Social Security Ruling, SSR 05-03p.; Title XVI: Determining Continuing Disability at Step 2 of the Medical Improvement Review Standard Sequential Evaluation Process for Children Under Age 18-Functional Equivalence, 21833-21835 [05-8390]
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Federal Register / Vol. 70, No. 80 / Wednesday, April 27, 2005 / Notices
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[FR Doc. E5–1986 Filed 4–26–05; 8:45 am]
BILLING CODE 8010–01–P
SOCIAL SECURITY ADMINISTRATION
Social Security Ruling, SSR 05–03p.;
Title XVI: Determining Continuing
Disability at Step 2 of the Medical
Improvement Review Standard
Sequential Evaluation Process for
Children Under Age 18—Functional
Equivalence
Social Security Administration.
Notice of Social Security Ruling.
AGENCY:
ACTION:
SUMMARY: In accordance with 20 CFR
402.35(b)(1), the Commissioner of Social
Security gives notice of Social Security
Ruling, SSR 05–03p. This Ruling
explains our policies for determining
continuing disability at step 2 of the
medical improvement review standard
for children under 20 CFR
416.994a(b)(2).
EFFECTIVE DATE:
April 27, 2005.
Judy
Hicks, Office of Disability Programs,
Social Security Administration, 6401
Security Boulevard, 4352 Annex
Building, Baltimore, MD 21235–6401,
FOR FURTHER INFORMATION CONTACT:
10 5
U.S.C. § 78s(b)(3)(A)(iii).
11 17 CFR 240.19b-4(f)(2).
12 For purposes of calculating the 60-day
abrogation period, the Commission considers the
proposed rule change to have been filed on April
18, 2005, when Amendment No. 1 was filed. See,
supra, note 3.
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13 17
CFR 200.30–3(a)(12).
Frm 00104
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Sfmt 4703
21833
(410) 965–9119. For information on
eligibility or filing for benefits, call our
national toll-free number 1–800–772–
1213 or TTY 1–800–325–0778, or visit
our Internet Web site, Social Security
Online, at https://
www.socialsecurity.gov.
SUPPLEMENTARY INFORMATION: Although
we are not required to do so pursuant
to 5 U.S.C. 552(a)(1) and (a)(2), we are
publishing this Social Security Ruling
in accordance with 20 CFR 402.35(b)(1).
Social Security Rulings make
available to the public precedential
decisions relating to the Federal old-age,
survivors, disability, supplemental
security income, and black lung benefits
programs. Social Security Rulings may
be based on case decisions made at all
administrative levels of adjudication,
Federal court decisions, Commissioner’s
decisions, opinions of the Office of the
General Counsel, and policy
interpretations of the law and
regulations.
Although Social Security Rulings do
not have the same force and effect as the
statute or regulations, they are binding
on all components of the Social Security
Administration, in accordance with 20
CFR 402.35(b)(1), and are to be relied
upon as precedents in adjudicating
cases.
If this Social Security Ruling is later
superseded, modified, or rescinded, we
will publish a notice in the Federal
Register to that effect.
(Catalog of Federal Domestic Assistance,
Program No. 96.006 Supplemental Security
Income.)
Dated: April 21, 2005.
Jo Anne B. Barnhart,
Commissioner of Social Security.
Policy Interpretation Ruling
Title XVI: Determining Continuing
Disability at Step 2 of the Medical
Improvement Review Standard
Sequential Evaluation Process for
Children Under Age 18—Functional
Equivalence.
Purpose: To explain our policies for
determining continuing disability at
step 2 of the medical improvement
review standard (MIRS) sequential
evaluation process for children under 20
CFR 416.994a(b)(2) and to explain how
we apply the functional equivalence
rule at step 2.
Citations (Authority): Sections
1614(a)(3), 1614(a)(4), and 1614(c) of the
Social Security Act; Regulations No. 16,
subpart I, sections 416.924, 416.925,
416.926, 416.926a, and 416.994a.
Introduction: When we conduct a
continuing disability review, we use a
three-step MIRS sequential evaluation
process, outlined in 20 CFR 416.994a(b).
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21834
Federal Register / Vol. 70, No. 80 / Wednesday, April 27, 2005 / Notices
1. At step 1, we determine whether
there has been medical improvement in
the impairment(s) that was present at
the time of the most recent favorable
determination or decision. (20 CFR
416.994a(b)(1)). We refer to the most
recent favorable determination or
decision as the ‘‘comparison point
decision’’ (CPD), and we refer to the
impairment(s) that was present at the
time of the most recent favorable
determination or decision as the ‘‘CPD
impairment(s).’’ If there has been no
medical improvement in the CPD
impairment(s), we find that the child’s
disability continues. If there has been
medical improvement, we proceed to
step 2.1
2. At step 2, we determine whether
the CPD impairment(s) still meets or
medically or functionally equals ‘‘the
severity of the listed impairment’’ that
it met or equaled at the time of the CPD.
(20 CFR 416.994a(b)(2)). If the CPD
impairment(s) still meets or medically
or functionally equals the severity of the
listing we considered at the CPD, we
find that the child is still disabled. As
long as we determine that the CPD
impairment(s) currently meets or
medically or functionally equals the
listing we considered before, we do not
have to make the same finding we made
at the CPD. For example, if we found at
the CPD that the child’s impairment(s)
met a listing, and now it no longer
meets that listing but it medically equals
that listing, we find that the child’s
disability continues. Likewise, if we
found that the child’s impairment(s)
functionally equaled a listing, and now
it meets that listing, we find that the
child’s disability continues. If the CPD
impairment(s) does not still meet or
equal the severity of that listed
impairment, we proceed to step 3.
3. At step 3, we determine whether
the child is currently disabled,
considering all current impairments. (20
CFR 416.994a(b)(3)). We determine if
the child’s current impairment(s) is
severe, as defined in 20 CFR 416.924(c).
If the impairment(s) is not severe, we
find that the child’s disability has
ended. If the impairment(s) is severe, we
consider whether it meets or medically
equals a listing. (20 CFR 416.924(d),
416.925, 416.926). If it does, we find
that the child’s disability continues. If
not, we consider whether it functionally
equals the listings. (20 CFR 416.926a). If
it does, we find that the child’s
1 At each step of the process certain ‘‘exceptions
to medical improvement’’ may apply, under which
disability can be found to have ended even though
medical improvement has not occurred. (20 CFR
416.994a(e)–(f)). Although we apply the exceptions
when appropriate, further discussion of the
exceptions is unnecessary in this Ruling.
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16:41 Apr 26, 2005
Jkt 205001
disability continues. If not, we find that
the child’s disability has ended.
On September 11, 2000, we published
final rules (the ‘‘2001 rules’’) for
evaluating disability in children under
the Supplemental Security Income
program. These rules became effective
on January 2, 2001.2 In section 416.926a
of the 2001 rules, (20 CFR 416.926a), we
clarified and simplified our prior rules
for evaluating functional equivalence 3
in a number of ways. Under the
functional equivalence policies that we
applied prior to January 2, 2001, we
required a comparison of the child’s
impairment(s) to a specific listing.4 One
way in which we clarified and
simplified functional equivalence under
the 2001 rules was to no longer refer to
specific listed impairments. Instead, we
determine whether a child’s impairment
functionally equals the listings. To
functionally equal the listings, a child’s
impairment(s) must cause ‘‘marked’’
limitations in two domains of
functioning, or ‘‘extreme’’ limitation in
one such domain, as described in 20
CFR 416.926a.
Therefore, findings of functional
equivalence made on or after January 2,
2001, are not based on a specific listing.
Because our current rules about step
2 of the MIRS sequential evaluation
process refer only to the specific listed
impairment(s) that we considered at the
CPD, we are issuing this ruling to
explain how we apply the functional
equivalence rules at step 2. We also
explain how we apply step 2 when the
CPD was based on functional
equivalence to the listings.
Policy Interpretation: When we
evaluate functional equivalence at step
2 of the MIRS sequential evaluation
process for children in 20 CFR
416.994a(b), we use the current rules for
evaluating functional equivalence.
How we apply step 2 of the MIRS
sequential evaluation process for
children depends on the date of and
basis for the CPD. A chart that
summarizes our policies on applying
step 2 follows the text.
a. If the CPD was made before January
2, 2001.
If the CPD was made before January
2, 2001, it was based either on a finding
that the child’s impairment(s) met or
medically equaled a specific listing, or
functionally equaled a specific listing
under the rules for functional
equivalence that were in effect at the
time of the CPD.
FR 54747–54790 (2000).
have included the policy of functional
equivalence in our childhood disability rules since
1991. See 56 FR 5534, 5543, 5561–5562 (1991).
4 20 CFR 416.926a(b) (1997); 20 CFR 416.926a(b)
(1993); 20 CFR 416.926a(b) (1991).
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2 65
3 We
Frm 00105
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When we determine whether a child’s
disability continues at step 2, we first
consider whether the CPD
impairment(s) now either meets or
medically equals the same listing that it
met, medically equaled, or functionally
equaled at the CPD, as that listing was
written at that time. If the CPD
impairment(s) now meets or medically
equals the severity of that listed
impairment as it was written at that
time, we find that the child is still
disabled.
If the CPD impairment(s) does not
now meet or medically equal the CPD
listing, we consider whether the CPD
impairment(s) now functionally equals
the listings under our current rules in 20
CFR 416.926a. If it does, we find that
the child is still disabled. If it does not,
we proceed to step 3.
b. If the CPD was made on or after
January 2, 2001.
If the CPD was made on or after
January 2, 2001, it was based either on
a finding that the child’s impairment(s)
met or medically equaled a listing, or
functionally equaled the listings under
the current rules in 20 CFR 416.926a.
(1) If the CPD impairment(s) met or
medically equaled a listing:
If our determination or decision at the
time of the CPD was that the child’s
impairment(s) met or medically equaled
a listing, we consider whether the CPD
impairment(s) now either meets or
medically equals that same listing, as it
was written at that time. If it does, we
find that the child is still disabled.
If the CPD impairment(s) does not
now meet or medically equal the CPD
listing, we consider whether the CPD
impairment(s) now functionally equals
the listings under our current rules in 20
CFR 416.926a. If it does, we find that
the child is still disabled. If it does not,
we proceed to step 3.
(2) If the CPD impairment(s)
functionally equaled the listings:
When we determine whether a child’s
disability continues at step 2 and the
CPD was based on functional
equivalence to the listings, we consider
only whether the CPD impairment(s)
now functionally equals the listings. We
do not consider whether the
impairment(s) now meets or medically
equals the CPD listing, because there is
no specific CPD listing. If that
impairment(s) now functionally equals
the listings under our current rules in 20
CFR 416.926a, we find that the child is
still disabled. If it does not, we proceed
to step 3.
Chart: This chart summarizes the
explanations above. Follow a. or b. as
appropriate.
a. If the CPD was made before January
2, 2001:
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Federal Register / Vol. 70, No. 80 / Wednesday, April 27, 2005 / Notices
→
YES →
Disability Continues 5
→
YES →
Disability Continues
→
YES →
Disability Continues
→
Does CPD impairment(s) now either meet or medically equal the CPD listing?
↓
NO
↓
Does CPD impairment(s) now functionally equal the listings?
↓
NO
↓
Proceed to Step 3
b. If the CPD was made on or after
January 2, 2001, follow (1) or (2) as
appropriate:
21835
YES →
Disability Continues
(1) CPD impairment(s) met or
medically equaled a listing:
Does CPD impairment(s) now either meet or medically equal the CPD listing?
↓
NO
↓
Does CPD impairment(s) now functionally equal the listings?
↓
NO
↓
Proceed to Step 3
(2) CPD impairment(s) functionally
equaled the listings:
Does CPD impairment(s) now functionally equal the listings?
→ YES → Disability Continues
↓
NO
↓
Proceed to Step 3.
5 The conclusion that disability continues here and elsewhere on this chart is subject to any applicable exceptions to the MIRS standard.
See footnote 1 above.
Effective Date: This SSR is effective
upon publication in the Federal
Register.
Cross-References: Program Operations
Manual System, sections DI 28005.020,
28005.025, and 28005.030.
[FR Doc. 05–8390 Filed 4–26–05; 8:45 am]
BILLING CODE 4191–02–P
DEPARTMENT OF TRANSPORTATION
Office of the Secretary
[Docket No. OST 2005–21067]
Notice of Request for Extension of a
Previously Approved Collection
Office of the Secretary.
Notice and request for
comments.
AGENCY:
ACTION:
SUMMARY: In accordance with the
Paperwork Reduction Act of 1995, this
notice announces the Department of
Transportation’s (DOT) intention to
request extension of a previously
approved information collection.
DATES: Comments on this notice must be
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ADDRESSES: You may submit comments
identified by DOT–DMS Docket Number
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OST–2005–21067 by any of the
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• Web site: https://dms.dot.gov.
Follow the instructions for submitting
comments on the DOT electronic docket
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Agencies
[Federal Register Volume 70, Number 80 (Wednesday, April 27, 2005)]
[Notices]
[Pages 21833-21835]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: 05-8390]
=======================================================================
-----------------------------------------------------------------------
SOCIAL SECURITY ADMINISTRATION
Social Security Ruling, SSR 05-03p.; Title XVI: Determining
Continuing Disability at Step 2 of the Medical Improvement Review
Standard Sequential Evaluation Process for Children Under Age 18--
Functional Equivalence
AGENCY: Social Security Administration.
ACTION: Notice of Social Security Ruling.
-----------------------------------------------------------------------
SUMMARY: In accordance with 20 CFR 402.35(b)(1), the Commissioner of
Social Security gives notice of Social Security Ruling, SSR 05-03p.
This Ruling explains our policies for determining continuing disability
at step 2 of the medical improvement review standard for children under
20 CFR 416.994a(b)(2).
EFFECTIVE DATE: April 27, 2005.
FOR FURTHER INFORMATION CONTACT: Judy Hicks, Office of Disability
Programs, Social Security Administration, 6401 Security Boulevard, 4352
Annex Building, Baltimore, MD 21235-6401, (410) 965-9119. For
information on eligibility or filing for benefits, call our national
toll-free number 1-800-772-1213 or TTY 1-800-325-0778, or visit our
Internet Web site, Social Security Online, at https://
www.socialsecurity.gov.
SUPPLEMENTARY INFORMATION: Although we are not required to do so
pursuant to 5 U.S.C. 552(a)(1) and (a)(2), we are publishing this
Social Security Ruling in accordance with 20 CFR 402.35(b)(1).
Social Security Rulings make available to the public precedential
decisions relating to the Federal old-age, survivors, disability,
supplemental security income, and black lung benefits programs. Social
Security Rulings may be based on case decisions made at all
administrative levels of adjudication, Federal court decisions,
Commissioner's decisions, opinions of the Office of the General
Counsel, and policy interpretations of the law and regulations.
Although Social Security Rulings do not have the same force and
effect as the statute or regulations, they are binding on all
components of the Social Security Administration, in accordance with 20
CFR 402.35(b)(1), and are to be relied upon as precedents in
adjudicating cases.
If this Social Security Ruling is later superseded, modified, or
rescinded, we will publish a notice in the Federal Register to that
effect.
(Catalog of Federal Domestic Assistance, Program No. 96.006
Supplemental Security Income.)
Dated: April 21, 2005.
Jo Anne B. Barnhart,
Commissioner of Social Security.
Policy Interpretation Ruling
Title XVI: Determining Continuing Disability at Step 2 of the
Medical Improvement Review Standard Sequential Evaluation Process for
Children Under Age 18--Functional Equivalence.
Purpose: To explain our policies for determining continuing
disability at step 2 of the medical improvement review standard (MIRS)
sequential evaluation process for children under 20 CFR 416.994a(b)(2)
and to explain how we apply the functional equivalence rule at step 2.
Citations (Authority): Sections 1614(a)(3), 1614(a)(4), and 1614(c)
of the Social Security Act; Regulations No. 16, subpart I, sections
416.924, 416.925, 416.926, 416.926a, and 416.994a.
Introduction: When we conduct a continuing disability review, we
use a three-step MIRS sequential evaluation process, outlined in 20 CFR
416.994a(b).
[[Page 21834]]
1. At step 1, we determine whether there has been medical
improvement in the impairment(s) that was present at the time of the
most recent favorable determination or decision. (20 CFR
416.994a(b)(1)). We refer to the most recent favorable determination or
decision as the ``comparison point decision'' (CPD), and we refer to
the impairment(s) that was present at the time of the most recent
favorable determination or decision as the ``CPD impairment(s).'' If
there has been no medical improvement in the CPD impairment(s), we find
that the child's disability continues. If there has been medical
improvement, we proceed to step 2.\1\
---------------------------------------------------------------------------
\1\ At each step of the process certain ``exceptions to medical
improvement'' may apply, under which disability can be found to have
ended even though medical improvement has not occurred. (20 CFR
416.994a(e)-(f)). Although we apply the exceptions when appropriate,
further discussion of the exceptions is unnecessary in this Ruling.
---------------------------------------------------------------------------
2. At step 2, we determine whether the CPD impairment(s) still
meets or medically or functionally equals ``the severity of the listed
impairment'' that it met or equaled at the time of the CPD. (20 CFR
416.994a(b)(2)). If the CPD impairment(s) still meets or medically or
functionally equals the severity of the listing we considered at the
CPD, we find that the child is still disabled. As long as we determine
that the CPD impairment(s) currently meets or medically or functionally
equals the listing we considered before, we do not have to make the
same finding we made at the CPD. For example, if we found at the CPD
that the child's impairment(s) met a listing, and now it no longer
meets that listing but it medically equals that listing, we find that
the child's disability continues. Likewise, if we found that the
child's impairment(s) functionally equaled a listing, and now it meets
that listing, we find that the child's disability continues. If the CPD
impairment(s) does not still meet or equal the severity of that listed
impairment, we proceed to step 3.
3. At step 3, we determine whether the child is currently disabled,
considering all current impairments. (20 CFR 416.994a(b)(3)). We
determine if the child's current impairment(s) is severe, as defined in
20 CFR 416.924(c). If the impairment(s) is not severe, we find that the
child's disability has ended. If the impairment(s) is severe, we
consider whether it meets or medically equals a listing. (20 CFR
416.924(d), 416.925, 416.926). If it does, we find that the child's
disability continues. If not, we consider whether it functionally
equals the listings. (20 CFR 416.926a). If it does, we find that the
child's disability continues. If not, we find that the child's
disability has ended.
On September 11, 2000, we published final rules (the ``2001
rules'') for evaluating disability in children under the Supplemental
Security Income program. These rules became effective on January 2,
2001.\2\ In section 416.926a of the 2001 rules, (20 CFR 416.926a), we
clarified and simplified our prior rules for evaluating functional
equivalence \3\ in a number of ways. Under the functional equivalence
policies that we applied prior to January 2, 2001, we required a
comparison of the child's impairment(s) to a specific listing.\4\ One
way in which we clarified and simplified functional equivalence under
the 2001 rules was to no longer refer to specific listed impairments.
Instead, we determine whether a child's impairment functionally equals
the listings. To functionally equal the listings, a child's
impairment(s) must cause ``marked'' limitations in two domains of
functioning, or ``extreme'' limitation in one such domain, as described
in 20 CFR 416.926a.
---------------------------------------------------------------------------
\2\ 65 FR 54747-54790 (2000).
\3\ We have included the policy of functional equivalence in our
childhood disability rules since 1991. See 56 FR 5534, 5543, 5561-
5562 (1991).
\4\ 20 CFR 416.926a(b) (1997); 20 CFR 416.926a(b) (1993); 20 CFR
416.926a(b) (1991).
---------------------------------------------------------------------------
Therefore, findings of functional equivalence made on or after
January 2, 2001, are not based on a specific listing.
Because our current rules about step 2 of the MIRS sequential
evaluation process refer only to the specific listed impairment(s) that
we considered at the CPD, we are issuing this ruling to explain how we
apply the functional equivalence rules at step 2. We also explain how
we apply step 2 when the CPD was based on functional equivalence to the
listings.
Policy Interpretation: When we evaluate functional equivalence at
step 2 of the MIRS sequential evaluation process for children in 20 CFR
416.994a(b), we use the current rules for evaluating functional
equivalence.
How we apply step 2 of the MIRS sequential evaluation process for
children depends on the date of and basis for the CPD. A chart that
summarizes our policies on applying step 2 follows the text.
a. If the CPD was made before January 2, 2001.
If the CPD was made before January 2, 2001, it was based either on
a finding that the child's impairment(s) met or medically equaled a
specific listing, or functionally equaled a specific listing under the
rules for functional equivalence that were in effect at the time of the
CPD.
When we determine whether a child's disability continues at step 2,
we first consider whether the CPD impairment(s) now either meets or
medically equals the same listing that it met, medically equaled, or
functionally equaled at the CPD, as that listing was written at that
time. If the CPD impairment(s) now meets or medically equals the
severity of that listed impairment as it was written at that time, we
find that the child is still disabled.
If the CPD impairment(s) does not now meet or medically equal the
CPD listing, we consider whether the CPD impairment(s) now functionally
equals the listings under our current rules in 20 CFR 416.926a. If it
does, we find that the child is still disabled. If it does not, we
proceed to step 3.
b. If the CPD was made on or after January 2, 2001.
If the CPD was made on or after January 2, 2001, it was based
either on a finding that the child's impairment(s) met or medically
equaled a listing, or functionally equaled the listings under the
current rules in 20 CFR 416.926a.
(1) If the CPD impairment(s) met or medically equaled a listing:
If our determination or decision at the time of the CPD was that
the child's impairment(s) met or medically equaled a listing, we
consider whether the CPD impairment(s) now either meets or medically
equals that same listing, as it was written at that time. If it does,
we find that the child is still disabled.
If the CPD impairment(s) does not now meet or medically equal the
CPD listing, we consider whether the CPD impairment(s) now functionally
equals the listings under our current rules in 20 CFR 416.926a. If it
does, we find that the child is still disabled. If it does not, we
proceed to step 3.
(2) If the CPD impairment(s) functionally equaled the listings:
When we determine whether a child's disability continues at step 2
and the CPD was based on functional equivalence to the listings, we
consider only whether the CPD impairment(s) now functionally equals the
listings. We do not consider whether the impairment(s) now meets or
medically equals the CPD listing, because there is no specific CPD
listing. If that impairment(s) now functionally equals the listings
under our current rules in 20 CFR 416.926a, we find that the child is
still disabled. If it does not, we proceed to step 3.
Chart: This chart summarizes the explanations above. Follow a. or
b. as appropriate.
a. If the CPD was made before January 2, 2001:
[[Page 21835]]
Does CPD impairment(s) now either meet or [rarr] YES Disability Continues \5\
medically equal the CPD listing? [rarr]
[darr]
NO
[darr]
Does CPD impairment(s) now functionally equal the [rarr] YES Disability Continues
listings? [rarr]
[darr]
NO
[darr]
Proceed to Step 3
b. If the CPD was made on or after January 2, 2001, follow (1) or
(2) as appropriate:
(1) CPD impairment(s) met or medically equaled a listing:
Does CPD impairment(s) now either meet or [rarr] YES Disability Continues
medically equal the CPD listing? [rarr]
[darr]
NO
[darr]
Does CPD impairment(s) now functionally equal the [rarr] YES Disability Continues
listings? [rarr]
[darr]
NO
[darr]
Proceed to Step 3
(2) CPD impairment(s) functionally equaled the listings:
Does CPD impairment(s) now functionally equal the [rarr] YES Disability Continues
listings? [rarr]
[darr]
NO
[darr]
Proceed to Step 3.
\5\ The conclusion that disability continues here and elsewhere on this chart is subject to any applicable
exceptions to the MIRS standard. See footnote 1 above.
Effective Date: This SSR is effective upon publication in the
Federal Register.
Cross-References: Program Operations Manual System, sections DI
28005.020, 28005.025, and 28005.030.
[FR Doc. 05-8390 Filed 4-26-05; 8:45 am]
BILLING CODE 4191-02-P