Title 20--EMPLOYEES' BENEFITS
Chapter III--SOCIAL SECURITY ADMINISTRATION


Page 400 [Reserved] 401 Privacy...


governed by this part. SSA employees governed by this part include all regular and special government employees of SSA; experts and consultants whose temporary...


(a) Make available to an individual records which are not retrieved by that individual's name or other personal identifier. (b) Make available to the general public...


SSA's rules for implementing the Privacy Act, apply to all agency records accessed by an individual's name or personal identifier subject to the Privacy Act. ...


subject individual. Act means the Social Security Act. Agency means the Social Security Administration. Commissioner means the Commissioner of Social Security. ...


to protect the privacy of individuals to the fullest extent possible while nonetheless permitting the exchange of records required to fulfill our administrative and...


right to direct access to most records about yourself that are in our systems of records. Exceptions to this Privacy Act right include-- (a) Special procedures for access...


access. Subject to the provisions governing medical records in Sec. 401.55, you may ask for notification of or access to any record about yourself that is in an SSA system...


making a request for notification of or access to a record in person, and you are personally known to the SSA representative, you must verify your identity in accordance...


to the provisions governing medical records in Sec. 401.55 and the provisions governing exempt systems in Sec. 401.85, upon receipt of your request for notification of...


(a) General. In general, you have a right to notification of or access to your medical records, including psychological records, as well as to other...


When information about two or more individuals is in one record filed under your social security number, you may receive the information about you and the fact...


section applies to all records kept by SSA (as described in Sec. 401.5) except for records of earnings. (20 CFR 422.125 describes how to request correction of...


are covered. This section describes how to appeal a decision made under the Privacy Act concerning your request for correction of a record or for access to your...


this part, a parent or guardian of any minor or the legal guardian of any individual who has [[Page 13]] been declared incompetent due to physical or mental incapacity...


all disclosures of a record for five years or for the life of the record, whichever is longer; except that, we will not make accounting for: (1) Disclosures...


certain types of specific systems of records to be exempt from some of its requirements. Our policy is to exercise authority to exempt systems of records only in...


maintain, or on behalf of SSA to maintain, a system of records to accomplish an SSA function must contain a provision requiring the contractor to comply with the Privacy Act...


for copying records in accordance with the schedule set forth in this section. We may only charge fees where you request that a copy be made of the record to which you are...


the record. (a) Except as permitted by the Privacy Act and the regulations in this chapter, or if required by the FOIA, we will not disclose your...


the subject of the record. (a) SSA maintains two categories of records which contain personal information: (1) Nonprogram records, primarily administrative...


without the consent of the subject of the record. The disclosures listed in this section may be made from our nonprogram records, e.g., administrative and...


the consent of the subject of the record. This section describes how various laws control the disclosure or confidentiality of personal information which we...


when a law specifically requires it. The Social Security Act requires us to disclose information for certain program purposes. These include disclosures to the SSA Office...


disclose information when a law specifically prohibits it. The Internal Revenue Code generally prohibits us from disclosing tax return information which we receive to...


us to disclose any information in our records upon request from the public, unless one of several exemptions in the FOIA applies. When the FOIA requires disclosure (see part...


may not disclose any personal information unless both the Privacy Act and section 1106 of the Social Security Act permit the disclosure. Section 1106 of the Social Security...


or prohibiting disclosure applies to a question of whether to disclose information, we follow FOIA principles to resolve that question. We do this to insure...


(a) The FOIA does not authorize us to impose any restrictions on how information is used after we disclose it under that law. In applying FOIA principles, we...


Privacy Act allows us to disclose information, without the consent of the individual, to any other party for routine uses. (b) Routine use. We publish notices of systems...


Privacy Act allows us to disclose information for law enforcement purposes under certain conditions. Much of the information in our files is especially sensitive or very...


to disclose information in compelling circumstances where an individual's health or safety is affected. For example, if we learn that someone has been exposed to an...


(a) General. Statistical and research activities often do not require information in a format that identifies specific individuals. Therefore, whenever possible, we release...


either House of Congress. We also disclose information to any committee or subcommittee of either House, or to any joint committee of Congress or subcommittee of that committee,...


[Code of Federal Regulations] [Title 20, Volume 2] [Revised as of April 1, 2004] From the U.S. Government Printing Office via GPO Access [CITE: 20CFR401.175] [Page 19] TITLE 20--EMPLOYEES' BENEFITS CHAPTER III--SOCIAL SECURITY ADMINISTRATION PART 401_PRIVACY AND DISCLOSURE OF OFFICIAL RECORDS AND INFORMATION--Table of Contents Subpart C_Disclosure of Official Records and Information Sec. 401.175 General Accounting Office. We disclose information to the General Accounting Office when that agency needs the information to carry out its duties. ...


us to disclose information when we receive an order from a court of competent jurisdiction. However, much of our information is especially sensitive. Participation in...


disclosures we make under the routine use provision, we also release information to-- (a) The Bureau of the Census for purposes of planning or carrying out a census, survey,...


disclosure of information about a deceased person to be a clearly unwarranted invasion of [[Page 20]] that person's privacy. However, in disclosing information about...


If no other provision in this part specifically allows SSA to disclose information, the Commissioner or designee may disclose this information if not prohibited by Federal law....


will enter into arrangements with State agencies under which we will furnish to them at their request the last known personal mailing addresses (residence or post office box)...


the Privacy Act of 1974. 402.20 Requests not handled under the FOIA. 402.25 Referral of requests outside of SSA. 402.30 Definitions. 402.35 Publication. 402.40...


public access to information in the possession of SSA, but also protect the [[Page 25]] integrity of internal processes. In addition, we recognize the...


records. The Privacy Act, 5 U.S.C. 552a, applies to records that are about individuals, but only if the records are in a system of records. ``Individuals'' and ``system...


to the extent it asks for records that are currently available, either from SSA or from another part of the Federal Government, under a separate statute that provides...


and if that agency asserts control over the records, we may refer the records and your request to that agency. We may likewise refer requests for classified records to...


government controlled corporation, or other establishment in the executive branch of the Federal Government, or any independent regulatory agency. A private organization...


(a)(1) and (a)(2), we publish in one of the following ways: (1) By publication in the Federal Register of Social Security Administration regulations, and by their...


and procedures of the Social Security Administration may be purchased from the Superintendent of Documents, Government Printing Office, Washington, DC...


see, and get a copy of, any Federal agency's records unless the material is exempt from mandatory disclosure as described in Sec. 402.70 of this part. (b) FOIA. Under the...


instructions to staff personnel which contain policies, procedures, or interpretations that affect the public are available for inspection and copying. A complete listing of...


will be made available for inspection at the district offices and branch offices: (1) Compilation of the Social Security Laws. (2) Social Security...


are available [[Page 29]] for inspection in the field offices of the Office of Hearings and Appeals: (1) Regulations of the Social...


[Code of Federal Regulations] [Title 20, Volume 2] [Revised as of April 1, 2004] From the U.S. Government Printing Office via GPO Access [CITE: 20CFR402.65] [Page 29] TITLE 20--EMPLOYEES' BENEFITS CHAPTER III--SOCIAL SECURITY ADMINISTRATION PART 402_AVAILABILITY OF INFORMATION AND RECORDS TO THE PUBLIC--Table of Contents Sec. 402.65 Health care information. We have some information about health care programs under titles XVIII and XIX (Medicare and Medicaid) of the Social Security Act. We follow the rules in 42 CFR part 401 in determining whether to provide any portion of it to a requester. ...


mandatory disclosure of records. We describe these exemptions in Sec. Sec. 402.75 through 402.110 of this part and explain how we apply them to disclosure determinations. (In...


as provided by FOIA, are ``(a) specifically authorized under criteria established by an Executive Order to be kept secret in the interest of national defense or foreign...


are ``related solely to the internal personnel rules and practices of an agency.'' Under this exemption, we may withhold routine internal agency practices and procedures....


another statute specifically allows or requires us to withhold them. We may use another statute to justify withholding only if it absolutely prohibits disclosure or if it...


withhold trade secrets and commercial or financial information that is obtained from a person and is privileged or confidential. (a) Trade secrets. A trade secret is a...


notes that fall within a generally recognized evidentiary privilege. Internal government communications include an agency's communications with an outside consultant or...


if disclosure would constitute a clearly unwarranted invasion of their personal privacy. (b) Balancing test. In deciding whether to release records to you...


government has compiled for law enforcement purposes. The records may apply to actual or potential violations of either criminal or civil laws or regulations. We can...


permits us to withhold records about regulation or supervision of financial institutions. Exemption nine permits the withholding of geological and geophysical information and...


of Public Disclosure, Office of the General Counsel, SSA, or her or his designee may determine whether to release any record in SSA's control and possession. This official...


extent practicable, and in the future, we will attempt to provide access for requests by telephone, fax, Internet, and e-mail. Any request should reasonably describe the record...


Public Disclosure, Office of the General Counsel, Social Security Administration, 6401 Security Boulevard, Baltimore, Maryland 21235. [62 FR 4154, Jan. 29, 1997, as amended...


will be provided within 20 days (excepting Saturdays, Sundays, and legal public holidays) after receipt of a request by the appropriate official (see Sec. 402.135). This...


in our possession or we can retrieve them from storage. We will make reasonable efforts to search for records manually or by automated means, including any information stored in...


the past, we will ordinarily release it to you also. However, we will not release it to you if a statute forbids this disclosure, and we will not necessarily release it to you if...


the type of fees that we will generally charge. However, for each of these categories, the fees may be limited, waived, or reduced for the reasons given below or for...


or even if we do not find any records at all. (b) If we are not charging you for the first two hours of search time, under paragraph (c) of Sec. 402.155, and those...


(a) Manual searching for or reviewing of records. When the search or review is performed by employees at grade GS-1 through GS-8, we will charge an hourly rate based on the salary...


(a) Program purposes described. (1) We consider a request to be program related if the information must be disclosed under the Social Security Act. For example,...


Social Security Act permits the Commissioner to require requesters of information to pay the full cost of supplying the information where the information is requested to...


us a request, you agree to pay for the services needed to locate and send that record to you. You may specify in your request a limit on the amount you are willing to spend....


if disclosure of the information meets both tests which are explained in paragraphs (b) and (c) of this section: (1) It is in the public interest because it is likely...


Office of the General Counsel, SSA, or her or his designee is authorized to deny a written request to obtain, inspect, or copy any social security record. [62...


for the Office of Public Disclosure, Office of the General Counsel (or designee) has not previously made a determination to release the record you want, we will tell...


denied, you may request that the Commissioner of Social Security, 6401 Security Boulevard, Baltimore, MD 21235 review that determination. Your request for review: ...


in whole or in part, you may ask a U.S. District Court to review that denial. See 5 U.S.C. 552(a)(4)(B). If we fail to act on your request for a record or for review of a...


can an SSA employee testify or produce information or records in legal proceedings? 403.105 What is the relationship between this part...


General. Disclosure of SSA's records and information contained in those records is governed by the regulations at 20 CFR parts 401 and 402. SSA employees will not disclose records...


(a) Application means a written request for testimony that conforms to the requirements of Sec. 403.120. (b)(1) Employee includes-- (i) Any person employed in any...


part applies to any request in connection with any legal proceeding for SSA records or other information or for testimony from SSA or its employees. This part applies...


an SSA employee. Your application must- (1) Describe in detail the nature and relevance of the testimony sought in the legal proceeding; (2) Include a...


the Inspector General? A request for records or information of the Office of the Inspector General or the testimony of an employee of the Office of the Inspector...


for testimony? In deciding whether to authorize the testimony of an SSA employee, the Commissioner will consider applicable law and factors relating to your...


permit disclosure of information about which you seek testimony from an SSA employee, we will notify you under Sec. 403.145. (b) If 20 CFR part 401 or 402 permits...


The employee's testimony must be limited to matters that were specifically approved. We will provide testimony in the form that is least burdensome to SSA unless...


or 402? (a) We will provide the following information, as appropriate, to you or the court or other tribunal conducting the legal proceeding if your request states that...


you must pay fees for our services in providing information, records, or testimony. You must pay [[Page 45]] the fees as prescribed by the Commissioner....


pursuant to 20 CFR parts 401 and 402, and this part. We will provide this service only in response to your written request. If we certify, we will do so at the time of...


pursuant to 20 CFR parts 401 and 402, and this part. We will provide this service only in response to your written request. If we certify, we will do so at the time of...
...


(a) Terms relating to the Act and regulations. (1) The Act means the Social Security Act, as amended (42 U.S.C. Chapter 7). (2) Section means a section of the regulations in part...


The cross references in the regulations in this part 404 to other portions of the regulations, when the word see is used, are made only for convenience and shall be...


213, 214, 216, 217, 223, and 702(a)(5) of the Social Security Act (42 U.S.C. 405(a), 412, 413, 414, 416, 417, 423, and 902(a)(5)). Source: 45 FR 25384, Apr. 15,...


Act means the Social Security Act, as amended. Age means how many years old you are. You reach a particular age on the day before your birthday. For example, if...


(a) General. We describe how we determine the number of quarters of coverage (QCs) you need to be fully insured in paragraphs (b), (c), and (d) of this section. The table in...


II active military or naval service. We consider that a person, who was not otherwise fully insured, died fully insured if-- (a) The person was in the...


to be fully insured. If you are age 55 or over on January 1, 1984, and are on that date an employee of an organization described in Sec. 404.1025(a)...


to be fully insured. (a) General. You may use the following table to determine the number of quarters of coverage (QCs) you need to be fully insured under...


(a) What the period is for determining currently insured status. You are currently insured if you have at least 6 quarters of coverage (QCs) during the 13-quarter period ending...


(a) General. We have four different rules for determining if you are insured for purposes of establishing a period of disability or becoming entitled to disability...


(a) For a period of disability. To establish a period of disability, you must have disability insured status in the quarter in which you become disabled or in a later quarter...


disability or disability insurance benefits. In determining if you are fully insured for purposes of paragraph (b), (c), (d), or (e) of Sec. 404.130 on disability...


to establish a period of disability. For purposes of establishing a period of disability only, we give you quarters of coverage (QCs) for your military...


quarter of coverage (QC) is the basic unit of social security coverage used in determining a worker's insured status. We credit you with QCs based on your earnings covered...


before 1978. (a) General. The rules in this section tell how we credit calendar quarters as quarters of coverage (QCs) for calendar years before 1978. We credit...


taxable years beginning before 1978. In crediting quarters of coverage under Sec. 404.141(b)(2), we credit any self-employment income you derived during a...


1977. (a) Crediting quarters of coverage (QCs). For calendar years after 1977, we credit you with a QC for each part of the total wages paid and...


for taxable years beginning after 1977. In crediting quarters of coverage under Sec. 404.143(a), we credit self-employment income you derived during a taxable year...


If we credit you with a quarter of coverage (QC) for a calendar quarter under paragraph (b), (c), or (d) of Sec. 404.141 for calendar years before 1978 or assign it to a specific...


This section applies when we credit you with quarters of coverage (QCs) under Sec. 404.141 for calendar years before 1978 and under Sec. 404.143 for calendar years...


202(a), 205(a), 215, and 702(a)(5) of the Social Security Act (42 U.S.C. 402(a), 405(a), 415, and 902(a)(5)). Source: 47 FR 30734, July 15, 1982, unless...


This subpart is related to several others. In subpart B of this part, we describe how you become insured for social security benefits as a result of your work in covered employment....


in this subpart-- Ad hoc increase in primary insurance amounts means an increase in primary insurance amounts enacted by the Congress and signed into law by...


(a) General. We compute most workers' primary insurance amounts under one of two major methods. There are, in addition, several special methods of computing...


(a) Who is eligible for this method. If after 1978, you reach age 62, or become disabled or die before age 62, we will compute your primary insurance amount under...


(a) General. In this method, your social security earnings after 1950 are indexed, as described in paragraph (d) of this section, then averaged over the period of time you...


indexed monthly earnings. (a) General. We compute your primary insurance amount under the average-indexed-monthly-earnings method by applying a benefit formula...


your noncovered employment. (a) When applicable. Except as provided in paragraph (d) of this section, we will modify the formula prescribed in Sec. 404.212 and...


for this method. You must before 1979, reach age 62, become disabled or die to be eligible for us to compute your primary insurance amount under the average-monthly-wage...


General. Under the average-monthly-wage method, your social security earnings are averaged over the length of time you can reasonably have been expected to have worked under...


from your average monthly wage. (a) General. We find your primary insurance amount under the average-monthly-wage method in the benefit table in appendix III. ...


reach age 62 after 1978 but before 1984, we compute your primary insurance amount under a modified average-monthly- wage method as a guaranteed alternative to your primary...


guaranteed alternative--general. If you reach age 62 after 1978 but before 1984, we follow three major steps in finding your guaranteed alternative: (a)...


(a) General. With the exception described in paragraph (b) of this section, we follow the rules in Sec. 404.221 to compute your average monthly...


after age 62. (a) If you do not become entitled to benefits at the time you reach age 62, we adjust the guaranteed alternative computed for you under...


or substantially all your social security earnings before 1951, your primary insurance amount computed under the ``1977 simplified old-start'' method may be higher than any...


is qualified. To qualify for the old-start computation, you must meet the conditions in paragraphs (a) (1), (2), or (3) of this section: (1) You must-- (i) Have...


If your primary insurance amount as computed under the old-start method is higher than your primary insurance amount computed under...


noncovered employment. The provisions of Sec. 404.213 are applicable to computations under the old-start method, except for paragraphs (c) (1) and (2) and (d)...


disability. If you were disabled at some time in your life, received disability insurance benefits, and those benefits were terminated because you recovered from...


entitlement to disability benefits ended. (a) Disability before 1979; second entitlement after 1978. In this situation, we compute your second-entitlement...


entitlement to disability benefits ended. In this situation, we compute your second-entitlement primary insurance amount by selecting the higher of the...


Regardless of the method we use to compute your primary insurance amount, if the special minimum primary insurance amount described in Sec. 404.261 is higher, then your benefits...


(a) Years of coverage. (1) The first step in computing your special minimum primary insurance amount is to find the number of your years of coverage, which is the...


may be automatically increased each December so it keeps up with rises in the cost of living. These automatic increases also apply to other benefit amounts, as described...


Besides increases in the primary insurance amounts of current beneficiaries, automatic cost-of-living increases also apply to-- (a) The benefits of certain uninsured people age...


(a) The bases. To measure increases in the cost-of-living for annual automatic increase purposes, we use either: (1) The revised Consumer Price Index (CPI) for...


We make automatic cost-of-living increases if the applicable index, either the CPI or the AWI, rises by 3.0 percent or more over a specified measuring period (see the...


(a) General. Depending on the OASDI fund ratio, we measure the rise in one index or in both indexes during the applicable measuring period (described in paragraphs (b) and (c) of...


(a) Based on CPI. When the average of the CPI for the three months of the quarter ending the measuring period is at least 3.0 percent higher than the average of the CPI for the...


determine that an automatic cost-of-living increase is due, we publish in the Federal Register within 45 days of the end of the measuring period used in finding the amount of...


because of cost-of-living adjustments? (a) What is the frozen minimum primary insurance amount (PIA)? The frozen minimum is a minimum PIA for certain workers...


In addition to the cost-of-living increase explained in Sec. 404.275 for a given year, we will further increase the amounts in Sec. 404.271 if-- (1) The OASDI fund...


become entitled to benefits, we will recompute your primary insurance amount. Usually we will recompute only if doing so will increase your primary insurance amount....


(a) Earnings not included in earlier computation or recomputation. The most common reason for recomputing your primary insurance amount is to include earnings of yours...


effective beginning with January of the calendar year after the year in which the additional earnings used in the recomputation were paid. However, a recomputation...


primary insurance amount. In some cases, we may recompute your primary insurance amount under a computation method different from the method used in the...


or die before age 62 after 1978. (a) General. Years of your earnings after 1978 not used in the computation of your primary insurance amount (or in...


year, we examine the earnings record of every retired, disabled, and deceased worker to see if the worker's primary insurance amount may be recomputed under any of the methods we...


You may request that your primary insurance amount be recomputed sooner than it would be recomputed automatically. To do so, you must make [[Page 95]] the request...


would be disadvantaged in some way by a recomputation of your primary insurance amount, or you and every member of your family do not want your primary insurance amount to...


on noncovered employment. (a) After entitlement to old-age or disability insurance benefits. If you first become eligible for old-age or disability...


on noncovered employment. (a) After entitlement to old-age or disability insurance benefits. If you first become eligible for old-age or disability...
...


Introduction. Authority: Secs. 202, 203 (a) and (b), 205(a), 216, 223, 225, 228(a)-(e), and 702(a)(5) of the Social Security Act (42 U.S.C. 402, 403 (a) and...


Other regulations related to this subpart. This subpart is related to several others. Subpart H sets out what evidence you need to prove you qualify for...


Definitions. As used in this subpart: Apply means to sign a form or statement that the Social Security Administration accepts as an application for...


404.304 What are the general rules on benefit amounts? This subpart describes how we determine the highest monthly benefit amount you ordinarily could qualify for...


When you may not be entitled to benefits. In addition to the situations described in Sec. 404.304 when you may not receive a benefit payment, there are...


When am I entitled to old-age benefits? We will find you entitled to old-age benefits if you meet the following three conditions: (a) You are at least...


When does my entitlement to old-age benefits begin and end? (a) We will find you entitled to old-age benefits beginning with: (1) If you have attained...


How is my old-age benefit amount calculated? (a) If your old-age benefits begin in the month you attain full retirement age (as defined in Sec. 404.409), your...


404.313 What are delayed retirement credits and how do they increase my old-age benefit amount? (a) What are delayed retirement credits and how do I earn...


Who is entitled to disability benefits? (a) General. You are entitled to disability benefits while disabled before attaining full retirement age as defined in...


404.316 When entitlement to disability benefits begins and ends. (a) You are entitled to disability benefits beginning with the first month covered by your application...


How is the amount of my disability benefit calculated? Your monthly benefit is equal to the primary insurance amount (PIA). This amount is computed under the rules...


404.320 Who is entitled to a period of disability. (a) General. A period of disability is a continuous period of time during which [[Page 114]] you...


When a period of disability begins and ends. (a) When a period of disability begins. Your period of disability begins on the day your disability begins if you...


404.322 When you may apply for a period of disability after a delay due to a physical or mental condition. If because of a physical or mental condition you did not...


The termination month. If you do not have a disabling impairment, your termination month is the third month following the month in which your impairment is...


Who is entitled to wife's or husband's benefits. You are entitled to benefits as the wife or husband of an insured person who is entitled to old-age or...


Who is entitled to wife's or husband's benefits as a divorced spouse. You are entitled to wife's or husband's benefits as the divorced wife or divorced...


404.332 When wife's and husband's benefits begin and end. (a) You are entitled to wife's or husband's benefits beginning with the first month covered by your...


Wife's and husband's benefit amounts. Your wife's or husband's monthly benefit is equal to one-half the insured person's primary insurance amount. If you are...


404.335 How do I become entitled to widow's or widower's benefits? We will find you entitled to benefits as the widow or widower of a person who died fully insured if...


404.336 How do I become entitled to widow's or widower's benefits as a surviving divorced spouse? We will find you entitled to widow's or widower's benefits as...


404.337 When does my entitlement to widow's and widower's benefits start and end? (a) We will find you entitled to widow's or widower's benefits under Sec....


How is the amount of my widow's or widower's benefit calculated? Your widow's or widower's monthly benefit is equal to the insured person's primary...


404.339 Who is entitled to mother's or father's benefits. You may be entitled as the widow or widower to mother's or father's benefits on the earnings record of...


Who is entitled to mother's or father's benefits as a surviving divorced spouse. You may be entitled to mother's or father's benefits as the suviving...


When mother's and father's benefits begin and end. (a) You are entitled to mother's or father's benefits beginning with the first month covered by your application...


Mother's and father's benefit amounts. Your mother's or father's monthly benefit is equal to 75 percent of the insured person's primary insurance amount. The...


Your relationship by marriage to the insured. You may be eligible for benefits if you are related to the insured person as a wife, husband, widow, or widower....


Your relationship as wife, husband, widow, or widower under State law. To decide your relationship as the insured's wife or husband, we look to the laws of...


Your relationship as wife, husband, widow, or widower based upon a deemed valid marriage. (a) General. If your relationship as the insured's wife,...


404.347 ``Living in the same household'' defined. Living in the same household means that you and the insured customarily lived together as husband and wife in the...


When a child living with you is ``in your care''. To become entitled to wife's benefits before you become 62 years old or to mother's or father's benefits, you...


404.349 When a child living apart from you is ``in your care''. (a) In your care. A child living apart from you is in your care if-- (1) The child lived apart from...


Who is entitled to child's benefits. (a) General. You are entitled to child's benefits on the earnings record of an insured person who is entitled to old-age...


Who may be reentitled to child's benefits. If your entitlement to child's benefits has ended, you may be reentitled on the same earnings record if you have...


404.352 When does my entitlement to child's benefits begin and end? (a) We will find your entitlement to child's benefits begins at the following times: (1)...


Child's benefit amounts. (a) General. Your child's monthly benefit is equal to one-half of the insured person's primary insurance amount if he or she is alive...


Your relationship to the insured. You may be related to the insured person in one of several ways and be entitled to benefits as his or her child, i.e., as a...


404.355 Who is the insured's natural child? (a) Eligibility as a natural child. You may be eligible for benefits as the insured's natural child if any of the...


Who is the insured's legally adopted child. You may be eligible for benefits as the insured's child if you were legally adopted by the insured. If you were...


404.357 Who is the insured's stepchild. You may be eligible for benefits as the insured's stepchild if, after your birth, your natural or adopting parent married...


Who is the insured's grandchild or stepgrandchild. (a) Grandchild and stepgrandchild defined. You may be eligible for benefits as the insured's grandchild...


Who is the insured's equitably adopted child. You may be eligible for benefits as an equitably adopted child if the insured had agreed to adopt you as his or...


When a child is dependent upon the insured person. One of the requirements for entitlement to child's benefits is that you be dependent upon the insured. The...


When a natural child is dependent. (a) Dependency of natural child. If you are the insured's natural child, as defined in Sec. 404.355, you are considered...


404.362 When a legally adopted child is dependent. (a) General. If you were legally adopted by the insured before he or she became entitled to old-age or...


When a stepchild is dependent. If you are the insured's stepchild, as defined in Sec. 404.357, you are considered dependent upon him or her if you were either...


When a grandchild or step grand child is dependent. If you are the insured's grandchild or stepgrandchild, as defined in Sec. 404.358(a), you are considered...


When an equitably adopted child is dependent. If you are the insured's equitably adopted child, as defined in Sec. 404.359, you are considered dependent upon him...


404.366 ``Contributions for support,'' ``one-half support,'' and ``living with'' the insured defined--determining first month of entitlement. To be eligible for...


404.367 When you are a ``full-time elementary or secondary school student''. You may be eligible for child's benefits if you are a full-time elementary or...


When you are considered a full-time student during a period of nonattendance. If you are a full-time student, your eligibility may continue during a period...


Who is entitled to parent's benefits. You may be entitled to parent's benefits on the earnings record of someone who has died and was fully insured. You are...


404.371 When parent's benefits begin and end. (a) You are entitled to parent's benefits beginning with the first month covered by your application in which you meet...


Parent's benefit amounts. Your parent's monthly benefit before any reduction that may be made as explained in Sec. 404.304, is figured in one of the...


Parent's relationship to the insured. You may be eligible for benefits as the insured person's parent if-- (a) You are the mother or father of the insured...


General. Some older persons had little or no chance to become fully insured for regular social security benefits during their working years. For those who...


Who is entitled to special age 72 payments. You are entitled to a special age 72 payment if-- (a) You have attained the age of 72; and (1) You...


When special age 72 payments begin and end. (a) Your entitlement to the special age 72 payment begins with the first month covered by your application in which...


404.383 Special age 72 payment amounts. (a) Payment from May 1983 on. If you are entitled to special age 72 payments from May 1983 on, you will receive a monthly...


Reductions, suspensions, and nonpayments of special age 72 payments. (a) General. Special age 72 payments may not be paid for any month you receive...


404.390 General. If a person is fully or currently insured when he or she dies, a lump-sum death payment of $255 may be paid to the widow or widower of the...


Who is entitled to the lump-sum death payment as a widow or widower who was living in the same household. You are entitled to the lump-sum death payment as a widow...


Who is entitled to the lump-sum death payment when there is no widow(er) who was living in the same household. (a) General. If the insured individual is not...


benefits or lump-sum death payments. Authority: Secs. 202, 203, 204(a) and (e), 205(a) and (c), 216(l), 223(e), 224, 225, 702(a)(5), 1129A and 1147 of the...


disability beneficiary's work activity. If you are receiving benefits because you are disabled or blind as defined in title II of the Social Security Act, we will stop...


and nonpayment of benefits. (a) Deductions, reductions, adjustment. Deductions because of earnings or work (see Sec. Sec. 404.415 and 404.417); failure...


family benefits payable. (a) General. (1) The Social Security Act limits the amount of monthly benefits that can be paid for any month based on the earnings...


and other persons entitled on his earnings record. If a reduction of monthly benefits is required under the provisions of Sec. 404.403, the monthly benefit...


because of ``savings clause.'' The following provisions are savings clauses and describe exceptions to the rules concerning the maximum amount payable on...


of application for monthly benefits. Under the provisions described in Sec. 404.403, beginning with the month in which a person files an application and...


(a) Entitlement to old-age or disability insurance benefit and other monthly benefit. If an individual is entitled to an old-age insurance benefit or...


(a) Entitlement to old-age or disability insurance benefit and other monthly benefit. If an individual is entitled to an old-age insurance benefit or...
...


pension. (a) When reduction is required. Unless you meet one of the exceptions in paragraph (b) of this section, your monthly Social Security benefits as a...


where supplemental security income (SSI) payments were received for the same period. (a) When reduction is required. We will reduce your...


age is the age at which you may receive unreduced old-age, wife's, husband's, widow's, or widower's benefits. Full retirement age has been 65 but is being gradually raised...


begins before full retirement age? Generally your old-age, wife's, husband's, widow's, or widower's benefits are reduced if entitlement begins before the month...


is entitled to two or more benefits? (a) What is the general rule? Except as specifically provided in this section, benefits of an individual entitled to more than...


how will adjustments to that reduction be made? (a) When may adjustment be necessary? The following months are not counted for purposes of reducing benefits...


there is an increase in my primary insurance amount? (a) What is the general rule on reduction of increases? After an individual's benefits are reduced for age...


test. (a) Deductions because of beneficiary's earnings. Under the annual earnings test, deductions are made from monthly benefits (except disability...


(a) Deductions because of excess earnings of insured individual. For taxable years beginning after 1960, or ending after June 1961, if excess earnings (as described in...


outside the United States; 45 hour and 7-day work test. (a) Deductions because of individual's activity--(1) Prior to May 1983. For months prior to May 1983,...


States,'' defined. An individual is engaged in noncovered remunerative activity outside the United States for purposes of deductions described in Sec....


individual's earnings record. For purposes of imposing deductions under the annual earnings test (see Sec. 404.415) and the foreign work test (see Sec. 404.417),...


to have a child in his or her care? Deductions for failure to have a child in care (as defined in subpart D of this part) are made as follows: (a) Wife's...


for in Sec. Sec. 404.415, 404.417, and 404.421 (as modified in Sec. 404.458) are made by withholding benefits (in whole or in part, depending upon the amount to...


event occurs in a month. If more than one of the deduction events specified in Sec. Sec. 404.415, 404.417, and 404.421 occurred in any 1 month, each of...


in more than 1 month. If a deduction event described in Sec. Sec. 404.415, 404.417, and 404.421 occurs in more than 1 month, the total amount deducted from...


(a) General. (1) In applying the annual earnings test (see Sec. 404.415(a)) under this subpart, all of a beneficiary's earnings (as defined in Sec. 404.429) for all months of...


the term earnings is used in this subpart other than as a part of the phrase net earnings from self-employment, it means an individual's earnings for a taxable year after 1954....


after December 1972; monthly exempt amount defined. (a) Method of determining excess earnings for years ending after December 1972. For taxable years ending...


(a) Months charged. For purposes of imposing deductions for taxable years after 1960, the excess earnings (as described in Sec. 404.430) of an individual are charged to each...


cannot be charged. (a) Monthly benefits payable for months after 1977. Beginning with monthly benefits payable for months after 1977, no matter how much...


cannot be charged because individual is deemed not entitled to benefits. Under the annual earnings test, excess earnings (as described in Sec. 404.430) are not...


of excess earnings. For purposes of deductions because of excess earnings (as described in Sec. 404.430), the benefit rate against which excess earnings...


individual charged against his benefits and the benefits of persons entitled (or deemed entitled) to benefits on his earnings record. Deductions are made against...


payment exceeds the benefit before deduction for excess earnings. Where, under the apportionment described in Sec. 404.439, a person's prorated share of the...


another person entitled (or deemed entitled) on the same earnings record both have excess earnings. Where both the insured individual and another person entitled...


(a) General. In general, the substantial services test will be applicable only in a grace year (including a termination grace year) as defined in...


test. In determining whether an individual's services are substantial, consideration is given to the following factors: (a) Amount of time devoted to...


or failure to have care of a child. (a) Beneficiary engaged in noncovered remunerative activity; report by beneficiary. Any individual entitled to a benefit which...


prescribed time limit noncovered remunerative activity outside the United States or not having care of a child. (a) Penalty for failure to report. If an...


earnings; wages; net earnings from self-employment. (a) Conditions under which a report of earnings, wages, and net earnings from self-employment is required....


timely. (a) Penalty for failure to report earnings; general. Penalty deductions are imposed against an individual's benefits, in addition to the deductions...


(a) General. The failure of an individual to make a timely report under the provisions described in Sec. Sec. 404.450 and 404.452 will not result in a...


of earnings and estimated earnings; effect of failure to comply with request. (a) Request by Social Security Administration for report during taxable year; effect...


works or engages in self-employment. (a) Circumstances under which benefit payments may be suspended. If, on the basis of information obtained by or submitted...


of certain maritime employees nor paid. (a) When deduction is required. A deduction is required where: (1) An individual performed services after September 1941...


would not be affected or would be only partly affected. Notwithstanding the provisions described in Sec. Sec. 404.415, 404.417, 404.421, 404.451, and 404.453...


(a) Why would SSA penalize me? You will be subject to a penalty if you make, or cause to be made, a statement or representation of a material fact for use in...


the United States. (a) Nonpayment of monthly benefits to aliens outside the United States more than 6 months. Except as described in paragraph (b) and subject...


United States for more than 6 months. Where an individual dies outside the United States after January 1957 and no monthly benefit was or could have been paid to...


of alien outside United States for more than 6 months. No payments may be made under part A (hospital insurance benefits) of [[Page...


United States; ``foreign social insurance system,'' and ``treaty obligation'' exceptions defined. (a) Foreign social insurance system exception. The...


against payment of lump sum based on deported individual's earnings records. (a) Old-age or disability insurance benefits. When an individual...


monthly benefits and entitlement to hospital insurance benefits. (a) Effect of conviction. Where an individual is convicted of any offense (committed after August 1,...


enrollment for supplementary medical insurance benefits. An individual may not enroll under part B (supplementary medical insurance benefits) of title XVIII if he has...


disability insurance benefits or childhood disability benefits based on statutory blindness is engaging in substantial gainful activity. (a) Disability...


(a) General. No monthly benefits will be paid to any individual for any month any part of which the individual is confined in a jail, prison, or other penal institution...


not furnished or applied for a Social Security number. No monthly benefits will be paid to an entitled individual unless he or she [[Page...


rules regarding treatment for drug addiction or alcoholism. (a) Suspension of monthly benefits. (1) For an individual entitled to benefits based on a...


alcoholism. (a) General. For disabled beneficiaries who receive benefit payments through a representative payee because drug addiction or alcoholism is...


Sec. 404.501 General applicability of section 204 of the Act. Authority: Secs. 204, 205(a), and 702(a)(5) of the Social Security Act (42 U.S.C. 404, 405(a),...


Sec. 404.502 Overpayments. Upon determination that an overpayment has been made, adjustments will be made against monthly benefits and lump sums as...


Sec. 404.502a Notice of right to waiver consideration. Whenever an initial determination is made that more than the correct amount of payment has been made,...


Sec. 404.503 Underpayments. Underpayments will be adjusted as follows: (a) Individual underpaid is living. If an individual to whom an underpayment...


404.504 Relation to provisions for reductions and increases. The amount of an overpayment or underpayment is the difference between the amount paid to...


404.505 Relationship to provisions requiring deductions. Adjustments required by any of the provisions in this subpart F are made in addition to, but after,...


Sec. 404.506 When waiver may be applied and how to process the request. (a) Section 204(b) of the Act provides that there shall be no adjustment or recovery...


Sec. 404.507 Fault. Fault as used in without fault (see Sec. 404.506 and 42 CFR 405.355) applies only to the individual. Although the Administration...


404.508 Defeat the purpose of Title II. (a) General. Defeat the purpose of title II, for purposes of this subpart, means defeat the purpose of benefits...


Sec. 404.509 Against equity and good conscience; defined. (a) Recovery of an overpayment is against equity and good conscience (under title II and title...


Sec. 404.510 When an individual is ``without fault'' in a deduction overpayment. In determining whether an individual is ``without fault'' with respect to...


404.510a When an individual is ``without fault'' in an entitlement overpayment. A benefit payment under title II or title XVIII of the Act to or on...


404.511 When an individual is at ``fault'' in a deduction overpayment. (a) Degree of care. An individual will not be without fault if the Administration...


Sec. 404.512 When adjustment or recovery of an overpayment will be waived. (a) Adjustment or recovery deemed ``against equity and good conscience.'' In...


404.513 Liability of a certifying officer. No certifying or disbursing officer shall be held liable for any amount certified or paid by him to...


Sec. 404.515 Collection and compromise of claims for overpayment. (a) General effect of the Federal Claims Collection Act of 1966. Claims by the...


404.520 Referral of overpayments to the Department of the Treasury for tax refund offset--General. (a) The standards we will apply and the procedures we...


Sec. 404.521 Notice to overpaid individual. A request for reduction of a Federal income tax refund will be made only after we determine that an amount is...


404.522 Review within SSA that an overpayment is past due and legally enforceable. (a) Notification by overpaid individual. An overpaid individual...


404.523 Findings by SSA. (a) Following the hearing or a review of the record, we will issue written findings which include supporting rationale for...


Sec. 404.524 Review of our records related to the overpayment. (a) Notification by the overpaid individual. An overpaid individual who intends to inspect or...


404.525 Suspension of offset. If, within 60 days of the date of the notice described in Sec. 404.521, the overpaid individual notifies us that he or she...


404.526 Tax refund insufficient to cover amount of overpayment. If a tax refund for a given taxable year is insufficient to recover an overpayment...


404.527 Additional methods for recovery of title II benefit overpayments. (a) General. In addition to the methods specified in Sec. Sec. 404.502 and 404.520,...


(j), (o), (p), and (r), 205(a), 216(i)(2), 223(b), 228(a), and 702(a)(5) of the Social Security Act (42 U.S.C. 402 (i), (j), (o), (p), and (r), 405(a), 416(i)(2), 423(b), 428(a),...


Applicant means the person who files an application for benefits for himself or herself or for someone else. A person who files for himself or herself is both the...


In addition to meeting other requirements, you must file an application to become entitled to benefits. If you believe you may be entitled to benefits, you should file...


We will consider your application a claim for benefits if it generally meets all of the following conditions: (a) You must file on a prescribed form, as stated in Sec....


(a) General rule. You must apply for benefits on an application that we prescribe. See Sec. 422.505(a) of this chapter for the types of applications we will...


may sign an application according to the following rules: (a) A claimant who is 18 years old or over, mentally competent, and physically able to do so, must sign his...


(a) A person who signs an application for someone else will be required to provide evidence of his or her authority to sign the application for the person...


(a) General rule. Except as otherwise provided in paragraph (b) of this section and in Sec. Sec. 404.630 through 404.633 which relate to the filing date of an...


A claimant must be alive at the time an application is filed. There are the following exceptions to this general rule: (a) If a disabled person dies before filing...


benefit applicants in designated geographic areas. (a) To be eligible for Social Security disability insurance benefits in the designated pilot geographic...


benefits. (a) General rule. If you file an application for benefits (except special age 72 payments) before the first month you meet all the other...


the requirements for benefits? (a) Filing for disability benefits and for old-age, survivors', or dependents' benefits. (1) If you file an application for...


entitle you to benefits for up to 6 months or 12 months (depending on the type of benefit, as explained in Sec. 404.621) before the month in which it is filed. You may limit...


old-age and husband's or wife's benefits? (a) Presumed filing for husband's or wife's benefits. If you file an application for old-age benefits, you are presumed...


If a written statement, such as a letter, indicating your intent to claim benefits either for yourself or for another person is filed with us under the rules stated in...


A written statement filed with the Railroad Retirement Board will be considered a written statement filed with us under the rules in Sec. 404.630...


a hospital admission form) filed with a hospital may serve as a written statement under Sec. 404.630 if the requirements of this section are met. The statement will...


(a) General. You may have considered applying for monthly benefits for yourself or for another person, and you may have contacted us in writing, by telephone or in person...


withdrawal filed before a determination is made. An application may be withdrawn before we make a determination on it if-- (1) A written request for withdrawal is filed at...


A request to withdraw an application may be cancelled and the application reinstated if-- (a) A written request for cancellation is filed at a place described in Sec. 404.614...


the Social Security Act (42 U.S.C. 405(a) and 902(a)(5)). Source: 43 FR 24795, June 7, 1978, unless otherwise noted. ...


sign a form or statement that the Social Security Administration accepts as an application for benefits under the rules set out in subpart G. Benefits means any...


will ask for evidence that you are eligible for them. After you become entitled to benefits, we may ask for evidence showing whether you continue to be entitled to benefits;...


needed to prove your eligibility or your right to continue to receive benefit payments, you will be responsible for obtaining and giving the evidence to us. We will be glad to...


asked to give us by a certain date specific kinds of evidence or information to prove you are eligible for benefits. If we do not receive the evidence or information by that date,...


the people at a Social Security Administration office. In the Philippines evidence [[Page 216]] should be given to the people at the Veterans Administration...


prove your eligibility or continuing entitlement to benefits, you may be asked to show us an original document or record. These original records or documents will be returned to...


evidence, we examine it to see if it is convincing evidence. If it is, no other evidence is needed. In deciding if evidence is convincing, we consider whether-- (a)...


type of evidence we have shown as preferred in the following sections of this subpart, we will generally find it is convincing evidence. This means that unless we have information...


benefits, we will ask for evidence of age which shows your date of birth unless you are applying for-- (1) A lump-sum death payment; (2) A wife's benefit and you have...


best evidence of your age, if you can obtain it, is either: a birth certificate or hospital birth record recorded before age 5; or a religious record which shows your date...


required. If you apply for benefits on the record of a deceased person, we will ask for evidence of the date and place of his or her death. We may also ask for evidence of...


the person is dead but evidence of death is needed, we will presume he or she died at a certain time if you give us the following evidence: (a) A certified copy of,...


made based on Sec. 404.721(b) can be rebutted by evidence that establishes that the person is still alive or explains the individual's absence in a manner consistent with...


as the insured person's husband or wife, widow or widower, divorced wife or divorced husband, we will ask for evidence of the marriage and where and when it took place. We...


valid ceremonial marriage is one that follows procedures set by law in the State or foreign country where it takes place. These procedures cover who may perform the marriage...


is one considered valid under certain State laws even though there was no formal ceremony. It is a marriage between two persons free to marry,...


marriage is a ceremonial marriage we consider valid even though the correct procedures set by State law were not strictly followed or a former marriage had not yet ended....


needed that a marriage has ended. If you apply for benefits as the insured person's divorced wife or divorced husband, you will be asked for evidence of your divorce. If you are...


If you apply for parent's or child's benefits, we will ask for evidence showing your relationship to the insured person. What evidence we will ask for depends on whether you are...


natural parent of the insured person, we will ask for a copy of his or her public or religious birth record made before age 5. If you are the natural child of the insured person,...


stepparent or stepchild of the insured person, we will ask for the evidence described in Sec. 404.731 or Sec. 404.733 that which shows your natural or adoptive relationship to...


If you are the adopting parent or adopted child, we will ask for the following evidence: (a) A copy of the birth certificate made following the adoption;...


the law will treat someone as a child of another if he or she agreed to adopt the child, the natural parents or the person caring for the child were parties to the agreement, he...


are the grandchild or stepgrandchild of the insured person, we will ask you for the kind of evidence described in Sec. Sec. 404.731 through 404.733 that shows your relationship to...


child's dependency is needed. If you apply for child's benefit's we may ask for evidence you were the insured person's dependent at a specific time--usually the time you applied...


If you apply for child's benefits as a student age 18 or over, we may ask for evidence you are attending school. We may also ask for evidence from the school you attend showing...


benefits, we will ask you for evidence to show that you received at least one-half of your support from the insured person in the one-year period before he or she died or...


If you apply for the lump-sum death payment as the insured person's widow or widower, or for wife's, husband's, widow's, or widower's benefits based upon a deemed valid marriage...


65 and apply for wife's benefits based upon caring for a child, or for mother's benefits as a widow or divorced wife, or for father's benefits as a widower, we will ask...


(a) When evidence of the insured's permanent home is needed. We may ask for evidence of where the insured person's permanent home was at the time you applied or, if earlier, the...


of support or application for a lump-sum death payment. (a) When evidence of good cause is needed. We may ask for evidence that [[Page 223]] you...


(c)(4), (c)(5), (c)(6), and (p), 702(a)(5), and 1143 of the Social Security Act (42 U.S.C. 405(a), (c)(1), (c)(2)(A), (c)(4), (c)(5), (c)(6), and (p), 902(a)(5),...


Earnings means wages and self-employment income earned by a person based on work covered by social security. (See subpart K for the rules about what constitutes wages...


Generally. For social security purposes, SSA records are evidence of the amounts of your earnings and the periods in which they were received. (b) Before time limit ends....


(a) Right to a statement of earnings and a benefit estimate. You or your legal representative or, after your death, your survivor or the legal...


(a) General. After receiving a request for a statement of earnings and the information we need to comply with the request, we will provide you or your...


(a) Who will be sent a statement. Unless one of the conditions in paragraph (b) of this section applies to you, we will send you, without request, a statement...


(a) When to file a request for correction. You or your survivor must file a request for correction of the record of your earnings within the time limit for the year...


Before the time limit ends for any year, we will correct the record of your earnings for that year for any reason if satisfactory evidence shows SSA records...


ends. (a) Generally. After the time limit for any year ends, we may correct the record of your earnings for that year if satisfactory evidence shows SSA records...


of the United States. We may correct the record of your earnings to remove, reduce, or enter [[Page 229]] earnings for work in the employ of...


remove or reduce an amount of wages entered on the record of your earnings, we will notify you of this correction if we previously notified you of the amount of your wages for...


If we remove or reduce an amount of self-employment income entered on the record of your earnings, we will notify you of this correction. We will notify your survivor if...


404.900 Introduction. Authority: Secs. 201(j), 204(f), 205(a), (b), (d)-(h), and (j), 221, 225, and 702(a)(5) of the Social Security Act (42 U.S.C. 401(j),...


Definitions. As used in this subpart: Date you receive notice means 5 days after the date on the notice, unless you show us that you did not receive...


404.902 Administrative actions that are initial determinations. Initial determinations are the determinations we make that are subject to administrative and...


404.903 Administrative actions that are not initial determinations. Administrative actions that are not initial determinations may be reviewed by us, but they are...


Notice of the initial determination. We shall mail a written notice of the initial determination to you at your last known address. The reasons for the...


Effect of an initial determination. An initial determination is binding unless you request a reconsideration within the stated time period, or we revise...


404.906 Testing modifications to the disability determination procedures. (a) Applicability and scope. Notwithstanding any other provision in this part or part 422...


Reconsideration--general. If you are dissatisfied with the initial determination, reconsideration is the first step in the administrative review process...


Parties to a reconsideration. (a) Who may request a reconsideration. If you are dissatisfied with the initial determination, you may request that we reconsider...


How to request reconsideration. (a) We shall reconsider an initial determination if you or any other party to the reconsideration files a written request-- ...


404.911 Good cause for missing the deadline to request review. (a) In determining whether you have shown that you had good cause for missing a deadline to...


Reconsideration procedures. (a) Case review. With the exception of the type of case described in paragraph (b) of this section, the reconsideration...


Disability hearing--general. (a) Availability. We will provide you with an opportunity for a disability hearing if: (1) You have been receiving...


Disability hearing--disability hearing officers. (a) General. Your disability hearing will be conducted by a disability hearing officer who was not involved...


404.916 Disability hearing--procedures. (a) General. The disability hearing will enable you to introduce evidence and present your views to a disability...


Disability hearing--disability hearing officer's reconsidered determination. (a) General. The disability hearing officer who conducts your disability...


404.918 Disability hearing--review of the disability hearing officer's reconsidered determination before it is issued. (a) General. The Director of the Office...


Notice of another person's request for reconsideration. If any other person files a request for reconsideration of the initial determination in your case, we...


404.920 Reconsidered determination. After you or another person requests a reconsideration, we shall review the [[Page 239]] evidence considered...


Effect of a reconsidered determination. The reconsidered determination is binding unless-- (a) You or any other party to the reconsideration requests a...


Notice of a reconsidered determination. We shall mail a written notice of the reconsidered determination to the parties at their last known address. We shall...


Expedited appeals process--general. By using the expedited appeals process you may go directly to a Federal district court without first completing...


When the expedited appeals process may be used. You may use the expedited appeals process if all of the following requirements are met: (a) We have made...


404.925 How to request expedited appeals process. (a) Time of filing request. You may request the expedited appeals process-- (1) Within 60 days after the...


Agreement in expedited appeals process. If you meet all the requirements necessary for the use of the expedited appeals process, our authorized...


Effect of expedited appeals process agreement. After an expedited appeals process agreement is signed, you will not need to complete the remaining steps of...


Expedited appeals process request that does not result in agreement. If you do not meet all of the requirements necessary to use the expedited...


Hearing before an administrative law judge--general. If you are dissatisfied with one of the determinations or decisions listed in Sec. 404.930 you may request...


404.930 Availability of a hearing before an administrative law judge. (a) You or another party may request a hearing before an administrative law judge if we...


Parties to a hearing before an administrative law judge. (a) Who may request a hearing. You may request a hearing if a hearing is available under Sec. 404.930....


How to request a hearing before an administrative law judge. (a) Written request. You may request a hearing by filing a written request. You should include in...


Submitting evidence prior to a hearing before an administrative law judge. If possible, the evidence or a summary of evidence you wish to have considered...


404.936 Time and place for a hearing before an administrative law judge. (a) General. The administrative law judge sets the time and place for the hearing. He...


Notice of a hearing before an administrative law judge. (a) Issuing the notice. After the administrative law judge sets the time and place of the hearing, we...


Objections to the issues. If you object to the issues to be decided upon at the hearing, you must notify the administrative law judge in writing at the...


Disqualification of the administrative law judge. An administrative law judge shall not conduct a hearing if he or she is prejudiced or partial with respect to...


404.941 Prehearing case review. (a) General. After a hearing is requested but before it is held, we may, for the purposes of a prehearing...


404.942 Prehearing proceedings and decisions by attorney advisors. (a) General. After a hearing is requested but before it is held, an attorney advisor in our...


404.943 Responsibilities of the adjudication officer. (a)(1) General. Under the procedures set out in this section we will test modifications to the procedures...


Administrative law judge hearing procedures--general. A hearing is open to the parties and to other persons the administrative law judge considers necessary...


404.946 Issues before an administrative law judge. (a) General. The issues before the administrative law judge include all the issues brought out in the...


Deciding a case without an oral hearing before an administrative law judge. (a) Decision wholly favorable. If the evidence in the hearing record supports...


Presenting written statements and oral arguments. You or a person you designate to act as your representative may appear before the administrative law judge...


404.950 Presenting evidence at a hearing before an administrative law judge. (a) The right to appear and present evidence. Any party to a hearing has a right...


When a record of a hearing before an administrative law judge is made. The administrative law judge shall make a complete record of the hearing...


404.952 Consolidated hearing before an administrative law judge. (a) General. (1) A consolidated hearing may be held if-- (i) You have requested a hearing to...


The decision of an administrative law judge. (a) General. The administrative law judge shall issue a written decision that gives the findings of fact and...


The effect of an administrative law judge's decision. The decision of the administrative law judge is binding on all parties to the hearing unless-- ...


Removal of a hearing request from an administrative law judge to the Appeals Council. If you have requested a hearing and the request is pending before...


404.957 Dismissal of a request for a hearing before an administrative law judge. An administrative law judge may dismiss a request for a hearing under any of...


Notice of dismissal of a request for a hearing before an administrative law judge. We shall mail a written notice of the dismissal of the hearing request...


Effect of dismissal of a request for a hearing before an administrative law judge. The dismissal of a request for a hearing is binding, unless it is...


Vacating a dismissal of a request for a hearing before an administrative law judge. An administrative law judge or the Appeals Council may vacate...


404.961 Prehearing and posthearing conferences. The administrative law judge may decide on his or her own, or at the request of any party to the hearing, to hold...


Testing elimination of the request for Appeals Council review. (a) Applicability and scope. Notwithstanding any other provision in this part or part 422 of...


Appeals Council review--general. If you or any other party is dissatisfied with the hearing decision or with the dismissal of a hearing request, you may...


404.968 How to request Appeals Council review. (a) Time and place to request Appeals Council review. You may request Appeals Council review by filing a...


404.969 Appeals Council initiates review. (a) General. Anytime within 60 days after the date of a decision or dismissal that is subject to review under this...


Cases the Appeals Council will review. (a) The Appeals Council will review a case if-- (1) There appears to be an abuse of discretion by the...


Dismissal by Appeals Council. The Appeals Council will dismiss your request for review if you did not file your request within the stated period of time and...


Effect of dismissal of request for Appeals Council review. The dismissal of a request for Appeals Council review is binding and not subject to...


Notice of Appeals Council review. When the Appeals Council decides to review a case, it shall mail a notice to all parties at their last known address stating...


Obtaining evidence from Appeals Council. You may request and receive copies or a statement of the documents or other written evidence upon which the...


Filing briefs with the Appeals Council. Upon request, the Appeals Council shall give you and all other parties a reasonable opportunity to file briefs or...


404.976 Procedures before Appeals Council on review. (a) Limitation of issues. The Appeals Council may limit the issues it considers if it notifies you and the...


Case remanded by Appeals Council. (a) When the Appeals Council may remand a case. The Appeals Council may remand a case to an administrative law judge so that...


404.979 Decision of Appeals Council. After it has reviewed all the evidence in the administrative law judge hearing record and any additional evidence...


Effect of Appeals Council's decision or denial of review. The Appeals Council may deny a party's request for review or it may decide to review a case and make...


Extension of time to file action in Federal district court. Any party to the Appeals Council's decision or denial of review, or to an expedited appeals...


Case remanded by a Federal court. When a Federal court remands a case to the Commissioner for further consideration, the Appeals Council, acting on behalf of...


404.984 Appeals Council review of administrative law judge decision in a case remanded by a Federal court. (a) General. In accordance with Sec. 404.983, when a case...


404.985 Application of circuit court law. The procedures which follow apply to administrative determinations or decisions on claims involving the application...


Reopening and revising determinations and decisions. (a) General. Generally, if you are dissatisfied with a determinationor decision made in the...


404.988 Conditions for reopening. A determination, revised determination, decision, or revised decision may be reopened-- (a) Within 12 months of the date...


Good cause for reopening. (a) We will find that there is good cause to reopen a determination or decision if-- (1) New and material evidence...


Finality of determinations and decisions on revision of an earnings record. A determination or a decision on a revision of an earnings record may be...


Finality of determinations and decisions to suspend benefit payments for entire taxable year because of earnings. A determination or decision to suspend...


404.991a Late completion of timely investigation. We may revise a determination or decision after the applicable time period in Sec. 404.988(a) or Sec. 404.988(b)...


404.992 Notice of revised determination or decision. (a) When a determination or decision is revised, notice of the revision will be mailed to the parties at...


Effect of revised determination or decision. A revised determination or decision is binding unless-- (a) You or another party to the revised determination...


Time and place to request a hearing on revised determination or decision. You or another party to a revised determination or decision may request,...


Finality of findings when later claim is filed on same earnings record. If two claims for benefits are filed on the same earnings records, findings of...


Increase in future benefits where time period for reopening expires. If, after the time period for reopening under Sec. 404.988(b) has ended, new evidence...


404.999a Payment of certain travel expenses--general. When you file a claim for Social Security benefits, you may incur certain travel expenses in pursuing...


404.999b Who may be reimbursed. (a) The following individuals may be reimbursed for certain travel expenses-- (1) You, when you attend medical examinations...


404.999c What travel expenses are reimbursable. Reimbursable travel expenses include the ordinary expenses of public or private transportation as well as...


404.999d When and how to claim reimbursement. (a)(1) Generally, you will be reimbursed for your expenses after your trip. However, travel advances may be...


202(v), 205(a), 209, 210, 211, 229(a), 230, 231, and 702(a)(5) of the Social Security Act (42 U.S.C. 402(v), 405(a), 409, 410, 411, 429(a), 430, 431, and 902(a)(5)). ...


As used in this subpart-- The Act means the Social Security Act, as amended. The Code means the Internal Revenue Code of 1954, as amended. We, our, or us...


any service covered by social security performed by an employee for his or her employer. The rules on who is an employee and who is an employer are contained in Sec....


(a) General requirements of employment. Unless otherwise excluded from coverage under Sec. Sec. 404.1012 through 404.1038, the work you perform as an employee for...


must be an employee for your work to be covered as employment for social security purposes. You are an employee if you are-- (a) A corporation officer as described in...


are an officer of a corporation, you are an employee of the corporation if you are paid or you are entitled to be paid for holding office or performing services. However, if you are...


The common-law rules on employer-employee status are the basic test for determining whether you and the person or firm you work for have the relationship of employee and...


life insurance salesman, home worker, or traveling or city salesman. (a) General. In addition to common-law employees and corporation officers, we consider...


an employer if he or she employs at least one employee. Sometimes it is not clear who a worker's employer is, since the employer does not always pay the worker's wages. When...


A farm crew leader furnishes workers to do agricultural labor for another person, usually a farm operator. If the crew leader pays the workers (the money can be the crew leader's...


Certain kinds of work performed by an employee are excluded from employment. They are described in Sec. Sec. 404.1014 through 404.1038 and are exceptions to the general rule...


If part of your work for an employer during a pay period is covered as employment and part excluded, all of your work during that period is considered covered if at least one-half...


club, fraternity or sorority. (a) General. If you are a student and do work of a household nature in or about the club rooms or house of a local college club...


you work as an employee of a relative, the work is excluded from employment if-- (1) You work while under age 18 in the employ of your parent; (2) You do...


Farm work done by foreign workers lawfully admitted to the United States on a temporary basis to do farm work is not covered as employment. The excluded work includes any...


a sharefarmer, your services are not covered as employment, but as self-employment. (b) You are a sharefarmer if you have an arrangement with the owner or tenant of the...


Government or its instrumentalities--wages paid after 1983. (a) General. If you are a civilian employee of the United States Government or an instrumentality of...


Government or its instrumentalities--remuneration paid prior to 1984. (a) General--remuneration paid prior to 1984. If you worked as a civilian employee of the...


(a) General. The work of a Federal, State, or local government employee not otherwise subject to Social Security coverage may constitute Medicare...


the United States. (a) Your work as a member of a uniformed service of the United States is covered under Social Security (unless creditable under the Railroad...


and instrumentalities. (a) General. If you work as an employee of a State, a political subdivision of a State, or any wholly owned instrumentality of one...


If you work as an employee of the District of Columbia or a wholly owned instrumentality of the District of Columbia, your work is covered as employment unless-- ...


Work in American Samoa or Guam. Work in American Samoa or Guam for a private employer is covered as employment the same as in the 50 States. Work done by a resident of the Republic...


religious orders. (a) General. If you are a duly ordained, commissioned, or licensed minister of a church, the work you do in the exercise of your ministry is excluded...


A religious order whose members are required to take a vow of poverty, or any autonomous subdivision of that religious order, may elect to have social security...


certain other organizations exempt from income tax. (a) After 1983. Work done after 1983 by an employee in the employ of a religious, charitable, educational,...


(a) General. If you work for a church or qualified church-controlled organization, as described in this section, your employer may elect to...


employment any work you do as an employee or employee representative as described in the Railroad Retirement Tax Act. However, railroad compensation can be counted for...


university. (a) For purposes of this section, a school, college, or university has its usual accepted meaning. It does not, however, include any school, college,...


student nurse, your work for a hospital or nurses training school is excluded from employment if you are enrolled and regularly attending classes in a nurses training school which...


newspapers, shopping news, and magazines. (a) If you are under age 18. Work you do before you reach age 18 delivering or distributing newspapers or shopping news...


a boat engaged in catching fish or other forms of aquatic animal life, your work is not employment if you have an arrangement with the owner or operator of the boat which provides...


If you work as an employee of a foreign government in any capacity, your work is excluded from employment. If you are a citizen of the United States and work in the United States...


a foreign government. (a) If you work as an employee of an instrumentality of a foreign government, your work is excluded from employment if-- (1) The...


(a) If you work as an employee of an international organization entitled to enjoy privileges, exemptions, and immunities as an international organization under...


If you work as an employee of an organization which is registered, or which is required by a final order of the Subversive Activities Control Board to register under the...


(a) Foreign students. (1) Foreign students (nonimmigrant aliens) may be temporarily in the United States under subparagraph (F) of section 101(a)(15) of the Immigration...


or aircraft. If you work as an employee within the United States on or in connection with (as explained in Sec. 404.1004(b)(8)) a vessel or aircraft that...


Domestic services you perform in a private home of your employer are excluded from employment, regardless of the amount earned, in any year in which you are under age 18...


employees who are both members of certain religious groups opposed to insurance. (a) You and your employer (or, if the employer is a partnership, each of its...


remuneration paid to you as an employee for employment unless specifically excluded. Wages are counted in determining your entitlement to retirement, survivors', and...


(a) In general. Wages are received by an employee at the time they are paid by the employer to the employee. Wages are paid by an employer at the time that they are actually...


(a) Excluding the value of employer provided facilities or privileges from employee gross income prior to January 1, 1985. (1) Generally, the facilities or...


[Code of Federal Regulations] [Title 20, Volume 2] [Revised as of April 1, 2004] From the U.S. Government Printing Office via GPO Access [CITE: 20CFR404.1044] [Page 287] TITLE 20--EMPLOYEES' BENEFITS CHAPTER III--SOCIAL SECURITY ADMINISTRATION PART 404_FEDERAL OLD-AGE, SURVIVORS AND DISABILITY INSURANCE (1950 ) --Table of Contents Subpart K_Employment, Wages, Self-Employment, and Self-Employment Income Sec. 404.1044 Vacation pay. We consider your salary while on vacation, or a vacation allowance paid by your employer, to be wages. ...


your employer pays you specifically--either as advances or reimbursements--for traveling or for other ordinary and necessary expenses incurred, or reasonably expected to...


(a) If you are a member of a religious order who has taken a vow of poverty (Sec. 404.1023), and the order has elected Social Security coverage under...


made by an employer to you as an employee in a calendar year that are more than the annual wage limitation are not wages. The annual wage...


(a) General. The contribution and benefit base after 1992 is figured under the formula described in paragraph (b) of this section in any calendar year in which...


(a) Payments to, or on behalf of, you or any of your dependents under your employer's plan or system are excluded from wages if made because of your or...


after 1983 to you (including any amount paid by an employer for insurance or annuities) on account of your retirement for age are not excluded from wages unless-- (a)...


or related medical or hospitalization expenses. (a) We do not include as wages any payment that an employer makes to you, or on your behalf, on account...


or payments under or into certain annuity plans. (a) We do not include as wages any payment made-- (1) Into a tax-exempt trust or annuity plan by your employer...


We do not include as wages any qualified benefits under a cafeteria plan as described in section 125 of the Code if such payment would not be treated as wages...


or employee's contribution under State law. (a) We exclude as wages any payment by an employer (described in paragraph (b) of this section) that is not deducted...


(a) When cash payments are not wages. We do not include as wages your cash payments in a calendar year after 1987 from an employer for agricultural labor (see Sec. 404.1056)...


(a) What is agricultural labor. (1) If you work on a farm as an employee of any person, you are doing agricultural labor if your work has to do with-- (i)...


(a) Payments for domestic service--(1) The applicable dollar threshold. We do not include as wages cash payments that an employer makes to you in any calendar year...


Payments for service not in course of employer's trade or business (nonbusiness work) and payments to certain home workers--(1) The $100 standard. We do not include as wages cash pay...


during World War II. (a) In general. Persons who were interned during any period of time from December 7, 1941, through December 31, 1946, by the United...


For an individual to have self-employment coverage under social security, the individual must be engaged in a trade or business and have net earnings from self-employment that can...


For you to be covered as a self-employed person for social security purposes, you must be engaged in a trade or business. You can carry on a trade or business as an individual or as...


(a) General. Although we generally exclude services performed by employees from the definition of trade or business, certain types of services are considered a trade...


(a) Trade or business. If you perform services after 1982 as a qualified real estate agent or as a direct seller, as defined in section 3508 of the Code, you are...


If you are a Christian Science practitioner, the services you perform in the exercise of your profession are a trade or business unless you were granted an exemption from...


(a) If you are a duly ordained, commissioned, or licensed minister of a church, or a member of a religious order who has not taken a vow of poverty, the services...


performance of the functions of a public office is not a trade or business except under the circumstances explained in paragraph (b) of this section. If you are an officer of...


If you are a farm crew leader and are deemed the employer of the workers as described in Sec. 404.1010, we consider you to be engaged in a trade or business. This...


to insurance. (a) You may file an application with the Internal Revenue Service for exemption from social security self-employment tax if-- (1) You are a...


If you are an employee or employee representative as defined in section 3231 (b) and (c) of the Code, your work is not a trade or business. Your services are...


(a) Definition of net earnings from self-employment. If you are self-employed, you must first determine the amount of your net earnings from self-employment before...


self-employment. (a) Determining net earnings. (1) In determining your gross income and the deductions attributable to your trade or business for the purpose...


(a) In general. Your rentals from real estate and from personal property leased with the real estate (including rentals paid in crop shares) and the...


The dividends you receive on shares of stock are excluded in determining your net earnings from self-employment, unless you are a dealer in stocks and securities and receive...


capital assets; timber, coal, and iron ore; involuntary conversion. (a) If you are engaged in a trade or business, you must, in determining your net earnings...


When determining your net earnings from self-employment, you disregard the deduction provided by section 172 of the Code that relates to net operating losses sustained in years...


of an individual. (1) If community property laws apply to income that an individual derives from a trade or business (other than a trade or business carried on by a partnership),...


for taxable year which ends as a result of death. (a) General. In the case of a deceased partner whose taxable year ends because of death, the...


(a) In general. If you are a retired partner, in figuring your net earnings from self-employment you must exclude payments made to you on a periodic basis by a partnershp...


of Puerto Rico. (a) Residents. If you are a resident of Puerto Rico, whether or not you are an alien, a citizen of the United States, or a citizen of...


[Code of Federal Regulations] [Title 20, Volume 2] [Revised as of April 1, 2004] From the U.S. Government Printing Office via GPO Access [CITE: 20CFR404.1090] [Page 305] TITLE 20--EMPLOYEES' BENEFITS CHAPTER III--SOCIAL SECURITY ADMINISTRATION PART 404_FEDERAL OLD-AGE, SURVIVORS AND DISABILITY INSURANCE (1950 ) --Table of Contents Subpart K_Employment, Wages, Self-Employment, and Self-Employment Income Sec. 404.1090 Personal exemption deduction. The deduction provided by section 151 of the Code, relating to personal exemptions, is excluded in determining net earnings from self- employment. ...


members of religious orders. (a) General. If you are a duly ordained, commissioned, or licensed minister of a church or a member of a religious order who has not...


residents living outside the United States. (a) Taxable years beginning after December 31, 1983. If you are a citizen or resident of the United States and are engaged...


In using the exclusions from gross income provided under section 931 of the Code (relating to income from sources within possessions of the United States) and section 932 of...


from self-employment. (a) General. If you have income from a trade or business in certain situations, you have options for figuring your net earnings...


(a) An agricultural trade or business is one in which, if the trade or business were carried on entirely by employees, the major portion of the services would be agricultural...


(a) General. Self-employment income is the amount of your net earnings from self-employment that is subject to social security tax and counted for social security benefit purposes....


210, 218, and 702(a)(5) of the Social Security Act (42 U.S.C. 405, 410, 418, and 902(a)(5)); sec. 12110, Pub. L. 99- 272, 100 Stat. 287 (42 U.S.C. 418 note); sec. 9002, Pub. L....


reports and adjustments. This subpart contains the rules of SSA about: (a) Coverage under section 218 of the Act-- (1) How a State enters into and...


special meaning in this subpart are described in this section. Where necessary, further explanation is included in the section where the term is used. (b)...


(a) State's responsibility for submitting evidence. The State, under the provisions of the agreement, is responsible for accurately reporting the wages paid employees...


State. (a) Each State which enters into an agreement shall designate the official or officials authorized to act on the State's behalf in administering the agreement....


An absolute coverage group is a permanent grouping of employees, e.g., all the employees of a city or town. It is a coverage group for coverage and reporting purposes. When...


(a) General. Section 218(d) of the Act authorizes coverage of services of employees in positions under a retirement system. For purposes of obtaining coverage, a system may...


(a) General. Under section 218(d)(6)(C) of the Act certain States and under section 218(g)(2) of the Act all interstate instrumentalities may divide a retirement system...


An ineligible is an employee who, on first occupying a position under a retirement system, is not eligible for membership in that system because of a personal...


Some services are mandatorily excluded from coverage under a State's agreement. They are: (a) Services of employees who are hired to relieve them from unemployment; ...


Certain services and positions may, if the State requests it, be excluded from coverage. These exclusions may be applied on a statewide basis or selectively by coverage groups....


For Social Security coverage purposes under section 218 of the Act, interstate instrumentalities are treated, to the extent practicable, as States, that is: (a) They must...


(a) General. For Social Security coverage purposes under section 218 of the Act, a police officer's or firefighter's position is any position so classified under State statutes...


State may enter into a written agreement with the Commissioner to provide for Social Security coverage for its employees or the employees of one or more of its...


(a) General. A State or interstate instrumentality may modify in writing its agreement, for example, to: (1) Exclude, in limited situations, employee services or...


(a) General. If an agreement or modification contains an error, the State may correct the error by a subsequent modification to the agreement. For example, the...


The coverage of State and local government employees continues as follows: (a) Absolute coverage group. Generally, the services of an employee covered as a part of an...


20, 1983, an agreement could be terminated in its entirety or with respect to one or more coverage groups designated by the State. Coverage of any coverage group which has...


If a political subdivision whose employees are covered under the agreement is legally dissolved, the State shall give us satisfactory evidence of its dissolution or...


and local governments. When a State submits a modification to its agreement under section 218 of the Act, which extends coverage to periods prior to 1987, SSA will assign a...


(a) Who keeps the records. Every State which enters into an agreement shall keep, or require the political subdivisions whose employees are included under its agreement to...


that the services of employees covered by a State's agreement are reported and that those employees receive Social Security credit for their covered earnings, we periodically...


on four areas: (a) State's controls and recordkeeping--to assess a State's systems for assuring timely receipt, correctness, and completeness of wage reports...


staff personnel conduct the onsite review. Occasionally, members of the Office of the Inspector General may conduct or participate in the review. (b) The review is...


We provide the State Social Security Administrator with reports of the review's findings. These reports may contain coverage questions which need development and resolution and...


paid prior to 1987. (a) Wage reports. Each State shall report each year the wages paid each covered employee during that year. With the wage report...


more than one coverage group--for wages paid prior to 1987. (a) Employee of State in more than one coverage group. If a State employee is in more than one...


pay is pay received in one period of time which would have been paid in a prior period of time except for a wrongful or improper action taken by an employer. It includes...


1987. (a) Submitting wage reports. In the form and manner required by SSA, a State shall submit an annual report of the covered wages the State and its...


1987. A State shall report wages for the calendar year in which they were actually paid. If the wages were constructively paid in a prior calendar year, the wages shall...


to file contribution returns and wage reports--for wages paid prior to 1987. (a) Deposits of contributions. The State shall pay contributions in the...


If a political subdivision is legally dissolved, the State shall file a final report on that entity. The report shall include each coverage group whose existence...


prior to 1987. A State's liability for contributions equals the sum of the taxes which would be imposed by sections 3101 and 3111 of the Internal Revenue Code...


multiple employment situations--for wages paid prior to 1987. (a) Limitation due to multiple employment. Where an individual in any calendar year...


1987. The State's contributions are equal to the product of the applicable contribution rate (which is equivalent to both the tax rates imposed under sections 3101...


paid prior to 1987. When paying its contributions, the State shall deposit its payment at the specific Federal Reserve bank or branch designated...


paid prior to 1987. In paying contributions to a Federal Reserve bank or branch, a State may disregard a fractional part of a cent unless it amounts...


paid prior to 1987. (a) Contributions not paid timely. If a State fails to pay its contributions to the appropriate Federal Reserve bank or branch (see...


prior to 1987. If a State does not pay its contributions when due, the Commissioner has the authority under section 218(j) of the Act as it read prior to the enactment...


1987. States have the opportunity to adjust errors in the payment of contributions. A State but not its political subdivisions is authorized to adjust errors in...


paid prior to 1987. (a) General. If a State pays more than the correct amount of contributions, the State shall adjust the overpayment with the...


not adjustable--for wages paid prior to 1987. (a) General. If a State pays more than the correct amount of contributions or interest to the appropriate Federal...


paid prior to 1987. The amount of contributions a State deducts from an employee's remuneration for covered services, or any correction of that amount, is...


Internal Revenue Service-transfer of funds--for wages paid prior to 1987. (a) General. In some instances, State or local governmental entities not covered under an...


prior to 1987. If a State pays more than the amount of contributions due under an agreement, SSA may allow the State, subject to the time limitations in Sec. 404.1282...


no liability exists--for wages paid prior to 1987. If a State pays contributions for any period of time for which contributions are not due, but the State is...


paid prior to 1987. (a) General. To get a credit or refund, a State must file a claim for a credit or refund of the overpaid amount with the Commissioner...


or refunds--for wages paid prior to 1987. (a)(1) Extension by agreement. The applicable time period described in Sec. 404.1282 for filing a claim for credit for,...


paid prior to 1987. (a) State fails to make adjustment for allowance of credit. If SSA notifies a State that a credit is due the State, and the State does...


prior to 1987. (a) A State is liable for any amount due (which includes contributions or interest) under an agreement until the Commissioner is satisfied that the...


prior to 1987. (a) Subject to the exceptions to the time limitations in Sec. Sec. 404.1287 and 404.1289, a State is not liable for an amount due under an agreement...


wages paid prior to 1987. (a)(1) Extension by agreement. The applicable time period described in Sec. 404.1286 for assessment of an amount due may, before...


assessment--for wages paid prior to 1987. The Commissioner accepts wage reports filed by a State even though the applicable time limitation described in Sec. 404.1286...


paid prior to 1987. What decisions will be reviewed. A State, under section 218(s) of the Act as it read prior to the enactment of Pub. L. 99-509, may request...


After the State requests review of the assessment or allowance or disallowance of a credit or refund, and prior to the Commissioner's review, that decision may...


1987. (a) Form of request. No particular form of request is required. However, a written request for review must: (1) Identify the assessment, allowance or...


prior to 1987. (a) Time for filing. The State must file its request for review within 90 days after the date of the notice of assessment, allowance,...


paid prior to 1987. (a) The State will be notified in writing of the reconsidered determination on the assessment, allowance, or disallowance, and the...


1987. Upon request by the State, the Commissioner will review the reconsidered determination (or the assessment, allowance or disallowance as initially issued...


paid prior to 1987. The Commissioner notifies the State in writing of the decision on the assessment, allowance, or disallowance, and the basis for...


(a) Who can file civil action in court. A State may file a civil action under section 218(t) of the Act as it read prior to the enactment of Pub. L. 99-509 requesting...


to 1987. (a) Time for filing. The State must file the civil action for a redetermination of the correctness of the assessment, allowance or disallowance within 2...


(a) Overpayments. Payment of amounts due to a State required as the result of a final judgment of the court shall be adjusted under Sec. Sec. 404.1271 and 404.1272. ...


Introduction. Authority: Secs. 205 (a) and (p), 210 (l) and (m), 215(h), 217, 229, and 702(a)(5) of the Social Security Act (42 U.S.C. 405 (a) and (p), 410 (l)...


Definitions. As used in this subpart-- Act means the Social Security Act, as amended. Active duty means periods of time an individual is on full-time duty...


Who is a World War II veteran. You are a World War II veteran if you were in the active service of the United States during the World War II period and, if no longer...


Ninety-day active service requirement for World War II veterans. (a) The 90 days of active service required for World War II veterans do not have to be consecutive...


World War II service included. Your service was in the active service of the United States during the World War II period if you were in the-- (a) Army, Navy,...


World War II service excluded. Your service was not in the active service of the United States during the World War II period if, for example, you were in the-- ...


Who is a post-World War II veteran. You are a post-World War II veteran if you were in the active service of the United States during the post-World War II period and,...


Ninety-day active service requirement for post-World War II veterans. (a) The 90 days of active service required for post-World War II veterans do not have to...


Post-World War II service included. Your service was in the active service of the United States during the post-World War II period if you were in the-- (a) Air...


Post-World War II service excluded. Your service was not in the active service of the United States during the post-World War II period if, for example, you were in the-- ...


Separation from active service under conditions other than dishonorable. Separation from active service under conditions other than dishonorable means any discharge...


Who is a member of a uniformed service. A member of a uniformed service is an individual who served on active duty after 1956. You are a member of a uniformed service...


Wage credits for World War II and post-World War II veterans. In determining your entitlement to, and the amount of, your monthly benefit or lump-sum death payment based...


Wage credits for a member of a uniformed service. (a) General. In determining your entitlement to, and the amount of your monthly benefit (or lump sum death payment)...


Limits on granting World War II and post-World War II wage credits. (a) You get wage credits for World War II or post-World War II active service only if the use of...


When the limits on granting World War II and post-World War II wage credits do not apply. The limits on granting wage credits described in Sec. 404.1342 (c) and (d)...


Deemed insured status. (a) When deemed insured status applies. If you are the survivor of a World War II veteran, we consider the veteran to have died fully insured...


When deemed insured status does not apply. As a survivor of a World War II veteran, you cannot get a monthly benefit or lump-sum death payment based on the veteran's...


Benefits and payments based on deemed insured status. (a) Our determination. We determine your monthly benefit or lump-sum death payment under the deemed insured...


Veterans Administration pension or compensation payable. (a) Before we determine and certify payment. If we are informed by the Veterans Administration that a pension...


Federal benefit payable other than by Veterans Administration. (a) Before we determine and certify payment. If we are informed by another Federal agency or instrumentality...


Treatment of social security benefits or payments where Veterans Administration pension or compensation payable. (a) Before we receive notice from the Veterans...


Treatment of social security benefits or payments where Federal benefit payable other than by Veterans Administration. If we certify your monthly benefit or lump-sum...


Evidence of active service and separation from active service. (a) General. When you file an application for a monthly benefit or lump-sum death payment based on...


Evidence of membership in a uniformed service during the years 1957 through 1967. (a) General. When you file an application for a monthly benefit or lump-sum death...


404.1401 What is the interrelationship between the Railroad Authority: Secs. 202(l), 205(a), (c)(5)(D), (i), and (o), 210 (a)(9) and (l)(4), 211(c)(3),...


404.1402 When are railroad industry services by a non-vested worker covered under Social Security? If you are a non-vested worker, we (the Social...


404.1404 Effective date of coverage of railroad services under the act. Coverage under the act of services performed after 1936 by an individual in...


404.1405 If you have been considered a non-vested worker, what are the situations when your railroad industry work will not be covered under...


404.1406 Eligibility to railroad retirement benefits as a bar to payment of social security benefits. Notwithstanding the fact that, pursuant to the...


404.1407 When railroad retirement benefits do not bar payment of social security benefits. The provisions of Sec. 404.1406 shall not operate if: (a)...


404.1408 Compensation to be treated as wages. (a) General. Where pursuant to the preceding provisions of this subpart, [[Page...


404.1409 Purposes of using compensation. Compensation which is treated as wages under Sec. 404.1408 shall be used, together with wages (see subpart K of...


404.1410 Presumption on basis of certified compensation record. (a) Years prior to 1975. Where the Railroad Retirement Board certifies to SSA a report...


404.1412 Compensation quarters of coverage. As used in this subpart, a compensation quarter of coverage is any quarter of coverage computed with respect...


404.1413 When will we certify payment to the Railroad Retirement Board (RRB)? (a) When we will certify payment to RRB. If we find that you are entitled...


205(a), (b), and (d)-(h), 216(i), 221 (a) and (i), 222(c), 223, 225, and 702(a)(5) of the Social Security Act (42 U.S.C. 402, 405 (a), (b), and (d)-(h), 416(i), 421(a) and...


As used in the subpart-- Acceptable medical source refers to one of the sources described in Sec. 404.1513(a) [[Page 350]] who provides evidence...


(a) State agencies. State agencies make disability and blindness determinations for the Commissioner for most persons living in the State. State agencies make...


our program any individual or entity, except to provide existing medical evidence, who is currently excluded, suspended, or otherwise barred from participation in the Medicare...


A decision by any nongovernmental agency or any other governmental agency about whether you are disabled or blind is based on its rules and is not our decision about...


law defines disability as the inability to do any substantial gainful activity by reason of any medically determinable physical or mental impairment which can be expected to...


(a) Permanent exclusion of felony-related impairment. In determining whether you are under a disability, we will not consider any physical or mental impairment, or any increase...


If you are not doing substantial gainful activity, we always look first at your physical or mental impairment(s) to determine whether you are disabled or blind. Your impairment...


impairment is expected to result in death, it must have lasted or must be expected to last for a continuous period of at least 12 months. We call this the...


Substantial gainful activity means work that-- (a) Involves doing significant and productive physical or mental duties; and (b) Is done (or intended) for pay or profit. ...


(a) Disabled workers, persons disabled since childhood and, for months after December 1990, disabled widows, widowers, and surviving divorced spouses. If you are entitled to...


have to prove to us that you are blind or disabled. Therefore, you must bring to our attention everything that shows that you are blind or disabled. This means that you must...


(a) Sources who can provide evidence to establish an impairment. We need evidence from acceptable medical sources to establish whether you have a medically...


We need specific medical evidence to determine whether you are disabled or blind. You are responsible for providing that evidence. However, we will pay physicians not employed by...


You may give us evidence about your impairment at any of our offices or at the office of any State agency authorized to make disability determinations. You may also give evidence to...


If you do not give us the medical and other evidence that we need and request, we will have to make a decision based on information available in your case. We will not...


If your medical sources cannot or will not give us sufficient medical evidence about your impairment for us to determine whether you are disabled or blind, we may ask you to have one...


(a) General. If you are applying for benefits and do not have a good reason for failing or refusing to take part in a consultative examination or test which we arrange...


is a physical or mental examination or test purchased for you at our request and expense from a treating source or another medical source, including a...


how we will use it. (a)(1) General. The decision to purchase a consultative examination for you will be made after we have given full consideration to whether...


We will not purchase a consultative examination in situations including, but not limited to, the following situations: (a) In period of disability and...


purchase only the specific examinations and tests we need to make a determination in your claim. For example, we will not authorize a comprehensive medical examination when the...


(a) We will purchase a consultative examination only from a qualified medical source. The medical source may be your own physician or psychologist, or another...


treating source is qualified, equipped, and willing to perform the additional examination or tests for the fee schedule payment, and generally furnishes complete and...


We will use a medical source other than your treating source for a purchased examination or test in situations including, but not limited to, the following situations: ...


perform the consultative examination. You or your representative may object to your being examined by a medical source we have designated to perform a...


other services. We may purchase medical examinations, including psychiatric and psychological examinations, X-rays and laboratory tests (including...


We will request the results of any diagnostic tests or procedures that have been performed as part of a workup by your treating source or other medical source and will use the results...


report content, and signature requirements. The medical sources who perform consultative examinations will have a good understanding of our disability programs...


has not been received. If a consultative examination report is received unsigned or improperly signed we will take the following action. (a) When we...


(a) We will review the report of the consultative examination to determine whether the specific information requested has been furnished. We will consider the following...


possible conflict of interest between medical or psychological consultants and their medical or psychological practices will be avoided. Such consultants are not only...


(a) Day-to-day responsibility for the consultative examination process rests with the State agencies that make disability determinations for us. (b)...


(a) We will ensure that referrals for consultative examinations and purchases of consultative examinations are made in accordance with our policies. We will also monitor both the...


(a) General--(1) Purpose of this section. This section explains the five-step sequential evaluation process we use to decide whether you are disabled, as defined in Sec. 404.1505. ...


(a) General. The steps outlined in Sec. 404.1520 apply to the evaluation of physical and mental impairments. In addition, when we evaluate the severity of mental impairments for...


(a) Non-severe impairment(s). An impairment or combination of impairments is not severe if it does not significantly limit your physical or mental ability to do basic...


(a) Unrelated severe impairments. We cannot combine two or more unrelated severe impairments to meet the 12- [[Page 369]] month...


your physical or mental impairment or impairments are of a sufficient medical severity that such impairment or impairments could be the basis of eligibility under the law, we...


(a) Purpose of the Listing of Impairments. The Listing of Impairments describes, for each of the major body systems, impairments which are considered severe enough to prevent a...


is determined. We will decide that your impairment(s) is medically equivalent to a listed impairment in appendix 1 if the medical findings are at least equal in severity...


(1) You can only be found disabled if you are unable to do any substantial gainful activity by reason of any medically determinable physical or mental impairment which can...


Medical findings consist of symptoms, signs, and laboratory findings: (a) Symptoms are your own description of your physical or mental impairment. Your statements alone...


(a) General. In determining whether you are disabled, we consider all your symptoms, including pain, and the extent to which your symptoms can reasonably be accepted as...


What treatment you must follow. In order to get benefits, you must follow treatment prescribed by your physician if this treatment can restore your ability to work. (b) When...


alcoholism is a contributing factor material to the determination of disability. (a) General. If we find that you are disabled and have medical evidence...


alcoholism is a contributing factor material to the determination of disability. (a) If we determine that you are disabled and drug addiction or...


By appropriate treatment, we mean treatment for drug addiction or alcoholism that serves the needs of the individual in the least restrictive setting possible consistent with...


Institutions or facilities that we may approve include-- (a) An institution or facility that furnishes medically recognized treatment for drug addiction or alcoholism...


Our determination about whether treatment is available to you for your drug addiction or your alcoholism will depend upon-- (a) The capacity of an approved institution...


(a) General. Generally, we will consider information from the treatment institution or facility to evaluate your compliance with your treatment plan. The...


We will contract with one or more agencies in each of the States, Puerto Rico and the District of Columbia to provide services to individuals whose disabilities...


(a) General--(1) Residual functional capacity assessment. Your impairment(s), and any related symptoms, such as pain, may cause physical and mental limitations that affect what you can...


(a) Responsibility for assessing residual functional capacity at the State agency. When a State agency makes the disability determination, a State agency...


(a) General. If you are applying for a period of disability, or disability insurance benefits as a disabled worker, or child's insurance benefits based on disability...


make an adjustment to other work. (a) If you have done only arduous unskilled physical labor. If you have no more than a marginal education (see Sec. 404.1564) and...


``Age'' means your chronological age. When we decide whether you are disabled under Sec. 404.1520(g)(1), we will consider your chronological age in combination with your...


(a) General. Education is primarily used to mean formal schooling or other training which contributes to your ability to meet vocational requirements, for example, reasoning...


(a) General. Work experience means skills and abilities you have acquired through work you have done which show the type of work you may be expected to do. Work you have...


(a) General. We consider that work exists in the national economy when it exists in significant numbers either in the region where you live or in several other regions of...


physical exertion requirements of work in the national economy, we classify jobs as sedentary, light, medium, heavy, and very heavy. These terms have the same meaning as...


skills and to help determine the existence in the national economy of work you are able to do, occupations are classified as unskilled, semi-skilled, and skilled....


The Dictionary of Occupational Titles includes information about jobs (classified by their exertional and skill [[Page 388]] requirements) that exist...


(a) General. Your impairment(s) and related symptoms, such as pain, may cause limitations of function or restrictions which limit your ability to meet certain demands of...


that you have done during any period in which you believe you are disabled may show that you are able to work at the substantial gainful activity level. If you are able...


Substantial gainful activity is work activity that is both substantial and gainful: (a) Substantial work activity. Substantial work activity is work activity that...


(a) The nature of your work. If your duties require use of your experience, skills, supervision and responsibilities, or contribute substantially to the operation of a...


(a) We use several guides to decide whether the work you have done shows that you are able to do substantial gainful activity. If you are working or have worked as an employee,...


(a) If your work as an employee or as a self-employed person was continuous without significant change in work patterns or earnings, and there has been no change in...


(a) If you are a self-employed person. If you are working or have worked as a self-employed person, we will use the provisions in paragraphs (a) through (d) of this section...


(a) General. When we figure your earnings in deciding if you have done substantial gainful activity, we will subtract the reasonable costs to you of certain items and services...


spouses for monthly benefits payable for months prior to January 1991. For monthly benefits payable for months prior to January 1991, the...


surviving divorced spouses for monthly benefits payable for months prior to January 1991. (a) For monthly benefits payable for months prior to January 1991,...


surviving divorced spouses for monthly benefits payable for months prior to January 1991. (a) For monthly benefits payable for months prior to January 1991,...
...


We will consider you blind under the law for a period of disability and for payment of disability insurance benefits if we determine that you are statutorily blind....


If we find that you are blind and you meet the insured status requirement, we may establish a period of disability for you regardless of whether you can do substantial...


age 55 or older. We will find that you are eligible for disability insurance benefits even though you are still engaging in substantial gainful activity, if-- ...


(a) General. If you are blind (as explained in Sec. 404.1581), we will consider the earnings from the work you are doing to determine whether or not you should be paid...


blind. If you become eligible for disability benefits even though you were doing substantial gainful activity because you are blind and age 55 or older, you are entitled...


(a) When you are not entitled to benefits. If you become entitled to disability cash benefits as a statutorily blind person, we will find that you are no longer entitled...


we make a determination. We will suspend your benefits if all of the information we have clearly shows that you are not disabled and we will be unable...


your disability status. If you are entitled to cash benefits or to a period of disability because you are disabled, you should promptly tell us if-- (a)...


be disabled. After we find that you are disabled, we must evaluate your impairment(s) from time to time to determine if you are still eligible for...


review. (a) General. We conduct continuing disability reviews to determine whether or not you continue to meet the disability requirements of the law....


work. If your impairment was expected to improve and you returned to full- time work with no significant medical limitations and acknowledge that medical improvement...


the trial work period. The trial work period is a period during which you may test your ability to [[Page 416]] work and still be considered disabled. It begins...


reentitlement period is an additional period after 9 months of trial work during which you may continue to test your ability to work if you have a disabling impairment,...


(a) General. If you are entitled to benefits or if a period of disability has been established for you because you are disabled, we will have your case file with...


(a) General. If you are entitled to benefits or if a period of disability has been established for you because you are disabled, we will have your case file with...
...


(a) When we will give you advance notice. Except in those circumstances described in paragraph (d) of this section, we will give you advance notice when we have...


before we make a determination. (a) General. Under some circumstances, we may stop your benefits before we make a determination. Generally, we do this when...


(a) General. If we determine that you do not meet the disability requirements of the law, your benefits generally will stop. We will send you a formal written...


determination. (a) General. If we determine that you are not entitled to benefits because the physical or mental impairment(s) on the basis of which...


If a new severe impairment(s) begins in or before the month in which your last impairment(s) ends, we will find that your disability is continuing. The new impairment(s)...


projects in the disability program. (a) Authority and purpose. Section 505(a) of the Social Security Disability Amendments of 1980, Pub. L. 96-265, directs...


and 702(a)(5) of the Social Security Act (42 U.S.C. 405(a), 421, and 902(a)(5)). Source: 46 FR 29204, May 29, 1981, unless otherwise noted. ...


Act means the Social Security Act, as amended. Class or classes of cases means the categories into which disability claims are divided according to...


(a) General. We will work with the State to provide and maintain an effective system for processing claims of those who apply for and who are receiving benefits under the...


determination function. (a) Deemed notice. Any State that has in effect as of June 1, 1981, an agreement with us to make disability determinations will be deemed...


function. (a) If a State notifies us in writing that it wishes to perform the disability determination function, we will notify the State in...


(a) General rule. A State agency will make determinations of disability with respect to all persons in the State except those individuals whose cases are in a class specifically...


(a) The State agency will secure from the claimant, or other sources, any evidence it needs to make a disability determination. (b) We...


a disability determination, the State agency will apply subpart P, part 404, of our regulations. (b) The State agency will make disability determinations based only on...


(a) What is a medical consultant? A medical consultant is a person who is a member of a team that makes disability determinations in a State agency, as explained in Sec. 404.1615, or...


or psychologist. (a) The State agency must determine if additional qualified psychiatrists and psychologists are needed to make the necessary reviews...


The State agency will prepare denial notices in accordance with subpart J of this part whenever it makes a disability determination which is wholly or partly unfavorable to...


State will provide the organizational structure, qualified personnel, medical consultant services, and a quality assurance function sufficient to ensure that disability...


State will comply with all applicable Federal statutes, executive orders and regulations concerned with equal employment opportunities. (b) Selection, tenure,...


have an acceptable level of competence. We will provide training and other instructional materials to facilitate basic and advanced technical proficiency of disability...


other services. Subject to appropriate Federal funding, the State will provide adequate space, equipment, supplies, and other services to facilitate making accurate...


will determine the rates of payment to be used for purchasing medical or other services necessary to make determinations of disability. The rates may not exceed the highest rate...


maintain the records and furnish the schedules, financial, cost, and other reports relating to the administration of the disability programs as we may require. (b)...


advance or by way of reimbursement, for necessary costs in making disability determinations under these regulations. Necessary costs are direct as well as indirect costs as...


Audits of accounts and [[Page 538]] records pertaining to the administration of the disability program under the Act, will be performed by the...


for disability program purposes. The State will be responsible for maintaining all property it acquires or which we furnish to it for performing the...


We will invite State participation in federally funded research and demonstration projects to assess the effectiveness of the disability program and to ascertain the effect...


will establish cooperative working relationships with other agencies concerned with serving the disabled and, insofar as practicable, use their services, facilities, and...


The State will comply with the confidentiality of information, including the security of systems, and records requirements described in 20 CFR part 401 and pertinent written...


comply with the provisions of other Federal laws and regulations that directly affect its responsibilities in carrying out the disability determination function; for...


will provide the State agency with written guidelines necessary for it to carry out its responsibilities in performing the disability determination function. (b) The State...


procedures and guidelines we use to determine whether the State agency is substantially complying with our regulations and other written guidelines, including...


standards include both a target level of performance and a threshold level of performance for the State agency. The target level represents a level of performance that we...


processing time refers to the average number of days, including Saturdays, Sundays, and holidays, it takes a State agency to process an initial disability claim from the day...


accuracy refers to the percentage of cases that do not have to be returned to State agencies for further development or correction of decisions based on evidence in...


are met. (a) How we determine processing times. For all initial title II cases, we calculate the mean number of days, including Saturdays, Sundays and...


is met. (a) How we determine performance accuracy. We determine a State agency's performance accuracy rate on the basis of decision and documentation...


If a State agency does not meet two of the three established threshold levels (one of which must be performance accuracy) for two or more consecutive...


State agency combined title II and title XVI initial performance accuracy rate, title II initial processing time, and title XVI initial processing time. Within budgeted...


(a) Optional support. We may offer, or a State may request, performance support at any time that the regular monitoring and review process reveals that support could enhance...


may include, but is not limited to, any or all of the following: (a) An onsite review of cases processed by the State agency emphasizing adherence to...


of three established threshold levels, one being performance accuracy, for two consecutive quarters, and after the mandatory performance support period, we will give the...


other written guidelines. If a State has good cause for not following the Act, our regulations, or other written guidelines, we will not find that the State...


substantial failure with respect to a State may not be made unless and until the State is afforded an opportunity for a hearing. Hearings...


If, following the mandatory performance support period and the 3- month adjustment period, a State agency again falls below two of three threshold...


Disputes concerning monetary disallowances will be resolved in proceedings before the Department of Health and Human Services' Departmental Appeals Board if the issue cannot...


it will be conducted by the Department of Health and Human Services' Grant Appeals Board (the Board). [46 FR 29204, May 29, 1981, as amended at 62 FR 38452, July...


and appeals before the Board are provided in 45 CFR part 16. A notice under Sec. 404.1680 of this subpart will be considered a ``final written decision'' for purposes of...


(a) Notice to State. When we find that substantial failure exists, we will notify the State in writing that we will assume responsibility for performing the...


determination function. (a) Notice to the Commissioner. If a State no longer wishes to perform the disability determination function, it will notify us...


We will develop and initiate procedures to implement a plan to partially or completely assume the disability determination function from the State agency under Sec. 404.1690...


The State agency may not, after it receives the notice referred to in Sec. 404.1690, or gives the notice referred to in Sec. 404.1691, make any new commitments to spend...


submit its final claims to us as soon as possible, but in no event later than 1 year from the effective date of our assumption of the disability determination function unless we...


702(a)(5) of the Social Security Act (42 U.S.C. 405(a), 406, and 902(a)(5)). Source: 45 FR 52090, Aug. 5, 1980, unless otherwise noted. You may...


Past-due benefits means the total amount of benefits payable under title II of the Act to all beneficiaries that has accumulated because of a favorable administrative or...


may appoint as your representative in dealings with us, any attorney in good standing who-- (1) Has the right to practice law before a court of a State, Territory,...


If you are not represented by an attorney and we make a determination or decision that is subject to the administrative review process provided under subpart J of...


person as your representative if the following things are done: (a) You sign a written notice stating that you want the person to be your representative in dealings...


may do. Your representative may, on your behalf-- (1) Obtain information about your claim to the same extent that you are able to do; (2)...


shall send your representative-- (1) Notice and a copy of any administrative action, determination, or decision; and (2) Requests for information or evidence. (b)...


A representative may charge and receive a fee for his or her services as a representative only as provided in paragraph (b) of this section. (b) Charging and receiving...


request. In order for your representative to obtain approval of a fee for services he or she performed in dealings with us, he or she shall file a written request with one of our...


(a) Representation of a party in court proceedings. We shall not consider any service the representative gave you in any proceeding before a State or Federal court to be services...


We will pay a representative who is an attorney, out of the claimant's past-due benefits, the amount of fee allowed by a Federal court in a proceeding under title II of...


Services provided a claimant in any dealing with us under title II of the Act consist of services performed for that claimant in connection with any claim he or she may...


(a) Purpose and scope. (1) All attorneys or other persons acting on behalf of a party seeking a statutory right or [[Page...


When we have evidence that a representative fails to meet our qualification requirements or has violated the rules governing dealings with us, we may begin proceedings to...


(a) The Deputy Commissioner for Disability and Income Security Programs (or other official the Commissioner may designate), or his or her designee, will prepare a notice containing...


We may withdraw charges against a representative. We will do this if the [[Page 551]] representative files an answer, or we obtain evidence, that satisfies us...


If the Deputy Commissioner for Disability and Income Security Programs (or other official the Commissioner may designate), or his or her designee, does not take action...


After the close of the hearing, the hearing officer shall issue a decision or certify the case to the Appeals Council. The decision must be in writing, will contain findings of...


(a) General. After the hearing officer issues a decision, either the representative or the other party to the hearing may ask the Appeals Council to review the decision. ...


Upon receipt of a request for review of the hearing officer's decision, the matter will be assigned to a panel consisting of three members of the...


(a) Upon request, the Appeals Council shall give the parties a reasonable time to file briefs or other written statements as to fact and law, and to appear before the...


the Appeals Council will not consider evidence in addition to that introduced at the hearing. However, if the Appeals Council believes that the evidence offered is...


shall base its decision upon the evidence in the hearing record and any other evidence it may permit on review. The Appeals Council shall either-- (1) Affirm, reverse,...


The Appeals Council may dismiss a request for the review of any proceeding to suspend or disqualify a representative in any of the following circumstances: ...


[Code of Federal Regulations] [Title 20, Volume 2] [Revised as of April 1, 2004] From the U.S. Government Printing Office via GPO Access [CITE: 20CFR404.1797] [Page 554] TITLE 20--EMPLOYEES' BENEFITS CHAPTER III--SOCIAL SECURITY ADMINISTRATION PART 404_FEDERAL OLD-AGE, SURVIVORS AND DISABILITY INSURANCE (1950 ) --Table of Contents Subpart R_Representation of Parties Sec. 404.1797 Reinstatement after suspension--period of suspension expired. We shall automatically allow a person to serve again as a representative in dealings with us at the end of any suspension. ...


suspension not expired. (a) After more than one year has passed, a person who has been suspended or disqualified, may ask the Appeals Council for permission...


702(a)(5), and 708(a) of the Social Security Act (42 U.S.C. 405 (a) and (n), 407, 902(a)(5) and 909(a)). Source: 45 FR 52095, Aug. 5, 1980, unless...


have made a determination or decision that you are entitled to benefits, we certify to the Secretary of the Treasury, who is the Managing Trustee of the Trust Funds-- (1)...


made a determination or decision that you are entitled to recurring monthly benefits, you will be assigned a monthly payment day. Thereafter, any recurring monthly benefits...


have established special procedures to expedite the payment of benefits in certain initial and subsequent claims. This section tells how you may request an expedited payment and when...


may be withheld. After a determination or decision, we may withhold certification to the Managing Trustee, or, if we have already made certification, we may notify...


shall not certify payment to-- (1) Any person designated as your assignee or transferee; or (2) Any person claiming payment because of an execution, levy,...


in same family. If an amount is payable under title II of the Act for any month to two or more persons who are members of the same family, we may certify any two or more...


702(a)(5) of the Social Security Act (42 U.S.C. 405(a), 433, and 902(a)(5)). Source: 44 FR 42964, July 23, 1979, unless otherwise noted. ...


Act means the Social Security Act (42 U.S.C. 301 et seq.). Agency means the agency responsible for the specific administration of a social security system...


be negotiated with the national government of the foreign country for the entire country. However, agreements may only be negotiated with foreign countries that have a...


Section 233 of the Social Security Act provides that a totalization agreement shall become effective on any date provided in the agreement if-- (a) The date occurs after...


provisions for its possible termination. If an agreement is terminated, entitlement to benefits and coverage acquired by an individual before termination shall be...


General. To have foreign periods of coverage combined with U.S. periods of coverage for purposes of determining entitlement to and the amount of benefits payable under title II,...


(a) An agreement may not provide for combining periods of coverage under more than two social security systems. (b) If a person qualifies under more than one...


benefits. A person may not become entitled to hospital insurance benefits under section 226 or section 226A of the Act by combining the person's...


or self-employment or services recognized as equivalent under the Act or the social security system of the foreign country shall, on or after the effective date of the...


of coverage under one social security system may be required before the individual may be exempt from coverage under the other system. Requests for certificates of coverage...


of the agreement, to the extent that employment or self-employment (or service recognized as equivalent) under the U.S. social security system or foreign system is...


otherwise provided in an agreement, benefits will be computed in accordance with this section. Benefits payable under an agreement are based on a pro rata primary insurance...


in an agreement, we will recompute benefits in accordance with this section. We will recompute the pro rata PIA only if the inclusion of the additional earnings results in...


benefits is less than the U.S. minimum benefit. If a resident of the U.S. receives benefits under an agreement from both the U.S. and from the foreign country,...


amount due an individual (or several individuals, e.g., children, where several benefits are combined in one check) as a result of a claim filed under an agreement is less...


requesting benefits, filed with the competent authority or agency of a country with which the U.S. has concluded an agreement shall be considered an application...


an agreement shall submit the evidence needed to establish entitlement, as provided in subpart H of this part. Special [[Page 565]] evidence requirements...


or Appeals Council review of a determination that is filed with the competent authority or agency of a country with which the U.S. has concluded an agreement, shall...


agreement may provide that a person entitled to benefits under title II of the Social Security Act may receive those benefits while residing in the foreign country party to...


adjustment of title II benefits to recover an overpayment made under the social security system of a foreign country (see Sec. 404.501). Where an overpayment is made under...


under an agreement generally shall be governed by the national statutes on confidentiality and disclosure of information of the country that has been furnished...


and (k), and 702(a)(5) of the Social Security Act (42 U.S.C. 405 (a), (j), and (k), and 902(a)(5)). Source: 47 FR 30472, July 14, 1982, unless otherwise noted. ...


(a) We pay benefits to a representative payee on behalf of a beneficiary 18 years old or older when it appears to us that this method of payment will be in the interest of...


In determining whether to make representative payment we consider the following information: (a) Court determinations. If we learn that...


In selecting a payee we try to select the person, agency, organization or institution that will best serve the interest of the beneficiary. In making our selection...


As a guide in selecting a representative payee, categories of preferred payees have been established. These preferences are flexible. Our primary concern is to select the...


(a) Before we select a representative payee, the payee applicant must give us information showing his or her relationship to the beneficiary and his or her responsibility for...


(a) Generally, whenever we intend to make representative payment and to name a payee, we notify the beneficiary or the individual acting on his or...


representative payee has a responsibility to-- (a) Use the payments he or she receives only for the use and benefit of the beneficiary in a manner and for the purposes he or...


We will consider that payments we certify to a representative payee have been used for the use and benefit of the beneficiary if they are used for the beneficiary's...


payees. (a) General. A community-based, nonprofit social service agency which meets the requirements set out in paragraph (b) of this section may...


to the beneficiary is completely discharged when we make a correct payment to a representative payee on behalf of the beneficiary. The payee in his or her personal...


(a) General. After the representative payee has used benefit payments consistent with the guidelines in this subpart (see Sec. 404.2040 regarding use of benefits), any...


When we learn that the interests of the beneficiary are not served by continuing payment to the present payee or that the present payee is no longer able to carry out the...


If a beneficiary receiving representative payment shows us that he or she is mentally and physically able to manage or direct the management of benefit payments, we will make...


payee who has conserved or invested benefit payments shall transfer these funds, and the interest earned from the invested funds, to either a successor payee or to us, as...


is accountable for the use of benefits. We may require periodic written reports from representative payees. We may also, in certain situations, verify how a representative...


and 702(a)(5) of the Social Security Act (42 U.S.C. 405(a), 422, and 902(a)(5)). Source: 48 FR 6293, Feb. 10, 1983, unless otherwise noted. ...


the rules under which the Commissioner will pay the State VR agencies or alternate participants for VR services. Payment will be provided for VR services provided on...


Accept the beneficiary as a client for VR services means that the State VR agency determines that the individual is eligible for VR services and places the...


(a) General. In order to participate in the payment program under this subpart through its VR agency(ies), a State must have a plan...


(a) General. We may arrange for VR services through an alternate participant by written agreement or contract as explained in Sec. 404.2104(f). An alternate...


VR agency or alternate participant must file a claim for payment in each individual case within the time periods specified in Sec. 404.2116; (b) The claim for payment...


The Commissioner will decide-- (a) Whether a continuous period of 9 months of SGA has been completed; (b) Whether a disability beneficiary whose disability...


of 9 months''. (a) What we mean by ``SGA''. In determining whether an individual's work is SGA, we will follow the rules in Sec. Sec. 404.1572 through 404.1575....


be considered to have contributed to a continuous period of 9 months. The State VR agency or alternate participant may be paid for VR services if such...


to receive disability payments based on participation in an approved VR program. Sections 404.1586(g), 404.316(c), 404.337(c), and 404.352(c)...


(a) General. Payment may be made for VR services provided by a State VR agency in accordance with title I of the Rehabilitation Act of 1973, as amended, or by an...


(a) In order for the VR agency or alternate participant to be paid, the services must have been provided-- (1) After September 30, 1981; (2) No earlier than...


made (filing deadlines). The State VR agency or alternate participant must file a claim for payment in each individual case within the following time periods: (a)...


with section 222(d) of the Social Security Act, the Commissioner will pay the State VR agency or alternate participant for the VR services described in Sec. 404.2114 which...


When an alternate participant provides rehabilitation services under this subpart, the payment procedures stated herein shall apply except that: ...


VR agencies or alternate participants pursuant to this subpart will be made either by advancement of funds or by payment for services provided (with necessary adjustments for...


alternate participant shall permit us and the Comptroller General of the United States (including duly authorized representatives) access to and the right to examine records...


will conduct a validation review of a sample of the claims for payment filed by each State VR agency or alternate participant. We will conduct some of these reviews on a...


The State or alternate participant shall comply with the provisions for confidentiality of information, including the security of systems,...


Each State VR agency and alternate participant shall comply with the provisions of other Federal laws and regulations that directly affect its responsibilities in carrying out...


the amount to be paid. The appropriate SSA official will notify the State VR agency or alternative participant in writing of his or her determination concerning the amount to...


Subpart A_Introduction, General Provision and Definitions Sec. 408.101 What is this part about? 408.105 Purpose and administration of the program. 408.110...


purpose of the title VIII program is to assure a basic income level for certain veterans who are entitled to supplemental security income (SSI) and who want to leave the United...


to the Act and regulations. (1) The Act means the Social Security Act as amended (42 U.S.C. Chap.7). (2) Title means the title of the Act. (3) Section or Sec....


Title VIII of the Act and the regulations in this part require you to take certain actions within specified time periods or you may lose your right to a portion or all of...


802, 803, 804, 806, 810 and 1129A of the Social Security Act (42 U.S.C. 902(a)(5), 1001, 1002, 1003, 1004, 1006, 1010 and 1320a-8a); Sec. 251, Pub. L. 106-169, 113...


meet all of the following requirements. (a) Age. You were age 65 or older on December 14, 1999 (the date on which Pub. L. 106-169 was enacted into law). (b) World War...


entitled to receive SVB payments? (a) General rule. Even if you meet all the qualification requirements in Sec. 408.202, you will not be qualified for SVB for...


you apply for SVB, we will ask you for documents and other information that we need to determine if you meet all the requirements for qualification. You must give us...


4 calendar months? If you begin residing outside the United States within 4 calendar months after the month in which your SVB qualification notice is dated,...


within 4 calendar months? If you do not establish residence outside the United States within 4 calendar months after the month in which your SVB qualification...


the United States? If you meet all the requirements for qualification listed in Sec. 408.202 and if none of the conditions listed in Sec. 408.204 exist, we...


of the day before the anniversary of your birth corresponding to age 65. Thus, you must have been born on or before December 15, 1934 to be at least age 65 on December 14,...


SVB purposes, you are a World War II veteran if you: (1) Served in the active military, naval or air service of the United States during World War II at any time...


purposes, you are eligible for SSI for a given month if all of the following are met: (a) You have been determined to be eligible for SSI (except as noted in paragraph (c)...


other benefit income. Other benefit income is any regular periodic payment (such as an annuity, pension, retirement or disability benefit) that you receive. For other benefit...


(a) Income began before you qualify for SVB. If, at the time you file your application for SVB, your other benefit income is equal to, or more than, the maximum SVB payment possible...


If your other benefit income is paid in other than monthly amounts, we will compute the equivalent monthly amount as follows: (a) Weekly payments. We multiply...


become entitled to SVB? If you begin receiving other benefit income after you become entitled to SVB, we will reduce your SVB by the amount of those payments only...


(a) Effect of residency on SVB eligibility. You can be paid SVB only for those months in which you are residing outside the United States but you can not be...


(a) 4-month rule. Except as provided in paragraph (b) of this section, you must begin residing outside the United States by the end of the fourth calendar month after the month...


rule. We consider you to have lost or abandoned your residence outside the United States if you: (1) Enter the United States and stay for more than 1 full calendar...


States for more than 1 full calendar month? (a) When we will consider your foreign residence to continue. We will continue to consider you to be a foreign resident...


and 810 of the Social Security Act (42 U.S.C. 902(a)(5), 1102, 1106 and 1110); Sec. 251, Pub. L. 106- 169, 113 Stat. 1844. Filing...


In addition to meeting other requirements, you must file an application to become entitled to SVB. If you believe you may be entitled to SVB, you should file an application. Filing...


claim for SVB, an application must generally meet all of the following conditions: (a) It must be on the prescribed SVB application form (SSA-2000-F6, Application for...


are mentally competent, and physically able to do so, you must sign your own application. (b) When someone else may sign for you. (1) If you are mentally incompetent,...


you? (a) A person who signs an application for you will be required to give us evidence of his or her authority to sign the application for you under...


consider an application for SVB filed on the day it is received by an SSA employee at one of our offices, by an SSA employee who is authorized to receive it at a place other than...


SVB will remain in effect from the date it is filed until we make a final determination on it, unless there is a hearing decision on your application. If there is a...


If you file with us under the rules stated in Sec. 408.325 a written statement, such as a letter, indicating your intent to claim SVB, we will use the filing date of the written...


date? We will use the date of an oral inquiry about SVB as the filing date of your application for SVB if the following requirements are met: (a) The inquiry...


(a) General rule. You may have considered applying for SVB, for yourself or another person and you may have contacted us in writing, by telephone or in person...


before a determination is made. You may withdraw your application for SVB before we make a determination on it if-- (1) You, or a person who may sign an application...


You may request to cancel your request to withdraw your application and have your application reinstated if all of the following requirements are met: (a) You, or someone who...


and 810 of the Social Security Act (42 U.S.C. 902(a)(5), 1006, and 1010); sec. 251, Pub. L. 106-169, 113 Stat. 1844. ...


we will ask you for any evidence we need to make sure that you meet the SVB qualification and entitlement requirements. After you begin receiving SVB, we may ask you for...


evidence to the people at a Social Security Administration office. In the Philippines, you [[Page 596]] should give your evidence to the people at the Veterans...


(a) You have not yet qualified for SVB. Generally, we will ask you to give us specific evidence or information by a certain date to prove that you qualify for SVB or to prove...


(a) General rule. To prove your qualification for or continuing entitlement to SVB, you may be asked to show us an original document or record. These original documents or records...


us evidence, we examine it to see if it is convincing evidence. This means that unless we have information in our records that raises a doubt about the evidence, other evidence...


SVB you must establish that you were age 65 or older on December 14, 1999, the date on which Public Law 106-169 was enacted into law. If we have already established your age...


[Code of Federal Regulations] [Title 20, Volume 2] [Revised as of April 1, 2004] From the U.S. Government Printing Office via GPO Access [CITE: 20CFR408.412] [Page 597] TITLE 20--EMPLOYEES' BENEFITS CHAPTER III--SOCIAL SECURITY ADMINISTRATION PART 408_SPECIAL BENEFITS FOR CERTAIN WORLD WAR II VETERANS--Table of Contents Subpart D_Evidence Requirements Sec. 408.412 What kinds of evidence of age do you need to give us? For a description of the kinds of evidence of age you may need to give us, see Sec. 416.802 of this chapter. ...


[Code of Federal Regulations] [Title 20, Volume 2] [Revised as of April 1, 2004] From the U.S. Government Printing Office via GPO Access [CITE: 20CFR408.413] [Page 597] TITLE 20--EMPLOYEES' BENEFITS CHAPTER III--SOCIAL SECURITY ADMINISTRATION PART 408_SPECIAL BENEFITS FOR CERTAIN WORLD WAR II VETERANS--Table of Contents Subpart D_Evidence Requirements Sec. 408.413 How do we evaluate the evidence of age you give us? In evaluating the evidence of age you give us, we use the rules in Sec. 416.803 of this chapter. Military Service ...


(a) Kinds of evidence you can give us. To show that you are a World War II veteran as defined in Sec. 408.216, you can give us any of the documents listed in...


SVB, you must have been eligible for SSI for the month of December 1999, the month in which Public Law 106-169 was enacted, and for the month in which you filed your application...


If you tell us or if we have information indicating that you are receiving other benefit income that could affect your qualification for or the amount of your SVB...


give us? As evidence of your other benefit income, we may require a document such as an award notice or other letter from [[Page 598]] the paying agency...


(a) General rule. To establish that you are residing outside the United States for SVB purposes, you must give us all of the following: (1) Evidence of the date on...


States for more than 1 full calendar month? (a) General rule. If you believe that you meet the requirements in Sec. 408.234 and that you should continue to receive...


805, and 810 of the Social Security Act (42 U.S.C. 902(a)(5), 1001, 1005, and 1010); Sec. 251, Pub. L. 106- 169, 113 Stat. 1844. This subpart explains how...


Maximum SVB payment. The maximum monthly SVB payment is equal to 75% of the FBR for an individual under title XVI of the Act. See Sec. 416.410 of this chapter. ...


(a) Amount of the reduction. If you receive other benefit income as defined in Sec. 408.220, we will reduce your SVB payment by the amount of the other benefit income...


the first day of each month and represent payment for that month. If the first day of the month falls on a Saturday, Sunday, or Federal legal holiday, payment will be made on...


Authority: Secs. 702(a)(5) of the Social Security Act (42 U.S.C. 902(a)(5)), Secs. 3 (g) and (h), 402, 411, 412, 413, 414, 426(a), and 508, 83 Stat. 744; 30 U.S.C. 802 (g)...


use of terms. For purposes of this part, except where the context clearly indicates otherwise, the following definitions apply: (a) The Act, means the Federal...


Disclosure of any file, record, report, or other paper, or any information obtained at any time by the Social Security Administration, or any officer...


on nonworkdays. Where any provision of part B of title IV of the Act, or any provision of another law of the United States, relating to or changing the effect of...


Evidence Sec. 410.200 Types of benefits; general. Authority: Sec. 702(a)(5) of the Social Security Act (42 U.S.C. 902(a)(5)), sec. 402, 411, 412, 413, 414,...


Evidence Sec. 410.201 Conditions of entitlement; miner. An individual is entitled to benefits if such individual: (a) Is a miner (see Sec. 410.110(j)); and ...


Evidence Sec. 410.202 Duration of entitlement; miner. (a) An individual is entitled to benefits as a miner for each month beginning with the first month...


Evidence Sec. 410.210 Conditions of entitlement; widow or surviving divorced wife. An individual is entitled to benefits if such individual: (a) Is the...


Evidence Sec. 410.211 Duration of entitlement; widow or surviving divorced wife. (a) An individual is entitled to benefits as a widow, or as a surviving...


Evidence Sec. 410.212 Conditions of entitlement; child. (a) An individual is entitled to benefits if such individual: (1) Is the child or stepchild (see...


Evidence Sec. 410.213 Duration of entitlement; child. (a) An individual is entitled to benefits as a child for each month beginning with the first month in...


Evidence Sec. 410.214 Conditions of entitlement; parent, brother, or sister. An individual is entitled to benefits if: (a) Such individual: (1)...


Evidence Sec. 410.215 Duration of entitlement; parent, brother, or sister. (a) parent, brother, or sister is entitled to benefits beginning with the month all...


Evidence Sec. 410.216 ``Good cause'' for delayed filing of proof of support. (a) What constitutes ``good cause.'' Good cause may be found for failure to...


Evidence Sec. 410.219 Filing a claim under State workmen's compensation law; when filing such claim shall be considered futile. (a) A claimant for benefits...


Evidence Sec. 410.220 Claim for benefits; definitions. For purposes of this part: (a) Claim defined. The term claim means a writing asserting a right...


Evidence Sec. 410.221 Prescribed application and request forms. (a) Claims shall be made as provided in this subpart on such application forms and in...


Evidence Sec. 410.222 Execution of a claim. The Administration determines who is the proper party to execute a claim in accordance with the following rules: ...


Evidence Sec. 410.223 Evidence of authority to execute a claim on behalf of another. Where the claim is executed by a person other than the claimant,...


Evidence Sec. 410.224 Claimant must be alive when claim is filed. For a claim to be effective, the claimant must be alive at the time a properly executed claim...


Evidence Sec. 410.226 Periods for which claims are effective. (a) Application effective for entire month of filing. Benefits are payable for full calendar...


Evidence Sec. 410.227 When a claim is considered to have been filed; time and place of filing. (a) Date of receipt. Except as otherwise provided in this part,...


Evidence Sec. 410.228 Requests and notices to be in writing. Except as otherwise provided in this part, any request to the Administration for a determination or...


Evidence Sec. 410.229 When written statement is considered a claim; general. (a) Written statement filed by claimant on his own behalf. Where an...


Evidence Sec. 410.230 Written statement filed by or for a miner on behalf of a member of his family. Notwithstanding the provisions of Sec. 410.229, the...


Evidence Sec. 410.231 Time limits for filing claims. (a) A claim by or on behalf of a miner must be filed on or before December 31, 1973, and when so filed, is...


Evidence Sec. 410.232 Withdrawal of a claim. (a) Before adjudication of claim. A claimant (or an individual who is authorized to execute a claim on his behalf...


Evidence Sec. 410.233 Cancellation of a request for withdrawal. Before or after a written request for withdrawal has been approved by...


Evidence Sec. 410.234 Interim provisions. (a) Notwithstanding any other provision of this subpart, a written request for benefits which is filed before January...


Evidence Sec. 410.240 Evidence. (a) Evidence of eligibility. A claimant for benefits shall submit such evidence of eligibility as is specified in this...


Evidence Sec. 410.250 Effect of conviction of felonious and intentional homicide on entitlement to benefits. An individual who has been finally convicted by a...


Authority: Sec. 702(a)(5) of the Social Security Act (42 U.S.C. 902(a)(5)), secs. 402, 412(a), 426(a), and 508, 83 Stat. 792; 30 U.S.C. 902, 922(a), 936,...


An individual will be considered to be the wife of a miner if: (a) The courts of the State in which such miner is domiciled (see Sec. 410.392) would find that...


wife. An individual will be considered to be the divorced wife of a miner if her marriage to such miner has been terminated by a final divorce on or after the...


An individual will be considered to be the widow of a miner if: (a) The courts of the State in which such miner was domiciled (see Sec. 410.392) at the time...


divorced wife. An individual will be considered to be the surviving divorced wife of a deceased miner if her marriage to such miner had been terminated by a...


As used in this section, the term beneficiary means only a widow entitled to benefits at the time of her death (see Sec. 410.211), or a miner, except where there...


brother, or sister. An individual will be considered to be the parent, brother, or sister of a miner if the courts of the State in which such miner was domiciled...


An individual who is the miner's wife (see Sec. 410.310) will be determined to be dependent upon the miner if: (a) She is a member of the same household as the...


An individual who is the miner's divorced wife (see Sec. 410.311) will be determined to be dependent upon the miner if: (a) She is receiving at least...


(a) General. An individual who is the miner's widow (see Sec. 410.320) will be determined to have been dependent on the miner if, at the time of the...


wife. An individual who is the miner's surviving divorced wife (see Sec. 410.321) will be determined to have been dependent on the miner if, for the...


For purposes of augmenting the benefits of a miner or widow (see Sec. 410.510 (c)), the term beneficiary as used in this section means only a miner or widow...


brother, or sister. An individual who is the miner's parent, brother, or sister (see Sec. 410.340) will be determined to have been dependent on the miner if,...


(a) Relationship and dependency of wife or child. With respect to the wife or child of a miner entitled to benefits, and with respect to the child of a widow entitled to...


For purposes of this subpart C, legal impediment means an impediment resulting from the lack of dissolution of a previous marriage or otherwise arising out of such previous marriage or...


of this subpart C, the term domicile means the place of an individual's true, fixed, and permanent home to which, whenever he is absent, he has the intention of returning. ...


with''; ``living in the same household''; and ``living in the miner's household''. (a) Defined. (1) The term member of the same household as used in...


(a) Support defined. The term support includes food, shelter, clothing, ordinary medical expenses, and other ordinary and customary items for the maintenance of the...


Authority: Sec. 702(a)(5) of the Social Security Act (42 U.S.C. 902(a)(5)), secs. 401-426, 83 Stat. 792, as amended, 86 Stat. 150; 30 U.S.C. 901 et. seq. ...


pneumoconiosis, including statutory presumption. (a) Benefits are provided under the Act to coal miners ``who are totally disabled due to pneumoconiosis arising out...


(a) A miner shall be considered totally disabled due to pneumoconiosis if: (1) His pneumoconiosis prevents him from engaging in gainful work in the...


of pneumoconiosis, including statutory presumption. (a) General. A finding of the existence of pneumoconiosis as defined in Sec. 410.110(o)(1) may be made under...


including statutory presumption. (a) If a miner was employed for 10 or more years in the Nation's coal mines, and is suffering or suffered...


total disability due to pneumoconiosis. There is an irrebuttable presumption that a miner is totally disabled due to pneumoconiosis, or that a miner was...


criteria. (a) A determination of total disability due to pneumoconiosis is made in accordance with this section when a miner cannot be presumed to be...


criteria only. (a) Medical considerations alone shall justify a finding that a miner is (or was) totally disabled where his impairment is one that meets...


Age, education, and work experience criteria. (a) Pneumoconiosis which constitutes neither an impairment listed in the appendix to this subpart (see...


evidence of pneumoconiosis. (a) A finding of the existence of pneumoconiosis as defined in Sec. 410.110(o)(1) may be made under the provisions of Sec. 410.414(a)...


Spirometric tests to measure ventilatory function must be expressed in liters or liters per minute. The reported maximum voluntary ventilation (MVV) or maximum...


(a) Where it has been determined that a miner is totally disabled under Sec. 410.412, such disability shall be found to have ceased in the month in which his...


statutory presumption. Benefits are provided under the Act to the eligible survivor of a coal miner who was entitled to benefits at the time of his death,...


pneumoconiosis, including statutory presumption--survivor's claim. (a) Medical findings. A finding of the existence of pneumoconiosis as defined in Sec....


including statutory presumption--survivor's claim. (a) If a miner was employed for 10 years or more in the Nation's coal mines, and suffered...


death due to pneumoconiosis--survivor's claim. There is an irrebuttable presumption that the death of a miner was due to pneumoconiosis if he suffered from a...


respirable disease. (a) Even though the existence of pneumoconiosis as defined in Sec. 410.110 (o)(1) is not established as provided in Sec. 410.454(a), if a deceased...


or other governmental agency. The decision of any nongovernmental organization or any other governmental agency that an individual is, or is...


miner's disability or death. The function of deciding whether or not an individual is totally disabled due to pneumoconiosis, or was totally disabled due...


Upon reasonable notice of the time and place thereof, any individual filing a claim alleging to be totally disabled due to pneumoconiosis shall present himself...


disability. An individual who has been determined to be totally disabled due to pneumoconiosis, upon reasonable notice, shall, if requested to do so (e.g., where...


evidence. Evidence in support of a claim for benefits based on disability shall be filed in the manner and at the place or places prescribed in subpart B of...


An individual shall not be determined to be totally disabled unless he furnishes such medical and other evidence thereof as is reasonably required to establish...


of event which may affect a change in disability status. An individual who is determined to be totally disabled due to pneumoco niosis shall notify the...


for certain part B claims filed by a miner before July 1, 1973, or by a survivor where the miner died before January 1, 1974. (a) Basis for rules. In...


702(a)(5) of the Social Security Act (42 U.S.C. 902(a)(5)), secs. 411(a), 412 (a) and (b), 413(b), 426(a), and 508, 83 Stat. 793; 30 U.S.C. 921(a), 922 (a) and (b),...


may be paid as appropriate, to a beneficiary (see Sec. 410.110(r)), to a qualified dependent (see Sec. 410.511), or to a representative payee on behalf of a beneficiary...


(a) Basic rate. The benefit amount of each beneficiary entitled to a benefit for a month is determined, in the first instance, by computing the ``basic rate.'' The basic rate...


of benefit. (a) If the benefit of a miner or of a widow is augmented because of one or more dependents (see Sec. 410.510(c)), and it appears to...


Under certain conditions, the amount of monthly benefits as computed in Sec. 410.510 must be modified to determine the amount actually to be paid to a...


(a) As used in this section, the term State benefit means a payment to a beneficiary made because of the disability of the miner due to pneumoconiosis under State...


Benefit payments to a miner, parent, brother, or sister are reduced by an amount equal to the deductions which would be made with respect to excess earnings under the provisions...


for benefits. Beginning with the month in which a person (other than a miner) files a claim and becomes entitled to benefits, the benefits of other persons entitled...


benefits based on subsequent qualification of individual. (a) Ordinarily, a written request that the benefits of a miner or widow be augmented on account of a...


If a reduction for receipt of State benefits (see Sec. 410.520) and a reduction on account of excess earnings (see Sec. 410.530) are chargeable to the same month,...


certain States. No benefit shall be paid under this part to the residents of any State which, after December 30, 1969, reduces the benefits payable to persons eligible...


As used in this subpart the term overpayment includes a payment where no amount is payable under part B of title IV of the Act; a payment in excess of the amount due under part...


Whenever an initial determination is made that more than the correct amount of payment has been made, and we seek adjustment or recovery of the overpayment,...


to process the request. (a) There shall be no adjustment or recovery in any case where an overpayment under part B of title IV of the Act has been made to an...


in without fault (see Sec. 410.561a) applies only to the individual. Although the Administration may have been at fault in making the overpayment, that fact does not relieve...


(a) General. Defeat the purpose of title IV for purposes of this subpart, means defeat the purpose of benefits under this title, i.e., to deprive a person of income...


Against equity and good conscience means that adjustment or recovery of an incorrect payment will be considered inequitable if an individual, because of a...


in a reduction-overpayment. Except as provided in Sec. 410.561g, or elsewhere in this subpart, an individual will be considered without fault in accepting a...


in an entitlement overpayment. A benefit payment under part B of title IV of the Act to or on behalf of an individual who fails to meet one or more requirements...


a reduction-overpayment. (a) Degree of care. An individual will not be without fault if the Administration has evidence in its possession which shows either a lack...


will be waived. (a) Adjustment or recovery deemed ``against equity and good conscience.'' In the situations described in Sec. Sec. 410.561e (a), (b),...


No certifying or disbursing officer shall be held liable for any amount certified or paid by him to any individual: (a) Where adjustment or recovery of such amount...


overpayment. (a) General effect of the Federal Claims Collection Act of 1966. Claims by the Administration against an individual for recovery of overpayments...


As used in this subpart, the term underpayment includes a payment in an amount less than the amount of the benefit due for such month, and nonpayment where some amount of...


increases. The amount of an overpayment or underpayment is the difference between the amount actually paid to the beneficiary and the amount of the payment to which...


When it appears to the Administration that the interest of a beneficiary entitled to a payment under part B of title IV of the Act would be served thereby, certification...


Before any amount shall be certified for payment to any relative or other person as representative payee for and on behalf of a beneficiary, such relative...


A relative or other person to whom certification of payment is made on behalf of a beneficiary as representative payee shall, subject to review by the Administration...


Payments certified to a relative or other person on behalf of a beneficiary shall be considered as having been applied for the use and benefit of the beneficiary...


Payments certified to a relative or other person on behalf of a beneficiary which are not needed for the current maintenance of the beneficiary except as they may...


institution. Where a beneficiary is confined in a Federal, State, or private institution because of mental or physical incapacity, the relative or other person to...


or parent. If current maintenance needs of a beneficiary are being reasonably met, a relative or other person to whom payments are certified as representative...


relative or other person to whom payments under part B of title IV of the Act are certified as representative payee on behalf of a beneficiary may not be required to use such payments...


other person to whom payments are certified as representative payee on behalf of a beneficiary shall submit a written report in such form and at such times as the...


A representative payee who has conserved or invested funds from payments under part B of title IV of the Act certified to him on behalf of a beneficiary shall,...


part C of title IV of the act. The Social Security Administration will notify each miner entitled to benefits on the basis of a claim filed under part B of the...


Representation of Parties Sec. 410.601 Determinations of disability. Authority: Sec. 702(a)(5) of the Social Security...


Decisions, and Representation of Parties Sec. 410.610 Administrative actions that are initial determinations. (a) Entitlement...


Decisions, and Representation of Parties Sec. 410.615 Administrative actions that are not initial determinations. ...


Representation of Parties Sec. 410.620 Notice of initial determination. Written notice of an initial determination shall...


Representation of Parties Sec. 410.621 Effect of initial determination. The initial determination shall be final...


Representation of Parties Sec. 410.622 Reconsideration and hearing. Any party who is dissatisfied with an...


Representation of Parties Sec. 410.623 Reconsideration; right to reconsideration. (a) We shall reconsider an...


Representation of Parties Sec. 410.624 Time and place of filing request. The request for reconsideration shall be made...


Representation of Parties Sec. 410.625 Parties to the reconsideration. The parties to the reconsideration shall be...


Representation of Parties Sec. 410.626 Notice of reconsideration. If the request for reconsideration is filed by a...


Representation of Parties Sec. 410.627 Reconsidered determination. When a request for reconsideration has been filed,...


Representation of Parties Sec. 410.628 Notice of reconsidered determination. Written notice of the...


Representation of Parties Sec. 410.629 Effect of a reconsidered determination. The reconsidered determination shall...


and Representation of Parties Sec. 410.629a Expedited appeals process; conditions for use of such process. In cases in which...


Decisions, and Representation of Parties Sec. 410.629b Expedited appeals process; place and time of filing request. (a) Place...


and Representation of Parties Sec. 410.629c Expedited appeals process; parties. The parties to the expedited appeals...


and Representation of Parties Sec. 410.629d Expedited appeals process; agreement requirements. (a)(1) An...


and Representation of Parties Sec. 410.629e Expedited appeals process; effect of agreement. The agreement described in...


and Representation of Parties Sec. 410.629f Effect of a request that does not result in agreement. If a request for...


Representation of Parties Sec. 410.630 Hearing; right to hearing. An individual referred to in Sec. 410.632 or Sec....


Representation of Parties Sec. 410.631 Time and place of filing request. The request for hearing shall be made in...


Representation of Parties Sec. 410.632 Parties to a hearing. The parties to a hearing shall be the person or persons...


Representation of Parties Sec. 410.633 Additional parties to the hearing. The following individuals, in addition to...


Representation of Parties Sec. 410.634 Administrative Law Judge. The hearing provided for in this subpart F shall,...


Representation of Parties Sec. 410.635 Disqualification of Administrative Law Judge. No Administrative Law Judge...


Representation of Parties Sec. 410.636 Time and place of hearing. The Administrative Law Judge (formerly called...


Representation of Parties Sec. 410.637 Hearing on new issues. At any time after a request for hearing has been made,...


Decisions, and Representation of Parties Sec. 410.638 Change of time and place for hearing. The Administrative Law Judge may...


Representation of Parties Sec. 410.639 Subpenas. When reasonably necessary for the full presentation of a case,...


Representation of Parties Sec. 410.640 Conduct of hearing. Hearings shall be open to the parties and to such other...


Representation of Parties Sec. 410.641 Evidence. Evidence may be received at the hearing even though...


Representation of Parties Sec. 410.642 Witnesses. Witnesses at the hearing shall testify under oath or affirmation...


Representation of Parties Sec. 410.643 Oral argument and written allegations. The parties, upon their request, shall...


Decisions, and Representation of Parties Sec. 410.644 Record of hearing. A complete record of the proceedings at the hearing shall...


Representation of Parties Sec. 410.645 Joint hearings. When two or more hearings are to be held, and the same...


Representation of Parties Sec. 410.646 Consolidated issues. When one or more additional issues are raised by...


Representation of Parties Sec. 410.647 Waiver of right to appear and present evidence. (a) General. Any party to a...


Decisions, and Representation of Parties Sec. 410.648 Dismissal of request for hearing; by application of party. With the approval...


Representation of Parties Sec. 410.649 Dismissal by abandonment of party. With the approval of the Administrative...


Representation of Parties Sec. 410.650 Dismissal for cause. The presiding officer may, on his own motion, dismiss a...


Representation of Parties Sec. 410.651 Notice of dismissal and right to request review thereon. Notice of...


Representation of Parties Sec. 410.652 Effect of dismissal. The dismissal of a request for hearing shall be final...


Decisions, and Representation of Parties Sec. 410.653 Vacation of dismissal of request for hearing. A presiding officer or the...


Representation of Parties Sec. 410.654 Administrative Law Judge's decision or certification to Appeals Council. ...


Representation of Parties Sec. 410.655 Effect of Administrative Law Judge's decision. The decision of the...


Representation of Parties Sec. 410.656 Removal of hearing to Appeals Council. The Appeals Council on its own motion...


Decisions, and Representation of Parties Sec. 410.657 Appeals Council proceedings on certification and review; procedure before...


Representation of Parties Sec. 410.658 Evidence in proceeding before Appeals Council. Evidence in addition to that...


Representation of Parties Sec. 410.659 Decision of Appeals Council. The decision of the Appeals Council, when a case...


Representation of Parties Sec. 410.660 Right to request review of Administrative Law Judge's decision or dismissal. ...


Representation of Parties Sec. 410.661 Time and place of filing request. The request for review shall be made in...


Representation of Parties Sec. 410.662 Action by Appeals Council on review. The Appeals Council may dismiss (see...


Decisions, and Representation of Parties Sec. 410.663 Procedure before Appeals Council on review. (a) Availability of documents...


Representation of Parties Sec. 410.664 Evidence admissible on review. (a) Admissibility of additional evidence. Evidence...


Decisions, and Representation of Parties Sec. 410.665 Decision by Appeals Council or remanding of case. (a) General. If a case...


Representation of Parties Sec. 410.666 Effect of Appeals Council's decision or refusal to review. The Appeals Council...


Representation of Parties Sec. 410.667 Dismissal by Appeals Council. The Appeals Council may dismiss a request for...


Representation of Parties Sec. 410.668 Extension of time to request reconsideration. If a party to an initial...


Representation of Parties Sec. 410.669 Extension of time to request hearing or review or begin civil action. ...


Representation of Parties Sec. 410.670 Review by Appeals Council. Where an Administrative Law Judge has determined...


and Representation of Parties Sec. 410.670a Judicial review. A civil action may be commenced in a district court of the...


Decisions, and Representation of Parties Sec. 410.670b Interim provision for the adjudication of certain claims filed prior to May...


Decisions, and Representation of Parties Sec. 410.670c Application of circuit court law. The procedures which follow apply...


Decisions, and Representation of Parties Sec. 410.671 Revision for error or other reason; time limitation generally. (a)...


Representation of Parties Sec. 410.672 Reopening initial, revised or reconsidered determinations of the Administration...


Representation of Parties Sec. 410.673 Good cause for reopening a determination or decision. Good cause shall be deemed...


Representation of Parties Sec. 410.674 Finality of suspension of benefit payments for entire taxable year because...


Representation of Parties Sec. 410.675 Time limitation for revising finding suspending benefit payments for entire taxable...


and Representation of Parties Sec. 410.675a Late completion of timely investigation. The Administration may revise...


Representation of Parties Sec. 410.676 Notice of revision. (a) When any determination or decision is revised, as...


Representation of Parties Sec. 410.677 Effect of revised determination. The revision of a determination or decision...


Decisions, and Representation of Parties Sec. 410.678 Time and place of requesting hearing on revised determination. The request...


Representation of Parties Sec. 410.679 Finality of findings with respect to other claims for benefits based on the disability...


Representation of Parties Sec. 410.680 Imposition of reductions. The imposition of reductions constitutes an...


Representation of Parties Sec. 410.681 Change of ruling or legal precedent. Good cause shall be deemed not to exist...


Representation of Parties Sec. 410.682 General applicability. The provisions of Sec. Sec. 410.672, 410.673, and 410.679...


Representation of Parties Sec. 410.683 Certification of payment; determination or decision providing for payment. ...


and Representation of Parties Sec. 410.683b Transfer or assignment. The Administration shall not certify any amount...


Decisions, and Representation of Parties Sec. 410.684 Representation of party; appointment of representative. A party in an...


Representation of Parties Sec. 410.685 Qualifications of representative. (a) Attorney. Any attorney in good standing...


Representation of Parties Sec. 410.686 Authority of representative. A representative, appointed and qualified as...


Decisions, and Representation of Parties Sec. 410.686a Proceedings before a State or Federal court. (a) Representation of claimant...


Decisions, and Representation of Parties Sec. 410.686b Fee for services performed for an individual before the Social...


Decisions, and Representation of Parties Sec. 410.686c Petition for approval of fee. (a) Filing of petition. In accordance with...


and Representation of Parties Sec. 410.686d Payment of fees. (a) Fees allowed by a Federal court. Subject to the...


and Representation of Parties Sec. 410.686e Services rendered for an individual in a proceeding before the Administration under part...


Representation of Parties Sec. 410.687 Rules governing the representation and advising of claimants and parties. ...


and Representation of Parties Sec. 410.687a Effective date. The provisions of Sec. Sec. 410.686a, 410.686b,...


Representation of Parties Sec. 410.688 Disqualification or suspension of an individual from acting as a representative...


Representation of Parties Sec. 410.689 Notice of charges. The Deputy Commissioner for Programs and Policy, or his or...


Representation of Parties Sec. 410.690 Withdrawal of charges. If an answer is filed or evidence is obtained...


Representation of Parties Sec. 410.691 Referral to the Deputy Commissioner for Programs and Policy, or his or her designee,...


Decisions, and Representation of Parties Sec. 410.692 Hearing on charges. (a) Hearing officer. Upon receipt of the notice of...


Representation of Parties Sec. 410.693 Decision by hearing officer. (a) General. As soon as practicable after the close...


Representation of Parties Sec. 410.694 Right to request review of the hearing officer's decision. (a) General. After...


Representation of Parties Sec. 410.695 Procedure before Appeals Council on review of hearing officer's decision. ...


Decisions, and Representation of Parties Sec. 410.696 Evidence admissible on review. (a) General. Evidence in addition to...


Representation of Parties Sec. 410.697 Decision by Appeals Council on review of hearing officer's decision. ...


Representation of Parties Sec. 410.698 Dismissal by Appeals Council. The Appeals Council may dismiss a request for...


Decisions, and Representation of Parties Sec. 410.699 Reinstatement after suspension or disqualification. (a) General. An...


and Representation of Parties Sec. 410.699a Penalties for fraud. The penalty for any person found guilty of willfully...


(BLBRA) of 1977 Sec. 410.700 Background. Authority: Sec. 702(a)(5) of the Social Security Act (42 U.S.C. 902(a)(5)), sec. 411, 82 Stat. 793 and 30...


(BLBRA) of 1977 Sec. 410.701 Jurisdiction for determining entitlement under part B. In order for the Social Security Administration to approve a claim...


Act (BLBRA) of 1977 Sec. 410.702 Definitions and terms. The following definitions shall apply with regard to review under this subpart G. (a)...


(BLBRA) of 1977 Sec. 410.703 Adjudicatory rules for determining entitlement to benefits. (a) General. Section 402(f)(2) of the Act provides that the...


Act (BLBRA) of 1977 Sec. 410.704 Review procedures. (a) Notification. Each claimant who has filed a claim for benefits under part B of title IV of the Act,...


Act (BLBRA) of 1977 Sec. 410.705 Duplicate claims. (a) Approved by the Social Security Administration--denied or pending with the Office of...


(BLBRA) of 1977 Sec. 410.706 Effect of the Social Security Administration determination of entitlement. Under section 435 of the BLBRA of 1977 a...


(BLBRA) of 1977 Sec. 410.707 Hearings and appeals. The review of any determination made by the Social Security Administration of a claim under this subpart...


What is the purpose of the Ticket to Work program? 411.110 How is the Ticket to Work program implemented? 411.115 Definitions of terms used...


to Work program is to expand the universe of service providers available to individuals who are entitled to Social Security benefits based on disability or eligible for...


to Work program in graduated phases at phase-in sites around the country. We are implementing the program at sites on a wide enough scale to allow for a thorough evaluation...


(a) ``The Act'' means the Social Security Act, as amended. (b) ``Commissioner'' means the Commissioner of Social Security. (c) ``Cost reimbursement payment system'' means...


(a) A ticket under the Ticket to Work program is a document which provides evidence of the Commissioner's agreement to pay, under the rules in subpart H of this part, an employment...


(a) You will be eligible to receive a Ticket to Work in a month in which-- (1) You are age 18 or older and have not attained age 65; (2)(i)(A) You are...


(a) We will distribute tickets in graduated phases at phase-in sites selected by the Commissioner, to permit a thorough evaluation of the Ticket to Work program and...


the Ticket to Work program is voluntary. When you receive your ticket, you are free to choose when and whether to assign it (see Sec. 411.140 for information on assigning your...


ticket only during a month in which you meet the requirements of Sec. 411.125(a)(1) and (a)(2). You may assign your ticket to any EN which is serving under the program and...


be taken out of assignment? (a) If you assigned your ticket to an EN or a State VR agency, you may take your ticket out of assignment for any reason. You must notify...


(a) Yes. If you previously assigned your ticket and your ticket is no longer assigned (see Sec. 411.145) or you wish to change the assignment, you may reassign...


if and when you are no longer eligible to participate in the Ticket to Work program. If your ticket terminates, you may not assign or reassign it to an EN or State...


this subpart do? Introduction (a) This subpart explains our rules about continuing disability reviews for disability...


being in the Ticket to Work program affect my continuing disability reviews? We periodically review your case to determine if you are still disabled under our...


terms used in this subpart. (a) Active participation in your employment plan means you are engaging in activities outlined in your employment plan on a regular basis...


the period of using a ticket begin? The period of using a ticket begins on the effective date of the assignment of your ticket to an EN or State VR agency under...


the period of using a ticket end? The period of using a ticket ends with the earliest of the following-- (a) The month before the month in which the...


I assign my ticket after a continuing disability review has begun? (a) If we begin a continuing disability review before the date on which you assign a ticket, you may...


timely progress toward self-supporting employment? (a) General. The purpose of the Ticket to Work program is to provide you with the services and supports you need to...


do I need to earn to be considered to be working? For the purpose of determining if you are meeting the timely progress requirements for continued ticket use, we...


it determined if I am meeting the timely progress guidelines? (a) During the initial 24-month period. (1) General. During the initial 24-month period after you...


the guidelines for timely progress toward self-supporting employment. You may use the following table as a general guide to determine what you need to do...


the PM conduct my 24-month progress review? (a) In this review the PM will consider the following: (1) Are you actively participating in your employment plan?...


PM conduct my 12-month progress reviews? (a) The 12-month progress review is a two step process: (1) Step one--Retrospective review. Did you complete the...


I disagree with the PM's decision about whether I am making timely progress toward self-supporting employment? If you disagree with the PM's decision, you may request that...


if I do not make timely progress toward self-supporting employment? (a) General. If it is determined that you are not making timely progress toward...


my ticket is no longer assigned to an EN or State VR agency? (a) If your ticket was once assigned to an EN or State VR agency and is no longer assigned, you are eligible...


I reassign my ticket after the end of the extension period? (a) General. You may reassign your ticket after the end of the extension period under the...


is a PM? A program manager (PM) is an organization in the private or public sector that has entered into a contract to assist us in administering the Ticket to...


qualifications are required of a PM? A PM must have expertise and experience in the field of vocational rehabilitation or...


limitations are placed on a PM? A PM is prohibited from directly participating in the delivery of employment services, vocational rehabilitation services, or other...


What are a PM's responsibilities under the Ticket to Work program? A PM will assist us in administering the Ticket to Work program by conducting the...


will SSA evaluate a PM? (a) We will periodically conduct a formal evaluation of the PM. The evaluation will include, but not be limited to, an assessment examining...


has entered into an agreement with us to function as an EN under the Ticket to Work program and assume responsibility for the coordination and delivery of...


a State (or political subdivision thereof) or a private entity that assumes responsibility for the coordination and delivery of services under the Ticket to Work program...


determine whether an entity qualifies as an EN? (a) An entity other than a State VR agency applies by responding to our Request for Proposal (RFP), which we published in...


as an EN under the Ticket to Work program, an entity must meet and maintain compliance with both general selection criteria and specific selection criteria. (a) The...


An EN must-- (a) Enter into an agreement with us. (b) Serve a prescribed service area. The EN must designate the geographic area in which it will...


We will terminate our agreement with an EN if it does not comply with the requirements under Sec. Sec. 411.320, Sec. 411.325, or the conditions in...


to Work program? An EN must: (a) Report to the PM each time it accepts a ticket for assignment; (b) Submit a copy of each signed IWP to the PM; ...


the results of the work of each EN to ensure effective quality assurance in the provision of services by ENs. (b) In conducting such a review, we will solicit and...


Participation in the Ticket to Work Program Yes. Each State agency administering or supervising the administration of the State...


to Work program? (a) The Ticket to Work program provides different payment options that are available to a State VR agency for providing services to...


Ticket to Work program is implemented in States, we will notify the State VR agency by letter about payment systems available under the program. The letter will ask the State VR...


payment system for use when functioning as an EN? (a) When the State VR agency receives our letter described in Sec. 411.360(a) regarding implementation of the Ticket to...


A State VR agency does not have to function as an EN when serving a beneficiary with a ticket if the ticket has not previously been assigned to an EN or State VR agency or, if...


of the State plan approved under title I of the Rehabilitation Act of 1973, as amended (29 U.S.C. 720 et seq.), when functioning as an EN? Yes....


determine whether a person seeking services has a ticket? A State VR agency can contact the Program Manager (PM) to determine if a person seeking VR services has a...


VR services has a ticket that is available for assignment or reassignment? (a) Once the State VR agency determines that a beneficiary is eligible for...


already providing services has a ticket that is available for assignment? If a beneficiary who is receiving services from the State VR agency under an existing...


(a) For cases where a State VR agency provided services functioning as an EN, the State VR agency will be required to prepare periodic reports on the specific outcomes...


beneficiary to a State VR agency for services? Yes. An EN may refer a beneficiary it is serving under the Ticket to Work program to a State VR agency for services....


to be in place? Each EN must have an agreement with the State VR agency prior to referring a beneficiary it is serving under the Ticket to Work program to the...


agreement? No. The agreements between ENs and State VR agencies should be broad-based and apply to all beneficiaries who may be referred by the EN to the State...


State VR agencies? The PM will verify the establishment of these agreements. Each EN is required to submit a copy of the agreement it has established with the State...


EN and a State VR agency? The agreement between an EN and a State VR agency should state the conditions under which the State VR agency will provide services to...


an EN and no agreement has been established between the EN and the State VR agency? The State VR agency should contact the EN to discuss the need...


make a referral to a State VR agency without an agreement being in place? The PM will contact the EN to explain that a referral cannot be made to the...


State VR agencies be resolved? Disputes arising under agreements between ENs and State VR agencies must be resolved using the following steps: (a)...


(IWP) is a required written document signed by an employment network (EN) (other than a State VR agency) and a beneficiary, or a representative of a beneficiary, with a ticket. It...


outline the specific employment services, vocational rehabilitation services and other support services that the EN and beneficiary have determined are necessary to achieve...


the IWP? The beneficiary and the EN share the responsibility for determining the employment goal and the specific services needed to achieve that employment goal. The...


include at least-- (1) A statement of the vocational goal developed with the beneficiary, including, as appropriate, goals for earnings and job advancement; (2)...


if the following requirements are met-- [[Page 714]] (1) It has been signed by the beneficiary or the beneficiary's representative, and by a representative...


Base means for any calendar year-- (1) In connection with a title II disability beneficiary (including a concurrent title II/title XVI disability beneficiary), the...


the outcome payment system or the outcome-milestone payment system. The EN will elect a payment system at the time the EN enters into an agreement with SSA. (For State...


(a) The State VR agency's payment choices are described in Sec. 411.355. (b) The State VR agency's decision to serve the beneficiary must be communicated to the...


by an EN in its elected EN payment system will apply to beneficiaries who assign their ticket to the EN after the EN's change in election becomes effective. A change in the...


a change in that EN's elected payment system? A change in an EN's (or State VR agency's) elected payment system has no effect upon the beneficiaries who have assigned...


(a) For payments for outcome payment months, both EN payment systems use the payment calculation base as defined in Sec. 411.500(a)(1) or (a)(2),...


system? Under the outcome-milestone payment system, each outcome payment made to an EN with respect to an individual will be reduced by an amount equal...


the outcome-milestone payment system, there are four milestones for which the EN can be paid. The milestones occur after the date on which the ticket was first assigned and...


payment for the first milestone is equal to 34 percent of the payment calculation base for the calendar year in which the month of attainment of the milestone occurs, rounded to...


payment system? The amount of each monthly outcome payment under the outcome- milestone payment system is equal to 34 percent of the payment calculation...


payment system? Under the outcome payment system, the payment for an outcome payment month is equal to 40 percent of the payment calculation base for the calendar...


does not achieve all 60 outcome months? (a) Yes. The EN can keep each milestone and outcome payment for which the EN is eligible, even though the beneficiary does...


EN? Yes. It is possible for more than one EN to receive payment based on the same milestone or outcome. If the beneficiary has assigned the ticket to more than one EN...


have elected different EN payment systems? We will pay each EN according to its elected EN payment system in effect at the time the beneficiary assigned the ticket to...


the EN? No. Section 1148(b)(4) of the Act prohibits an EN from requesting or receiving compensation from the beneficiary for the services of...


achieved by a beneficiary who assigned a ticket to the EN? The EN will send its request for payment, evidence of the beneficiary's work or earnings and other information...


occur before the beneficiary assigns a ticket to the EN? No. An EN may be paid only for milestones or outcome payment months that are achieved after the ticket is assigned...


beneficiary? Yes. It is possible if the State VR agency serves the beneficiary as an EN. In this case, both the State VR agency serving as an EN and the other EN may...


receives a request for payment from an EN or a State VR agency that elected payment under an EN payment system and a request for payment from a State VR agency that elected...


(a) If an EN other than a State VR agency has a payment dispute with us, the dispute shall be resolved under the dispute resolution procedures contained in the...


We use audits, reviews, studies and observation of daily activities to identify areas for improvement. Internal [[Page 720]] reviews of our systems...


system for possible modifications? (a) Yes. We will periodically review the system of payments and their programmatic results to determine if they provide...


ENs that are not State VR agencies? Disputes Between Beneficiaries and Employment Networks Yes. After an IWP is signed, a process is available which...


regarding the dispute resolution process? The EN must: (a) Have grievance procedures that a beneficiary can use to seek a resolution to a dispute under the Ticket...


disputes? Each EN that is not a State VR agency must inform each beneficiary seeking services under the Ticket to Work program of the procedures for...


or the EN that is not a State VR agency may ask the PM to review a disputed issue. The PM will [[Page 721]] contact the EN to submit all relevant...


[Code of Federal Regulations] [Title 20, Volume 2] [Revised as of April 1, 2004] From the U.S. Government Printing Office via GPO Access [CITE: 20CFR411.620] [Page 721] TITLE 20--EMPLOYEES' BENEFITS CHAPTER III--SOCIAL SECURITY ADMINISTRATION PART 411_The Ticket to Work and Self-Sufficiency Program--Table of Contents Subpart I_Ticket to Work Program Dispute Resolution Sec. 411.620 How long does the PM have to recommend a resolution to the dispute? The PM has 20 working days to provide a written recommendation. The recommendation should explain the reasoning for the proposed resolution. ...


review of the PM's recommendation? (a) Yes. After receiving the PM's recommendation, either the beneficiary or the EN may request a review by us. The request must be...


the beneficiary or the EN that is not a State VR agency is unwilling to accept our decision, either has the right to terminate its relationship with...


the Ticket to Work program? Yes. Both the beneficiary and the EN that is not a State VR agency may use an attorney or other individual of their choice to...


1973, as amended (29 U.S.C. 720 et seq.), apply to beneficiaries seeking services from the State VR agency? Yes. The procedures in the Rehabilitation Act of 1973,...


State VR agencies and PMs, other than disputes on a payment request? Yes. Under the agreement to assist us in administering the Ticket to Work program, a PM is required...


days from the failure to come to a mutually agreeable solution with an EN to refer the dispute to us with all relevant information. The information should include: (a)...


[Code of Federal Regulations] [Title 20, Volume 2] [Revised as of April 1, 2004] From the U.S. Government Printing Office via GPO Access [CITE: 20CFR411.660] [Page 722] TITLE 20--EMPLOYEES' BENEFITS CHAPTER III--SOCIAL SECURITY ADMINISTRATION PART 411_The Ticket to Work and Self-Sufficiency Program--Table of Contents Subpart I_Ticket to Work Program Dispute Resolution Sec. 411.660 Is SSA's decision final? Yes. Our decision is final. ...


What is an alternate participant? An alternate participant is any public or private agency (other than a participating State VR agency described in Sec....


Can an alternate participant become an EN? In any State where the Ticket to Work program is implemented, each alternate participant whose service area is in...


How will an alternate participant choose to participate as an EN in the Ticket to Work program? (a) When the Ticket to Work program is implemented in a State,...


If an alternate participant becomes an EN, will beneficiaries for whom an employment plan was signed prior to implementation be covered under the Ticket to Work...


If an alternate participant chooses not to become an EN, can it continue to function under the programs for payments for VR services? Once the Ticket to Work...


If an alternate participant becomes an EN and it has signed employment plans, both as an alternate participant and an EN, how will SSA pay for services provided...


What happens if an alternate participant signed an employment plan with a beneficiary before Ticket to Work program implementation in the State and the required...


What happens if an alternate participant signed an employment plan with a beneficiary before Ticket to Work program implementation in the State and the required...
...


Income for the Aged, Blind, and Disabled program is administered by the Social Security Administration. [51 FR 11718, Apr. 7, 1986, as amended at 62 FR 38454, July...


underlying the supplemental security income program is to assure a minimum level of income for people who are age 65 or over, or who are blind or disabled and who do not...


(a) Terms relating to acts and regulations. As used in this part: (1) The Act means the Social Security Act as amended (42 U.S.C. Chap. 7). (2) Wherever a title...


under an approved State plan under title I, X, XIV, or XVI of the Social Security Act. (a) Recipient of aid or assistance defined. As used in this part...


1611, 1614, 1619(a), 1631, and 1634 of the Social Security Act (42 U.S.C. 902(a)(5), 1310(b), 1381a, 1382, 1382c, 1382h(a), 1383, and 1383c); secs. 211 and 212, Pub. L....


Any 9-month period means any period of 9 full calendar months ending with any full calendar month throughout which (as defined in Sec. 416.211) an individual is residing in a...


benefits if you meet all of the following requirements: (a) You are-- (1) Aged 65 or older (subpart H); (2) Blind (subpart I); or (3) Disabled...


when you apply for SSI benefits. When you apply for SSI benefits we will ask you for documents and any other information we need to make sure you meet all the requirements....


A redetermination is a review of your eligibility to make sure that you are still eligible and that you are receiving the right amount of SSI benefits. This review...


(a) To be eligible for SSI payments you must give us permission to contact any financial institution and request any financial records that financial institution...


You are not eligible for SSI benefits if you do not apply for all other benefits for which you may be eligible. (b) What ``other benefits'' includes. ``Other benefits''...


rule. (1) Subject to the exceptions described in paragraphs (b), (c), and (d) of this section and Sec. 416.212, you are not eligible for SSI benefits for any month...


(a) Benefits payable under section 1611(e)(1)(E) of the Social Security Act. Subject to eligibility and regular computation rules (see subparts B and D...


material to the determination of disability. (a) If you do not comply with treatment requirements. If you receive benefits because you are disabled and...


SSI benefits for any month during all of which you are outside of the United States. If you are outside of the United States for 30 days or more in a row, you are not...


(a) General rule. You may be eligible for continuation of SSI benefits if you live overseas and if-- (1) You are a child as described in Sec. 416.1856; (2) You are...


essential person you may be eligible for increased benefits. You may be a qualified individual and have an essential person only if you received benefits under a State...


if-- (a) You received aid or assistance for the month of December 1973 under a State plan approved under title I, X, XIV, or XVI (AABD) of the Act; (b)...


person is an essential person if-- (1) That person has continuously lived in the home of the same qualified individual since December 1973; (2) That person was not...


SSI benefits. We may increase the amount of your SSI benefits if-- (1) You are a qualified individual; and (2) You have one or more essential persons in...


(a) Authority and purpose. Section 1110(b) of the Act authorizes the Commissioner to develop and conduct experimental, pilot, and demonstration projects...


describe the rules for determining eligibility for special SSI cash benefits and for special SSI eligibility status for an individual who works despite a...


Special SSI cash benefits are benefits that we may pay you in lieu of regular SSI benefits because your gross earned income in a month of initial eligibility for...


You are eligible for special SSI cash benefits if you meet the following requirements-- (a) You were eligible to receive a regular SSI benefit or a federally...


to apply for special cash benefits nor is it necessary for you to apply to have the special SSI eligibility status determined. We will make these...


The special SSI eligibility status applies for the purposes of establishing or maintaining your eligibility for Medicaid. For these purposes we continue to consider you to be a blind...


In order to be eligible for the special SSI eligibility status, you must have been eligible to receive a regular SSI benefit or a federally administered State supplementary...


benefits because of your earnings and you are potentially eligible for the special SSI eligibility status you will continue to be considered an SSI recipient for purposes...


applies to you by verifying that you continue to be blind or have a disabling impairment by applying the rules in subpart I of this part, and by following the rules...


work. For us to determine that you need Medicaid benefits in order to continue to work, you must establish: (a) That you are currently using or have received...


provide comparable benefits and services you would receive in the absence of those earnings. (a) What we determine. We must determine whether your earnings...


1631 (a), (d), and (e) of the Social Security Act (42 U.S.C. 902(a)(5), 1382, and 1383 (a), (d), and (e)). Source: 45 FR 48120, July 18, 1980, unless...


Benefits means any payments made under the SSI program. SSI benefits also include any federally administered State supplementary payments. Claimant means the person who...


income benefits. (a) General rule. In addition to meeting other requirements, you must file an application to become eligible to receive benefits. If you...


An application will be considered a claim for benefits, if the following requirements are met: (a) An application form prescribed by us must be filled out. (b) be filed at...


may sign an application according to the following rules: (a) If you are 18 years old or over, mentally competent, and physically able, you must sign your...


(a) A person who signs an application for someone else will be required to provide evidence of his or her authority to sign the application for the person claiming...


rule. We consider an application for SSI benefits filed on the day it is received by an employee at any social security office, by someone at another Federal or State...


applicants in designated geographic areas. (a) To be eligible for SSI disability or blindness benefits in the designated pilot geographic areas during the...


eligibility. If you file an application for SSI benefits before the first month you meet [[Page 754]] all the other requirements for eligibility,...


When you file an application in the month that you meet all the other requirements for eligibility, the earliest month for which we can pay you benefits...


We will use the date a written statement, such as a letter, an SSA questionnaire or some other writing, is received at a social security office, at another Federal...


We will use the date of an oral inquiry about SSI benefits as the filing date of an application for benefits only if the use of that date will result in your eligibility...


benefits. (a) When a person applies for benefits under title II (retirement, survivors, or disability benefits) we will explain the requirements for receiving...


(a) General. You may have considered applying for SSI benefits for yourself or for another person, and you may have contacted us in writing, by telephone or in person to...


withdrawal filed before we make a determination. If you make a request to withdraw your application before we make a determination on your claim, we will approve the request if...


your request to withdraw your application and your application will still be good if the following requirements are met: (a) You or a person who may sign an application for...


(a), (b), (c), and (e), 1612, 1617, and 1631 of the Social Security Act (42 U.S.C. 902(a)(5), 1382 (a), (b), (c), and (e), 1382a, 1382f, and 1383). This subpart...


amounts under title II of the Act (part 404 of this chapter) are increased by any percentage effective with any month as a result of a determination made under Section 215(i)...


under this part for an eligible individual (including the eligible individual receiving benefits payable under the Sec. 416.212 provisions) who does not have an eligible...


this part for an eligible couple (including couples where one or both members of the couple are receiving benefits payable under the Sec. 416.212 provisions), neither of whom...


under this part for a qualified individual (defined in Sec. 416.221) is payable at the rate for an eligible individual or eligible couple plus an increment for each essential...


a medical care facility. (a) General rule. Except where the Sec. 416.212 provisions provide for payment of benefits at the rates specified under Sec. Sec....


18. (a) If you are a disabled child under age 18 and meet the conditions in Sec. 416.1165(i) for waiver of deeming, your parents' income will not be deemed to...


be determined for each month. The amount of the monthly payment will be computed by reducing the benefit rate (see Sec. Sec. 416.410, 416.412, 416.413, and 416.414) by the...


(a) In the month that you reacquire eligibility after a month or more of ineligibility (see Sec. 416.1320(b)), your benefit will be prorated according to the number of...


Whenever benefits are suspended or terminated for an individual because of ineligibility, no benefit is payable for that month. [50 FR 48571, Nov....


in his home. When an eligible individual without an eligible spouse has an essential person (as defined in Sec. 416.222 of this part) in his home, the...


(a) When an eligible individual with an eligible spouse has an essential person (Sec. 416.222) living in his or her home, or when both such persons each has...


When there is a change in status which involves the formation or dissolution of an eligible couple (for example, marriage, divorce), a redetermination of the benefit...


Whenever benefits are suspended or terminated for both members of a couple because of ineligibility, no benefits are payable for that month. However, when benefits...


Authority: Secs. 702(a)(5), 1147, 1601, 1602, 1611(c) and (e), and 1631(a)-(d) and (g) of the Social Security Act (42 U.S.C. 902(a)(5), 1320b-17, 1381, 1381a, 1382(c) and (e),...


individual reestablishes eligibility after a month of ineligibility, an SSI payment will be made on or after the day of the month on which the individual becomes reeligible...


If you receive an SSI benefit that does not include a State supplement the minimum monthly SSI benefit amount payable is $1. When an SSI benefit amount of less than $1 is payable,...


(a) General. We may pay a one-time emergency advance payment to an individual initially applying for benefits who is presumptively eligible for SSI benefits and who has a...


Notwithstanding Sec. 416.542, the Social Security Administration may, in accordance with the provisions of subpart S of this part, withhold supplemental...


with more than one eligible person. (a) When an essential person lives with an eligible individual and an eligible spouse, the State may report that the person...


Except as provided in Sec. 416.525 and subpart S of this part, the Social Security Administration will not certify payment of supplemental security income benefits to a transferee...


(a) General. When an individual receives SSI benefits of less than the correct amount, adjustment is effected as described in Sec. Sec. 416.542 and 416.543, and the additional...


occur only with respect to a period for which a recipient filed an application, if required, for benefits and met all conditions of eligibility for benefits. An...


used in this subpart, the term overpayment means payment of more than the amount due for any period, including any amounts of State supplementary payments which are due...


(a) General. The amount of an underpayment or overpayment is the difference between the amount paid to a recipient and the amount of payment actually due such recipient for...


payable. (a) Underpaid recipient alive--underpayment payable. (1) If an underpaid recipient is alive, the amount of any underpayment due him or her will be paid to him...


We apply any underpayment due an individual to reduce any overpayment to that individual that we determine to exist (see Sec. 416.558) for a different period,...


alcoholism. (a) General. For disabled recipients who receive benefit payments through a representative payee because drug addiction or alcoholism is a...


(a) General. Except as described in paragraph (c) of this section, when an [[Page 772]] individual is eligible for past-due benefits in an amount...


for eligible individuals under age 18 who have a representative payee. or purposes of this section, amounts subject to payment into dedicated accounts (see...


Waiver of adjustment or recovery of an overpayment of SSI benefits may be granted when (EXCEPTION: This section does not apply to a sponsor of an alien): ...


Waiver of adjustment or recovery of an overpayment from the overpaid person himself (or, after his death, from his estate) frees him and his eligible spouse from...


Without fault relates only to the situation of the individual seeking relief from adjustment or recovery of an overpayment. The overpaid individual (and any...


purpose of the supplemental security income program. We will waive adjustment or recovery of an overpayment when an individual [[Page 774]] on...


and good conscience. We will waive adjustment or recovery of an overpayment when an individual on whose behalf waiver is being considered is without fault...


Waiver of adjustment or recovery is proper when the overpaid person on whose behalf waiver is being considered is without fault, as defined in Sec. 416.552,...


in excess of the limits prescribed in Sec. 416.1205 by $50 or less. (a) If any overpayment with respect to an individual (or an individual and his or her spouse...


(a) Notice of overpayment and underpayment determination. Whenever a determination concerning the amount paid and payable for any period is made and it is found...


be refunded by the overpaid recipient or by anyone on his or her behalf. Refund should be made in every case where the overpaid individual is not currently eligible for...


recipient has been overpaid, the overpayment has not been refunded, and waiver of adjustment or recovery is not applicable, any payment due the overpaid recipient or his or...


Any adjustment or recovery of an overpayment for an individual in current payment status is limited in amount in any month to the lesser of (1) the amount...


to adjustment to recover title XVI overpayments? (a) Definitions. (1) Cross-program recovery. Cross-program recovery is the process that we will use to...


the Treasury for tax refund offset--General. (a) The standards we will apply and the procedures we will follow before requesting the Department of the Treasury to...


A request for reduction of a Federal income tax refund will be made only after we determine that an amount is owed and past due and provide the overpaid individual with 60...


and legally enforceable. (a) Notification by overpaid individual. An overpaid individual who receives a notice as described in Sec. 416.581 of this subpart has...


review of the record, we will issue written findings which include supporting rationale for the findings. Issuance of these findings concerning whether the overpayment or part of...


(a) Notification by the overpaid individual. An overpaid individual who intends to inspect or copy our records related to the overpayment as determined by us...


days of the date of the notice described in Sec. 416.581 of this subpart, the overpaid individual notifies us that he or she is exercising a right described in Sec. 416.582(a)...


If a tax refund is insufficient to recover an overpayment in a given year, the case will remain with the Department of the Treasury for succeeding years,...


title XVI benefit overpayments? (a) General. In addition to the methods specified in Sec. Sec. 416.560, 416.570, 416.572 and 416.580, we may recover an...


and (d)(1) of the Social Security Act (42 U.S.C. 902(a)(5) and 1383 (a)(2) and (d)(1)). Source: 47 FR 30475, July 14, 1982, unless otherwise noted. ...


(a) We pay benefits to a representative payee on behalf of a beneficiary 18 years old or older when it appears to us that this method of payment will be in the interest of...


In determining whether to make representative payment we consider the following information: (a) Court determinations. If we learn that...


In selecting a payee we try to select the person, agency, organization or institution that will best serve the interest of the beneficiary. In making our selection...


As a guide in selecting a representative payee, categories of preferred payees have been established. These preferences are flexible. Our primary concern is to select...


(a) Before we select a representative payee, the payee applicant must give us information showing his or her relationship to the beneficiary and his or her responsibility for...


(a) Generally, whenever we intend to make representative payment and to name a payee, we notify the beneficiary or the individual acting on his or her...


representative payee has a responsibility to-- (a) Use the payments he or she receives only for the use and benefit of the beneficiary in a manner and for the purposes he or...


will consider that payments we certify to a representive payee have been used for the use and benefit of the beneficiary if they are used for the beneficiary's...


payees. (a) General. A community-based, nonprofit social service agency which meets the requirements set out in paragraph (b) of this section may...


to the beneficiary is completely discharged when we make a correct payment to a representative payee on behalf of the beneficiary. The payee personally, and not SSA, may...


(a) General. If payments are not needed for the beneficiary's current maintenance or reasonably foreseeable needs, they shall be conserved or invested on behalf of the...


When we learn that the interests of the beneficiary are not served by continuing payment to the present payee or that the present payee is no longer able to carry out the...


If a beneficiary receiving representative payment shows us that he or she is mentally and physically able to manage or direct the management of benefit payments, we will make...


payee who has conserved or invested benefit payments shall transfer these funds, and the interest earned from the invested funds, to either a successor payee, or to us, as...


is accountable for the use of benefits. We may require periodic written reports from representative payees. We may also, in certain situations, verify how a representative...


1613, 1614, and 1631 of the Social Security Act (42 U.S.C. 902(a)(5), 1382, 1382a, 1382b, 1382c, and 1383); sec. 211, Pub. L. 93-66, 87 Stat. 154 (42 U.S.C. 1382...


Essential person means someone whose presence was believed to be necessary for your welfare under the State program that preceded the SSI program. (See Sec. Sec. 416.220...


making required reports to us if you are-- (1) An eligible individual (see Sec. 416.120(c)(13)); (2) An eligible spouse (see Sec. 416.120(c)(14)); (3) An...


events that you must report to us. They are-- (a) A change of address. You must report to us any change in your mailing address and any change in the address where...


must tell us-- (a) The name and social security number under which benefits are paid; (b) The name of the person about whom you are reporting; (c) The event...


the ways described in this section. (a) Written reports. You may write a report on your own paper or on a printed form supplied by us. You may mail a written report or bring...


should report to us as soon as an event listed in Sec. 416.708 happens. If you do not report within 10 days after the close of the month in which the event happens,...


A penalty deduction is made from your benefits if-- (a) You fail to make a required report on time (see Sec. Sec. 416.708 and 416.714); (b) We must reduce, suspend,...


we find that we must impose a penalty deduction, you will lose from your SSI benefits a total amount of-- (1) $25 for a report overdue in the first penalty period; ...


period. The first penalty period begins on the first day of the month you apply for SSI benefits and ends on the day we first learn that you should have made a required...


penalty period. The second penalty period begins on the day after the first penalty period ends. The second penalty period ends on the day we first learn that you should have...


(a) Third (or a following) penalty period. A third (or a following) penalty period begins the day after the last penalty period ends. This penalty period ends on the day we first...


timely. (a) We will find that you have good cause for failure to report timely and we will not impose a penalty deduction, if-- (1) You are ``without fault''...


702(a)(5), 1601, 1614(a)(1) and 1631 of the Social Security Act (42 U.S.C. 902(a)(5), 1381, 1382c(a)(1), and 1383). Source: 39 FR 12731, Apr. 8, 1974, unless...


required to submit evidence of date of birth as indicated in Sec. 416.801, he shall submit a public record of birth or a religious record of birth or baptism established...


value will be accorded to a public record of birth or a religious record of birth or baptism established or recorded before age 5. Where such record is not available, and...


original of any record, except a Bible or other family record, there may be submitted as evidence of age a copy of such record or a statement as to the date of birth shown by...


[Code of Federal Regulations] [Title 20, Volume 2] [Revised as of April 1, 2004] From the U.S. Government Printing Office via GPO Access [CITE: 20CFR416.805] [Page 793] TITLE 20--EMPLOYEES' BENEFITS CHAPTER III--SOCIAL SECURITY ADMINISTRATION PART 416_SUPPLEMENTAL SECURITY INCOME FOR THE AGED, BLIND, AND DISABLED --Table of Contents Subpart H_Determination of Age Sec. 416.805 When additional evidence may be required. If the evidence submitted is not convincing, additional evidence may be required. ...


Where documentary evidence of age recorded at least 3 years before the application is filed, which reasonably supports an aged applicant's allegation as to his age,...


1611, 1614, 1619, 1631(a), (c), and (d)(1), and 1633 of the Social Security Act (42 U.S.C. 902(a)(5), 1382, 1382c, 1382h, 1383(a), (c), and (d)(1), and 1383b); secs. 4(c)...


As used in this subpart-- Acceptable medical source refers to one of the sources described in Sec. 416.913(a) who provides evidence about your impairments....


(a) State agencies. State agencies make disability and blindness determinations for the Commissioner for most persons living in the State. State agencies make...


our program any individual or entity, except to provide existing medical evidence, who is currently excluded, suspended, or otherwise barred from participation in the Medicare...


A decision by any nongovernmental agency or any other governmental agency about whether you are disabled or blind is based on its rules and is not our decision about...


(a) The law defines disability as the inability to do any substantial gainful activity by reason of any medically determinable physical or mental impairment which can be expected...


If you are under age 18, we will consider you disabled if you have a medically determinable physical or mental impairment or combination of impairments that causes marked and...


be considered disabled for payment of supplemental security income benefits if-- (a) You were found to be permanently and totally disabled as defined under a State...


If you are not doing substantial gainful activity, we always look first at your physical or mental impairment(s) to determine whether you are disabled or blind. Your impairment must...


impairment is expected to result in death, it must have lasted or must be expected to last for a continuous period of at least 12 months. We call this the...


Substantial gainful activity means work that-- (a) Involves doing significant and productive physical or mental duties; and (b) Is done (or intended) for pay...


(a) If you are an adult: (1) A disabling impairment is an impairment (or combination of impairments) which, of itself, is so severe that it meets or equals a set of criteria...


have to prove to us that you are blind or disabled. This means that you must furnish medical and other evidence that we can use to reach conclusions about your medical...


(a) Sources who can provide evidence to establish an impairment. We need evidence from acceptable medical sources to establish whether you have a medically...


We need specific medical evidence to determine whether you are disabled or blind. We will pay for the medical evidence we request, if there is a charge. We will also be responsible...


give us evidence about your impairment at any of our offices or at the office of any State agency authorized to make disability or blindness determinations. You may also give...


You (and if you are a child, your parent, guardian, relative, or other person acting on your behalf) must co-operate in furnishing us with, or in helping us to obtain...


If your medical sources cannot or will not give us sufficient medical evidence about your impairment for us to determine whether you are disabled or blind, we may ask you to have one...


(a) General. If you are applying for benefits and do not have a good reason for failing or refusing to take part in a consultative examination or test which we...


is a physical or mental examination or test purchased for you at our request and expense from a treating source or another medical source, including a pediatrician...


how we will use it. (a)(1) General. The decision to purchase a consultative examination for you will be made after we have given full consideration to whether...


We will not purchase a consultative examination in situations including, but not limited to, the following situations: (a) When any issues about your...


purchase only the specific examinations and tests we need to make a determination in your claim. For example, we will not authorize a comprehensive medical examination when the...


(a) We will purchase a consultative examination only from a qualified medical source. The medical source may be your own physician or psychologist, or another...


treating source is qualified, equipped, and willing to perform the additional examination or tests for the fee schedule payment, and generally furnishes complete and...


We will use a medical source other than your treating source for a purchased examination or test in situations including, but not limited to, the following situations: ...


consultative examination. You or your representative may object to your being examined by a medical source we have designated to perform a consultative...


other services. We may purchase medical examinations, including psychiatric and psychological examinations, X-rays and laboratory tests (including...


We will request the results of any diagnostic tests or procedures that have been performed as part of a workup by your treating source or other medical source and will use the results...


report content, and signature requirements. The medical sources who perform consultative examinations will have a good understanding of our disability programs...


has not been received. If a consultative examination report is received unsigned or improperly signed we will take the following action. (a) When we...


(a) We will review the report of the consultative examination to determine whether the specific information requested has been furnished. We will consider the following...


possible conflict of interest between medical or psychological consultants and their medical or psychological practices will be avoided. Such consultants are...


(a) Day-to-day responsibility for the consultative examination process rests with the State agencies that make disability determinations for us. (b)...


(a) We will ensure that referrals for consultative examinations and purchases of consultative examinations are made in accordance with our policies. We will also monitor both the...


(a) General--(1) Purpose of this section. This section explains the five-step sequential evaluation process we use to decide whether you are disabled, as defined in...


(a) General. The steps outlined in Sec. Sec. 416.920 and 416.924 apply to the evaluation of physical and mental impairments. In addition, when we evaluate the severity of...


adult. (a) Non-severe impairment(s). An impairment or combination of impairments is not severe if it does not significantly limit your physical or mental ability to do...


(a) Unrelated severe impairments. We cannot combine two or more unrelated severe impairments to meet the 12-month duration test. If you have a...


your physical or mental impairment or impairments are of a sufficient medical severity that such impairment or impairments could be the basis of eligibility under the law, we...


(a) Steps in evaluating disability. We consider all relevant evidence in your case record when we make a determination or decision whether you are disabled. If you allege more...


(a) Basic considerations. We consider all relevant information (i.e., evidence) in your case record. The evidence in your case record may include information...


process for children. (a) General. In this section, we explain how we consider age when we decide whether you are disabled. Your age may or may not be a...


of part 404 of this chapter. (a) Purpose of the Listing of Impairments. The Listing of Impairments describes, for each of the major body systems, impairments that...


(a) How medical equivalence is determined. We will decide that your impairment(s) is medically equivalent to a listed impairment in appendix 1 of subpart P of part 404 of...


(a) How medical equivalence is determined. We will decide that your impairment(s) is medically equivalent to a listed impairment in appendix 1 of subpart P of part 404 of...
...


(1) If you are an adult, you can only be found disabled if you [[Page 837]] are unable to do any substantial gainful activity by reason of any...


Medical findings consist of symptoms, signs, and laboratory findings: (a) Symptoms are your own description of your physical or mental impairment. If you are a child under...


What treatment you must follow. In order to get benefits, you must follow treatment prescribed by your physician if this treatment can restore your ability to work, or, if you are...


If you are applying for supplemental security income benefits on the basis of disability or blindness, we may pay you benefits before we make a formal finding...


We may make payments to you on the basis of presumptive disability or presumptive blindness before we make a formal determination about your disability or blindness. The payments...


presumptive blindness. We may make a finding of presumptive disability or presumptive blindness if the evidence available at the time we make the...


or presumptive blindness. We may make findings of presumptive disability and presumptive blindness in specific impairment categories without obtaining...


alcoholism is a contributing factor material to the determination of disability. (a) General. If we find that you are disabled and have medical evidence of...


alcoholism is a contributing factor material to the determination of disability. (a) If we determine that you are disabled and drug addiction or...


By appropriate treatment, we mean treatment for drug addiction or alcoholism that serves the needs of the individual in the least restrictive setting possible consistent with...


Institutions or facilities that we may approve include-- (a) An institution or facility that furnishes medically recognized treatment for drug addiction or alcoholism...


Our determination about whether treatment is available to you for your drug addiction or your alcoholism will depend upon-- [[Page 847]] (a) The capacity...


(a) General. Generally, we will consider information from the treatment institution or facility to evaluate your compliance with your treatment plan. The...


We will contract with one or more agencies in each of the States and the District of Columbia to provide services to individuals whose disabilities are based on...


(a) General--(1) Residual functional capacity assessment. Your impairment(s), and any related symptoms, such as pain, may cause physical and mental limitations that affect what you can...


(a) Responsibility for assessing residual functional capacity at the State agency. When a State agency makes the disability determination, a State agency...


(a) General. If you are age 18 or older and applying for supplemental security income benefits based on disability, and we cannot decide whether you are disabled at one...


an adjustment to other work. (a) If you have done only arduous unskilled physical labor. If you have no more than a marginal education (see Sec. 416.964) and...


General. ``Age'' means your chronological age. When we decide whether you are disabled under Sec. 416.920(g)(1), we will consider your chronological age in combination with...


(a) General. Education is primarily used to mean formal schooling or other training which contributes to your ability to meet vocational requirements, for example, reasoning...


(a) General. Work experience means skills and abilities you have acquired through work you have done which show the type of work you may be expected to do. Work you have...


(a) General. We consider that work exists in the national economy when it exists in significant numbers either in the region where you live or in several other regions of the...


the physical exertion requirments of work in the national economy, we classify jobs as sedentary, [[Page 854]] light, medium, heavy, and very heavy. These...


skills and to help determine the existence in the national economy of work you are able to do, occupations are classified as unskilled, semi-skilled, and skilled....


of subpart P of part 404 of this chapter. The Dictionary of Occupational Titles includes information about jobs (classified by their exertional and skill...


(a) General. Your impairment(s) and related symptoms, such as pain, may cause limitations of function or restrictions which limit your ability to meet certain demands of...


that you have done during any period in which you believe you are disabled may show that you are able to work at the substantial gainful activity level. If you are able...


Substantial gainful activity is work activity that is both substantial and gainful: (a) Substantial work activity. Substantial work activity is work activity that...


(a) The nature of your work. If your duties require use of your experience, skills, supervision and responsibilities, or contribute substantially to the operation of a...


(a) We use several guides to decide whether the work you have done shows that you are able to do substantial gainful activity. If you are working or have worked as an employee,...


(a) To determine your initial eligibility for benefits, we will average any earnings you make during the month you file for benefits and any succeeding months to determine if...


(a) If you are a self-employed person. If you are working or have worked as a self-employed person, we will use the provisions in paragraphs (a) through (d) of this section...


(a) General. When we figure your earnings in deciding if you have done substantial gainful activity, and in determining your countable earned income (see Sec. 416.1112(c)(5)), we...


We will consider you blind under the law for payment of supplemental security income benefits if we determine that you are statutorily blind. Statutory blindness is central...


consider you blind for the purposes of payment of supplemental security income benefits if-- (a) You were found to be blind as defined under a State plan approved under...


will find that you are blind if you are statutorily blind within the meaning of Sec. 416.981. For us to find that you are statutorily blind, it is not necessary-- (a) That...


There is no requirement that you be unable to work in order for us to find that you are blind. However, if you are working, your earnings will be considered under the income...


If you are not blind as defined in the law, we will evaluate a visual impairment the same as we evaluate other impairments in determining disability. Although you will not...


benefits based on statutory blindness. (a) If your vision does not meet the definition of blindness. If you become entitled to payments as a statutorily blind...


age 18. (a) Who is affected by this section? (1) We must redetermine your eligibility if you are eligible for SSI disability benefits and: (i) You are at least...


your disability or blindness status. If you are entitled to payments because you are disabled or blind, you should promptly tell us if-- (a) Your...


be disabled. After we find that you are disabled, we must evaluate your impairment(s) from time to time to determine if you are still eligible for payments...


to be blind. After we find that you are blind, we must evaluate your impairment(s) from time to time to determine if you are still eligible for payments based...


review. (a) General. We conduct continuing disability reviews to determine whether or not you continue to meet the disability or blindness requirements of...


work. If your impairment was expected to improve and you returned to full- time work with no significant medical limitations and acknowledge that medical improvement...


(a) General. If you are entitled to benefits because you are disabled, we will have your case file with the supporting medical evidence previously used to...


(a) General. If you are entitled to benefits because you are disabled, we will have your case file with the supporting medical evidence previously used to...
...


or ends, and whether you are and have been receiving treatment that is medically necessary and available, disabled children. (a) Evaluation of...


has ceased, did not exist or is no longer disabling (Medical Cessation Determination). If we make a determination that the physical or...


of a medical cessation determination. (a) General. If we determine that you are not eligible for disability or blindness benefits because the physical or...


If a new severe impairment(s) begins in or before the month in which your last impairment(s) ends, we will find that your disability is continuing. The new impairment(s)...


1614, 1631, and 1633 of the Social Security Act (42 U.S.C. 902(a)(5), 1382c, 1383, and 1383b). Source: 46 FR 29211, May 29, 1981, unless otherwise noted. ...


Act means the Social Security Act, as amended. Class or classes of cases means the categories into which disability claims are divided according to...


(a) General. We will work with the State to provide and maintain an effective system for processing claims of [[Page 897]] those who apply for and who are...


determination function. (a) Deemed notice. Any State that has in effect as of June 1, 1981, an agreement with us to make disability determinations will be...


determination function. (a) If a State notifies us in writing that it wishes to perform the disability determination function, we will notify the State in...


(a) General rule. A State agency will make determinations of disability with respect to all persons in the State except those individuals whose cases are in a class...


(a) The State agency will secure from the claimant, or other sources, any evidence it needs to make a disability determination. (b) We...


making a disability determination, the State agency will apply subpart I, part 416, of our regulations. (b) The State agency will make disability determinations based...


(a) What is a medical consultant? A medical consultant is a person who is a member of a team that makes disability determinations in a State agency, as explained in Sec. 416.1015, or...


psychologist. (a) The State agency must determine if additional qualified psychiatrists and psychologists are needed to make the necessary reviews (see...


The State agency will prepare denial notices in accordance with subpart N of this part whenever it makes a disability determination which is wholly or partly unfavorable to...


(a) The State will provide the organizational structure, qualified personnel, medical consultant services, and a quality assurance function sufficient to ensure that...


State will comply with all applicable Federal statutes, executive orders and regulations concerned with equal employment opportunities. (b) Selection, tenure,...


have an acceptable level of competence. We will provide training and other instructional materials to facilitate basic and advanced technical proficiency of...


other services. Subject to appropriate Federal funding, the State will provide adequate space, equipment, supplies, and other services to facilitate making accurate and...


will determine the rates of payment to be used for purchasing medical or other services necessary to make determinations of disability. The rates may not exceed the highest...


establish and maintain the records and furnish the [[Page 902]] schedules, financial, cost, and other reports relating to the administration of the...


advance or by way of reimbursement, for necessary costs in making disability determinations under these regulations. Necessary costs are direct as well as indirect costs...


Generally. Audits of account and records pertaining to the administration of the disability program under the Act, will be performed by the States in accordance with...


purchased for disability program purposes. The State will be responsible for maintaining all property it acquires or which we furnish to it for performing the...


We will invite State participation in federally funded research and demonstration projects to assess the effectiveness of the disability program and to ascertain the...


will establish cooperative working relationships with other agencies concerned with serving the disabled and, insofar as practicable, use their services, facilities, and...


The State will comply with the confidentiality of information, including the security of systems, and records requirements described in 20 CFR part 401 and pertinent written...


will comply with the provisions of other Federal laws and regulations that directly affect its responsibilities in carrying out the disability determination function; for...


will provide the State agency with written guidelines necessary for it to carry out its responsibilities in performing the disability determination function. (b) The...


procedures and guidelines we use to determine whether the State agency is substantially complying with our regulations and other written guidelines, including meeting...


performance standards include both a target level of performance and a threshold level of performance for the State agency. The target level represents a level of performance...


II processing time refers to the average number of days (including Saturdays, Sundays, and holidays) it takes a State agency to process an initial disability claim from the day...


accuracy refers to the percentage of cases that do not have to be returned to State agencies for further development or correction of decisions based on evidence in...


standards are met. (a) How we determine processing times. For all initial title II cases, we calculate the mean number of days, including Saturdays, Sundays,...


is met. (a) How we determine performance accuracy. We determine a State agency's performance accuracy rate on the basis of decision and...


standards. If a State agency does not meet two of the three established threshold levels (one of which must be performance accuracy) for two or more...


State agency combined title II and title XVI initial performance accuracy rate, title II initial processing time, and title XVI initial processing time. Within budgeted...


(a) Optional support. We may offer, or a State may request, performance support at any time that the regular monitoring and review process reveals that support could...


may include, but is not limited to, any or all of the following: (a) An onsite review of cases processed by the State agency emphasizing adherence to...


of three established threshold levels, one being performance accuracy, for two consecutive quarters, and after the mandatory performance support period, we will give the...


other written guidelines. If a State has good cause for not following the Act, our regulations, or other written guidelines, we will not find that the State...


substantial failure with respect to a State may not be made unless and until the State is afforded an opportunity for a hearing. Hearings...


failure. If, following the mandatory performance support period and the 3- month adjustment period, a State agency again falls below two of three...


Disputes concerning monetary disallowances will be resolved in proceedings before the Department of Health and Human Services, Departmental Appeals Board if the issue cannot...


required, it will be conducted by the Department of Health and Human Services' Departmental Appeals Board (the Board). [46 FR 29211, May 29, 1981, as amended at 62 FR 38455,...


hearings and appeals before the Board are provided in 45 CFR part 16. A notice under Sec. 416.1080 of this subpart will be considered a ``final written decision'' for purposes of...


(a) Notice to State. When we find that substantial failure exists, we will notify the State in writing that we will assume responsibility for performing the...


disability determination function. (a) Notice to the Commissioner. If a State no longer wishes to perform the disability determination function, it will notify us...


We will develop and initiate procedures to implement a plan to partially or completely assume the disability determination function from the State agency under Sec....


The State agency may not, after it receives the notice referred to in Sec. 416.1090, or gives the notice referred to in Sec. 416.1091, make any new commitments to spend...


submit its final claims to us as soon as possible, but in no event later than 1 year from the effective date of our assumption of the disability determination function unless...


1611, 1612, 1613, 1614(f), 1621, and 1631 of the Social Security Act (42 U.S.C. 902(a)(5), 1381a, 1382, 1382a, 1382b, 1382c(f), 1382j, and 1383); sec. 211, Pub. L. 93-66,...


Calendar quarter means a period of three full calendar months beginning with January, April, July, or October. Child means someone who is not married, is not the head of...


or in kind that you can use to meet your needs for food, clothing, and shelter. Sometimes income also includes more or less than you actually receive (see Sec. 416.1110 and...


income because you cannot use them as food, clothing, or shelter, or use them to obtain food, clothing, or shelter. In addition, what you receive from the sale or exchange of...


is and is not for SSI purposes (Sec. 416.1103). There are different types of income, earned and unearned, and we have rules for counting each. The earned income rules...


or in kind. We may include more of your earned income than you actually receive. We include more than you actually receive if amounts are withheld from earned income because of...


the earliest of the following points: when you receive them or when they are credited to your account or set aside for your use. We determine wages for each month. (b)...


must know the source and amount of all of your earned income for SSI, we do not count all of it to determine your eligibility and benefit amount. We first exclude income...


is not earned income. We describe some of the types of unearned income in Sec. 416.1121. We consider all of these items as unearned income, whether you receive them in cash...


are-- (a) Annuities, pensions, and other periodic payments. This unearned income is usually related to prior work or service. It includes, for example, private...


income. We count unearned income at the earliest of the following points: When you receive it or when it is credited to your account or set aside for your use. We determine...


we must know the source and amount of all of your unearned income for SSI, we do not count all of it to determine your eligibility and benefit amount. We first exclude income...


income include items received in kind (Sec. 416.1102). Generally, we value in-kind items at their current market value and we apply the various exclusions for both earned...


Instead of determining the actual dollar value of in-kind support and maintenance, we count one-third of the Federal benefit [[Page 920]] rate as additional...


(a) Household. For purposes of this subpart, we consider a household to be a personal place of residence. A commercial establishment such as a hotel or boarding house is not...


(a) General. If you pay your pro rata share toward monthly household operating expenses, you are living in your own household and are not receiving in-kind support...


rule. (1) When you receive in- kind support and maintenance and the one-third reduction rule does not apply, we use the presumed value rule. Instead of determining the...


rule applies whenever we must count in-kind support and maintenance as unearned income and the one-third reduction rule does not apply. This means that the presumed value...


Definition. A public assistance household is one in which every member receives some kind of public income-maintenance payments. These are payments made under-- (1) Title...


Definitions. For purposes of this subpart you live in a noninstitutional care situation if all the following conditions exist: (1) You are placed by a public or private agency...


(a) Definitions. For purposes of this section the following definitions apply: (1) Nonprofit retirement home or similar institution means a...


If you live in a nonmedical for-profit institution, we consider the amount accepted by that institution as payment in full to be the current market...


(a) Both members of a couple live in another person's household and receive food and shelter from that person. When both of you live in another person's household throughout...


and maintenance. (a) General. This section explains the rules for determining countable income, including in-kind support...


is deemed to you. (a) The one-third reduction and deeming of income. If you live in the household of your spouse, parent, essential person, or sponsor whose...


(a) General. A temporary absence may be due to employment, hospitalization, vacations, or visits. The length of time an absence can be temporary varies depending on the...


(a) General. The Disaster Relief and Emergency Assistance Act and other Federal statutes provide assistance to victims of major disasters. In this section we describe when we do...


resources. (a) General rule. If a resource is lost, damaged, or stolen, you may receive cash to repair or replace it or the resource may be repaired or...


of Pub. L. 98-369, effective October 1, 1984, amended section 1612(b)(13) to provide that certain support and maintenance assistance, which includes home energy assistance,...


term deeming to identify the process of considering another person's income to be your own. When the deeming rules apply, it does not matter whether the income of the other...


for deeming purposes. The first step in deeming is determining how much income your ineligible spouse, ineligible parent (if you are a child), your...


(a) General. In many States, an individual who is eligible for SSI or a Federally administered State optional supplementary payment is in turn eligible...


If you have an ineligible spouse who lives in the same household, we apply the deeming rules to your ineligible spouse's income in the following order. (a) Determining...


If you are a child living with your parents, we apply the deeming rules to you through the month in which you reach age 18. We follow the rules in paragraphs (a) through (e)...


spouse. If you and your eligible child live in the same household with your ineligible spouse, we deem your ineligible spouse's income first to you, and...


Before we deem your sponsor's income to you if you are an alien, we determine how much earned and unearned income your sponsor has under Sec. 416.1161(b). We...


a temporary absence, we continue to consider the absent person a member of the household. A temporary absence occurs when-- (1) You, your ineligible spouse, parent,...


(a) Essential person's income. If you have an essential person, we deem all of that person's income (except any not counted because of other Federal statutes as described in...


If including the income deemed to you from your essential person causes you to be ineligible for an SSI benefit, you are no longer considered to have that essential person...


meet the requirements in Sec. 416.1171, we use one of two rules to see how much countable income you have. We use whichever of the following rules results in the lower...


the alternative. We use the alternative income counting rules for you if you meet all the following conditions: (1) You were eligible for, and received, assistance for...


to help blind or disabled persons become self-supporting. If you are blind or disabled, we will pay you SSI benefits and will not count the part of your income that you use or...


achieve self-support must-- (a) Be designed especially for you; (b) Be in writing; (c) Be approved by us (a change of plan must also be approved); (d) Be...


We will begin to count the earned and unearned income that would have been excluded under your plan in the month in which any of the following circumstances first exist: ...


1602, 1611, 1612, 1613, 1614(f), 1621, and 1631 of the Social Security Act (42 U.S.C. 902(a)(5), 1381a, 1382, 1382a, 1382b, 1382c(f), 1382j, and 1383); sec. 211, Pub. L....


the case of an individual who is living with a person not eligible under this part and who is considered to be the husband or wife of such individual under the criteria in...


In the case of a qualified individual (as defined in Sec. 416.221) whose payment standard has been increased because of the presence of an essential person (as defined in Sec....


The resources of an alien who first applies for SSI benefits after September 30, 1980, are deemed to include the resources of the alien's sponsor for 3 years after the...


Section 416.1161a of this part describes certain circumstances affecting Medicaid eligibility in which the Department will not deem family income to an individual....


eligible spouse. An aged, blind, or disabled individual with no spouse is eligible for benefits under title XVI of the Act if his or her nonexcludable resources do not exceed...


determinations are made as of the first moment of the month. A resource determination is based on what assets an individual has, what their values are, and whether or not...


(a) General. Funds held in a financial institution account (including savings, checking, and time deposits, also known as certificates of deposit) are an...


the resources of an individual (and spouse, if any) the following items shall be excluded: [[Page 951]] (a) The home (including the land appertaining...


is any property in which an individual (and spouse, if any) has an ownership interest and which serves as the individual's principal place of residence. This property includes...


(a) Household goods and personal effects; defined. Household goods are defined as including household furniture, furnishings and equipment which are commonly found in or about...


As used in this section, the term automobile includes, in addition to passenger cars, other vehicles used to provide necessary transportation. (b) Limitation...


When counting the value of resources an individual (and spouse, if any) has, the value of property essential to self-support is not counted, within certain limits. There...


counted. (a) General. When deciding the value of property used in a trade or business or nonbusiness income-producing activity, only the individual's equity...


to self-support is counted. Nonbusiness property is considered to be essential for an individual's (and spouse, if any) self-support if it is used to...


If the individual is blind or disabled, resources will not be counted that are identified as necessary to fulfill a plan for achieving self-support which is in writing, has been...


to achieve self-support must-- (a) Be designed especially for the individual; (b) Be in writing; (c) Be approved by the Social Security Administration (a change...


to count. The resources that were excluded under the individual's plan will begin to be counted as of the first day of the month following the month...


(a) In determining the resources of a native of Alaska (and spouse, if any) there will be excluded from resources, shares of stock held in a regional...


or losses suffered as a result of a crime. (a) In determining the resources of an individual (and spouse, if any), any amount received from a fund established...


determining the resources of an individual (and spouse, if any), life insurance owned by the individual (and spouse, if any) will be considered to the extent of its cash...


(a) Burial spaces--(1) General. In determining the resources of an individual, the value of burial spaces for the individual, the individual's spouse or any...


(a) Cash (including any interest earned on the cash) or in-kind replacement received from any source for purposes of repairing or replacing an excluded resource...


(a) General. In determining the resources of an eligible individual (and spouse, if any), we will exclude, for 6 months following the month of receipt, the unspent portion of...


resources of an individual (and spouse, if any) who is of Indian descent from a federally recognized Indian tribe, we will exclude any interest of the individual (or spouse, if any)...


the resources of an individual (and spouse, if any), we exclude in the month following the month of receipt the unspent portion of any refund of Federal income taxes...


(a) For the purpose of Sec. 416.1210(j), payments or benefits provided under a Federal statute other than title XVI of the Social Security Act where exclusion...


(a) Assistance received under the Disaster Relief and Emergency Assistance Act or other assistance provided under a Federal statute because of a catastrophe which is declared to...


value of any assistance paid with respect to a dwelling under the statutes listed in Sec. 416.1124(c)(14) is excluded from resources. [55 FR 28378, July...


In determining the resources of an individual (or spouse, if any), relocation assistance provided by a State or local government (as described in Sec. 416.1124(c)(18))...


of an individual (and spouse, if any) are determined to exceed the limitations prescribed in Sec. 416.1205, such individual (and spouse, if any) shall not be eligible...


order for payment conditioned on the disposition of nonliquid resources to be made, the individual must agree in writing to dispose of real property within 9 months and...


(a) Upon disposition of the resources, the net proceeds to the individual from the sale are considered available to repay that portion of the payments that would not...


(a) Loss of housing for joint owner. Excess real property which would be a resource under Sec. 416.1201 is not a countable resource for conditional benefit purposes when:...


(a) General. (1) An individual (or eligible spouse) who gives away or sells a nonexcluded resource for less than fair market value for the purpose of establishing SSI...


(a) General. In determining the resources of an individual (or spouse, if any), the funds in a dedicated account in a financial institution established and maintained...


plan. (a) General. In the case of any individual (or individual and spouse, as the case may be) who for the month of December 1973 was a recipient of aid or...


In determining the resources of an individual (and spouse, if any) who meets the conditions specified in Sec. 416.1260(a), either the State plan resource limit and exclusions...


persons. (a) Essential persons continuously meet criteria of eligibility. In determining the resources of an individual (and spouse, if any) who meet...


In the case of an individual who meets the conditions specified in Sec. 416.1260 but whose spouse does not meet such conditions, whichever of the following is...


1973. Where only one person, either the eligible individual or the eligible spouse, meets the conditions specified in Sec. 416.1260 and that person dies...


1129A, 1611-1614, 1619, and 1631 of the Social Security Act (42 U.S.C. 902(a)(5), 1320a-8a, 1382-1382c, 1382h, and 1383). Source: 40 FR 1510, Jan. 8,...


institutions. (a) If you don't give us permission to contact any financial institution and request any financial records about you when we think it...


(a) Suspension of benefit payments is required effective with the month following the month in which it is determined in accordance with Sec. 416.714(b)...


Suspension of payments due to ineligibility for benefits because of excess income is effective with the first month in which ``countable income'' (see Sec. Sec....


(a) Effective date. Except as specified in Sec. Sec. 416.1240 through 416.1242, suspension of benefit payments because of excess resources is required effective with the month...


(a) Except as provided in Sec. 416.211 (b) and (c), a recipient is ineligible for benefits for the first full calendar month in which he or she is a...


addiction or alcoholism. (a) Basis for suspension. If you are disabled and drug addiction or alcoholism is a contributing factor material to the determination...


(a) Suspension effective date. A recipient is not eligible for SSI benefits if he is outside the United States for a full calendar month. For purposes of...


citizenship, or status as an alien lawfully admitted for permanent residence or otherwise permanently residing in the United States under color...


benefits. (a) Suspension effective date. A recipient ceases to be an eligible individual or eligible spouse when, in the absence of a showing of incapacity to...


(a) General. The last month for which we can pay you benefits based on disability is the second month after the first month in which you are determined to no longer have...


Special SSI cash benefits (see Sec. 416.261) will be payable for the period beginning January 1, 1981, and ending June 30, 1987 if you meet eligibility requirements...


A recipient, his legal guardian, or his representative payee, may terminate his eligibility for benefits under this part by filing a written request for termination which shows...


[Code of Federal Regulations] [Title 20, Volume 2] [Revised as of April 1, 2004] From the U.S. Government Printing Office via GPO Access [CITE: 20CFR416.1334] [Page 972] TITLE 20--EMPLOYEES' BENEFITS CHAPTER III--SOCIAL SECURITY ADMINISTRATION PART 416_SUPPLEMENTAL SECURITY INCOME FOR THE AGED, BLIND, AND DISABLED --Table of Contents Subpart M_Suspensions and Terminations Sec. 416.1334 Termination due to death of recipient. Eligibility for benefits ends with the month in which the recipient dies. Payments are terminated effective with the month after the month of death. ...


We will terminate your eligibility for benefits following 12 consecutive months of benefit suspension for any reason beginning with the first month you were no longer eligible...


status. (a) Advance written notice requirement. Advance written notice of intent to discontinue payment because of an event requiring suspension, reduction (see...


level. (a) Multiple payments exception. (1) Where it is determined that a recipient is receiving two or more regular monthly payments in one month,...


(a) When your benefits based on disability may be continued. Your benefits may be continued after your impairment is no longer disabling if-- ...


custody or confinement after conviction, or due to violation of probation or parole. (a) Basis for suspension. An individual is ineligible for SSI...


(a) Why would SSA penalize me? You will be subject to a penalty if you make, or cause to be made, a statement or representation of a material fact for use in determining...


416.1400 Introduction. Authority: Secs. 702(a)(5), 1631, and 1633 of the Social Security Act (42 U.S.C. 902(a)(5), 1383, and 1383b). Source: 45...


416.1401 Definitions. As used in this subpart: Date you receive notice means 5 days after the date on the notice, unless you show us that you did not receive...


416.1402 Administrative actions that are initial determinations. Initial determinations are the determinations we make that are subject to administrative...


416.1403 Administrative actions that are not initial determinations. (a) Administrative actions that are not initial determinations may be reviewed by us, but...


416.1404 Notice of the initial determination. (a) We shall mail a written notice of the initial determination to you at your last known address. Generally, we will...


416.1405 Effect of an initial determination. An initial determination is binding unless you request a reconsideration within the stated time period, or we revise...


416.1406 Testing modifications to the disability determination procedures. (a) Applicability and scope. Notwithstanding any other provision in this part or part...


416.1407 Reconsideration--general. Reconsideration is the first step in the administrative review process that we provide if you are dissatisfied with the...


416.1408 Parties to a reconsideration. (a) Who may request a reconsideration. If you are dissatisfied with the initial determination, you may request that we...


416.1409 How to request reconsideration. (a) We shall reconsider an initial determination if you or any other party to the reconsideration files a written request...


416.1411 Good cause for missing the deadline to request review. (a) In determining whether you have shown that you have good cause for missing a deadline to...


416.1413 Reconsideration procedures. If you request reconsideration, we will give you a chance to present your case. How you can present your case depends upon...


416.1413a Reconsiderations of initial determinations on applications. The method of reconsideration we will use when you appeal an initial determination on...


416.1413b Reconsideration procedures for post-eligiblity claims. If you are eligible for supplemental security income benefits and we notify you that we are going...


416.1413c Arrangement for conferences. (a) As soon as we receive a request for a formal or informal conference, we shall set the time, date and place for...


416.1414 Disability hearing--general. (a) Availability. We will provide you with an opportunity for a disability hearing if: (1) You have been...


416.1415 Disability hearing--disability hearing officers. (a) General. Your disability hearing will be conducted by a disability hearing officer who was not involved...


416.1416 Disability hearing--procedures. (a) General. The disability hearing will enable you to introduce evidence and present your views to a disability...


416.1417 Disability hearing--disability hearing officer's reconsidered determination. (a) General. The disability hearing officer who conducts your...


416.1418 Disability hearing--review of the disability hearing officer's reconsidered determination before it is issued. (a) General. The Director of the Office...


416.1419 Notice of another person's request for reconsideration. If any other person files a request for reconsideration of the initial determination in your case,...


416.1420 Reconsidered determination. After you or another person requests a reconsideration, we shall review the evidence considered in making the initial...


416.1421 Effect of a reconsidered determination. The reconsidered determination is binding unless-- (a) You or any other party to the reconsideration requests...


416.1422 Notice of a reconsidered determination. We shall mail a written notice of the reconsidered determination to the parties at their last known address. We...


416.1423 Expedited appeals process--general. By using the expedited appeals process you may go directly to a Federal district court without first completing...


416.1424 When the expedited appeals process may be used. You may use the expedited appeals process if all of the following requirements are met: (a) We...


416.1425 How to request expedited appeals process. (a) Time of filing request. You may request the expedited appeals process-- (1) Within 60 days after...


416.1426 Agreement in expedited appeals process. If you meet all the requirements necessary for the use of the expedited appeals process, our authorized...


416.1427 Effect of expedited appeals process agreement. After an expedited appeals process agreement is signed, you will not need to complete the remaining steps of...


416.1428 Expedited appeals process request that does not result in agreement. If you do not meet all of the requirements necessary to use the expedited...


416.1429 Hearing before an administrative law judge--general. If you are dissatisfied with one of the determinations or decisions listed in Sec. 416.1430 you...


416.1430 Availability of a hearing before an administrative law judge. (a) You or another party may request a hearing before an administrative law judge if we...


416.1432 Parties to a hearing before an administrative law judge. (a) Who may request a hearing. You may request a hearing if a hearing is available under...


416.1433 How to request a hearing before an administrative law judge. (a) Written request. You may request a hearing by filing a written request. You should include...


416.1435 Submitting evidence prior to a hearing before an administrative law judge. If possible, the evidence or a summary of evidence you wish to have...


416.1436 Time and place for a hearing before an administrative law judge. (a) General. The administrative law judge sets the time and place for the hearing....


416.1438 Notice of a hearing before an administrative law judge. (a) Issuing the notice. After the administrative law judge sets the time and place of the hearing,...


416.1439 Objections to the issues. If you object to the issues to be decided upon at the hearing, you must notify the administrative law judge in writing at...


416.1440 Disqualification of the administrative law judge. An administrative law judge shall not conduct a hearing if he or she is prejudiced or partial with respect...


416.1441 Prehearing case review. (a) General. After a hearing is requested but before it is held, we may, for the purposes of a prehearing case review, forward...


416.1442 Prehearing proceedings and decisions by attorney advisors. (a) General. After a hearing is requested but before it is held, an attorney advisor in...


416.1443 Responsibilities of the adjudication officer. (a)(1) General. Under the procedures set out in this section we will test modifications to the procedures...


416.1444 Administrative law judge hearing procedures--general. A hearing is open to the parties and to other persons the administrative law judge considers...


416.1446 Issues before an administrative law judge. (a) General. The issues before the administrative law judge include all the issues brought out in the...


416.1448 Deciding a case without an oral hearing before an administrative law judge. (a) Decision wholly favorable. If the evidence in the hearing record...


416.1449 Presenting written statements and oral arguments. You or a person you designate to act as your representative may appear before the administrative law judge...


416.1450 Presenting evidence at a hearing before an administrative law judge. (a) The right to appear and present evidence. Any party to a hearing has a...


416.1451 When a record of a hearing before an administrative law judge is made. The administrative law judge shall make a complete record of the...


416.1452 Consolidated hearings before an administrative law judge. (a) General. (1) A consolidated hearing may be held if-- (i) You have requested a hearing...


416.1453 The decision of an administrative law judge. (a) General. The administrative law judge shall issue a written decision which gives the findings of fact and...


416.1455 The effect of an administrative law judge's decision. The decision of the administrative law judge is binding on all parties to the hearing unless-- ...


416.1456 Removal of a hearing request from an administrative law judge to the Appeals Council. If you have requested a hearing and the request is pending before...


416.1457 Dismissal of a request for a hearing before an administrative law judge. An administrative law judge may dismiss a request for a hearing under any of...


416.1458 Notice of dismissal of a request for a hearing before an administrative law judge. We shall mail a written notice of the dismissal of the hearing...


416.1459 Effect of dismissal of a request for a hearing before an administrative law judge. The dismissal of a request for a hearing is binding, unless it...


416.1460 Vacating a dismissal of a request for a hearing before an administrative law judge. An administrative law judge or the Appeals Council may vacate...


416.1461 Prehearing and posthearing conferences. The administrative law judge may decide on his or her own, or at the request of any party to the hearing, to hold...


416.1466 Testing elimination of the request for Appeals Council review. (a) Applicability and scope. Notwithstanding any other provision in this part or part 422...


416.1467 Appeals Council review--general. If you or any other party is dissatisfied with the hearing decision or with the dismissal of a hearing request, you...


416.1468 How to request Appeals Council review. (a) Time and place to request Appeals Council review. You may request Appeals Council review by filing a...


416.1469 Appeals Council initiates review. (a) General. Anytime within 60 days after the date of a decision or dismissal that is subject to review under...


416.1470 Cases the Appeals Council will review. (a) The Appeals Council will review a case if-- (1) There appears to be an abuse of discretion by the...


416.1471 Dismissal by Appeals Council. The Appeals Council will dismiss your request for review if you did not file your request within the stated period of time...


416.1472 Effect of dismissal of request for Appeals Council review. The dismissal of a request for Appeals Council review is binding and not subject to...


416.1473 Notice of Appeals Council review. When the Appeals Council decides to review a case, it shall mail a notice to all parties at their last known address...


416.1474 Obtaining evidence from Appeals Council. You may request and receive copies or a statement of the documents or other written evidence upon which the...


416.1475 Filing briefs with the Appeals Council. Upon request, the Appeals Council shall give you and all other parties a reasonable opportunity to file briefs...


416.1476 Procedures before Appeals Council on review. (a) Limitation of issues. The Appeals Council may limit the issues it considers if it notifies you and the...


416.1477 Case remanded by Appeals Council. (a) When the Appeals Council may remand a case. The Appeals Council may remand a case to an administrative law judge...


416.1479 Decision of Appeals Council. After it has reviewed all the evidence in the administrative law judge hearing record and any additional evidence...


416.1481 Effect of Appeals Council's decision or denial of review. The Appeals Council may deny a party's request for review or it may decide to review a case and...


416.1482 Extension of time to file action in Federal district court. Any party to the Appeals Council's decision or denial of review, or to an expedited...


416.1483 Case remanded by a Federal court. When a Federal court remands a case to the Commissioner for further consideration, the Appeals Council, acting...


416.1484 Appeals Council review of administrative law judge decision in a case remanded by a Federal court. (a) General. In accordance with Sec. 416.1483, when...


416.1485 Application of circuit court law. The procedures which follow apply to administrative determinations or decisions on claims involving the application...


416.1487 Reopening and revising determinations and decisions. (a) General. Generally, if you are dissatisfied with a determination or decision made in...


416.1488 Conditions for reopening. A determination, revised determination, decision, or revised decision may be reopened-- (a) Within 12 months of the date...


416.1489 Good cause for reopening. (a) We will find that there is good cause to reopen a determination or decision if-- (1) New and material evidence...


416.1491 Late completion of timely investigation. We may revise a determination or decision after the applicable time period in Sec. 416.1488(a) or...


416.1492 Notice of revised determination or decision. (a) When a determination or decision is revised, notice of the revision will be mailed to the parties at...


416.1493 Effect of revised determination or decision. A revised determination or decision is binding unless-- (a) You or a party to the revised determination file...


416.1494 Time and place to request further review or a hearing on revised determination or decision. You or another party to the revised determination or decision...


416.1495 Payment of certain travel expenses--general. When you file a claim for supplemental security income (SSI) benefits, you may incur certain travel expenses...


416.1496 Who may be reimbursed. (a) The following individuals may be reimbursed for certain travel expenses-- (1) You, when you attend medical...


416.1498 What travel expenses are reimbursable. Reimbursable travel expenses include the ordinary expenses of public or private transportation as well as...


416.1499 When and how to claim reimbursement. (a)(1) Generally, you will be reimbursed for your expenses after your trip. However, travel advances may be authorized...


1631(d) of the Social Security Act (42 U.S.C. 902(a)(5) and 1383(d)). Source: 45 FR 52106, Aug. 5, 1980, unless otherwise noted. You may appoint someone...


Representative means an attorney who meets all of the requirements of Sec. 416.1505(a), or a person other than an attorney who meets all of the requirements of Sec. 416.1505(b),...


may appoint as your representative in dealings with us any attorney in good standing who-- (1) Has the right to practice law before a court of a State,...


If you are not represented by an attorney and we make a determination or decision that is subject to the administrative review process provided under subpart N...


person as your representative if the following things are done: (a) You sign a written notice stating that you want the person to be your representative in dealings...


representative may do. Your representative may, on your behalf-- (1) Obtain information about your claim to the same extent that you are able to do; (2)...


We shall send your representative-- (1) Notice and a copy of any administrative action, determination, or decision; and (2) Requests for information or evidence. ...


(a) General. A representative may charge and receive a fee for his or her services as a representative only as provided in paragraph (b) of this section. (b) Charging...


a request. In order for your representative to obtain approval of a fee for services he or she performed in dealings with us, he or she shall file a written request with one of...


We shall not consider any service the representative gave you in any proceeding before a State or Federal court to be services as a representative in dealings with us. However, if...


Services provided a claimant in any dealing with us under title XVI of the Act consist of services performed for that claimant in connection with any claim he or she may...


representatives. (a) Purpose and scope. (1) All attorneys or other persons acting on behalf of a party seeking a statutory right or benefit shall, in their...


When we have evidence that a representative fails to meet our qualification requirements or has violated the rules governing dealings with us, we may begin proceedings...


(a) The Deputy Commissioner for Disability and Income Security Programs (or other official the Commissioner may designate), or his or her designee, will prepare a notice containing...


We may withdraw charges against a representative. We will do this if the representative files an answer, or we obtain evidence, that satisfies us that there is reasonable doubt...


hearing. If the Deputy Commissioner for Disability and Income Security Programs (or other official the Commissioner may designate), or his or her designee, does not take action...


After the close of the hearing, the hearing officer shall issue a decision or certify the case to the Appeals Council. The decision must be in writing, will contain findings...


(a) General. After the hearing officer issues a decision, either the representative or the other party to the hearing may ask the Appeals Council to review the decision. ...


Upon receipt of a request for review of the hearing officer's decision, the matter will be assigned to a panel consisting of three members of the...


(a) Upon request, the Appeals Council shall give the parties a reasonable time to file briefs or other written statements as to fact and law, and to appear before...


the Appeals Council will not consider evidence in addition to that introduced at the hearing. However, if the Appeals Council believes that the evidence offered is...


Council shall base its decision upon the evidence in the hearing record and any other evidence it may permit on review. The Appeals Council shall either-- (1)...


The Appeals Council may dismiss a request for the review of any proceeding to suspend or disqualify a representative in any of the following circumstances: ...


[Code of Federal Regulations] [Title 20, Volume 2] [Revised as of April 1, 2004] From the U.S. Government Printing Office via GPO Access [CITE: 20CFR416.1597] [Page 1022] TITLE 20--EMPLOYEES' BENEFITS CHAPTER III--SOCIAL SECURITY ADMINISTRATION PART 416_SUPPLEMENTAL SECURITY INCOME FOR THE AGED, BLIND, AND DISABLED --Table of Contents Subpart O_Representation of Parties Sec. 416.1597 Reinstatement after suspension--period of suspension expired. We shall automatically allow a person to serve again as a representative in dealings with us at the end of any suspension. ...


suspension not expired. (a) After more than one year has passed, a person who has been suspended or disqualified may ask the Appeals Council for permission...


(a)(1)(B) and (e), and 1631 of the Social Security Act (42 U.S.C. 902(a)(5), 1382c (a)(1)(B) and (e), and 1383); 8 U.S.C. 1254a; sec. 502, Pub. L. 94-241, 90 Stat. 268...


We or Us means the Social Security Administration. You or Your means the person who applies for or receives SSI benefits or the person for whom an application...


(a) What you should give us. Your home address in the United States may be sufficient to establish that you are a resident. However, if we have any reason to question...


United States. (a) What you should give us. You can prove that you are a citizen or a national of the United States by giving us-- (1) A certified copy of...


in the United States. (a) What you should give us. You can prove that you are lawfully admitted for permanent residence in the United States by giving us-- ...


United States under color of law. (a) General. We will consider you to be permanently residing in the United States under color of law and you may be eligible for...


United States under color of law. We will not consider you to be permanently residing in the United States under color of law and you are not eligible for SSI...


Scope of subpart. Authority: Secs. 702(a)(5), 1611(e)(3), 1615, and 1631 of the Social Security Act (42 U.S.C. 902(a)(5), 1382(e)(3), 1382d, and 1383). ...


416.1705 Definitions. As used in this subpart-- Vocational rehabilitation services refers to services provided blind or disabled persons under the State...


Whom we refer and when. (a) Whom we refer. If you are 16 years of age or older and under 65 years old, and receiving supplemental security income (SSI) benefits,...


Whom we refer. We will refer you to an approved facility for treatment of your alcoholism or drug addiction if-- (a) You are disabled; (b) You...


Effect of your failure to comply with treatment requirements for your drug addiction or alcoholism. (a) Suspension of benefits. Your eligibility for benefits will...


(c), and (d), and 1631(d)(1) and (e) of the Social Security Act (42 U.S.C. 902(a)(5), 1382c (b), (c), and (d), and 1383 (d)(1) and (e)). Source: 45 FR 71795, Oct....


(a) If you have an ineligible spouse--(1) Counting income. If you apply for or receive SSI benefits, and you are married to someone who is not eligible for SSI benefits and...


(a) We will consider someone to be your spouse (and therefore consider you to be married) for SSI purposes if-- (1) You are legally married under the laws of the State where...


When you apply for SSI benefits, we will ask whether you are married. If you are married, we will ask whether you are living with your spouse. If you are unmarried...


(a) General rule: Proof is unnecessary. If you tell us you are married we will consider you married unless we have information to the contrary. We will also consider you married,...


(a) General rule: Proof is unnecessary. If you do not live with an unrelated person of the opposite sex and you say that you are not married, we will generally accept...


We will stop considering you and your spouse an eligible couple, even if [[Page 1031]] you both remain eligible, at the beginning of whichever...


marriage ended when-- (a) Your spouse dies; (b) Your divorce or annulment becomes final; (c) We decide that either of you is not a spouse of the other...


become eligible for SSI. (a) If you and your spouse stop living together. If you and your spouse stop living together, you must promptly report that fact to us,...


to be a child for SSI purposes, the rules in this section apply when we determine your eligibility for SSI and the amount of your SSI benefits. (a) If we consider you...


a child if-- (a)(1) You are under 18 years old; or (2) You are under 22 years old and you are a student regularly attending school or college or training that is designed...


(a) Are you a student? You are a student regularly attending school or college or training that is designed to prepare you for a paying job if you are enrolled for one or...


(a) Meaning of head of household. You are the head of a household if you have left your parental home on a permanent basis and you are responsible for...


[Code of Federal Regulations] [Title 20, Volume 2] [Revised as of April 1, 2004] From the U.S. Government Printing Office via GPO Access [CITE: 20CFR416.1876] [Page 1033] TITLE 20--EMPLOYEES' BENEFITS CHAPTER III--SOCIAL SECURITY ADMINISTRATION PART 416_SUPPLEMENTAL SECURITY INCOME FOR THE AGED, BLIND, AND DISABLED --Table of Contents Subpart R_Relationship Sec. 416.1876 Effects a parent (or parents) can have on the child's benefits. Section 416.1851 (b) and (c) tells what effects a parent's income and resources can have on his or her child's benefits. ...


(a) We consider your parent to be-- (1) Your natural mother or father; or (2) A person who legally adopted you. (b) We consider your stepparent to be the...


and 1631 of the Social Security Act (42 U.S.C. 902(a)(5) and 1383). Source: 46 FR 47449, Sept. 27, 1981, unless otherwise noted. ...


1034]] Authorization means your written permission, in a form legally acceptable to us and to the State from which you received interim...


We may withhold your SSI benefit payment and send it to the State to repay the State for the interim assistance it gave to you, if-- (a) We have an interim assistance agreement...


Your authorization for us to withhold your SSI benefit payment, to repay the State for interim assistance the State gives you, is effective when we receive it, or (if our agreement...


event described in Sec. 416.1906 occurs, your authorization is no longer effective. If you reapply for SSI benefits, or the authorization has expired, the State must obtain a...


An interim assistance agreement must be in effect between us and the State if we are to repay the State for interim assistance. The following requirements must be part of...


interim assistance agreement with us, the State must agree to give you an opportunity for a hearing if you disagree with the State's actions regarding repayment of interim...


the total amount of money we have withheld and sent to the State for the interim assistance it gave to you, you have a right to appeal to us, as described in subpart N of...


Authority: Secs. 702(a)(5), 1616, 1618, and 1631 of the Social Security Act (42 U.S.C. 902(a)(5), 1382e, 1382g, and 1383); sec. 212, Pub. L. 93-66, 87 Stat. 155...


(a) Agreement-mandatory only. Subject to the provisions of paragraph (d) of this section, any State having an agreement with the Social Security Administration (SSA)...


(a) Payments. Any agreement between SSA and a State made pursuant to Sec. 416.2005 must provide that, if for optional supplementation, such State...


(a) Applications. Any person who meets the application requirements of subpart C of this part is deemed to have filed an application for any federally administered...


(a) Payment procedures. A federally administered State supplementary payment will be made on a monthly basis and will be included in the same check as a...


(a) Earned and unearned income. No less than the amounts of earned or unearned income which were excluded in determining eligibility for or amount of a title...