Amendments to the Quick Disability Determination Process, 51173-51179 [E7-17533]

Agencies

• Social Security Administration

[Federal Register Volume 72, Number 172 (Thursday, September 6, 2007)]
[Rules and Regulations]
[Pages 51173-51179]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: E7-17533]


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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: Final rule.

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SUMMARY: We are amending 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 (DDSs). 
We also are removing from the QDD process the existing requirements 
that each State DDS maintain a separate QDD unit and that each case 
referred under QDD be adjudicated within 20 days. These actions stem 
from our continuing effort to improve our disability adjudication 
process.

DATES: This rule is effective September 6, 2007. State agencies outside 
of the Boston region must notify SSA of the date by which they will be 
ready to accept QDD referrals. That date should be no earlier than 
October 9, 2007 and must be no later than March 4, 2008. State agencies 
must be ready to process claims referred under this rule no later than 
March 4, 2008.

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.

Introduction

    We are making final the rule we proposed in the Notice of Proposed 
Rulemaking (NPRM) published in the Federal Register on July 10, 2007 at 
72 FR 37496. We provide a summary of the provisions of the final rule 
below. We then provide a summary of the public comments and our reasons 
for adopting or not adopting the recommendations in the summaries of 
the comments in the section, ``Public Comments.'' The text of the final 
rule follows the preamble.

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 making 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 
are accelerating our implementation of the QDD process and extending 
QDD to all States. -
    Nevertheless, in order to improve the efficiencies that we have 
seen by using the QDD process, we are modifying 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 modifications will give 
State agencies greater flexibility in managing their QDD workloads. 
Specifically, we are eliminating the requirement that QDD claims be

[[Page 51174]]

adjudicated within 20 days of receipt in the State agency and removing 
the performance standard and sanction provisions related to that 20-day 
adjudication requirement. We also are eliminating 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 are eliminating 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 will be better served and the State 
agencies' resources will 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 eliminating 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 will gather data in order to monitor the performance 
of State agencies with these claims. SSA currently shares this 
information with appropriate oversight agencies and will continue to do 
so. We will consider broadly or selectively reinstituting a formal time 
deadline, if warranted.
    Our second change to the QDD rules removes the 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 are 
eliminating the requirement that State agencies create a separate QDD 
unit. We will 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 are amending 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 accelerating 
our nationwide roll-out of the QDD process independent of the other 
changes in the March 2006 final rules, we are moving 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.
    State agencies within the Boston region are already processing 
cases under QDD, and the changes we are making to the QDD process will 
apply to those State agencies immediately. However, we recognize that 
State agencies newly affected by this accelerated roll-out of the QDD 
process will need a reasonable time to establish QDD procedures and 
make any needed software modifications. Some State agencies may also 
need time to satisfy collective bargaining obligations. Therefore, we 
are allowing the State agencies outside of the Boston region additional 
time to prepare for the implementation of the QDD process. Each newly 
affected State agency must notify us of the date by which the State 
agency will be ready to accept QDD referrals. That date should be no 
earlier than 30 days from the date of publication of this rule and must 
be no later than 180 days from its publication. We will not refer any 
claims to a State agency outside the Boston region for processing under 
QDD until the earlier of the date that agency has notified us it will 
be ready to accept and process QDD referrals or the date 180 days from 
the publication of this final rule.

Notices of Initial Determinations

    In this rule we also are revising 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 are revising the 
language to be consistent in all three sections. We wish to emphasize 
that we are not in any way changing 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).

Public Comments

    In the NPRM we published on July 10, 2007 (72 FR 37496), we 
provided the public with a 30-day period in which to comment. That 
comment period ended on August 9, 2007.
    We received timely comments from 21 individuals and organizations. 
We carefully considered all the comments. Because some of the comments 
were lengthy, we have summarized the comments. In addition, some of the 
comments did not relate to the Quick Disability Determination process. 
We have provided responses to each significant issue raised by 
commenters that was within the scope of this rule.
    Comment: Many commenters expressed support for the proposed 
expansion of the QDD process and indicated that it will help alleviate 
delays in receiving disability determinations. However, several 
commenters expressed a concern that accelerating decisions at the 
initial level will increase the pending caseloads at

[[Page 51175]]

the subsequent levels of our administrative adjudicative process.
    Response: We agree that improving our performance at the initial 
level, as these commenters recognized QDD would do, is only one part of 
the changes we need to make, and we want to assure the public that we 
are looking at a number of other areas as well. We have a number of 
initiatives underway, including proposals that will improve service at 
the reconsideration, hearings, and appeals levels of our administrative 
adjudicative process. We believe those other activities will address 
the commenters' concerns about processing times at the subsequent 
levels of our administrative process.
    Comment: One commenter expressed concern that the predictive model 
is the sole method for identifying QDD claims. The commenter suggested 
allowing experienced disability examiners to refer cases for QDD 
processing based on their initial review of the claim.
    Response: The QDD process is designed to take advantage of the 
technology now available to us to screen cases automatically and select 
for QDD processing those cases that involve a high potential that the 
claimant is disabled and that require evidence that can be easily and 
quickly obtained to support the claimant's allegations. We believe the 
predictive model that has been developed, and that we will revise as 
appropriate, will identify the appropriate cases for QDD processing. We 
therefore are not adopting the suggestion to let disability examiners 
or others involved in the claims-taking process select cases for QDD 
processing based on their own assessment of the case.
    Comment: Several commenters expressed concern that eliminating the 
20-day time limit for processing QDD claims would lessen the likelihood 
of quick determinations. These commenters also stated that it will be 
difficult to monitor State agency performance in the QDD process 
without any specific time limitations in the rule. Other commenters 
recognized the need to provide for additional time to obtain medical 
evidence without removing a claim from the QDD process. Some of these 
commenters suggested retaining the 20-day time limit and allowing one 
20-day extension to complete the QDD process. Others suggested adding 
incentives for meeting the time frames and sanctions where time frames 
are not met. On the other hand, several commenters supported the 
proposal to eliminate the 20-day time limit and related sanctions. They 
reasoned that the processing times for QDD cases in the Boston region 
showed that State agencies are completing most QDD cases well before 
the 20-day limit, demonstrating that the time limit is not necessary. 
Some of these commenters believed eliminating the time limit would give 
State agencies greater flexibility to handle their workloads.
    Response: We understand the concerns on both sides of this 
question. We have decided to eliminate the 20-day time limit, as 
proposed, for several reasons. First, we believe that the QDD 
processing results in the Boston region amply demonstrate that our 
partners in the State agencies share our commitment to processing these 
cases as quickly as possible. They have completed most QDD cases well 
before the 20-day limit, which indicates to us that the time limit was 
not the reason for their performance. Second, as we discussed earlier, 
the 20-day time limit has proven too short for some cases, leading to 
reassignment as non-QDD cases and additional work that could have been 
avoided by allowing the cases to remain with the QDD examiner. While 
some commenters suggested allowing the QDD examiner to obtain an 
extension of time in those cases, we believe the additional burdens of 
obtaining or justifying such an extension would needlessly divert the 
examiner's attention from adjudicating claims. Third, we anticipate 
that we may increase the percentage of cases selected for QDD as we 
gain more experience with it. As we increase that percentage, the 
additional cases will be those where the indicators for QDD are not as 
strong as the cases selected earlier, and where the adjudication of the 
claim will be more difficult. We reasonably expect that such an 
increase in the percentage of cases selected will lead to longer 
average processing times, and we believe we need the flexibility to 
continually adjust our process as we do this. Eliminating the 20-day 
rule gives us more flexibility. Therefore, we are eliminating the 20-
day limit on processing QDD cases.
    Our goal of processing QDD claims within 20 days remains, however. 
As noted above, we will gather data in order to monitor the performance 
of State agencies with these claims. SSA currently shares this 
information with appropriate oversight agencies and will continue to do 
so. We also will consider adding incentives and sanctions as part of 
possible future changes to the QDD process if we determine that such 
changes are necessary.
    Comment: Three organizations representing State and Federal 
employees supported our proposed elimination of the requirement for 
separate QDD units, stating that the removal of that requirement would 
provide greater flexibility and efficiency. One commenter suggested 
that State agencies be required to have separate QDD units for 2 years 
to ensure that staff is fully trained and any local issues are 
addressed.
    Response: We agree with the commenters who believed that the 
flexibility and efficiency gains for the State agencies of eliminating 
the separate QDD unit requirement outweigh the advantages of retaining 
the requirement. Because all QDD claims must be assigned to experienced 
disability examiners, we do not agree with the suggestion that a 
separate unit be required for 2 years for training or other purposes. 
Therefore, we are eliminating the separate unit requirement.
    Comment: Our proposed rule requires that 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 established by us 
for making a quick disability determination. Two commenters suggested 
that the experienced disability examiners who will handle QDD cases be 
given the authority to make the quick disability determination on their 
own if they decide that a medical or psychological consultant is 
unnecessary. Another commenter supported our requirement for medical or 
psychological consultant review in all QDD cases, stating that it 
maintains the medical integrity of the QDD decision.
    Response: We believe that medical or psychological consultant 
involvement in the disability determination is a critical component of 
the QDD process and helps ensure the quality of the determinations. 
Therefore, we are not adopting the suggestion to allow disability 
examiners to make determinations without a medical or psychological 
consultant's involvement.
    Comment: Commenters also suggested expanding the use of the Single 
Decision Maker (SDM) case processing model currently operating in 20 
States. They stated that SDM performance data show quicker processing 
times while maintaining the quality of the determinations. One 
commenter asked that we clarify how QDD's requirement for involvement 
of a medical or psychological consultant will work in States currently 
using the SDM model.
    Response: We are still evaluating the SDM model. It is premature to 
make any decisions about expanding it to other States. Under the SDM 
model generally, the decision maker is directed to make

[[Page 51176]]

the disability determination ``after any appropriate consultation with 
a medical or psychological consultant.'' See 20 CFR 404.906(b)(2); 
416.1406(b)(2). Because of the nature of the QDD process and the 
importance we are placing on the medical or psychological consultant's 
involvement in the QDD process, it is both ``appropriate'' and 
necessary in States operating under the SDM model for the decision 
maker to obtain the medical or psychological consultant involvement 
that is required by the QDD rules. We may revisit this question, 
however, during our evaluation of the SDM model.
    Comment: One commenter believes that we should monitor the 
predictive model software to ensure that it selects only cases 
appropriate for QDD processing. The commenter also suggested expanding 
QDD ``compassionate reviews'' throughout the DDSs.
    Response: As noted above, we agree with the need to monitor the 
predictive model software as part of our ongoing evaluation of the 
entire QDD process. We will make changes to the predictive model as 
data dictates. With regard to the comment on compassionate allowances, 
we recently published an advance notice of proposed rulemaking 
requesting public comments on the rules for compassionate allowances 
(72 FR 41649, July 31, 2007), and will consider any relevant comments 
we receive as we proceed with that initiative.
    Comment: In the NPRM, we specifically requested comments on the 
lead time, if any, that State agencies outside the Boston region would 
need to implement these rules. We received only one comment on this 
question. That commenter, an organization that represents disability 
determination directors, suggested that most States could implement the 
QDD process within 30 days, even considering the need for systems 
changes, outreach to medical providers, and staff selection and 
training. The commenter acknowledged that States with specific 
collective bargaining obligations requiring negotiations for the 
designation of QDD adjudicators might need additional time to implement 
the QDD process.
    Response: We appreciate the commenter's observations. Because the 
needs of individual State agencies may vary, particularly with regard 
to collective bargaining issues, we have provided in this final rule 
for additional time for State agencies outside the Boston region to 
become ready to accept QDD referrals. That lead time is provided in the 
DATES section of this final rule and discussed under the ``Quick 
Disability Determinations'' heading in the SUPPLEMENTARY INFORMATION 
section.
    Comment: Four organizations representing individuals with 
disabilities expressed concerns about the QDD process in regard to low 
income claimants. They noted that to qualify for the QDD process, the 
claim must have a ``high degree of probability that the individual is 
disabled'' and the ``individual's allegations will be easily and 
quickly verified.'' They noted that many people with low incomes have 
difficulty obtaining ongoing medical care and, thus, may lack the 
readily available medical evidence to meet the QDD selection criteria. 
They urged us to consider ways to allow claims from such individuals to 
qualify for the QDD process.
    Response: The ready availability of medical evidence to support the 
claimant's alleged disability is crucial to the QDD process. We 
recognize that some claimants may be disabled but, for financial or 
other reasons, will not have readily available medical evidence 
supporting their claim. In those cases, we expend considerable time and 
resources to get the medical evidence necessary to decide the claim, 
even to the extent of arranging for medical examinations at our 
expense. While we share the commenters' concerns for these claimants, 
we do not believe cases lacking the necessary medical evidence can 
benefit from the QDD process. Therefore, we will process these claims 
using existing procedures.
    Comment: These same commenters urged us to expand the categories of 
claims that will satisfy the criteria of the predictive model and 
qualify for the QDD process. In particular, they suggested that more 
mental impairments be included in the QDD selection criteria.
    Response: Our predictive model does not necessarily identify 
specific conditions, but rather considers a variety of factors, 
including medical history, treatment protocols, and medical signs and 
findings. We will continue to evaluate the predictive model and make 
appropriate changes as we gain more data and experience. We will 
consider the commenters' concerns during that process. However, the 
specific criteria of the predictive model are not prescribed by this 
rule, and therefore we are making no changes to this rule in response 
to this comment.
    Comment: One commenter stated that we used inconsistent language in 
the preamble and in the proposed rule itself. The commenter correctly 
noted that in the proposed rule, in Sec. Sec.  404.1619(a) and 
416.1019(a), we referred to allegations being ``easily and quickly 
verified.'' However, the commenter stated that in the preamble, 72 FR 
at 37497, we referred to allegations that ``can be quickly and easily 
obtained.''
    Response: We agree that our choice of words should be consistent, 
and in this instance we believe it was. The preamble language actually 
refers to claims ``where evidence of the claimant's allegations can be 
quickly and easily obtained.'' That is, we must be able to ``obtain'' 
the evidence and ``verify'' the allegations.

Regulatory Procedures

Executive Order 12866, as Amended

    We have consulted with the Office of Management and Budget (OMB) 
and determined that this 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 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 rule will impose no additional reporting or recordkeeping 
requirements requiring OMB clearance.

Federalism Impact and Unfunded Mandates Impact

    We have reviewed this 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 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.)

[[Page 51177]]

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: August 17, 2007.
Michael J. Astrue,
Commissioner of Social Security.

0
For the reasons set out in the preamble, we are amending subparts J, P 
and Q of part 404, subparts 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]

0
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).


0
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;
* * * * *

0
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]

0
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).


Sec.  404.1503  [Amended]

0
5. Amend Sec.  404.1503 by removing the last sentence in paragraph (a).

Subpart Q--[Amended]

0
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)).


0
7. Amend Sec.  404.1602 by adding in alphabetical order 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.
* * * * *

0
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);
* * * * *

0
9. Add a new undesignated center heading following Sec.  404.1618 and 
add new Sec.  404.1619 to read as follows:

Quick Disability Determinations


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.

0
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

0
11. The authority citation for part 405 continues to read as follows:


[[Page 51178]]


    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]

0
12. Amend Sec.  405.5 by removing the definitions of the terms ``Quick 
disability determination'' and ``Quick Disability Determination Unit.''

Appendix to Subpart A of Part 405 [Amended]

0
13. Amend the appendix to subpart A by removing paragraph (d).

Subpart B--[Amended]


Sec.  405.101  [Amended]

0
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,''.


Sec.  405.105  [Removed]

0
15. Remove and reserve Sec.  405.105.


Sec.  405.110  [Removed]

0
16. Remove and reserve Sec.  405.110.
0
17. 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 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]

0
18. 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]

0
19. 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).


Sec.  416.903  [Amended]

0
20. Amend Sec.  416.903 by removing the last sentence in paragraph (a).

Subpart J--[Amended]

0
21. 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).


0
22. 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.
* * * * *

0
23. 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);
* * * * *

0
24. Add a new undesignated center heading following Sec.  416.1018 and 
add new Sec.  416.1019 to read as follows:

Quick Disability Determinations


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.

0
25. 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]

0
26. 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).

0
27. 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;
* * * * *

[[Page 51179]]


0
28. Amend Sec.  416.1404 by revising paragraph (a), removing paragraph 
(b) and redesignating paragraph (c) as paragraph (b).
    The revision reads 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 
to reconsideration. We will not mail a notice if the beneficiary's 
entitlement to benefits has ended because of his or her death.
* * * * *
 [FR Doc. E7-17533 Filed 9-5-07; 8:45 am]
BILLING CODE 4191-02-P