federal Register on June 27, 2013. We expect that these final rules will have a minimal impact on the public, help ensure the integrity of our programs, and allow us to administer our programs more efficiently.
GPO FDSys XML | Text type regulations.gov FR Doc. 2014-13802 RIN 0960-AH44 Docket No. SSA-2011-0099 SOCIAL SECURITY ADMINISTRATION Interim final rules with request for comments. Effective Date: This interim final rule is effective June 12, 2014. Comment Date: To ensure that your comments are considered, we must receive them no later than August 11, 2014. 20 CFR Parts 404 and 416 We are amending our regulations to state that we will obtain evidence from any appropriate source. Our current regulations provide that we will obtain information from “special arrangement sources” for those infrequent situations when we are in a better position than our State agency partners to obtain evidence. Due to improved evidence collection through our increased use of health information technology (health IT), we are obtaining evidence electronically with increasing frequency. We expect that, over time, the electronic exchange of medical records will become our primary means for obtaining medical evidence. As we increase our use of health IT, the designation of “special arrangement sources” will no longer adequately describe from whom we collect evidence.
GPO FDSys XML | Text type regulations.gov FR Doc. 2014-13803 RIN 0960-AH55 Docket No. SSA-2013-0005 SOCIAL SECURITY ADMINISTRATION Final rule; technical corrections. This rule is effective June 12, 2014. 20 CFR Parts 404 and 416 We are making technical corrections to several of our regulations. In some cases, we are correcting outdated cross-references in light of revisions we made to other rules. We are also revising the maximum dollar amount of overpayments subject to compromise based on other changes in the law, and we are adjusting the formula we use to calculate the maximum benefits payable in the first and second installment payments of large past-due benefits for the same reason. In addition, we are updating references to the coverage status of affected non-temporary employees of the government of the Commonwealth of the Northern Mariana Islands. These changes do not alter the substance of the regulations or effect the rights of claimants or any other parties. We expect that the changes will make our rules more internally consistent and make them easier to use.
GPO FDSys XML | Text type regulations.gov FR Doc. 2014-03426 RIN 0960-AH53 Docket No. SSA-2012-0068 SOCIAL SECURITY ADMINISTRATION Notice of proposed rulemaking (NPRM). To ensure that your comments are considered, we must receive them by no later than April 21, 2014. 20 CFR Parts 404, 405, and 416 We propose to clarify our regulations to require you to inform us about or submit all evidence known to you that relates to your disability claim, subject to two exceptions for certain privileged communications. This requirement would include the duty to submit all evidence obtained from any source in its entirety, unless subject to one of these exceptions. We also propose to require your representative to help you obtain the information or evidence that we would require you to submit under our regulations. These modifications to our regulations would better describe your duty to submit all evidence that relates to your disability claim and enable us to have a more complete case record on which to make more accurate disability determinations and decisions.
GPO FDSys XML | Text type regulations.gov FR Doc. 2013-28034 RIN 0960-AH45 Docket No. SSA-2011-0104 SOCIAL SECURITY ADMINISTRATION Notice of proposed rulemaking (NPRM). To ensure that your comments are considered, we must receive them no later than January 24, 2014. 20 CFR Part 416 We reimburse States that provide interim assistance to Supplemental Security Income (SSI) claimants under our interim assistance reimbursement (IAR) program. We provide this reimbursement from the SSI recipient's initial retroactive SSI payment. On November 20, 2010, we began using an electronic Interim Assistance Reimbursement system (eIAR) to streamline the way we process reimbursements to the States. The eIAR process replaced our prior paper-based process with an electronic one, and greatly reduced our and the State's involvement in manually processing IAR cases. This electronic system did not change the amount of payments we make to States and SSI recipients. We propose to revise our rules about how we administer the IAR process to reflect the electronic process. We also made minor language changes and reorganized the sections for clarity.
GPO FDSys XML | Text type regulations.gov FR Doc. 2013-26524 RIN 0960-AH59 Docket No. SSA-2013-0023 SOCIAL SECURITY ADMINISTRATION Final rule. This final rule is effective November 6, 2013. 20 CFR Parts 404 and 416 We are extending the expiration date of our rules that authorizes State agency disability examiners to make fully favorable determinations without the approval of a State agency medical or psychological consultant in claims that we consider under our quick disability determination (QDD) and compassionate allowance (CAL) processes. The current rules will expire on November 12, 2013. In this final rule, we are changing the November 12, 2013 expiration or “sunset” date to November 14, 2014, extending the authority for 1 year. We are making no other substantive changes, although we are making minor, nonsubstantive editorial changes to the rule for clarity.
GPO FDSys XML | Text type regulations.gov FR Doc. 2013-18552 RIN 0960-AH52 Docket No. SSA-2012-0066 SOCIAL SECURITY ADMINISTRATION Final rule. This final rule is effective September 3, 2013. 20 CFR Parts 404 and 416 This final rule adopts, without change, the notice of proposed rulemaking (NPRM) we published in the Federal Register on January 28, 2013. We are replacing 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 reflects the widespread adoption of the term “intellectual disability” by Congress, government agencies, and various public and private organizations.
GPO FDSys XML | Text type regulations.gov FR Doc. 2013-18360 RIN Docket No. SSA 2013-0011 SOCIAL SECURITY ADMINISTRATION Notice and request for comments. To ensure that your comments are considered, we must receive them no later than September 30, 2013. 20 CFR Parts 404 and 416 We are requesting information from the public regarding whether and how we should change our rules of administrative finality. These rules govern when we can reopen and revise a determination or decision that has become final and is no longer subject to administrative or judicial review. We are requesting information about several possible ways to change various aspects of our administrative finality rules. We are interested in obtaining information about issues such as whether and how we should revise the rules that govern the timeframes in which we can reopen a determination or decision, and whether and how we should revise the rules that govern the diligent pursuit of an investigation. We are also interested in obtaining information about whether we should adopt rules that would address our ability to make prospective changes to the amount of an individual's benefits without making changes for months in which the individual has already received payment. We are requesting your comments on several questions that we address below.
GPO FDSys XML | Text type regulations.gov FR Doc. 2013-18143 RIN 0960-AH58 Docket No. SSA-2013-0016 SOCIAL SECURITY ADMINISTRATION Final rule. This final rule is effective July 29, 2013. 20 CFR Parts 404 and 416 We are extending our pilot program that authorizes the agency to set the time and place for a hearing before an administrative law judge (ALJ). This final rule will extend the pilot program for 1 year. The extension of the pilot program continues our commitment to improve the efficiency of our hearing process and maintain a hearing process that results in accurate, high-quality decisions for claimants. The current pilot program will expire on August 9, 2013. In this final rule, we are extending the effective date to August 9, 2014. We are making no other substantive changes.
GPO FDSys XML | Text type regulations.gov FR Doc. 2013-18145 RIN 0960-AH56 Docket No. SSA-2013-0006 SOCIAL SECURITY ADMINISTRATION Final rule. This final rule is effective July 29, 2013. 20 CFR Parts 404 and 416 We are extending for 2 years our rule authorizing attorney advisors to conduct certain prehearing procedures and to issue fully favorable decisions. The current rule will expire on August 9, 2013. In this final rule, we are extending the sunset date to August 7, 2015. We are making no other substantive changes.
GPO FDSys XML | Text type regulations.gov FR Doc. 2013-14894 RIN 0960-AH37 Docket No. 2011-0056 SOCIAL SECURITY ADMINISTRATION Notice of proposed rulemaking. To ensure that your comments are considered, we must receive them no later than August 26, 2013. 20 CFR Parts 404, 405, and 416 We propose to revise our rules to protect the integrity of our programs and preserve limited resources. Prior to scheduling a hearing, we will notify the claimant that his or her hearing may be held by video teleconferencing. The claimant will have an opportunity to object to appearing by video teleconferencing within 30 days after the date he or she receives the notice. We also propose changes that allow us to determine that a claimant will appear via video teleconferencing if he or she changes residences while his or her request for hearing is pending, regardless of whether or not the claimant previously declined a hearing by video teleconferencing. Additionally, we propose changes that require a claimant to notify us, in writing, of an objection to the time and place of hearing at the earliest opportunity, but not later than 5 days before the date set for the hearing, or, if earlier, 30 days after receiving the notice of the hearing. We also propose to revise our rules so that an administrative law judge (ALJ) can direct a claimant and any other party to a hearing to appear by telephone in extraordinary circumstances. We anticipate that these proposed changes will have a minimal impact on the public, and will help ensure the integrity of our programs and allow us to administer our programs more efficiently.
GPO FDSys XML | Text type regulations.gov FR Doc. 2013-12567 RIN 3206-AM17 DEPARTMENT OF THE TREASURY, SOCIAL SECURITY ADMINISTRATION, DEPARTMENT OF VETERANS AFFAIRS, RAILROAD RETIREMENT BOARD, OFFICE OF PERSONNEL MANAGEMENT, Fiscal Service Final rule. This final rule is effective June 28, 2013. 5 CFR Parts 831, 841 Treasury, SSA, VA, RRB and OPM (Agencies) are adopting as final an interim rule to amend their regulation governing the garnishment of certain Federal benefit payments that are directly deposited to accounts at financial institutions. The rule establishes procedures that financial institutions must follow when they receive a garnishment order against an account holder who receives certain types of Federal benefit payments by direct deposit. The rule requires financial institutions that receive such a garnishment order to determine the sum of such Federal benefit payments deposited to the account during a two month period, and to ensure that the account holder has access to an amount equal to that sum or to the current balance of the account, whichever is lower.
GPO FDSys XML | Text type regulations.gov FR Doc. 2013-11601 RIN 0960-AG28 Docket No. SSA-2011-0081 SOCIAL SECURITY ADMINISTRATION Notice of proposed rulemaking. To ensure that your comments are considered, we must receive them by no later than July 22, 2013. 20 CFR Parts 404 and 416 Several body systems in our Listing of Impairments (listings) contain listings for children based on impairment of linear growth or weight loss. We propose to replace those listings with new listings, add a listing to the genitourinary body system for children, and provide new introductory text for each listing explaining how to apply the new criteria. The proposed revisions to our listings reflect our program experience, advances in medical knowledge, comments we received from medical experts and the public at an outreach policy conference, and comments we received in response to a notice of intent to issue regulations and request for comments (request for comments) and an advance notice of proposed rulemaking (ANPRM). We are also proposing conforming changes in our regulations for title XVI of the Social Security Act (Act).
GPO FDSys XML | Text type regulations.gov FR Doc. 2013-11932 RIN 0960-AH40 Docket No. SSA 2007-0044 SOCIAL SECURITY ADMINISTRATION Final rule. This rule is effective June 20, 2013. 20 CFR Parts 404, 405, and 416 This final rule is another step in our continual efforts to handle workloads more effectively and efficiently. We are publishing final rules for portions of the rules we proposed in October 2007 that relate to persons, other than the claimant or any other party to the hearing, appearing by telephone. We are also clarifying that the administrative law judge (ALJ) will allow the claimant or any other party to a hearing to appear by telephone under certain circumstances when the claimant or other party requests to make his or her appearance in that manner. We expect that these final rules will make the hearings process more efficient and help us continue to reduce the hearings backlog. In addition, we made some minor editorial changes to our regulations that do not have any effect on the rights of claimants or any other parties.
GPO FDSys XML | Text 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 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).
GPO FDSys XML | Text 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 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.
GPO FDSys XML | Text 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 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.
GPO FDSys XML | Text type regulations.gov FR Doc. 2012-7684 RIN 0960-AG12 Docket No. SSA 2006-0173 SOCIAL SECURITY ADMINISTRATION Proposed rules; withdrawal. The proposed rules identified in this document are withdrawn as of March 30, 2012. 20 CFR Parts 404 and 416 We are withdrawing the proposed rules we published in the Federal Register on December 5, 2005.
GPO FDSys XML | Text type regulations.gov FR Doc. 2012-5673 RIN Docket No. SSA-2011-0094 SOCIAL SECURITY ADMINISTRATION Revised notification of implementation of requirement. The effective date of this revised notification of implementation of requirement is March 16, 2012. 20 CFR Parts 404 and 416 We are revising the Notification of implementation of requirement we published on January 31, 2012 (77 FR 4653). We are clarifying the requirement that appointed representatives file certain appeals using our electronic systems in matters for which the representatives request direct fee payment. Specifically, we are clarifying that the electronic filing requirement includes both the submission of the forms we require to file the appeal request and the Disability Report—Appeal. This is the first service required under the regulation we published on September 12, 2011 (76 FR 56107), Requiring Use of Electronic Services.
GPO FDSys XML | Text type regulations.gov FR Doc. 2012-4177 RIN 0960-AG89 Docket No. SSA 2010-0044 SOCIAL SECURITY ADMINISTRATION Final rule. These rules are effective March 26, 2012. 20 CFR Parts 404 and 416 We are modifying the requirement to recontact your medical source(s) first when we need to resolve an inconsistency or insufficiency in the evidence he or she provided. Depending on the nature of the inconsistency or insufficiency, there may be other, more appropriate sources from whom we could obtain the information we need. By giving adjudicators more flexibility in determining how best to obtain this information, we will be able to make a determination or decision on disability claims more quickly and efficiently in certain situations. Eventually, our need to recontact your medical source(s) in many situations will be significantly reduced as a result of our efforts to improve the evidence collection process through the increased use of Health Information Technology (HIT).
GPO FDSys XML | Text type regulations.gov FR Doc. 2012-4178 RIN 0960-AH29 Docket No. SSA-2011-0008 SOCIAL SECURITY ADMINISTRATION Final rule. These final rules are effective February 23, 2012. 20 CFR Parts 404 and 416 We are clarifying our regulations to ensure the safety of the public and our employees in our hearing process. Due to increasing reports of threats to our hearing office employees, we are taking steps to explicitly increase the level of protection we provide to our staff and to the public during the hearing process. We expect these changes to result in a safer work environment for our employees, while at the same time ensuring that our claimants continue to receive a full and fair hearing on their claims for benefits.