Revised Medical Criteria for Evaluating Cardiovascular Disorders, 20564-20566 [E8-8111]
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20564
Federal Register / Vol. 73, No. 74 / Wednesday, April 16, 2008 / Proposed Rules
(4) No secondary financing at closing,
except grants, forgivable loans or soft
loans made by a not-for-profit
organization or government agency in
order to assist in the loan refinancing or
restructuring or that provided down
payment or closing cost assistance for
the original purchase of the home; and
(5) No characteristics of a
nontraditional or subprime loan.
(B) Prohibited fees. Members shall not
charge the household fees on the new
AHP-assisted refinanced or restructured
loan, including origination fees, and
discount points that increase the yield
above the Freddie Mac Primary
Mortgage Market Survey weekly
national average 30-year fixed-rate
mortgage rate.
(10) Repayment of AHP subsidy in
event of foreclosure. If, during the AHP
five-year retention period, the member,
an affiliate of the member, or any other
entity forecloses on, or accepts a deed
in lieu of foreclosure on, a loan
restructured or refinanced pursuant to
this paragraph (f), the member shall
repay the Bank a pro rata share of the
AHP direct subsidy, reduced for every
year prior to the foreclosure or deed in
lieu, for the five-year period.
(11) Sunset. The requirements
contained in this paragraph (f) shall
expire on June 30, 2011, and the Bank
may not commit AHP subsidy to
households under its program
established pursuant to this paragraph
(f) after that date.
3. Amend § 951.7 by:
a. In paragraph (b)(1)(i), adding ‘‘and
§ 951.6(f)(6)’’ after ‘‘§ 951.6(c)(2)’’;
b. In paragraph (b)(1)(ii), adding ‘‘and
§ 951.6(f)’’ after ‘‘§ 951.6(c)’’; and
c. In paragraph (b)(2)(i), adding ‘‘and
§ 951.6(f)’’ after ‘‘§ 951.6(c)’’.
Dated: April 9, 2008.
By the Board of Directors of the Federal
Housing Finance Board.
Ronald A. Rosenfeld.
Chairman.
[FR Doc. E8–7949 Filed 4–15–08; 8:45 am]
BILLING CODE 6725–01–P
SOCIAL SECURITY ADMINISTRATION
20 CFR Parts 404 and 416
[Docket No. SSA 2007–0102]
pwalker on PROD1PC71 with PROPOSALS
RIN 0960–AG74
Revised Medical Criteria for Evaluating
Cardiovascular Disorders
Social Security Administration.
Advance notice of proposed
rulemaking.
AGENCY:
ACTION:
VerDate Aug<31>2005
17:09 Apr 15, 2008
Jkt 214001
SUMMARY: We are requesting your
comments on whether and how we
should update and revise the criteria we
use to evaluate claims involving
cardiovascular disorders in adults and
children. These criteria are found in
sections 4.00 and 104.00 of the Listing
of Impairments in appendix 1 to subpart
P of part 404 of our regulations (the
listings). We are requesting your
comments as part of our ongoing effort
to ensure that the listings are up-to-date.
After we have considered your
comments and suggestions, other
information about advances in medical
knowledge, treatment, and methods of
evaluating cardiovascular disorders, and
our program experience using the
current listings, we will determine
whether we should revise any of the
cardiovascular listings. If we propose
specific revisions to the listings, we will
publish a Notice of Proposed
Rulemaking (NPRM) in the Federal
Register.
To be sure that your comments
are considered, we must receive them
no later than June 16, 2008.
ADDRESSES: You may submit comments
by one of four methods—Internet,
facsimile, regular mail, or handdelivery. Please do not submit the same
comments multiple times or by more
than one method. Regardless of which
of the following methods you choose,
please state that your comments refer to
Docket No. SSA–2007–0102 to ensure
that we can associate your comments
with the correct regulation:
1. Federal eRulemaking portal at
https://www.regulations.gov. (This is the
most expedient method for submitting
your comments, and we strongly urge
you to use it.) In the Comment or
Submission section of the webpage, type
‘‘SSA–2007–0102’’, select ‘‘Go’’, and
then click ‘‘Send a Comment or
Submission.’’ The Federal eRulemaking
portal issues you a tracking number
when you submit a comment.
2. Telefax to (410) 966–2830.
3. Letter to the Commissioner of
Social Security, P.O. Box 17703,
Baltimore, Maryland 21235–7703.
4. Deliver your comments to the
Office of Regulations, Social Security
Administration, 922 Altmeyer Building,
6401 Security Boulevard, Baltimore,
Maryland 21235–6401, between 8 a.m.
and 4:30 p.m. on regular business days.
All comments are posted on the
Federal eRulemaking portal, although
they may not appear for several days
after receipt of the comment. You may
also inspect the comments on regular
business days by making arrangements
with the contact person shown in this
preamble.
DATES:
PO 00000
Frm 00013
Fmt 4702
Sfmt 4702
Caution: Our policy for comments we
receive from members of the public is to
make them available for public viewing
in their entirety on the Federal
eRulemaking portal at https://
www.regulations.gov. Therefore, you
should be careful to include in your
comments only information that you
wish to make publicly available on the
Internet. We strongly urge you not to
include any personal information, such
as your Social Security number or
medical information, in your comments.
FOR FURTHER INFORMATION CONTACT:
Diane Braunstein, Director, Office of
Compassionate Allowances and Listings
Improvement, Social Security
Administration, 4468 Annex Building,
6401 Security Boulevard, Baltimore, MD
21235–6401, (410) 965–1020, 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/.
What is the purpose of this ANPRM?
The purpose of this ANPRM is to give
you an opportunity to send us
comments and suggestions on whether
and how we might update and revise
listings 4.00 and 104.00 for evaluating
cardiovascular disorders. We last
published final rules revising the
criteria that we use to evaluate
cardiovascular disorders in the Federal
Register on January 13, 2006 (71 FR
2311). We are publishing this ANPRM
as part of our ongoing effort to ensure
that our criteria are effective and reflect
the latest advances in medicine.
On which rules are we inviting
comments?
We are interested in any comments
and suggestions you have on whether
and how we might revise, update, and
clarify sections 4.00 and 104.00 of the
listings. You can find the current rules
for these listings on the Internet at the
following locations:
• Sections 4.00 and 104.00 are in the
Listing of Impairments in appendix 1 to
subpart P of part 404 of our regulations
at https://www.ssa.gov/OP_Home/cfr20/
404/404-ap10.htm.
• Section 4.00 of the listings is also
available at https://www.ssa.gov/
disability/professionals/bluebook/4.00Cardiovascular-Adult.htm.
E:\FR\FM\16APP1.SGM
16APP1
Federal Register / Vol. 73, No. 74 / Wednesday, April 16, 2008 / Proposed Rules
• Section 104.00 of the listings is also
available at https://www.ssa.gov/
disability/professionals/bluebook/
104.00-Cardiovascular-Childhood.htm.
If you do not have Internet access, you
can find the Code of Federal Regulations
in some public libraries, Federal
depository libraries, and public law
libraries.
Who should send us comments and
suggestions?
We invite comments and suggestions
from anyone who has an interest in the
rules we use to evaluate claims for
benefits filed by people who have
cardiovascular disorders. We are
interested in getting comments and
suggestions from people who apply for
or receive benefits from us, members of
the general public, advocates and
organizations who represent people who
have cardiovascular disorders, State
agencies that make disability
determinations for us, experts in the
evaluation of cardiovascular disorders,
and researchers.
What should you comment about?
We are interested in any comments
and suggestions you have on how we
might update and revise sections 4.00
and 104.00 of our listings. For example,
with regard to our listings, we are
interested in knowing if:
• You have concerns about any of the
provisions in the current cardiovascular
listings, such as whether you think we
should change any of our criteria or
whether you think a listing is difficult
to use or to understand.
• You would like to see our
cardiovascular listings include
something that they do not include now,
such as other cardiovascular disorders,
additional medical technologies,
specific laboratory studies, or new
medical criteria.
• You think our cardiovascular
listings should include additional
functional criteria and, if so, what those
criteria should be.
• You think there are cardiac diseases
or conditions, however rare, that have
such a devastating effect on patients that
we should presume that they are unable
to work.
• You think new imaging techniques
can provide new standards for allowing
us to presume disability for certain
advanced diseases and conditions.
Will we respond to your comments
from this notice?
We will not respond directly to
comments you send us in response to
this ANPRM. However, after we
consider your comments along with
other information, such as medical
research and other information about
advances in medical knowledge,
treatment, methods of evaluating
cardiovascular disease, and our program
experience, we will decide whether and
how to revise the listings we use to
evaluate cardiovascular disorders. If we
propose revisions to these listings, we
will publish an NPRM in the Federal
20565
Register. In accordance with the usual
rulemaking procedures we follow, if we
publish an NPRM, you will have a
chance to comment on the revisions we
propose, and we will summarize and
respond to the significant comments on
the NPRM in the preamble to any final
rules.
Other Information
Who can get disability benefits?
Under title II of the Social Security
Act (the Act), we provide for the
payment of disability benefits if you are
disabled and belong to one of the
following three groups:
• Workers insured under the Act,
• Children of insured workers, and
• Widows, widowers, and surviving
divorced spouses (see § 404.336) of
insured workers.
Under title XVI of the Act, we provide
for Supplemental Security Income (SSI)
payments on the basis of disability if
you are disabled and have limited
income and resources.
How do we define disability?
Under both the title II and title XVI
programs, disability must be the result
of any medically determinable physical
or mental impairment or combination of
impairments that is expected to result in
death or which has lasted or can be
expected to last for a continuous period
of at least 12 months. Our definitions of
disability are shown in the following
table:
If you file a claim under . . .
And you are . . .
Disability means you have a medically determinable impairment(s) as
described above that results in . . .
title II ................................................
title XVI ............................................
title XVI ............................................
an adult or child .............................
an individual age 18 or older .........
an individual under age 18 ............
the inability to do any substantial gainful activity (SGA).
the inability to do any SGA.
marked and severe functional limitations.
pwalker on PROD1PC71 with PROPOSALS
How do we decide whether you are
disabled?
If you are applying for benefits under
title II of the Act, or if you are an adult
applying for payments under title XVI of
the Act, we use a five-step ‘‘sequential
evaluation process’’ to decide whether
you are disabled. We describe this fivestep process in our regulations at
§§ 404.1520 and 416.920. We follow the
five steps in order and stop as soon as
we can make a determination or
decision. The steps are:
1. Are you working, and is the work
you are doing SGA? If you are working
and the work you are doing is SGA, we
will find that you are not disabled,
regardless of your medical condition or
your age, education, and work
VerDate Aug<31>2005
17:09 Apr 15, 2008
Jkt 214001
experience. If you are not, we will go on
to step 2.
2. Do you have a ‘‘severe’’
impairment? If you do not have an
impairment or combination of
impairments that significantly limits
your physical or mental ability to do
basic work activities, we will find that
you are not disabled. If you do, we will
go on to step 3.
3. Do you have an impairment(s) that
meets or medically equals the severity
of an impairment in the listings? If you
do, and the impairment(s) meets the
duration requirement, we will find that
you are disabled. If you do not, we will
go on to step 4.
4. Do you have the residual functional
capacity (RFC) to do your past relevant
work? If you do, we will find that you
PO 00000
Frm 00014
Fmt 4702
Sfmt 4702
are not disabled. If you do not, we will
go on to step 5.
5. Does your impairment(s) prevent
you from doing any other work that
exists in significant numbers in the
national economy, considering your
RFC, age, education, and work
experience? If it does, and it meets the
duration requirement, we will find that
you are disabled. If it does not, we will
find that you are not disabled.
We use a different sequential
evaluation process for children who
apply for payments based on disability
under title XVI of the Act. See § 416.924
of our regulations. If you are already
receiving benefits, we also use a
different sequential evaluation process
when we decide whether your disability
continues. See §§ 404.1594, 416.924,
416.994, and 416.994a of our
E:\FR\FM\16APP1.SGM
16APP1
20566
Federal Register / Vol. 73, No. 74 / Wednesday, April 16, 2008 / Proposed Rules
List of Subjects
regulations. However, all of these
processes include steps at which we
consider whether your impairment(s)
meets or medically equals one of our
listings.
What are the listings?
The listings are examples of
impairments that we consider severe
enough to prevent you as an adult from
doing any gainful activity. If you are a
child seeking SSI payments under title
XVI of the Act, the listings describe
impairments that we consider severe
enough to result in marked and severe
functional limitations. Although the
listings are contained only in appendix
1 to subpart P of part 404 of our
regulations, we incorporate them by
reference in the SSI program in
§ 416.925 of our regulations and apply
them to claims under both title II and
title XVI of the Act.
The listings are in two parts. There
are listings for adults (part A) and for
children (part B). If you are an
individual age 18 or over, we apply the
listings in part A when we assess your
claim, and we never use the listings in
part B.
If you are an individual under age 18,
we first use the criteria in part B of the
listings. Part B contains criteria that
apply only to individuals who are under
age 18. If the criteria in part B do not
apply, we may use the criteria in part A
when those criteria give appropriate
consideration to the effects of the
impairment(s) in children. (See
§§ 404.1525 and 416.925.)
If your impairment(s) does not meet
any listing, we will also consider
whether it medically equals any listing;
that is, whether it is as medically severe
as an impairment in the listings. (See
§§ 404.1526 and 416.926.)
pwalker on PROD1PC71 with PROPOSALS
What if you do not have an
impairment(s) that meets or medically
equals a listing?
We use the listings only to decide that
you are disabled or that you are still
disabled. We will not deny your claim
or decide that you no longer qualify for
benefits because your impairment(s)
does not meet or medically equal a
listing. If you have a severe
impairment(s) that does not meet or
medically equal any listing, we may still
find you disabled based on other rules
in the sequential evaluation process.
Likewise, we will not decide that your
disability has ended only because your
impairment(s) no longer meets or
medically equals a listing.
17:09 Apr 15, 2008
20 CFR Part 416
Administrative practice and
procedure, Aged, Blind, Disability
benefits, Public assistance programs,
Reporting and recordkeeping
requirements, Supplemental Security
Income (SSI).
Dated: March 20, 2008.
Michael J. Astrue,
Commissioner of Social Security.
[FR Doc. E8–8111 Filed 4–15–08; 8:45 am]
BILLING CODE 4191–02–P
DEPARTMENT OF VETERANS
AFFAIRS
How do we use the listings?
VerDate Aug<31>2005
20 CFR Part 404
Administrative practice and
procedure, Blind, Disability benefits,
Old-Age, Survivors and Disability
Insurance, Reporting and recordkeeping
requirements, Social Security.
Jkt 214001
38 CFR Part 3
RIN 2900–AM74
Definition of Service in the Republic of
Vietnam
Department of Veterans Affairs.
Proposed rule.
AGENCY:
ACTION:
SUMMARY: The Department of Veterans
Affairs (VA) proposes to amend its
adjudication regulations regarding the
definition of service in the Republic of
Vietnam. We state that service in the
Republic of Vietnam for the purposes of
applying the presumption of exposure
to herbicide agents includes service on
land and on inland waterways in
Vietnam. The amendments clarify
existing regulatory provisions and
ensure the proper administration of VA
policy.
DATES: Comments must be received by
VA on or before June 16, 2008.
ADDRESSES: Written comments may be
submitted through https://
www.Regulations.gov; by mail or handdelivery to the Director, Regulations
Management (00REG), Department of
Veterans Affairs, 810 Vermont Ave.,
NW., Room 1068, Washington, DC
20420; or by fax to (202) 273–9026.
(This is not a toll-free number.)
Comments should indicate that they are
submitted in response to ‘‘RIN 2900–
AM74–Definition of Service in the
Republic of Vietnam.’’ Copies of
comments received will be available for
public inspection in the Office of
Regulation Policy and Management,
Room 1063B, between the hours of 8
a.m. and 4:30 p.m. Monday through
PO 00000
Frm 00015
Fmt 4702
Sfmt 4702
Friday (except holidays). Please call
(202) 461–4902 for an appointment.
(This is not a toll-free number.) In
addition, during the comment period,
comments may be viewed online
through the Federal Docket Management
System (FDMS) at https://
www.Regulations.gov.
FOR FURTHER INFORMATION CONTACT:
Rhonda F. Ford, Chief, Regulations Staff
(211D), Compensation and Pension
Service, Veterans Benefits
Administration, Department of Veterans
Affairs, 810 Vermont Avenue, NW.,
Washington, DC 20420, (202) 461–9739.
(This is not a toll-free number.)
SUPPLEMENTARY INFORMATION: This
rulemaking is necessitated by the recent
decision rendered by the U. S. Court of
Appeals for Veterans Claims (CAVC) in
Haas v. Nicholson, 20 Vet. App. 257
(2006).
In the Haas case, the CAVC addressed
what it perceived to be ambiguity in
VA’s regulatory definitions of the term
‘‘service in the Republic of Vietnam.’’
Mr. Haas, a veteran of the U.S. Navy,
filed a claim for VA disability
compensation based on diabetes that he
alleged had resulted from ‘‘exposure to
Agent Orange/radioactive materials’’
during his service in Vietnam. Haas, 20
Vet. App. at 260. VA denied his claim,
concluding that 38 CFR 3.307(a)(6)(iii)
does not provide a presumption of
herbicide exposure to a Vietnam Era
veteran who never set foot on land in
the Republic of Vietnam and did not
serve on its inland waterways.
Additionally, VA interpreted the
language in § 3.307(a)(6)(iii) that
presumes herbicide exposure for
veterans who had ‘‘service in the waters
offshore and service in other locations if
the conditions of service involved duty
or visitation in Vietnam’’ to require that
‘‘ ‘the ship must have come to port in
the [Republic of Vietnam] and you
disembarked.’ ’’ Haas, 20 Vet. App. at
260 (quoting a letter from a VA regional
office). Mr. Haas contended that
‘‘service in the Republic of Vietnam’’ as
defined by 38 CFR 3.307(a)(6)(iii) must
be read to include service in the
offshore waters, regardless of whether
the veteran set foot on land.
The issue in Haas was whether VA’s
interpretation of ‘‘service in the
Republic of Vietnam’’ in
§ 3.307(a)(6)(iii) is a permissible
interpretation of that regulation and the
authorizing statute, 38 U.S.C. 1116(f).
The CAVC held that the statute is not
clear on its face concerning whether the
phrase ‘‘service in the Republic of
Vietnam’’ refers only to service on land
or encompasses some forms of offshore
service. Haas, 20 Vet. App. at 265.
E:\FR\FM\16APP1.SGM
16APP1
]]>Agencies
[Federal Register Volume 73, Number 74 (Wednesday, April 16, 2008)]
[Proposed Rules]
[Pages 20564-20566]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: E8-8111]
=======================================================================
-----------------------------------------------------------------------
SOCIAL SECURITY ADMINISTRATION
20 CFR Parts 404 and 416
[Docket No. SSA 2007-0102]
RIN 0960-AG74
Revised Medical Criteria for Evaluating Cardiovascular Disorders
AGENCY: Social Security Administration.
ACTION: Advance notice of proposed rulemaking.
-----------------------------------------------------------------------
SUMMARY: We are requesting your comments on whether and how we should
update and revise the criteria we use to evaluate claims involving
cardiovascular disorders in adults and children. These criteria are
found in sections 4.00 and 104.00 of the Listing of Impairments in
appendix 1 to subpart P of part 404 of our regulations (the listings).
We are requesting your comments as part of our ongoing effort to ensure
that the listings are up-to-date.
After we have considered your comments and suggestions, other
information about advances in medical knowledge, treatment, and methods
of evaluating cardiovascular disorders, and our program experience
using the current listings, we will determine whether we should revise
any of the cardiovascular listings. If we propose specific revisions to
the listings, we will publish a Notice of Proposed Rulemaking (NPRM) in
the Federal Register.
DATES: To be sure that your comments are considered, we must receive
them no later than June 16, 2008.
ADDRESSES: You may submit comments by one of four methods--Internet,
facsimile, regular mail, or hand-delivery. Please do not submit the
same comments multiple times or by more than one method. Regardless of
which of the following methods you choose, please state that your
comments refer to Docket No. SSA-2007-0102 to ensure that we can
associate your comments with the correct regulation:
1. Federal eRulemaking portal at https://www.regulations.gov. (This
is the most expedient method for submitting your comments, and we
strongly urge you to use it.) In the Comment or Submission section of
the webpage, type ``SSA-2007-0102'', select ``Go'', and then click
``Send a Comment or Submission.'' The Federal eRulemaking portal issues
you a tracking number when you submit a comment.
2. Telefax to (410) 966-2830.
3. Letter to the Commissioner of Social Security, P.O. Box 17703,
Baltimore, Maryland 21235-7703.
4. Deliver your comments to the Office of Regulations, Social
Security Administration, 922 Altmeyer Building, 6401 Security
Boulevard, Baltimore, Maryland 21235-6401, between 8 a.m. and 4:30 p.m.
on regular business days.
All comments are posted on the Federal eRulemaking portal, although
they may not appear for several days after receipt of the comment. You
may also inspect the comments on regular business days by making
arrangements with the contact person shown in this preamble.
Caution: Our policy for comments we receive from members of the
public is to make them available for public viewing in their entirety
on the Federal eRulemaking portal at https://www.regulations.gov.
Therefore, you should be careful to include in your comments only
information that you wish to make publicly available on the Internet.
We strongly urge you not to include any personal information, such as
your Social Security number or medical information, in your comments.
FOR FURTHER INFORMATION CONTACT: Diane Braunstein, Director, Office of
Compassionate Allowances and Listings Improvement, Social Security
Administration, 4468 Annex Building, 6401 Security Boulevard,
Baltimore, MD 21235-6401, (410) 965-1020, 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.
What is the purpose of this ANPRM?
The purpose of this ANPRM is to give you an opportunity to send us
comments and suggestions on whether and how we might update and revise
listings 4.00 and 104.00 for evaluating cardiovascular disorders. We
last published final rules revising the criteria that we use to
evaluate cardiovascular disorders in the Federal Register on January
13, 2006 (71 FR 2311). We are publishing this ANPRM as part of our
ongoing effort to ensure that our criteria are effective and reflect
the latest advances in medicine.
On which rules are we inviting comments?
We are interested in any comments and suggestions you have on
whether and how we might revise, update, and clarify sections 4.00 and
104.00 of the listings. You can find the current rules for these
listings on the Internet at the following locations:
Sections 4.00 and 104.00 are in the Listing of Impairments
in appendix 1 to subpart P of part 404 of our regulations at https://
www.ssa.gov/OP_Home/cfr20/404/404-ap10.htm.
Section 4.00 of the listings is also available at https://
www.ssa.gov/disability/professionals/bluebook/4.00-Cardiovascular-
Adult.htm.
[[Page 20565]]
Section 104.00 of the listings is also available at http:/
/www.ssa.gov/disability/professionals/bluebook/104.00-Cardiovascular-
Childhood.htm.
If you do not have Internet access, you can find the Code of
Federal Regulations in some public libraries, Federal depository
libraries, and public law libraries.
Who should send us comments and suggestions?
We invite comments and suggestions from anyone who has an interest
in the rules we use to evaluate claims for benefits filed by people who
have cardiovascular disorders. We are interested in getting comments
and suggestions from people who apply for or receive benefits from us,
members of the general public, advocates and organizations who
represent people who have cardiovascular disorders, State agencies that
make disability determinations for us, experts in the evaluation of
cardiovascular disorders, and researchers.
What should you comment about?
We are interested in any comments and suggestions you have on how
we might update and revise sections 4.00 and 104.00 of our listings.
For example, with regard to our listings, we are interested in knowing
if:
You have concerns about any of the provisions in the
current cardiovascular listings, such as whether you think we should
change any of our criteria or whether you think a listing is difficult
to use or to understand.
You would like to see our cardiovascular listings include
something that they do not include now, such as other cardiovascular
disorders, additional medical technologies, specific laboratory
studies, or new medical criteria.
You think our cardiovascular listings should include
additional functional criteria and, if so, what those criteria should
be.
You think there are cardiac diseases or conditions,
however rare, that have such a devastating effect on patients that we
should presume that they are unable to work.
You think new imaging techniques can provide new standards
for allowing us to presume disability for certain advanced diseases and
conditions.
Will we respond to your comments from this notice?
We will not respond directly to comments you send us in response to
this ANPRM. However, after we consider your comments along with other
information, such as medical research and other information about
advances in medical knowledge, treatment, methods of evaluating
cardiovascular disease, and our program experience, we will decide
whether and how to revise the listings we use to evaluate
cardiovascular disorders. If we propose revisions to these listings, we
will publish an NPRM in the Federal Register. In accordance with the
usual rulemaking procedures we follow, if we publish an NPRM, you will
have a chance to comment on the revisions we propose, and we will
summarize and respond to the significant comments on the NPRM in the
preamble to any final rules.
Other Information
Who can get disability benefits?
Under title II of the Social Security Act (the Act), we provide for
the payment of disability benefits if you are disabled and belong to
one of the following three groups:
Workers insured under the Act,
Children of insured workers, and
Widows, widowers, and surviving divorced spouses (see
Sec. 404.336) of insured workers.
Under title XVI of the Act, we provide for Supplemental Security
Income (SSI) payments on the basis of disability if you are disabled
and have limited income and resources.
How do we define disability?
Under both the title II and title XVI programs, disability must be
the result of any medically determinable physical or mental impairment
or combination of impairments that is expected to result in death or
which has lasted or can be expected to last for a continuous period of
at least 12 months. Our definitions of disability are shown in the
following table:
------------------------------------------------------------------------
Disability means you
have a medically
If you file a claim under . . And you are . . . determinable
. impairment(s) as
described above that
results in . . .
------------------------------------------------------------------------
title II...................... an adult or child the inability to do
any substantial
gainful activity
(SGA).
title XVI..................... an individual age the inability to do
18 or older. any SGA.
title XVI..................... an individual marked and severe
under age 18. functional
limitations.
------------------------------------------------------------------------
How do we decide whether you are disabled?
If you are applying for benefits under title II of the Act, or if
you are an adult applying for payments under title XVI of the Act, we
use a five-step ``sequential evaluation process'' to decide whether you
are disabled. We describe this five-step process in our regulations at
Sec. Sec. 404.1520 and 416.920. We follow the five steps in order and
stop as soon as we can make a determination or decision. The steps are:
1. Are you working, and is the work you are doing SGA? If you are
working and the work you are doing is SGA, we will find that you are
not disabled, regardless of your medical condition or your age,
education, and work experience. If you are not, we will go on to step
2.
2. Do you have a ``severe'' impairment? If you do not have an
impairment or combination of impairments that significantly limits your
physical or mental ability to do basic work activities, we will find
that you are not disabled. If you do, we will go on to step 3.
3. Do you have an impairment(s) that meets or medically equals the
severity of an impairment in the listings? If you do, and the
impairment(s) meets the duration requirement, we will find that you are
disabled. If you do not, we will go on to step 4.
4. Do you have the residual functional capacity (RFC) to do your
past relevant work? If you do, we will find that you are not disabled.
If you do not, we will go on to step 5.
5. Does your impairment(s) prevent you from doing any other work
that exists in significant numbers in the national economy, considering
your RFC, age, education, and work experience? If it does, and it meets
the duration requirement, we will find that you are disabled. If it
does not, we will find that you are not disabled.
We use a different sequential evaluation process for children who
apply for payments based on disability under title XVI of the Act. See
Sec. 416.924 of our regulations. If you are already receiving
benefits, we also use a different sequential evaluation process when we
decide whether your disability continues. See Sec. Sec. 404.1594,
416.924, 416.994, and 416.994a of our
[[Page 20566]]
regulations. However, all of these processes include steps at which we
consider whether your impairment(s) meets or medically equals one of
our listings.
What are the listings?
The listings are examples of impairments that we consider severe
enough to prevent you as an adult from doing any gainful activity. If
you are a child seeking SSI payments under title XVI of the Act, the
listings describe impairments that we consider severe enough to result
in marked and severe functional limitations. Although the listings are
contained only in appendix 1 to subpart P of part 404 of our
regulations, we incorporate them by reference in the SSI program in
Sec. 416.925 of our regulations and apply them to claims under both
title II and title XVI of the Act.
How do we use the listings?
The listings are in two parts. There are listings for adults (part
A) and for children (part B). If you are an individual age 18 or over,
we apply the listings in part A when we assess your claim, and we never
use the listings in part B.
If you are an individual under age 18, we first use the criteria in
part B of the listings. Part B contains criteria that apply only to
individuals who are under age 18. If the criteria in part B do not
apply, we may use the criteria in part A when those criteria give
appropriate consideration to the effects of the impairment(s) in
children. (See Sec. Sec. 404.1525 and 416.925.)
If your impairment(s) does not meet any listing, we will also
consider whether it medically equals any listing; that is, whether it
is as medically severe as an impairment in the listings. (See
Sec. Sec. 404.1526 and 416.926.)
What if you do not have an impairment(s) that meets or medically equals
a listing?
We use the listings only to decide that you are disabled or that
you are still disabled. We will not deny your claim or decide that you
no longer qualify for benefits because your impairment(s) does not meet
or medically equal a listing. If you have a severe impairment(s) that
does not meet or medically equal any listing, we may still find you
disabled based on other rules in the sequential evaluation process.
Likewise, we will not decide that your disability has ended only
because your impairment(s) no longer meets or medically equals a
listing.
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 416
Administrative practice and procedure, Aged, Blind, Disability
benefits, Public assistance programs, Reporting and recordkeeping
requirements, Supplemental Security Income (SSI).
Dated: March 20, 2008.
Michael J. Astrue,
Commissioner of Social Security.
[FR Doc. E8-8111 Filed 4-15-08; 8:45 am]
BILLING CODE 4191-02-P
