Amendments to the Quick Disability Determination Process, 37496-37500 [E7-13288]
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Federal Register / Vol. 72, No. 131 / Tuesday, July 10, 2007 / Proposed Rules
Department are the airlines that are
subject to the on-time performance
reporting requirement. Those are the
U.S. carriers that each account for at
least 1 percent of total domestic
scheduled-service passenger revenues—
currently 18 airlines (see 14 CFR 234).
The Department’s monthly Air Travel
Consumer Report provides data for
these airlines in four areas: on-time
performance, baggage mishandling,
oversales, and consumer complaints.
The oversale data for that report are
derived from the Form 251 reports
mandated by Part 250. The data in the
Form 251 reports filed by the other
carriers is not keypunched,
summarized, published, or routinely
reviewed.
The Department seeks comment on
whether it should revise section 250.10
to relieve all carriers of this reporting
requirement except for the airlines
whose data is being used, i.e., U.S.
carriers that are required to report ontime performance under Part 234. Those
airlines account for the vast majority of
domestic traffic and bumpings, so the
Department will still receive adequate
information and the public will
continue to have access to published
data for the same category of carriers as
before. Such action would be consistent
with the Paperwork Reduction Act and
the Regulatory Flexibility Act. It would
also result in consistent carrier reporting
requirements for all four sections of the
Air Travel Consumer Report.
Regulatory Notices
A. Executive Order 12866 (Regulatory
Planning and Review) and DOT
Regulatory Policies and Procedures
This action has been determined to be
significant under Executive Order 12866
and the Department of Transportation
Regulatory Policies and Procedures. It
has been reviewed by the Office of
Management and Budget under that
Order. A preliminary discussion of
possible costs and benefits of the
proposed rule is presented above.
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B. Executive Order 13132 (Federalism)
This Advance Notice of Proposed
Rulemaking has been analyzed in
accordance with the principles and
criteria contained in Executive Order
13132 (‘‘Federalism’’). This notice does
not propose any regulation that: (1) Has
substantial direct effects on the States,
the relationship between the national
government and the States, or the
distribution of power and
responsibilities among the various
levels of government; (2) imposes
substantial direct compliance costs on
State and local governments; or (3)
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preempts state law. Therefore, the
consultation and funding requirements
of Executive Order 13132 do not apply.
C. Executive Order 13084
This notice has been analyzed in
accordance with the principles and
criteria contained in Executive Order
13084 (‘‘Consultation and Coordination
with Indian Tribal Governments’’).
Because none of the options on which
we are seeking comment would
significantly or uniquely affect the
communities of the Indian tribal
governments and would not impose
substantial direct compliance costs, the
funding and consultation requirements
of Executive Order 13084 do not apply.
D. Regulatory Flexibility Act
The Regulatory Flexibility Act (5
U.S.C. 601 et seq.) requires an agency to
review regulations to assess their impact
on small entities unless the agency
determines that a rule is not expected to
have a significant economic impact on
a substantial number of small entities.
Certain options on which we are seeking
comment may impose new requirements
on certain small air carriers, but few of
them are small businesses as defined by
the Small Business Administration and
the Department believes that the
economic impact would not be
significant. All air carriers have control
over the extent to which the rule
impacts them since they control their
own overbooking rates. Carriers can
mitigate the cost of denied boarding
compensation by obtaining volunteers
who are willing to give up their seat for
less compensation than what the rule
mandates for passengers who are
bumped involuntarily, and by offering
travel vouchers in lieu of cash
compensation. The vast majority of the
traffic that would be covered by the
oversales rule for the first time as a
result of the options on which we seek
comment is carried by airlines that are
owned by or affiliated with a major
carrier or its parent company. As noted
below, one of the options on which we
are seeking comment relieves an
existing reporting requirement for all
but the largest carriers. The monetary
costs of most of these options result in
a corresponding dollar-for-dollar
monetary benefit for members of the
public who are bumped from their
confirmed flights and for small
businesses that employ some of them.
The options provide an economic
incentive for carriers to use more
efficient overbooking rates that result in
fewer bumpings while still allowing the
carriers to fill seats that would go
unsold as the result of ‘‘no-show’’
passengers. Therefore, the options on
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which we are seeking comment are not
expected to have a significant economic
impact on a substantial number of small
entities.
E. Paperwork Reduction Act
The options on which we are seeking
comment impose no new information
reporting or record keeping
necessitating clearance by the Office of
Management and Budget. They relieve a
reporting requirement for many carriers
that are currently subject to that
requirement. One required handout that
airlines distribute to bumped passengers
would require minor revisions.
F. Unfunded Mandates Reform Act
The Department has determined that
the requirements of Title II of the
Unfunded Mandates Reform Act of 1995
do not apply to this notice.
Issued this 3rd day of July, 2007, at
Washington, DC.
Andrew B. Steinberg,
Assistant Secretary for Aviation and
International Affairs.
[FR Doc. E7–13365 Filed 7–9–07; 8:45 am]
BILLING CODE 4910–9X–P
SOCIAL SECURITY ADMINISTRATION
20 CFR Parts 404, 405 and 416
[Docket No. SSA 2007–0032]
RIN 0960–AG47
Amendments to the Quick Disability
Determination Process
Social Security Administration.
Notice of proposed rulemaking.
AGENCY:
ACTION:
SUMMARY: We propose to amend our
regulations to extend the quick
disability determination process (QDD),
which is operating now in the Boston
region, to all of the State disability
determination services. We also propose
to remove from the QDD process the
existing requirements that each State
disability determination service
maintain a separate QDD unit and that
each case referred under QDD be
adjudicated within 20 days. These
proposed actions stem from our
continuing effort to improve our
disability adjudication process.
DATES: To be sure that we consider your
comments, we must receive them no
later than August 9, 2007.
ADDRESSES: You may give us your
comments by: Internet through the
Federal eRulemaking Portal at https://
www.regulations.gov; e-mail to
regulations@ssa.gov; telefax to (410)
966–2830; or letter to the Commissioner
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Federal Register / Vol. 72, No. 131 / Tuesday, July 10, 2007 / Proposed Rules
of Social Security, P.O. Box 17703,
Baltimore, MD 21235–7703. You may
also deliver them to the Office of
Regulations, Social Security
Administration, 107 Altmeyer Building,
6401 Security Boulevard, Baltimore, MD
21235–6401, between 8 a.m. and 4:30
p.m. on regular business days.
Comments are posted on the Federal
eRulemaking Portal, or you may inspect
them on regular business days by
making arrangements with the contact
person shown in this preamble.
FOR FURTHER INFORMATION CONTACT:
Vince Sabatino, Social Security
Administration, 6401 Security
Boulevard, Baltimore, MD 21235–6401,
(410) 966–8331 for information about
this notice. 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 site, Social Security Online,
at https://www.socialsecurity.gov.
SUPPLEMENTARY INFORMATION:
Electronic Version
The electronic file of this document is
available on the date of publication in
the Federal Register at https://
www.gpoaccess.gov/fr/.
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Quick Disability Determinations
We are dedicated to providing highquality service to the American public.
When we announced changes in March
2006 to our administrative review
process for initial disability claims, we
explained that we expected that the
changes would improve disability
service. Our commitment to continuous
improvement in the way we process
disability claims did not end with the
publication of those rules as we
continually explore ways to improve
service to some of the most vulnerable
in our society. We nevertheless face
significant challenges now and in the
foreseeable future in our ability to
provide the level of service that
disability benefit claimants deserve
because of the increased complexity of
and growth in claims for those benefits.
Consequently, we are proposing
modifications to our administrative
review process that will further help us
provide accurate and timely service to
claimants for Social Security disability
benefits and supplemental security
income payments based on disability or
blindness.
In early spring 2006, we published a
final rule in which we laid out changes
to the administrative review process for
initial disability claims. We expected
that the changes would ‘‘improve the
accuracy, consistency, and timeliness of
decision-making throughout the
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disability determination process.’’ 71 FR
16424 (March 31, 2006). We planned a
gradual roll-out of the changes so that
we could test them and their effect on
the disability process overall. As we
explained then, ‘‘Gradual
implementation will allow us to
monitor the effects that our changes are
having on the entire disability
determination process * * *. We will
carefully monitor the implementation
process in the Boston region and
quickly address any problems that may
arise.’’ 71 FR at 16440–41. Having
thoroughly reviewed the initial
determination level of that process, we
have concluded that we need to modify
some of the changes made last spring.
The changes in the March 2006 final
rule included establishing, in the Boston
region, an initial-determination-level
process to identify and accelerate the
adjudication of the claims of persons
who have a ‘‘high degree of probability’’
of being disabled, where there was an
expectation that the claimant’s
‘‘allegations will be easily and quickly
verified * * * .’’ 20 CFR 405.101–.110
(2006). We refer to this as the Quick
Disability Determination (QDD) process.
Under QDD, a predictive model
analyzes specific elements of data
within the electronic claims file to
identify claims where there is a high
potential that the claimant is disabled
and where evidence of the claimant’s
allegations can be quickly and easily
obtained. Those claims are then sent to
a separate QDD unit in the State agency,
where experienced disability examiners
review the claims on an expedited basis.
The QDD process in essence is a
workload triaging tool that helps
identify, in an automated fashion,
claims where the disability should be
easy to verify.
This process has been working quite
well. Because our experience with QDD
has been very favorable, has proven to
be of significant benefit to those
claimants who have been affected by it,
has been well-received by the State
agencies in the Boston region, and has
shown that there are no significant
administrative costs associated with it,
we propose to accelerate our
implementation of the QDD process and
extend QDD to all States.
Nevertheless, in order to improve the
efficiencies that we have seen by using
the QDD process, we propose to modify
those aspects of the QDD process that
have served as a barrier to the type of
outstanding public service that we strive
to provide. These proposed
modifications would give State agencies
greater flexibility in managing their
QDD workloads. Specifically, we
propose to eliminate the requirement
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that QDD claims be adjudicated within
20 days of receipt in the State agency
and remove the performance standard
and sanction provisions related to that
20-day adjudication requirement. We
also propose to eliminate the
requirement that separate QDD units be
established within the State agencies.
The QDD rules published in 2006
required the State agency to adjudicate
any claim referred to it under QDD
within 20 days of the date the claim was
received in the QDD unit; any QDD
claim not decided within this time
frame had to be returned by the QDD
unit for regular processing in the State
agency. We propose to eliminate this 20day requirement for three reasons. First,
the early information concerning
processing times for QDD claims is quite
promising. The average QDD processing
time for the Boston region State agencies
has been approximately 12 days. For a
large majority of the cases, they have
processed claims selected for QDD in 9
days or less, and only a small minority
of the claims exceeded the 20-day
threshold. Given this experience, we are
confident that the State agencies will
continue to process the vast majority of
QDD claims within 20 days. Eliminating
the 20-day requirement will give the
State agencies more flexibility in
managing this workload.
Second, even where the processing
time goes beyond 20 days, we believe
disability claimants would be better
served and the State agencies’ resources
would be better utilized by allowing the
QDD examiner to complete the work on
the claim, rather than requiring the
examiner to return the claim for regular
processing in the State agency.
Third, we are concerned that the need
to obtain evidence within the 20-day
period may unduly burden the medical
and other providers who submit that
evidence to us, and we have reports of
some resistance from health care
providers stemming from efforts to
satisfy the 20-day deadline. In turn,
delays in obtaining the evidence might
cause an increasing number of
otherwise suitable claims to be removed
from the QDD process because of the 20day rule.
Though we are proposing to eliminate
the 20-day adjudication requirement to
give State agencies greater flexibility, we
still believe that State agencies should
strive to adjudicate any claim referred
under QDD within 20 days. We would
continue to monitor the performance of
State agencies with these claims and
would consider broadly or selectively
reinstituting a formal time deadline if
warranted.
Our second proposed change to the
QDD rules would remove the
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requirement that State agencies create
separate QDD units to handle the QDD
claims we refer. Our intent when we
created that requirement was to ensure
that QDD claims were processed by
individuals with the knowledge,
training, and experience to effectively
carry out the QDD function and to
ensure that they could be held
accountable for performing this
important task. 71 FR at 16429. At the
same time, we recognized the State
agencies’ need for flexibility in handling
their workloads. 71 FR at 16429. Now
that we have some experience with the
QDD process, we believe the
requirement of a separate QDD unit in
each DDS is not necessary. Particularly
in smaller States, we believe the
requirement of a separate QDD unit may
unnecessarily restrict the flexibility the
State agency needs to best address its
workloads. Therefore, we propose to
eliminate the requirement that State
agencies create a separate QDD unit. We
would retain the existing requirement
that all QDD claims be handled by
designated disability examiners who
have the knowledge, training, and
experience to effectively carry out the
QDD process. We believe this is
sufficient to afford QDD cases the
proper level of attention and
accountability.
In light of these considerations, we
propose to amend our regulations to
require all State agencies that perform
disability determinations for us to
handle claims we refer to them under
QDD and to remove from the QDD rules
the 20-day performance standard and
the separate unit requirements
discussed above. In addition, because
we are proposing to accelerate our
nationwide roll-out of the QDD process
independent of the other changes in the
March 2006 final rules, we would move
the substantive QDD rules from part 405
of our regulations to part 404, subpart Q,
and part 416, subpart J, which contain
the provisions covering the State agency
determination process.
We recognize that State agencies
newly affected by this proposed roll-out
of the QDD process will need a
reasonable time to establish QDD
procedures. Therefore, if these rules are
adopted as final regulations, we plan to
allow the State agencies outside of the
Boston region a reasonable period of
time within which to implement the
QDD process. We would welcome
comments from affected State agencies
as to the amount of lead time they
believe they would need to implement
the revised QDD process we now
propose.
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Notices of Initial Determinations
In this rule we also propose to revise
the provisions in parts 404, 405 and 416
of our regulations that describe the
contents of the notices we send to
inform claimants of our initial
determinations on our claims. The
current regulatory provisions, while not
substantively inconsistent with one
another, are phrased differently. In
order to avoid any unintended
suggestion that we apply different
standards when drafting the notices to
which these various sections apply, we
propose to revise the language to be
consistent in all three sections. We wish
to emphasize that we are not in any way
proposing to change the substance of
what must be in our notices of initial
determination, but rather are simply
adopting more uniform language based
on the statutory requirements in
sections 205(b)(1), 205(s) and
1631(c)(1)(A) of the Social Security Act
(Act).
Clarity of These Rules
Executive Order 12866, as amended,
requires each agency to write all rules
in plain language. In addition to your
substantive comments on these
proposed rules, we invite your
comments on how to make them easier
to understand. For example:
• Have we organized the material to
suit your needs?
• Are the requirements in the rules
clearly stated?
• Do the rules contain technical
language or jargon that isn’t clear?
• Would a different format (grouping
and order of sections, use of headings,
paragraphing) make the rules easier to
understand?
• Would more (but shorter) sections
be better?
• Could we improve clarity by adding
tables, lists, or diagrams?
• What else could we do to make the
rules easier to understand?
Regulatory Procedures
Executive Order 12866, as Amended
We have consulted with the Office of
Management and Budget (OMB) and
determined that this proposed rule
meets the criteria for a significant
regulatory action under Executive Order
12866, as amended. Thus, it was
reviewed by OMB.
Regulatory Flexibility Act
We certify that this proposed rule will
not have a significant economic impact
on a substantial number of small entities
as it affects only States and individuals.
Therefore, a regulatory flexibility
analysis as provided in the Regulatory
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Flexibility Act, as amended, is not
required.
Paperwork Reduction Act
This proposed rule will impose no
additional reporting or recordkeeping
requirements requiring OMB clearance.
Federalism Impact and Unfunded
Mandates Impact
We have reviewed this proposed rule
under the threshold criteria of Executive
Order 13132 and the Unfunded
Mandates Reform Act and have
determined that it does not have
substantial direct effects on the States,
on the relationship between the national
government and the States, on the
distribution of power and
responsibilities among the various
levels of government, or on imposing
any costs on State, local, or tribal
governments. This proposed rule does
not affect the roles of the State, local, or
tribal governments. However, the rule
takes administrative notice of existing
statutes governing the roles and
relationships of the State agencies and
SSA with respect to disability
determinations under the Act.
(Catalog of Federal Domestic Assistance
Program Nos. 96.001, Social Security—
Disability Insurance; 96.002, Social
Security—Retirement Insurance; 96.004,
Social Security—Survivors Insurance;
96.006, Supplemental Security Income.)
List of Subjects
20 CFR Part 404
Administrative practice and
procedure; Blind, Disability benefits;
Old-Age, Survivors, and Disability
Insurance; Reporting and recordkeeping
requirements; Social Security.
20 CFR Part 405
Administrative practice and
procedure; Blind, Disability benefits;
Old-Age, Survivors, and Disability
Insurance; Public assistance programs,
Reporting and recordkeeping
requirements; Social Security;
Supplemental Security Income (SSI).
20 CFR Part 416
Administrative practice and
procedure; Aged, Blind, Disability
benefits, Public assistance programs,
Reporting and recordkeeping
requirements; Supplemental Security
Income (SSI).
Dated: June 25, 2007.
Michael J. Astrue,
Commissioner of Social Security.
For the reasons set out in the
preamble, we propose to amend
subparts J, P and Q of part 404, subparts
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A, B and I of part 405, and subparts I,
J and N of part 416 as set forth below:
PART 404—FEDERAL OLD-AGE,
SURVIVORS AND DISABILITY
INSURANCE (1950– )
1. The authority citation for subpart J
of part 404 continues to read as follows:
Authority: Secs. 201(j), 204(f), 205(a), (b),
(d)–(h), and (j), 221, 223(i), 225, and 702(a)(5)
of the Social Security Act (42 U.S.C. 401(j),
404(f), 405(a), (b), (d)–(h), and (j), 421, 423(i),
425, and 902(a)(5)); sec. 5, Pub. L. 97–455, 96
Stat. 2500 (42 U.S.C. 405 note); secs. 5, 6(c)–
(e), and 15, Pub. L. 98–460, 98 Stat. 1802 (42
U.S.C. 421 note); sec. 202, Pub. L. 108–203,
118 Stat. 509 (42 U.S.C. 902 note).
2. Amend § 404.903 by revising
paragraphs (x) and (y) to read as follows:
§ 404.903 Administrative actions that are
not initial determinations.
*
*
*
*
*
(x) Determining whether to select
your claim for the quick disability
determination process under § 404.1619;
(y) The removal of your claim from
the quick disability determination
process under § 404.1619;
*
*
*
*
*
3. Revise § 404.904 to read as follows:
§ 404.904 Notice of the initial
determination.
We will mail a written notice of our
initial determination to you at your last
known address. The written notice will
explain in simple and clear language
what we have determined and the
reasons for and the effect of our
determination. If our determination
involves a determination of disability
that is in whole or in part unfavorable
to you, our written notice also will
contain in understandable language a
statement of the case setting forth the
evidence on which our determination is
based. The notice also will inform you
of your right to reconsideration. We will
not mail a notice if the beneficiary’s
entitlement to benefits has ended
because of his or her death.
Subpart P—[Amended]
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4. The authority citation for subpart P
continues to read as follows:
Authority: Secs. 202, 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 (i), 422(c), 423, 425, and
902(a)(5)); sec. 211(b), Pub. L. 104–193, 110
Stat. 2105, 2189; sec. 202, Pub. L. 108–203,
118 Stat. 509 (42 U.S.C. 902 note).
5. Amend § 404.1503 by removing the
last sentence in paragraph (a).
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6. The authority citation for subpart Q
continues to read as follows:
Authority: Secs. 205(a), 221, and 702(a)(5)
of the Social Security Act (42 U.S.C. 405(a),
421, and 902(a)(5)).
Subpart J—[Amended]
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Subpart Q—[Amended]
7. Amend § 404.1602 by adding a
definition for ‘‘Quick disability
determination,’’ to read as follows:
§ 404.1602
Definitions.
*
*
*
*
*
Quick disability determination means
an initial determination on a claim that
we have identified as one that reflects
a high degree of probability that you
will be found disabled and where we
expect that your allegations will be
easily and quickly verified.
*
*
*
*
*
8. Amend § 404.1603 by revising
paragraph (c)(2) to read as follows:
§ 404.1603 Basic responsibilities for us
and the State.
*
*
*
*
*
(c) * * *
(2) Provide an organizational
structure, adequate facilities, qualified
personnel, medical consultant services,
designated quick disability
determination examiners (§§ 404.1619
and 404.1620(c)), and a quality
assurance function (§§ 404.1620 through
404.1624);
*
*
*
*
*
9. Add a new § 404.1619 under the
new undesignated center heading
QUICK DISABILITY
DETERMINATIONS to read as follows:
medical and nonmedical evidence in
the files; and
(3) Subject to the provisions in
paragraph (c) of this section, make the
quick disability determination by
applying the rules in subpart P of this
part.
(c) If the quick disability
determination examiner cannot make a
determination that is fully favorable to
the individual or if there is an
unresolved disagreement between the
disability examiner and the medical or
psychological consultant, the State
agency will adjudicate the claim using
the regularly applicable procedures in
this subpart.
10. Amend § 404.1620 by adding a
new paragraph (c) to read as follows:
§ 404.1620 General administrative
requirements.
*
*
*
*
*
(c) Each State agency will designate
experienced disability examiners to
handle claims we refer to it under
§ 404.1619(a).
PART 405—ADMINISTRATIVE REVIEW
PROCESS FOR ADJUDICATING
INITIAL DISABILITY CLAIMS
11. The authority citation for part 405
continues to read as follows:
Authority: Secs. 201(j), 205(a)–(b), (d)–(h),
and (s), 221, 223(a)–(b), 702(a)(5), 1601, 1602,
1631, and 1633 of the Social Security Act (42
U.S.C. 401(j), 405(a)–(b), (d)–(h), and (s), 421,
423(a)–(b), 902(a)(5), 1381, 1381a, 1383, and
1383b).
Subpart A—[Amended]
§ 405.5
§ 404.1619
process.
Quick disability determination
(a) If we identify a claim as one
involving a high degree of probability
that the individual is disabled, and we
expect that the individual’s allegations
will be easily and quickly verified, we
will refer the claim to the State agency
for consideration under the quick
disability determination process
pursuant to this section and
§ 404.1620(c).
(b) If we refer a claim to the State
agency for a quick disability
determination, a designated quick
disability determination examiner must:
(1) Have a medical or psychological
consultant verify that the medical
evidence in the file is sufficient to
determine that, as of the alleged onset
date, the individual’s physical or mental
impairment(s) meets the standards we
establish for making quick disability
determinations;
(2) Make quick disability
determinations based only on the
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[Amended]
12. Amend § 405.5 by removing the
definitions of the terms ‘‘Quick
disability determination’’ and ‘‘Quick
Disability Determination Unit.’’
13. Amend the appendix to subpart A
by removing paragraph (d).
Subpart B—[Amended]
14. Amend § 405.101 by removing
from the first sentence the phrase
‘‘unless it makes a quick disability
determination under §§ 405.105–.110’’
and the commas that immediately
precede and follow that phrase.
§§ 405.105 and 405.110
[Removed]
15. Remove and reserve §§ 405.105
and 405.110.
16. Revise § 405.115 to read as
follows:
§ 405.115 Notice of the initial
determination.
We will mail a written notice of our
initial determination to you at your last
known address. The written notice will
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explain in simple and clear language
what we have determined and the
reasons for and the effect of our
determination. If our determination
involves a determination of disability
that is in whole or in part unfavorable
to you, our written notice also will
contain in understandable language a
statement of the case setting forth the
evidence on which our determination is
based. The notice also will inform you
of your right to review by a Federal
reviewing official and explain your right
to representation. We will not mail a
notice if the beneficiary’s entitlement to
benefits has ended because of his or her
death.
Subpart I—[Removed]
17. Remove and reserve subpart I,
consisting of §§ 405.801 through
405.850.
PART 416—SUPPLEMENTAL
SECURITY INCOME FOR THE AGED,
BLIND, AND DISABLED
Subpart I—[Amended]
18. The authority citation for subpart
I is revised to read as follows:
Authority: Secs. 702(a)(5), 1611, 1614,
1619, 1631(a), (c), (d)(1), and (p), and 1633
of the Social Security Act (42 U.S.C.
902(a)(5), 1382, 1382c, 1382h, 1383(a), (c),
(d)(1), and (p), and 1383b); secs. 4(c) and 5,
6(c)–(e), 14(a), and 15, Pub. L. 98–460, 98
Stat. 1794, 1801, 1802, and 1808 (42 U.S.C.
421 note, 423 note, 1382h note).
19. Amend § 416.903 by removing the
last sentence in paragraph (a).
Subpart J—[Amended]
20. The authority citation for subpart
J continues to read as follows:
Authority: Secs. 702(a)(5), 1614, 1631, and
1633 of the Social Security Act (42 U.S.C.
902(a)(5), 1382c, 1383, and 1383b).
21. Amend § 416.1002 by adding a
definition for ‘‘Quick disability
determination,’’ to read as follows:
§ 416.1002
Definitions.
rmajette on PROD1PC64 with PROPOSALS
*
*
*
*
*
Quick disability determination means
an initial determination on a claim that
we have identified as one that reflects
a high degree of probability that you
will be found disabled and where we
expect that your allegations will be
easily and quickly verified.
*
*
*
*
*
22. Amend § 416.1003 by revising
paragraph (c)(2) to read as follows:
§ 416.1003 Basic responsibilities for us
and the State.
*
*
*
VerDate Aug<31>2005
*
*
15:19 Jul 09, 2007
Jkt 211001
(c) * * *
(2) Provide an organizational
structure, adequate facilities, qualified
personnel, medical consultant services,
designated quick disability
determination examiners (§§ 416.1019
and 416.1020(c)), and a quality
assurance function (§§ 416.1020 through
416.1024);
*
*
*
*
*
23. Add a new § 416.1019 under the
new undesignated center heading
QUICK DISABILITY
DETERMINATIONS to read as follows:
§ 416.1019
process.
Quick disability determination
(a) If we identify a claim as one
involving a high degree of probability
that the individual is disabled, and we
expect that the individual’s allegations
will be easily and quickly verified, we
will refer the claim to the State agency
for consideration under the quick
disability determination process
pursuant to this section and
§ 416.1020(c).
(b) If we refer a claim to the State
agency for a quick disability
determination, a designated quick
disability determination examiner must:
(1) Have a medical or psychological
consultant verify that the medical
evidence in the file is sufficient to
determine that, as of the alleged onset
date, the individual’s physical or mental
impairment(s) meets the standards we
establish for making quick disability
determinations;
(2) Make quick disability
determinations based only on the
medical and nonmedical evidence in
the files; and
(3) Subject to the provisions in
paragraph (c) of this section, make the
quick disability determination by
applying the rules in subpart I of this
part.
(c) If the quick disability
determination examiner cannot make a
determination that is fully favorable to
the individual or if there is an
unresolved disagreement between the
disability examiner and the medical or
psychological consultant, the State
agency will adjudicate the claim using
the regularly applicable procedures in
this subpart.
24. Amend § 416.1020 by adding a
new paragraph (c) to read as follows:
§ 416.1020 General administrative
requirements.
*
*
*
*
*
(c) Each State agency will designate
experienced disability examiners to
handle claims we refer to it under
§ 416.1019(a).
PO 00000
Frm 00031
Fmt 4702
Sfmt 4702
Subpart N—[Amended]
25. The authority citation for subpart
N continues to read as follows:
Authority: Secs. 702(a)(5), 1631, and 1633
of the Social Security Act (42 U.S.C.
902(a)(5), 1383, and 1383b); sec. 202, Pub. L.
108–203, 118 Stat. 509 (42 U.S.C. 902 note).
26. Amend § 416.1403 by revising
paragraphs (a)(22) and (a)(23) to read as
follows:
§ 416.1403 Administrative actions that are
not initial determinations.
(a) * * *
(22) Determining whether to select
your claim for the quick disability
determination process under § 416.1019;
(23) The removal of your claim from
the quick disability determination
process under § 416.1019;
*
*
*
*
*
27. Amend § 416.1404 by revising
paragraph (a), removing existing
paragraph (b) and redesignating existing
paragraph (c) as paragraph (b), to read
as follows:
§ 416.1404 Notice of the initial
determination.
(a) We will mail a written notice of
our initial determination to you at your
last known address. The written notice
will explain in simple and clear
language what we have determined and
the reasons for and the effect of our
determination. If our determination
involves a determination of disability
that is in whole or in part unfavorable
to you, our written notice also will
contain in understandable language a
statement of the case setting forth the
evidence on which our determination is
based. The notice also will inform you
of your right reconsideration. We will
not mail a notice if the beneficiary’s
entitlement to benefits has ended
because of his or her death.
*
*
*
*
*
[FR Doc. E7–13288 Filed 7–9–07; 8:45 am]
BILLING CODE 4191–02–P
DEPARTMENT OF HOUSING AND
URBAN DEVELOPMENT
24 CFR Part 203
[Docket No. FR–5087–N–02]
RIN 2502–AI52
Standards for Mortgagor’s Investment
in Mortgaged Property: Extension of
Public Comment Period
Office of the Assistant
Secretary for Housing’Federal Housing
Commissioner, HUD.
AGENCY:
E:\FR\FM\10JYP1.SGM
10JYP1
]]>Agencies
[Federal Register Volume 72, Number 131 (Tuesday, July 10, 2007)]
[Proposed Rules]
[Pages 37496-37500]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: E7-13288]
=======================================================================
-----------------------------------------------------------------------
SOCIAL SECURITY ADMINISTRATION
20 CFR Parts 404, 405 and 416
[Docket No. SSA 2007-0032]
RIN 0960-AG47
Amendments to the Quick Disability Determination Process
AGENCY: Social Security Administration.
ACTION: Notice of proposed rulemaking.
-----------------------------------------------------------------------
SUMMARY: We propose to amend our regulations to extend the quick
disability determination process (QDD), which is operating now in the
Boston region, to all of the State disability determination services.
We also propose to remove from the QDD process the existing
requirements that each State disability determination service maintain
a separate QDD unit and that each case referred under QDD be
adjudicated within 20 days. These proposed actions stem from our
continuing effort to improve our disability adjudication process.
DATES: To be sure that we consider your comments, we must receive them
no later than August 9, 2007.
ADDRESSES: You may give us your comments by: Internet through the
Federal eRulemaking Portal at https://www.regulations.gov; e-mail to
regulations@ssa.gov; telefax to (410) 966-2830; or letter to the
Commissioner
[[Page 37497]]
of Social Security, P.O. Box 17703, Baltimore, MD 21235-7703. You may
also deliver them to the Office of Regulations, Social Security
Administration, 107 Altmeyer Building, 6401 Security Boulevard,
Baltimore, MD 21235-6401, between 8 a.m. and 4:30 p.m. on regular
business days. Comments are posted on the Federal eRulemaking Portal,
or you may inspect them on regular business days by making arrangements
with the contact person shown in this preamble.
FOR FURTHER INFORMATION CONTACT: Vince Sabatino, Social Security
Administration, 6401 Security Boulevard, Baltimore, MD 21235-6401,
(410) 966-8331 for information about this notice. 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 site,
Social Security Online, at https://www.socialsecurity.gov.
SUPPLEMENTARY INFORMATION:
Electronic Version
The electronic file of this document is available on the date of
publication in the Federal Register at https://www.gpoaccess.gov/fr/
index.html.
Quick Disability Determinations
We are dedicated to providing high-quality service to the American
public. When we announced changes in March 2006 to our administrative
review process for initial disability claims, we explained that we
expected that the changes would improve disability service. Our
commitment to continuous improvement in the way we process disability
claims did not end with the publication of those rules as we
continually explore ways to improve service to some of the most
vulnerable in our society. We nevertheless face significant challenges
now and in the foreseeable future in our ability to provide the level
of service that disability benefit claimants deserve because of the
increased complexity of and growth in claims for those benefits.
Consequently, we are proposing modifications to our administrative
review process that will further help us provide accurate and timely
service to claimants for Social Security disability benefits and
supplemental security income payments based on disability or blindness.
In early spring 2006, we published a final rule in which we laid
out changes to the administrative review process for initial disability
claims. We expected that the changes would ``improve the accuracy,
consistency, and timeliness of decision-making throughout the
disability determination process.'' 71 FR 16424 (March 31, 2006). We
planned a gradual roll-out of the changes so that we could test them
and their effect on the disability process overall. As we explained
then, ``Gradual implementation will allow us to monitor the effects
that our changes are having on the entire disability determination
process * * *. We will carefully monitor the implementation process in
the Boston region and quickly address any problems that may arise.'' 71
FR at 16440-41. Having thoroughly reviewed the initial determination
level of that process, we have concluded that we need to modify some of
the changes made last spring.
The changes in the March 2006 final rule included establishing, in
the Boston region, an initial-determination-level process to identify
and accelerate the adjudication of the claims of persons who have a
``high degree of probability'' of being disabled, where there was an
expectation that the claimant's ``allegations will be easily and
quickly verified * * * .'' 20 CFR 405.101-.110 (2006). We refer to this
as the Quick Disability Determination (QDD) process. Under QDD, a
predictive model analyzes specific elements of data within the
electronic claims file to identify claims where there is a high
potential that the claimant is disabled and where evidence of the
claimant's allegations can be quickly and easily obtained. Those claims
are then sent to a separate QDD unit in the State agency, where
experienced disability examiners review the claims on an expedited
basis. The QDD process in essence is a workload triaging tool that
helps identify, in an automated fashion, claims where the disability
should be easy to verify.
This process has been working quite well. Because our experience
with QDD has been very favorable, has proven to be of significant
benefit to those claimants who have been affected by it, has been well-
received by the State agencies in the Boston region, and has shown that
there are no significant administrative costs associated with it, we
propose to accelerate our implementation of the QDD process and extend
QDD to all States.
Nevertheless, in order to improve the efficiencies that we have
seen by using the QDD process, we propose to modify those aspects of
the QDD process that have served as a barrier to the type of
outstanding public service that we strive to provide. These proposed
modifications would give State agencies greater flexibility in managing
their QDD workloads. Specifically, we propose to eliminate the
requirement that QDD claims be adjudicated within 20 days of receipt in
the State agency and remove the performance standard and sanction
provisions related to that 20-day adjudication requirement. We also
propose to eliminate the requirement that separate QDD units be
established within the State agencies.
The QDD rules published in 2006 required the State agency to
adjudicate any claim referred to it under QDD within 20 days of the
date the claim was received in the QDD unit; any QDD claim not decided
within this time frame had to be returned by the QDD unit for regular
processing in the State agency. We propose to eliminate this 20-day
requirement for three reasons. First, the early information concerning
processing times for QDD claims is quite promising. The average QDD
processing time for the Boston region State agencies has been
approximately 12 days. For a large majority of the cases, they have
processed claims selected for QDD in 9 days or less, and only a small
minority of the claims exceeded the 20-day threshold. Given this
experience, we are confident that the State agencies will continue to
process the vast majority of QDD claims within 20 days. Eliminating the
20-day requirement will give the State agencies more flexibility in
managing this workload.
Second, even where the processing time goes beyond 20 days, we
believe disability claimants would be better served and the State
agencies' resources would be better utilized by allowing the QDD
examiner to complete the work on the claim, rather than requiring the
examiner to return the claim for regular processing in the State
agency.
Third, we are concerned that the need to obtain evidence within the
20-day period may unduly burden the medical and other providers who
submit that evidence to us, and we have reports of some resistance from
health care providers stemming from efforts to satisfy the 20-day
deadline. In turn, delays in obtaining the evidence might cause an
increasing number of otherwise suitable claims to be removed from the
QDD process because of the 20-day rule.
Though we are proposing to eliminate the 20-day adjudication
requirement to give State agencies greater flexibility, we still
believe that State agencies should strive to adjudicate any claim
referred under QDD within 20 days. We would continue to monitor the
performance of State agencies with these claims and would consider
broadly or selectively reinstituting a formal time deadline if
warranted.
Our second proposed change to the QDD rules would remove the
[[Page 37498]]
requirement that State agencies create separate QDD units to handle the
QDD claims we refer. Our intent when we created that requirement was to
ensure that QDD claims were processed by individuals with the
knowledge, training, and experience to effectively carry out the QDD
function and to ensure that they could be held accountable for
performing this important task. 71 FR at 16429. At the same time, we
recognized the State agencies' need for flexibility in handling their
workloads. 71 FR at 16429. Now that we have some experience with the
QDD process, we believe the requirement of a separate QDD unit in each
DDS is not necessary. Particularly in smaller States, we believe the
requirement of a separate QDD unit may unnecessarily restrict the
flexibility the State agency needs to best address its workloads.
Therefore, we propose to eliminate the requirement that State agencies
create a separate QDD unit. We would retain the existing requirement
that all QDD claims be handled by designated disability examiners who
have the knowledge, training, and experience to effectively carry out
the QDD process. We believe this is sufficient to afford QDD cases the
proper level of attention and accountability.
In light of these considerations, we propose to amend our
regulations to require all State agencies that perform disability
determinations for us to handle claims we refer to them under QDD and
to remove from the QDD rules the 20-day performance standard and the
separate unit requirements discussed above. In addition, because we are
proposing to accelerate our nationwide roll-out of the QDD process
independent of the other changes in the March 2006 final rules, we
would move the substantive QDD rules from part 405 of our regulations
to part 404, subpart Q, and part 416, subpart J, which contain the
provisions covering the State agency determination process.
We recognize that State agencies newly affected by this proposed
roll-out of the QDD process will need a reasonable time to establish
QDD procedures. Therefore, if these rules are adopted as final
regulations, we plan to allow the State agencies outside of the Boston
region a reasonable period of time within which to implement the QDD
process. We would welcome comments from affected State agencies as to
the amount of lead time they believe they would need to implement the
revised QDD process we now propose.
Notices of Initial Determinations
In this rule we also propose to revise the provisions in parts 404,
405 and 416 of our regulations that describe the contents of the
notices we send to inform claimants of our initial determinations on
our claims. The current regulatory provisions, while not substantively
inconsistent with one another, are phrased differently. In order to
avoid any unintended suggestion that we apply different standards when
drafting the notices to which these various sections apply, we propose
to revise the language to be consistent in all three sections. We wish
to emphasize that we are not in any way proposing to change the
substance of what must be in our notices of initial determination, but
rather are simply adopting more uniform language based on the statutory
requirements in sections 205(b)(1), 205(s) and 1631(c)(1)(A) of the
Social Security Act (Act).
Clarity of These Rules
Executive Order 12866, as amended, requires each agency to write
all rules in plain language. In addition to your substantive comments
on these proposed rules, we invite your comments on how to make them
easier to understand. For example:
Have we organized the material to suit your needs?
Are the requirements in the rules clearly stated?
Do the rules contain technical language or jargon that
isn't clear?
Would a different format (grouping and order of sections,
use of headings, paragraphing) make the rules easier to understand?
Would more (but shorter) sections be better?
Could we improve clarity by adding tables, lists, or
diagrams?
What else could we do to make the rules easier to
understand?
Regulatory Procedures
Executive Order 12866, as Amended
We have consulted with the Office of Management and Budget (OMB)
and determined that this proposed rule meets the criteria for a
significant regulatory action under Executive Order 12866, as amended.
Thus, it was reviewed by OMB.
Regulatory Flexibility Act
We certify that this proposed rule will not have a significant
economic impact on a substantial number of small entities as it affects
only States and individuals. Therefore, a regulatory flexibility
analysis as provided in the Regulatory Flexibility Act, as amended, is
not required.
Paperwork Reduction Act
This proposed rule will impose no additional reporting or
recordkeeping requirements requiring OMB clearance.
Federalism Impact and Unfunded Mandates Impact
We have reviewed this proposed rule under the threshold criteria of
Executive Order 13132 and the Unfunded Mandates Reform Act and have
determined that it does not have substantial direct effects on the
States, on the relationship between the national government and the
States, on the distribution of power and responsibilities among the
various levels of government, or on imposing any costs on State, local,
or tribal governments. This proposed rule does not affect the roles of
the State, local, or tribal governments. However, the rule takes
administrative notice of existing statutes governing the roles and
relationships of the State agencies and SSA with respect to disability
determinations under the Act.
(Catalog of Federal Domestic Assistance Program Nos. 96.001, Social
Security--Disability Insurance; 96.002, Social Security--Retirement
Insurance; 96.004, Social Security--Survivors Insurance; 96.006,
Supplemental Security Income.)
List of Subjects
20 CFR Part 404
Administrative practice and procedure; Blind, Disability benefits;
Old-Age, Survivors, and Disability Insurance; Reporting and
recordkeeping requirements; Social Security.
20 CFR Part 405
Administrative practice and procedure; Blind, Disability benefits;
Old-Age, Survivors, and Disability Insurance; Public assistance
programs, Reporting and recordkeeping requirements; Social Security;
Supplemental Security Income (SSI).
20 CFR Part 416
Administrative practice and procedure; Aged, Blind, Disability
benefits, Public assistance programs, Reporting and recordkeeping
requirements; Supplemental Security Income (SSI).
Dated: June 25, 2007.
Michael J. Astrue,
Commissioner of Social Security.
For the reasons set out in the preamble, we propose to amend
subparts J, P and Q of part 404, subparts
[[Page 37499]]
A, B and I of part 405, and subparts I, J and N of part 416 as set
forth below:
PART 404--FEDERAL OLD-AGE, SURVIVORS AND DISABILITY INSURANCE
(1950- )
Subpart J--[Amended]
1. The authority citation for subpart J of part 404 continues to
read as follows:
Authority: Secs. 201(j), 204(f), 205(a), (b), (d)-(h), and (j),
221, 223(i), 225, and 702(a)(5) of the Social Security Act (42
U.S.C. 401(j), 404(f), 405(a), (b), (d)-(h), and (j), 421, 423(i),
425, and 902(a)(5)); sec. 5, Pub. L. 97-455, 96 Stat. 2500 (42
U.S.C. 405 note); secs. 5, 6(c)-(e), and 15, Pub. L. 98-460, 98
Stat. 1802 (42 U.S.C. 421 note); sec. 202, Pub. L. 108-203, 118
Stat. 509 (42 U.S.C. 902 note).
2. Amend Sec. 404.903 by revising paragraphs (x) and (y) to read
as follows:
Sec. 404.903 Administrative actions that are not initial
determinations.
* * * * *
(x) Determining whether to select your claim for the quick
disability determination process under Sec. 404.1619;
(y) The removal of your claim from the quick disability
determination process under Sec. 404.1619;
* * * * *
3. Revise Sec. 404.904 to read as follows:
Sec. 404.904 Notice of the initial determination.
We will mail a written notice of our initial determination to you
at your last known address. The written notice will explain in simple
and clear language what we have determined and the reasons for and the
effect of our determination. If our determination involves a
determination of disability that is in whole or in part unfavorable to
you, our written notice also will contain in understandable language a
statement of the case setting forth the evidence on which our
determination is based. The notice also will inform you of your right
to reconsideration. We will not mail a notice if the beneficiary's
entitlement to benefits has ended because of his or her death.
Subpart P--[Amended]
4. The authority citation for subpart P continues to read as
follows:
Authority: Secs. 202, 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 (i),
422(c), 423, 425, and 902(a)(5)); sec. 211(b), Pub. L. 104-193, 110
Stat. 2105, 2189; sec. 202, Pub. L. 108-203, 118 Stat. 509 (42
U.S.C. 902 note).
5. Amend Sec. 404.1503 by removing the last sentence in paragraph
(a).
Subpart Q--[Amended]
6. The authority citation for subpart Q continues to read as
follows:
Authority: Secs. 205(a), 221, and 702(a)(5) of the Social
Security Act (42 U.S.C. 405(a), 421, and 902(a)(5)).
7. Amend Sec. 404.1602 by adding a definition for ``Quick
disability determination,'' to read as follows:
Sec. 404.1602 Definitions.
* * * * *
Quick disability determination means an initial determination on a
claim that we have identified as one that reflects a high degree of
probability that you will be found disabled and where we expect that
your allegations will be easily and quickly verified.
* * * * *
8. Amend Sec. 404.1603 by revising paragraph (c)(2) to read as
follows:
Sec. 404.1603 Basic responsibilities for us and the State.
* * * * *
(c) * * *
(2) Provide an organizational structure, adequate facilities,
qualified personnel, medical consultant services, designated quick
disability determination examiners (Sec. Sec. 404.1619 and
404.1620(c)), and a quality assurance function (Sec. Sec. 404.1620
through 404.1624);
* * * * *
9. Add a new Sec. 404.1619 under the new undesignated center
heading QUICK DISABILITY DETERMINATIONS to read as follows:
Sec. 404.1619 Quick disability determination process.
(a) If we identify a claim as one involving a high degree of
probability that the individual is disabled, and we expect that the
individual's allegations will be easily and quickly verified, we will
refer the claim to the State agency for consideration under the quick
disability determination process pursuant to this section and Sec.
404.1620(c).
(b) If we refer a claim to the State agency for a quick disability
determination, a designated quick disability determination examiner
must:
(1) Have a medical or psychological consultant verify that the
medical evidence in the file is sufficient to determine that, as of the
alleged onset date, the individual's physical or mental impairment(s)
meets the standards we establish for making quick disability
determinations;
(2) Make quick disability determinations based only on the medical
and nonmedical evidence in the files; and
(3) Subject to the provisions in paragraph (c) of this section,
make the quick disability determination by applying the rules in
subpart P of this part.
(c) If the quick disability determination examiner cannot make a
determination that is fully favorable to the individual or if there is
an unresolved disagreement between the disability examiner and the
medical or psychological consultant, the State agency will adjudicate
the claim using the regularly applicable procedures in this subpart.
10. Amend Sec. 404.1620 by adding a new paragraph (c) to read as
follows:
Sec. 404.1620 General administrative requirements.
* * * * *
(c) Each State agency will designate experienced disability
examiners to handle claims we refer to it under Sec. 404.1619(a).
PART 405--ADMINISTRATIVE REVIEW PROCESS FOR ADJUDICATING INITIAL
DISABILITY CLAIMS
11. The authority citation for part 405 continues to read as
follows:
Authority: Secs. 201(j), 205(a)-(b), (d)-(h), and (s), 221,
223(a)-(b), 702(a)(5), 1601, 1602, 1631, and 1633 of the Social
Security Act (42 U.S.C. 401(j), 405(a)-(b), (d)-(h), and (s), 421,
423(a)-(b), 902(a)(5), 1381, 1381a, 1383, and 1383b).
Subpart A--[Amended]
Sec. 405.5 [Amended]
12. Amend Sec. 405.5 by removing the definitions of the terms
``Quick disability determination'' and ``Quick Disability Determination
Unit.''
13. Amend the appendix to subpart A by removing paragraph (d).
Subpart B--[Amended]
14. Amend Sec. 405.101 by removing from the first sentence the
phrase ``unless it makes a quick disability determination under
Sec. Sec. 405.105-.110'' and the commas that immediately precede and
follow that phrase.
Sec. Sec. 405.105 and 405.110 [Removed]
15. Remove and reserve Sec. Sec. 405.105 and 405.110.
16. Revise Sec. 405.115 to read as follows:
Sec. 405.115 Notice of the initial determination.
We will mail a written notice of our initial determination to you
at your last known address. The written notice will
[[Page 37500]]
explain in simple and clear language what we have determined and the
reasons for and the effect of our determination. If our determination
involves a determination of disability that is in whole or in part
unfavorable to you, our written notice also will contain in
understandable language a statement of the case setting forth the
evidence on which our determination is based. The notice also will
inform you of your right to review by a Federal reviewing official and
explain your right to representation. We will not mail a notice if the
beneficiary's entitlement to benefits has ended because of his or her
death.
Subpart I--[Removed]
17. Remove and reserve subpart I, consisting of Sec. Sec. 405.801
through 405.850.
PART 416--SUPPLEMENTAL SECURITY INCOME FOR THE AGED, BLIND, AND
DISABLED
Subpart I--[Amended]
18. The authority citation for subpart I is revised to read as
follows:
Authority: Secs. 702(a)(5), 1611, 1614, 1619, 1631(a), (c),
(d)(1), and (p), and 1633 of the Social Security Act (42 U.S.C.
902(a)(5), 1382, 1382c, 1382h, 1383(a), (c), (d)(1), and (p), and
1383b); secs. 4(c) and 5, 6(c)-(e), 14(a), and 15, Pub. L. 98-460,
98 Stat. 1794, 1801, 1802, and 1808 (42 U.S.C. 421 note, 423 note,
1382h note).
19. Amend Sec. 416.903 by removing the last sentence in paragraph
(a).
Subpart J--[Amended]
20. The authority citation for subpart J continues to read as
follows:
Authority: Secs. 702(a)(5), 1614, 1631, and 1633 of the Social
Security Act (42 U.S.C. 902(a)(5), 1382c, 1383, and 1383b).
21. Amend Sec. 416.1002 by adding a definition for ``Quick
disability determination,'' to read as follows:
Sec. 416.1002 Definitions.
* * * * *
Quick disability determination means an initial determination on a
claim that we have identified as one that reflects a high degree of
probability that you will be found disabled and where we expect that
your allegations will be easily and quickly verified.
* * * * *
22. Amend Sec. 416.1003 by revising paragraph (c)(2) to read as
follows:
Sec. 416.1003 Basic responsibilities for us and the State.
* * * * *
(c) * * *
(2) Provide an organizational structure, adequate facilities,
qualified personnel, medical consultant services, designated quick
disability determination examiners (Sec. Sec. 416.1019 and
416.1020(c)), and a quality assurance function (Sec. Sec. 416.1020
through 416.1024);
* * * * *
23. Add a new Sec. 416.1019 under the new undesignated center
heading QUICK DISABILITY DETERMINATIONS to read as follows:
Sec. 416.1019 Quick disability determination process.
(a) If we identify a claim as one involving a high degree of
probability that the individual is disabled, and we expect that the
individual's allegations will be easily and quickly verified, we will
refer the claim to the State agency for consideration under the quick
disability determination process pursuant to this section and Sec.
416.1020(c).
(b) If we refer a claim to the State agency for a quick disability
determination, a designated quick disability determination examiner
must:
(1) Have a medical or psychological consultant verify that the
medical evidence in the file is sufficient to determine that, as of the
alleged onset date, the individual's physical or mental impairment(s)
meets the standards we establish for making quick disability
determinations;
(2) Make quick disability determinations based only on the medical
and nonmedical evidence in the files; and
(3) Subject to the provisions in paragraph (c) of this section,
make the quick disability determination by applying the rules in
subpart I of this part.
(c) If the quick disability determination examiner cannot make a
determination that is fully favorable to the individual or if there is
an unresolved disagreement between the disability examiner and the
medical or psychological consultant, the State agency will adjudicate
the claim using the regularly applicable procedures in this subpart.
24. Amend Sec. 416.1020 by adding a new paragraph (c) to read as
follows:
Sec. 416.1020 General administrative requirements.
* * * * *
(c) Each State agency will designate experienced disability
examiners to handle claims we refer to it under Sec. 416.1019(a).
Subpart N--[Amended]
25. The authority citation for subpart N continues to read as
follows:
Authority: Secs. 702(a)(5), 1631, and 1633 of the Social
Security Act (42 U.S.C. 902(a)(5), 1383, and 1383b); sec. 202, Pub.
L. 108-203, 118 Stat. 509 (42 U.S.C. 902 note).
26. Amend Sec. 416.1403 by revising paragraphs (a)(22) and (a)(23)
to read as follows:
Sec. 416.1403 Administrative actions that are not initial
determinations.
(a) * * *
(22) Determining whether to select your claim for the quick
disability determination process under Sec. 416.1019;
(23) The removal of your claim from the quick disability
determination process under Sec. 416.1019;
* * * * *
27. Amend Sec. 416.1404 by revising paragraph (a), removing
existing paragraph (b) and redesignating existing paragraph (c) as
paragraph (b), to read as follows:
Sec. 416.1404 Notice of the initial determination.
(a) We will mail a written notice of our initial determination to
you at your last known address. The written notice will explain in
simple and clear language what we have determined and the reasons for
and the effect of our determination. If our determination involves a
determination of disability that is in whole or in part unfavorable to
you, our written notice also will contain in understandable language a
statement of the case setting forth the evidence on which our
determination is based. The notice also will inform you of your right
reconsideration. We will not mail a notice if the beneficiary's
entitlement to benefits has ended because of his or her death.
* * * * *
[FR Doc. E7-13288 Filed 7-9-07; 8:45 am]
BILLING CODE 4191-02-P
