Compassionate Allowances, 41649-41651 [E7-14686]
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Federal Register / Vol. 72, No. 146 / Tuesday, July 31, 2007 / Proposed Rules
receive non-power goods and services
from a centralized service company at a
price above cost.
2. Subpart I is added to read as
follows:
Subpart I—Cross-Subsidization
Restrictions on Affiliate Transactions
Sec.
35.43 Generally.
35.44 Protections against affiliate crosssubsidization.
[FR Doc. E7–14618 Filed 7–30–07; 8:45 am]
BILLING CODE 6717–01–P
SOCIAL SECURITY ADMINISTRATION
Subpart I—Cross-Subsidization
Restrictions on Affiliate Transactions
§ 35.43
[Docket No. SSA 2007–0053]
Generally.
(a) For purposes of this subpart:
(1) Captive customers means any
wholesale or retail electric energy
customers served under cost-based
regulation.
(2) Franchised public utility means a
public utility with a franchised service
obligation under state law.
(3) Market-regulated power sales
affiliate means any power seller affiliate
other than a franchised public utility,
including a power marketer, exempt
wholesale generator, qualifying facility
or other power seller affiliate, whose
power sales are regulated in whole or in
part on a market-rate basis.
(4) Non-utility affiliate means any
affiliate that is not in the power sales or
transmission business.
(b) The provisions of this subpart
apply to all franchised public utilities
with captive customers.
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§ 35.44 Protections against affiliate crosssubsidization.
(a) Restriction on affiliate sales of
electric energy. No wholesale sale of
electric energy may be made between a
franchised public utility with captive
customers and a market-regulated power
sales affiliate without first receiving
Commission authorization for the
transaction under section 205 of the
Federal Power Act.
(b) Non-power goods or services. (1)
Unless otherwise permitted by
Commission rule or order, sales of any
non-power goods or services by a
franchised public utility with captive
customers, including sales made to or
through its affiliated exempt wholesale
generators or qualifying facilities, to a
market-regulated power sales affiliate or
non-utility affiliate, must be at the
higher of cost or market price.
(2) Unless otherwise permitted by
Commission rule or order, and except as
permitted by paragraph (b)(3) of this
section, a franchised public utility with
captive customers may not purchase or
receive non-power goods and services
from a market-regulated power sales
affiliate or a non-utility affiliate at a
price above market.
(3) A franchised public utility with
captive customers may not purchase or
VerDate Aug<31>2005
14:56 Jul 30, 2007
20 CFR Parts 404, 405, and 416
Jkt 211001
RIN 0960–AG54
Compassionate Allowances
AGENCY:
Social Security Administration
(SSA).
Advance notice of proposed
rulemaking.
ACTION:
Under titles II and XVI of the
Social Security Act (the Act), we pay
benefits to individuals who meet our
rules for entitlement and have medically
determinable physical or mental
impairments that are severe enough to
meet the definition of disability in the
Act. The rules for determining disability
can be very complicated, but some
individuals have such serious medical
conditions that their conditions
obviously meet our disability standards.
To address these individuals’ needs, we
strive to provide not only responsive,
but also compassionate, public service
that ensures the most severely disabled
in our society who meet the Act’s
requirements are awarded benefits
quickly. To that end, we are
investigating methods of making
‘‘compassionate allowances’’ by quickly
identifying individuals with obvious
disabilities. The purpose of this notice
is to give you an opportunity to send us
comments about what standards we
should use for compassionate
allowances, methods we might use to
identify compassionate allowances, and
suggestions for how to implement those
standards and methods.
DATES: To be sure that your comments
are considered, we must receive them
by October 1, 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
of Social Security, P.O. Box 17703,
Baltimore, MD 21235–7703. You may
also deliver them to the Office of
Regulations, Social Security
Administration, 960 Altmeyer Building,
6401 Security Boulevard, Baltimore, MD
21235–6401, between 8 a.m. and 4:30
p.m. on regular business days.
SUMMARY:
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41649
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:
James Julian, Director, Office of
Compassionate Allowances and Listings
Improvements, Social Security
Administration, 4470 Annex Building,
6401 Security Boulevard, Baltimore, MD
21235–6401, (410) 965–4015. 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:
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/.
Sequential Evaluation Process for
Determining Disability
We use a five-step ‘‘sequential
evaluation process’’ to decide whether
an individual is disabled, but will stop
at any point in the process at which we
are able to make a disability
determination. At step one, we
determine whether an individual is
currently engaged in substantial gainful
activity. If not, we then move to step
two and determine whether the
individual has a ‘‘severe’’ impairment or
combination of impairments
significantly limiting the ability to
perform basic work activities. At step
three, we compare the individual’s
impairment(s) to those in the Listing of
Impairments in appendix 1 of subpart P
of part 404 of our regulations (listing).
If the impairment does not meet or
equal in severity a listing, at step four,
we assess the individual’s residual
functional capacity to determine if the
individual can do any past relevant
work. Finally, at step five, we determine
whether other work exists in significant
numbers that such an individual can
perform, considering the individual’s
residual functional capacity, age,
education, and work experience. We use
different sequential evaluation
processes for children and for
individuals already receiving benefits
when we determine whether they are
still disabled. See §§ 404.1594, 416.924,
416.994, and 416.994a of our
regulations.
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Federal Register / Vol. 72, No. 146 / Tuesday, July 31, 2007 / Proposed Rules
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Current Examples of Compassionate
Allowances
In making disability determinations,
we already apply screening methods
that identify and assist some of the most
obviously disabled individuals. Some of
our current screening methods include:
1. Presumptive Disability/Presumptive
Blindness. Under the Act, an individual,
including a child, applying for
supplemental security income (SSI)
based on disability or blindness, may
receive up to 6 months of payments
before we make a formal determination
of disability or blindness if we
determine that he or she is
presumptively disabled or blind (PD/
PB) and meets all other eligibility
requirements. Generally, our field
offices are authorized to make a PD/PB
finding only for certain impairments
that are readily observable or that can be
easily confirmed; however, the State
agencies that make initial disability
determinations for us may make a PD/
PB finding in any case where there is a
strong likelihood that the claim will be
allowed on formal determination.
2. Terminal Illness. We expedite the
determinations of all disability cases in
which there is an indication of a
terminal illness (TERI). We may identify
a claim as a TERI case when an
individual alleges a terminal illness,
when there is an allegation or diagnosis
of AIDS, when an individual is
receiving hospice care, or when medical
records indicate that an individual has
an impairment that is untreatable.
3. Quick Disability Determinations
(QDD). Through the QDD process, we
screen claims for special assignment
within the State agencies so that they
may allow the claims quickly, often
within less than 10 days. We use a
complex computer screening tool at the
time an individual files his or her
application for disability benefits to
identify some cases that are likely to
qualify with evidence we can obtain
quickly. The screening tool searches the
application and other documents for key
words in identifying a claim as a likely
QDD.
4. The Listing of Impairments. As
described above, at the third step of the
‘‘sequential evaluation process’’ that we
use for determining disability, we
consider whether an individual’s
impairment meets or medically equals
the criteria of a listing. When an
individual’s impairment meets or
medically equals the criteria of any
listed impairment, we find the
individual disabled without considering
residual functional capacity, age,
education, or work experience.
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14:56 Jul 30, 2007
Jkt 211001
Examples of some listing-level
impairments that qualify for favorable
determinations with minimal medical
evidence establishing the diagnosis
include:
• Hemipelvectomy (sections 1.05D
and 101.05D),
• Non-mosaic Down syndrome
(sections 10.06 and 110.06),
• Catastrophic congenital anomalies,
such as anencephaly and cri du chat
(deletion 5p) syndrome (section 110.08),
• Amyotrophic lateral sclerosis
(section 11.10),
• Acute leukemia (sections 13.06A
and 113.06A),
• Small-cell carcinoma of a lung
(section 13.14B),
• Carcinoma (except islet cell
carcinoma) of the pancreas (section
13.20A), and
• Major organ transplants, such as
heart, liver, or lungs (various sections).
There are also some impairments that
qualify for favorable determinations
under a listing based solely on objective
medical evidence but with criteria for
clinical or laboratory findings
demonstrating the severity of the
impairment. However, this evidence is
also generally minimal. For example:
• Impairment of visual acuity
(statutory blindness) with remaining
vision in the better eye after best
correction of 20/200 or less (section 2.02
and 102.02A),
• Cystic fibrosis with specified levels
of forced expiratory volume (FEV1)
(sections 3.04A and 103.04A),
• Any symptomatic congenital heart
disease with cyanosis at rest and a
specified hematocrit or arterial oxygen
level (sections 4.06A and 104.06A),
• Any chronic renal (kidney) disease
requiring chronic hemodialysis or
peritoneal dialysis (sections 6.02A and
106.02A), and
• Many inoperable cancers and
cancers with distant metastases (various
provisions in sections 14.00 and
114.00).
Examples of Other Compassionate
Allowances That We Are Considering
In addition to these methods of
identifying compassionate allowances,
we are considering the creation of an
extensive list of impairments that we
can allow quickly with minimal
objective medical evidence that is based
on clinical signs or laboratory findings
or a combination of both. We believe
that we could use certain listed
impairments, such as those described
above, as a starting point for a much
longer list of impairments that could be
allowed based on established diagnoses
alone (supported by objective medical
evidence) or based on diagnoses that
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Sfmt 4702
have reached certain points in their
progression that would be considered
disabling. We would not limit, however,
the compilation of conditions to those
already covered by our listing. We
would incorporate any conditions that
should be allowed quickly with
minimal, but sufficient, objective
medical evidence. As such, the list of
qualifying conditions would be specific
and extensive.
Additionally, although we already
have some policies and procedures for
identifying the most obviously disabled
individuals quickly, we are
investigating methods for identifying
compassionate allowances by perhaps
starting with a specific allegation or
through the use of a computer system
that is able to search key words
included in an electronic disability
folder. Because the health care industry
is capturing more and more clinical
information in structured electronic
formats using standardized codesets, we
also are interested in your ideas about
whether and how we can use that
information for identifying
compassionate allowances.
Many, although by no means all, of
the individuals who would qualify for a
compassionate allowance will have
impairments that are expected to result
in death and need immediate decisions
on their claims. It is our hope that
compassionate allowances will not only
bring faster benefits to individuals in
need, but that they will also help to
quicken the processing time of those
claims that must be processed through
our existing procedures.
Request for Comments
Please provide us with any comments
and suggestions you have about new
standards and identification methods
for compassionate allowances. The
following questions raise issues that you
may wish to consider. Feel free to raise
other questions, thoughts, or comments.
• Do you have any ideas for how we
can better identify impairments that can
quickly be allowed without going
through the entire disability
determination process?
• Do you have any ideas for different
standards we should be using in our
effort to provide compassionate
assistance to individuals with the most
serious impairments?
• What is the minimum amount of
medical evidence we should accept to
support a compassionate allowance
finding?
• What procedures should we follow
in our Social Security field offices, the
State agencies, and the Office of
Disability Adjudication and Review to
identify compassionate allowances?
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Federal Register / Vol. 72, No. 146 / Tuesday, July 31, 2007 / Proposed Rules
• How can we best take advantage of
clinical information captured
electronically using standardized codes
to specify the nature of the impairment?
• What do you think about our idea
of a more extensive and specific list of
impairments based on established
diagnoses?
• What should the general criteria for
inclusion on such a list be?
• What specific impairment(s) or
kinds of impairments do you believe we
should include on such a list, and what
specific criteria for inclusion should we
use for those impairments (including
specific standardized codes if
appropriate)?
• How should the rules or procedures
for such a list be structured; for
example, should we include a list of all
of the diagnoses in the regulations, or
should we have the list on SSA’s
Internet site or somewhere else?
• What sources should we consult to
create such a list; for example, our
Listing of Impairments, the latest
edition of the World Health
Organization’s International
Classification of Diseases (ICD), and the
latest edition of the American
Psychiatric Association’s Diagnostic and
Statistical Manual of Mental Disorders
(DSM)? Are there individuals and
organizations we should also be
consulting?
• How should we keep the list up to
date?
• We intend to undertake special
outreach efforts in order to encourage
public discussion regarding potential
methods and standards for identifying
compassionate allowances, including
periodic quarterly hearings. What
methods should we use for community
outreach, and where should the
outreach take place?
We will not respond directly to
comments you send us because of this
notice. After we consider your
comments in response to this notice, we
will decide whether and how to revise
the rules we use to determine disability.
If we propose specific revisions to the
rules, we will publish a notice of
proposed rulemaking (NPRM) in the
Federal Register. In accordance with the
usual rulemaking procedures we follow,
you will have a chance to comment on
the revisions we propose when we
publish the NPRM, and we will
summarize and respond to the
significant comments on the NPRM in
the preamble to any final rules.
List of Subjects
20 CFR Part 404
Administrative practice and
procedure, Blind, Disability benefits,
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14:56 Jul 30, 2007
Jkt 211001
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: July 24, 2007.
Michael J. Astrue,
Commissioner of Social Security.
[FR Doc. E7–14686 Filed 7–30–07; 8:45 am]
BILLING CODE 4191–02–P
DEPARTMENT OF THE TREASURY
Internal Revenue Service
26 CFR Part 1
[REG–118719–07]
RIN 1545–BG65
Diversification Requirements for
Variable Annuity, Endowment, and Life
Insurance Contracts
Internal Revenue Service (IRS),
Treasury.
ACTION: Notice of proposed rulemaking.
AGENCY:
SUMMARY: This document proposes
changes to the regulations concerning
the diversification requirements of
section 817(h) of the Internal Revenue
Code (Code). The proposed changes
would expand the list of holders whose
beneficial interests in an investment
company, partnership, or trust do not
prevent a segregated asset account from
looking through to the assets of the
investment company, partnership, or
trust, to satisfy the requirements of
section 817(h). The proposed
regulations also would remove the
sentence in § 1.817–5(a)(2) that provides
that the payment required to remedy an
inadvertent diversification failure must
be based on the tax that would have
been owed by the policyholders if they
were treated as receiving the income on
the contract. These proposed regulations
would affect insurance companies that
issue variable contracts and would
affect policyholders who purchase such
contracts.
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41651
Written or electronic comments
and requests for a public hearing must
be received by October 29, 2007.
ADDRESSES: Send submissions to:
CC:PA:LPD:PR (REG–118719–07), room
5203, Internal Revenue Service, PO Box
7604, Ben Franklin Station, Washington,
DC 20044. Submissions may be hand
delivered Monday through Friday
between the hours of 8 a.m. and 4 p.m.
to CC:PA:LPD:PR (REG–118719–07),
Courier’s Desk, Internal Revenue
Service, 1111 Constitution Avenue,
NW., Washington, DC, or sent
electronically, via the Federal
eRulemaking Portal at https://
www.regulations.gov/ (IRS REG–
118719–07).
FOR FURTHER INFORMATION CONTACT:
Concerning the proposed regulations,
James Polfer, at (202) 622–3970 (not a
toll-free number). Concerning
submissions of comments, the hearing,
and/or to be placed on the building
access list to attend the hearing, e-mail
Richard A. Hurst@irscousel.treas.gov.
SUPPLEMENTARY INFORMATION:
DATES:
Background
Section 817(d) defines a variable
contract for purposes of part I of
subchapter L of the Code (sections 801–
818). For a contract to be a variable
contract, it must provide for the
allocation of all or a part of the amounts
received under the contract to an
account that, pursuant to state law or
regulation, is segregated from the
general asset accounts of the issuing
insurance company. In addition, for a
life insurance contract to be a variable
contract, it must qualify as a life
insurance contract for Federal income
tax purposes, and the amount of the
death benefits (or the period of
coverage) must be adjusted on the basis
of the investment return and the market
value of the segregated asset account; for
an annuity contract to be a variable
contract, it must provide for the
payment of annuities, and the amounts
paid in, or the amount paid out, must
reflect the investment return and the
market value of the segregated asset
account; for a contract that provides
funding of insurance on retired lives to
be a variable contract, the amounts paid
in, or the amounts paid out, must reflect
the investment return and the market
value of the segregated asset account.
Section 817(h)(1) provides that a
variable contract that is based on a
segregated asset account is not treated as
an annuity, endowment, or life
insurance contract unless the segregated
asset account is adequately diversified
in accordance with regulations
prescribed by the Secretary. If a
E:\FR\FM\31JYP1.SGM
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Agencies
[Federal Register Volume 72, Number 146 (Tuesday, July 31, 2007)]
[Proposed Rules]
[Pages 41649-41651]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: E7-14686]
=======================================================================
-----------------------------------------------------------------------
SOCIAL SECURITY ADMINISTRATION
20 CFR Parts 404, 405, and 416
[Docket No. SSA 2007-0053]
RIN 0960-AG54
Compassionate Allowances
AGENCY: Social Security Administration (SSA).
ACTION: Advance notice of proposed rulemaking.
-----------------------------------------------------------------------
SUMMARY: Under titles II and XVI of the Social Security Act (the Act),
we pay benefits to individuals who meet our rules for entitlement and
have medically determinable physical or mental impairments that are
severe enough to meet the definition of disability in the Act. The
rules for determining disability can be very complicated, but some
individuals have such serious medical conditions that their conditions
obviously meet our disability standards. To address these individuals'
needs, we strive to provide not only responsive, but also
compassionate, public service that ensures the most severely disabled
in our society who meet the Act's requirements are awarded benefits
quickly. To that end, we are investigating methods of making
``compassionate allowances'' by quickly identifying individuals with
obvious disabilities. The purpose of this notice is to give you an
opportunity to send us comments about what standards we should use for
compassionate allowances, methods we might use to identify
compassionate allowances, and suggestions for how to implement those
standards and methods.
DATES: To be sure that your comments are considered, we must receive
them by October 1, 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 of Social Security, P.O. Box 17703, Baltimore, MD 21235-
7703. You may also deliver them to the Office of Regulations, Social
Security Administration, 960 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: James Julian, Director, Office of
Compassionate Allowances and Listings Improvements, Social Security
Administration, 4470 Annex Building, 6401 Security Boulevard,
Baltimore, MD 21235-6401, (410) 965-4015. 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:
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.
Sequential Evaluation Process for Determining Disability
We use a five-step ``sequential evaluation process'' to decide
whether an individual is disabled, but will stop at any point in the
process at which we are able to make a disability determination. At
step one, we determine whether an individual is currently engaged in
substantial gainful activity. If not, we then move to step two and
determine whether the individual has a ``severe'' impairment or
combination of impairments significantly limiting the ability to
perform basic work activities. At step three, we compare the
individual's impairment(s) to those in the Listing of Impairments in
appendix 1 of subpart P of part 404 of our regulations (listing). If
the impairment does not meet or equal in severity a listing, at step
four, we assess the individual's residual functional capacity to
determine if the individual can do any past relevant work. Finally, at
step five, we determine whether other work exists in significant
numbers that such an individual can perform, considering the
individual's residual functional capacity, age, education, and work
experience. We use different sequential evaluation processes for
children and for individuals already receiving benefits when we
determine whether they are still disabled. See Sec. Sec. 404.1594,
416.924, 416.994, and 416.994a of our regulations.
[[Page 41650]]
Current Examples of Compassionate Allowances
In making disability determinations, we already apply screening
methods that identify and assist some of the most obviously disabled
individuals. Some of our current screening methods include:
1. Presumptive Disability/Presumptive Blindness. Under the Act, an
individual, including a child, applying for supplemental security
income (SSI) based on disability or blindness, may receive up to 6
months of payments before we make a formal determination of disability
or blindness if we determine that he or she is presumptively disabled
or blind (PD/PB) and meets all other eligibility requirements.
Generally, our field offices are authorized to make a PD/PB finding
only for certain impairments that are readily observable or that can be
easily confirmed; however, the State agencies that make initial
disability determinations for us may make a PD/PB finding in any case
where there is a strong likelihood that the claim will be allowed on
formal determination.
2. Terminal Illness. We expedite the determinations of all
disability cases in which there is an indication of a terminal illness
(TERI). We may identify a claim as a TERI case when an individual
alleges a terminal illness, when there is an allegation or diagnosis of
AIDS, when an individual is receiving hospice care, or when medical
records indicate that an individual has an impairment that is
untreatable.
3. Quick Disability Determinations (QDD). Through the QDD process,
we screen claims for special assignment within the State agencies so
that they may allow the claims quickly, often within less than 10 days.
We use a complex computer screening tool at the time an individual
files his or her application for disability benefits to identify some
cases that are likely to qualify with evidence we can obtain quickly.
The screening tool searches the application and other documents for key
words in identifying a claim as a likely QDD.
4. The Listing of Impairments. As described above, at the third
step of the ``sequential evaluation process'' that we use for
determining disability, we consider whether an individual's impairment
meets or medically equals the criteria of a listing. When an
individual's impairment meets or medically equals the criteria of any
listed impairment, we find the individual disabled without considering
residual functional capacity, age, education, or work experience.
Examples of some listing-level impairments that qualify for
favorable determinations with minimal medical evidence establishing the
diagnosis include:
Hemipelvectomy (sections 1.05D and 101.05D),
Non-mosaic Down syndrome (sections 10.06 and 110.06),
Catastrophic congenital anomalies, such as anencephaly and
cri du chat (deletion 5p) syndrome (section 110.08),
Amyotrophic lateral sclerosis (section 11.10),
Acute leukemia (sections 13.06A and 113.06A),
Small-cell carcinoma of a lung (section 13.14B),
Carcinoma (except islet cell carcinoma) of the pancreas
(section 13.20A), and
Major organ transplants, such as heart, liver, or lungs
(various sections).
There are also some impairments that qualify for favorable
determinations under a listing based solely on objective medical
evidence but with criteria for clinical or laboratory findings
demonstrating the severity of the impairment. However, this evidence is
also generally minimal. For example:
Impairment of visual acuity (statutory blindness) with
remaining vision in the better eye after best correction of 20/200 or
less (section 2.02 and 102.02A),
Cystic fibrosis with specified levels of forced expiratory
volume (FEV1) (sections 3.04A and 103.04A),
Any symptomatic congenital heart disease with cyanosis at
rest and a specified hematocrit or arterial oxygen level (sections
4.06A and 104.06A),
Any chronic renal (kidney) disease requiring chronic
hemodialysis or peritoneal dialysis (sections 6.02A and 106.02A), and
Many inoperable cancers and cancers with distant
metastases (various provisions in sections 14.00 and 114.00).
Examples of Other Compassionate Allowances That We Are Considering
In addition to these methods of identifying compassionate
allowances, we are considering the creation of an extensive list of
impairments that we can allow quickly with minimal objective medical
evidence that is based on clinical signs or laboratory findings or a
combination of both. We believe that we could use certain listed
impairments, such as those described above, as a starting point for a
much longer list of impairments that could be allowed based on
established diagnoses alone (supported by objective medical evidence)
or based on diagnoses that have reached certain points in their
progression that would be considered disabling. We would not limit,
however, the compilation of conditions to those already covered by our
listing. We would incorporate any conditions that should be allowed
quickly with minimal, but sufficient, objective medical evidence. As
such, the list of qualifying conditions would be specific and
extensive.
Additionally, although we already have some policies and procedures
for identifying the most obviously disabled individuals quickly, we are
investigating methods for identifying compassionate allowances by
perhaps starting with a specific allegation or through the use of a
computer system that is able to search key words included in an
electronic disability folder. Because the health care industry is
capturing more and more clinical information in structured electronic
formats using standardized codesets, we also are interested in your
ideas about whether and how we can use that information for identifying
compassionate allowances.
Many, although by no means all, of the individuals who would
qualify for a compassionate allowance will have impairments that are
expected to result in death and need immediate decisions on their
claims. It is our hope that compassionate allowances will not only
bring faster benefits to individuals in need, but that they will also
help to quicken the processing time of those claims that must be
processed through our existing procedures.
Request for Comments
Please provide us with any comments and suggestions you have about
new standards and identification methods for compassionate allowances.
The following questions raise issues that you may wish to consider.
Feel free to raise other questions, thoughts, or comments.
Do you have any ideas for how we can better identify
impairments that can quickly be allowed without going through the
entire disability determination process?
Do you have any ideas for different standards we should be
using in our effort to provide compassionate assistance to individuals
with the most serious impairments?
What is the minimum amount of medical evidence we should
accept to support a compassionate allowance finding?
What procedures should we follow in our Social Security
field offices, the State agencies, and the Office of Disability
Adjudication and Review to identify compassionate allowances?
[[Page 41651]]
How can we best take advantage of clinical information
captured electronically using standardized codes to specify the nature
of the impairment?
What do you think about our idea of a more extensive and
specific list of impairments based on established diagnoses?
What should the general criteria for inclusion on such a
list be?
What specific impairment(s) or kinds of impairments do you
believe we should include on such a list, and what specific criteria
for inclusion should we use for those impairments (including specific
standardized codes if appropriate)?
How should the rules or procedures for such a list be
structured; for example, should we include a list of all of the
diagnoses in the regulations, or should we have the list on SSA's
Internet site or somewhere else?
What sources should we consult to create such a list; for
example, our Listing of Impairments, the latest edition of the World
Health Organization's International Classification of Diseases (ICD),
and the latest edition of the American Psychiatric Association's
Diagnostic and Statistical Manual of Mental Disorders (DSM)? Are there
individuals and organizations we should also be consulting?
How should we keep the list up to date?
We intend to undertake special outreach efforts in order
to encourage public discussion regarding potential methods and
standards for identifying compassionate allowances, including periodic
quarterly hearings. What methods should we use for community outreach,
and where should the outreach take place?
We will not respond directly to comments you send us because of
this notice. After we consider your comments in response to this
notice, we will decide whether and how to revise the rules we use to
determine disability. If we propose specific revisions to the rules, we
will publish a notice of proposed rulemaking (NPRM) in the Federal
Register. In accordance with the usual rulemaking procedures we follow,
you will have a chance to comment on the revisions we propose when we
publish the NPRM, and we will summarize and respond to the significant
comments on the NPRM in the preamble to any final rules.
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: July 24, 2007.
Michael J. Astrue,
Commissioner of Social Security.
[FR Doc. E7-14686 Filed 7-30-07; 8:45 am]
BILLING CODE 4191-02-P