Clarification of Evidentiary Standard for Determinations and Decisions, 76940-76945 [E8-30056]
Download as PDF
76940
Federal Register / Vol. 73, No. 244 / Thursday, December 18, 2008 / Rules and Regulations
‘‘date’’ in the bracketed language of the
second sentence.
Dated: December 11, 2008.
By the Office of Thrift Supervision.
John M. Reich,
Director.
[FR Doc. E8–30021 Filed 12–17–08; 8:45 am]
BILLING CODE 6720–01–P
DEPARTMENT OF TRANSPORTATION
Federal Aviation Administration
14 CFR Part 71
[Docket No. FAA–2008–1018; Airspace
Docket No. 08–AAL–31]
Revocation of Class E Airspace;
Metlakatla, AK
Federal Aviation
Administration (FAA), DOT.
ACTION: Final rule.
AGENCY:
rwilkins on PROD1PC63 with RULES
SUMMARY: This action revokes Class E
airspace at Metlakatla, AK. The
privately funded special instrument
approaches serving Metlakatla Airport
have been removed. There is no longer
a requirement for the controlled
airspace. This action revokes existing
Class E airspace surrounding the
Metlakatla Airport, Metlakatla, AK.
DATES: Effective Date: 0901 UTC, March
12, 2009. The Director of the Federal
Register approves this incorporation by
reference action under title 1, Code of
Federal Regulations, part 51, subject to
the annual revision of FAA Order
7400.9 and publication of conforming
amendments.
FOR FURTHER INFORMATION CONTACT: Gary
Rolf, AAL–538G, Federal Aviation
Administration, 222 West 7th Avenue,
Box 14, Anchorage, AK 99513–7587;
telephone number (907) 271–5898; fax:
(907) 271–2850; e-mail:
gary.ctr.rolf@faa.gov. Internet address:
https://www.faa.gov/about/office_org/
headquarters_offices/ato/service_units/
systemops/fs/alaskan/rulemaking/.
SUPPLEMENTARY INFORMATION:
History
On Friday, October 17, 2008, the FAA
proposed to amend part 71 of the
Federal Aviation Regulations (14 CFR
part 71) to revoke the Class E airspace
at Metlakatla, AK (73 FR 61752). The
action was proposed in order to remove
controlled airspace no longer necessary,
due to the removal of the existing
instrument approach procedure
previously serving the Metlakatla
Airport. Class E controlled airspace
associated with the Metlakatla Airport
area is revoked by this action.
VerDate Aug<31>2005
17:41 Dec 17, 2008
Jkt 217001
Interested parties were invited to
participate in this rulemaking
proceeding by submitting written
comments on the proposal to the FAA.
No comments were received. The rule is
adopted as proposed.
The area will be depicted on
aeronautical charts for pilot reference.
The coordinates for this airspace docket
are based on North American Datum 83.
The Class E airspace areas designated as
700/1,200 ft. transition areas are
published in paragraph 6005 of FAA
Order 7400.9S, Airspace Designations
and Reporting Points, signed October 3,
2008, and effective October 31, 2008,
which is incorporated by reference in 14
CFR 71.1. The Class E airspace
designations listed in this document
will be published subsequently in the
Order.
The Rule
This amendment to 14 CFR part 71
revokes Class E airspace at the
Metlakatla Airport, Alaska. This Class E
airspace is revoked because there are no
longer any instrument procedures at the
Metlakatla Airport, and the airspace
depiction will be removed from
aeronautical charts.
The FAA has determined that this
regulation only involves an established
body of technical regulations for which
frequent and routine amendments are
necessary to keep them operationally
current. It, therefore—(1) Is not a
‘‘significant regulatory action’’ under
Executive Order 12866; (2) is not a
‘‘significant rule’’ under DOT
Regulatory Policies and Procedures (44
FR 11034; February 26, 1979); and (3)
does not warrant preparation of a
regulatory evaluation as the anticipated
impact is so minimal. Because this is a
routine matter that will only affect air
traffic procedures and air navigation, it
is certified that this rule will not have
a significant economic impact on a
substantial number of small entities
under the criteria of the Regulatory
Flexibility Act.
The FAA’s authority to issue rules
regarding aviation safety is found in
Title 49 of the United States Code.
Subtitle 1, Section 106 describes the
authority of the FAA Administrator.
Subtitle VII, Aviation Programs,
describes in more detail the scope of the
agency’s authority.
This rulemaking is promulgated
under the authority described in
Subtitle VII, Part A, Subpart 1, Section
40103, Sovereignty and use of airspace.
Under that section, the FAA is charged
with prescribing regulations to ensure
the safe and efficient use of the
navigable airspace. This regulation is
within the scope of that authority
PO 00000
Frm 00094
Fmt 4700
Sfmt 4700
because it revokes Class E airspace no
longer necessary for the Metlakatla
Airport and represents the FAA’s
continuing effort to safely and
efficiently use the navigable airspace.
List of Subjects in 14 CFR Part 71
Airspace, Incorporation by reference,
Navigation (air).
Adoption of the Amendment
In consideration of the foregoing, the
Federal Aviation Administration
amends 14 CFR part 71 as follows:
■
PART 71—DESIGNATION OF CLASS A,
CLASS B, CLASS C, CLASS D, AND
CLASS E AIRSPACE AREAS;
AIRWAYS; ROUTES; AND REPORTING
POINTS
1. The authority citation for 14 CFR
part 71 continues to read as follows:
■
Authority: 49 U.S.C. 106(g), 40103, 40113,
40120; E.O. 10854, 24 FR 9565, 3 CFR, 1959–
1963 Comp., p. 389.
§ 71.1
[Amended]
2. The incorporation by reference in
14 CFR 71.1 of Federal Aviation
Administration Order 7400.9S, Airspace
Designations and Reporting Points,
signed October 3, 2008, and effective
October 31, 2008, is amended as
follows:
■
Paragraph 6005 Class E Airspace Extending
Upward From 700 Feet or More Above the
Surface of the Earth.
*
*
*
AAL AK E5
*
*
*
*
Metlakatla, AK [Revoked]
*
*
*
Issued in Anchorage, AK, on December 4,
2008.
Anthony M. Wylie,
Manager, Alaska Flight Services Information
Area Group.
[FR Doc. E8–30013 Filed 12–17–08; 8:45 am]
BILLING CODE 4910–13–P
SOCIAL SECURITY ADMINISTRATION
20 CFR Parts 404, 408, 416, and 422
[Docket No. SSA–2008–0005]
RIN 0960–AG75
Clarification of Evidentiary Standard
for Determinations and Decisions
Social Security Administration.
Final Rules.
AGENCY:
ACTION:
SUMMARY: We are amending our rules to
clarify that we apply the preponderance
of the evidence standard when we make
determinations and decisions at all
levels of our administrative review
E:\FR\FM\18DER1.SGM
18DER1
Federal Register / Vol. 73, No. 244 / Thursday, December 18, 2008 / Rules and Regulations
process. These rules do not change our
policy that the Appeals Council applies
the substantial evidence standard when
it reviews a decision by an
administrative law judge (ALJ) to
determine whether to grant a request for
review. We are also adding definitions
of the terms ‘‘substantial evidence’’ and
‘‘preponderance of the evidence’’ for use
in applying these rules.
DATES: These final rules are effective on
January 20, 2009.
FOR FURTHER INFORMATION CONTACT:
Joshua Silverman, Office of Regulations,
Social Security Administration, 6401
Security Boulevard, Baltimore, MD
21235–6401, (410) 594–2128, for
information about these rules. 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/.
Explanation of Changes
Our Administrative Review Process
rwilkins on PROD1PC63 with RULES
We currently decide claims for
benefits using an administrative review
process that consists of four levels:
Initial determination, reconsideration,
hearing before an ALJ, and Appeals
Council review. See 20 CFR 404.900,
408.1000, and 416.1400. We make an
initial determination at the first level. If
a person is dissatisfied with the initial
determination, he may request
reconsideration.1 If a person is
dissatisfied with the reconsidered
determination, he may request a hearing
before an ALJ.2 Finally, if a person is
dissatisfied with the ALJ’s decision,3 he
may request that the Appeals Council
1 For disability claims, there are ten States that are
participating in a ‘‘prototype’’ test under 20 CFR
404.906 and 416.1406. In these States, the second
step for people who are dissatisfied with their
initial determinations in disability cases is a
hearing before an ALJ. The ten States are: Alabama,
Alaska, California (Los Angeles North and West
Branches), Colorado, Louisiana, Michigan,
Missouri, New Hampshire, New York, and
Pennsylvania.
2 In some cases, attorney advisors in our Office of
Disability Adjudication and Review make wholly
favorable decisions before an ALJ hearing is
conducted. 20 CFR 404.942 and 416.1442.
3 The words ‘‘determination’’ and ‘‘decision’’ are
defined in 20 CFR 404.900 and 416.1400. At the
initial and reconsideration levels of the
administrative review process, we issue
‘‘determinations.’’ At the ALJ hearing and Appeals
Council levels, we issue ‘‘decisions.’’
VerDate Aug<31>2005
17:41 Dec 17, 2008
Jkt 217001
review that decision. Once a person has
completed these administrative steps
and received our final decision, the
person may request judicial review of
the final decision in Federal district
court.
Each adjudicator reviewing a claim in
the administrative process makes an
independent (or de novo) determination
or decision based on the evidence in the
record.4 For example, an ALJ would not
simply review a State agency’s initial
and reconsideration disability
determinations to determine whether
they were correct. Rather, the ALJ
would review the evidence in the record
and make an independent decision.
In contrast, in deciding whether to
grant a person’s request for Appeals
Council review of an ALJ’s decision, the
Appeals Council first considers the
ALJ’s decision and the evidence before
the ALJ using the substantial evidence
standard of review, which we discuss
below. If the Appeals Council does not
grant a request for review, the ALJ’s
decision becomes our final decision.5 If
the Appeals Council grants the request
for review, it will usually either remand
the case to an ALJ for additional
proceedings and a new decision or issue
its own decision.
Our Standard of Proof
A claimant has the burden of proving
his claim with us. Adjudicators at each
level of the administrative review
process, including the Appeals Council,
consider whether a claimant has proven
his claim using an evidentiary standard
called the ‘‘preponderance of the
evidence’’ when they make a
determination or decision. We define
preponderance of the evidence as ‘‘such
relevant evidence that as a whole shows
that the existence of the fact to be
proven is more likely than not.’’ 20 CFR
405.5.
4 In
some States, adjudicators must consider, and
sometimes adopt, certain findings made in prior
disability adjudications under acquiescence rulings
(ARs) that we have issued to address circuit court
holdings. See AR 97–4(9), 62 FR 64038, available
at: https://www.socialsecurity.gov/OP_Home/rulings/
ar/09/AR97-04-ar-09.html; AR 98-3(6), 63 FR 29770,
available at: https://www.socialsecurity.gov/
OP_Home/rulings/ar/06/AR98-03-ar-06.html; AR
98-4(6), 63 FR 29771, corrected at 63 FR 31266,
available at: https://www.socialsecurity.gov/
OP_Home/rulings/ar/06/AR98-04-ar-06.html; and
AR 00-1(4), 65 FR 1936, available at: https://
www.socialsecurity.gov/OP_Home/rulings/ar/04/
AR2000-01-ar-04.html.
5 The Appeals Council may also dismiss the
request for review either with or without first
granting the request. Additionally, the Appeals
Council may review a case on its own motion
without an individual asking it to do so. See 20 CFR
404.967, 404.969, 404.984, 416.1467, 416.1469, and
416.1484. See also 20 CFR 408.1050, which
incorporates the relevant provisions of 20 CFR
416.1467–416.1482 by reference.
PO 00000
Frm 00095
Fmt 4700
Sfmt 4700
76941
The Social Security Act does not
specify the standard of proof to use
when we make a determination or
decision. Courts and scholars have long
recognized that the preponderance of
the evidence standard is the traditional
standard of proof in a civil or an
administrative adjudicatory
proceeding.6 Our longstanding policy
has been that the preponderance of the
evidence standard applies to
determinations or decisions on claims
under parts 404, 408, and 416.7 Prior to
these final rules, we did not have
regulations in parts 404, 408, and 416
that clearly stated that we use the
preponderance of the evidence standard
when we make a determination or
decision. The absence of explicit
language in these parts explaining the
standards we use at each level of the
administrative process caused some
confusion about the applicable
standard. By issuing these final rules,
we intend to resolve any confusion
about the applicable standard.
Our Standard of Review at the Appeals
Council
When the Appeals Council considers
whether to grant a request for review of
an ALJ’s decision, it does not use a
preponderance of the evidence
standard. Instead, it considers, among
other things, whether the action,
findings, or conclusions of the ALJ are
supported by substantial evidence.8 20
CFR 404.970(a) and 416.1470(a). The
definition of substantial evidence in
these final rules is ‘‘such relevant
evidence as a reasonable mind might
accept as adequate to support a
conclusion.’’ The substantial evidence
standard of review gives deference to
the findings of the ALJ rather than
requiring a decision based on a new
evaluation of the evidence.9
6 Federal courts apply a substantial evidence
standard when they review our final decisions. 42
U.S.C. 405(g), 1009(b), and 1383(c)(3).
7 A claimant must give us ‘‘convincing’’ evidence
to prove that he meets certain requirements for
eligibility, as described in subpart H of parts 404
and 416. Because these final rules address the
appropriate standard of proof to be applied in
making determinations or decisions rather than the
burden of proving eligibility for benefits, these final
rules are not applicable to subpart H of parts 404
and 416.
8 The Appeals Council also reviews any new and
material evidence under 20 CFR 404.970(b) and
416.1470(b).
9 Our regulations also provide that the Associate
Commissioner for Disability Determinations or his
delegate may use the substantial evidence standard
of review when reviewing a sample of disability
hearing officers’ reconsideration determinations. 20
CFR 404.918 and 416.1418. In general, disability
hearing officers make reconsideration
determinations in cases of beneficiaries who we
have determined are no longer disabled. See 20 CFR
404.914–404.918 and 416.1414–416.1418.
E:\FR\FM\18DER1.SGM
18DER1
76942
Federal Register / Vol. 73, No. 244 / Thursday, December 18, 2008 / Rules and Regulations
As stated earlier, the Appeals Council
uses the substantial evidence standard
to decide whether to review an ALJ’s
decision. If it grants review and then
issues its own decision, the Appeals
Council uses the preponderance of the
evidence standard when it issues its
decision.
rwilkins on PROD1PC63 with RULES
Explanation of Changes
We are revising several regulation
sections in parts 404, 408, 416, and 422
to clarify that we use the preponderance
of the evidence standard of proof to
adjudicate claims at all levels of the
administrative review process. We also
are adding a definition of the term
‘‘preponderance of the evidence’’ in 20
CFR 404.901, 408.1001, and 416.1401,
and a definition of the term ‘‘substantial
evidence’’ in 20 CFR 404.901 and
416.1401. These are the same
definitions we currently use in 20 CFR
405.5.
We are also making additional
changes from the language proposed in
the NPRM. None of these changes alter
the meaning of these sections. First, we
are revising several of the affected
regulatory sections in these final rules to
put them in active voice and to use
consistent language. Second, we are
making two changes to 20 CFR
422.203(c). We are adding a reference to
attorney advisor decisions under 20 CFR
404.942 and 416.1142 and deleting the
phrase ‘‘under applicable provisions of
the law and regulations and appropriate
precedents.’’ These changes make the
language in section 20 CFR 422.203(c)
consistent with the language in final 20
CFR 404.953(a) and 416.1453(a), and
they acknowledge that, under certain
circumstances, attorney advisors can
make decisions instead of an ALJ under
20 CFR 404.942 and 416.1442.
We believe these clarifications will
improve the accuracy and consistency
of the decision-making process.
We have the authority to make these
changes under 42 U.S.C. 405(a),
902(a)(5), 1010(a), and 1383(d)(1).
Public Comments
In the notice of proposed rulemaking
published at 73 FR 33745 (June 13,
2008), we provided the public with a
60-day period in which to comment on
the proposed changes. That comment
period ended on August 12, 2008. We
received comments from four people.
We carefully considered each comment.
Because some of the comments were
long and quite detailed, we have
condensed, summarized, and
paraphrased them in the following
discussions. However, we have tried to
present all views adequately and to
address carefully all of the significant
VerDate Aug<31>2005
17:41 Dec 17, 2008
Jkt 217001
issues raised by the commenters that are
within the scope of the proposed rules.
We generally have not addressed
comments that are outside the scope of
the rulemaking proceeding.
Comment: One commenter generally
supported the proposed rules and said
that there should be only one
evidentiary standard used by our
adjudicators at all levels of the
adjudication process.
Response: We agree with the
commenter that adjudicators at each
level of the administrative review
process, including the Appeals Council,
should use the same evidentiary
standard. These rules provide that they
will all use the preponderance of the
evidence standard of proof when they
make determinations or decisions. As
stated above, the Appeals Council only
uses the substantial evidence standard
of review when it considers whether to
grant a request for review of an ALJ’s
decision. Although it is unclear from the
commenter’s letter, to the extent that the
commenter suggested that the Appeals
Council should apply the
preponderance of the evidence standard
of proof when it reviews an ALJ’s
decision, we are not adopting the
comment. Our rules governing the
Appeals Council’s use of the substantial
evidence standard to review ALJ
decisions have worked well, and we do
not believe that there is any reason to
change them.
Comment: Two commenters were
concerned that the proposed changes
could create an ambiguity about who
has the burden of proof. One of these
commenters also said that our
determinations and decisions should be
made based on substantial evidence and
that the burden of a party is to provide
proof by a preponderance of the
evidence. Both commenters expressed
concern that the proposed changes
could appear to shift the burden of proof
in disability cases to us by requiring that
we base our determinations and
decisions on a preponderance of the
evidence. One of these commenters
suggested that we add regulatory text to
explain who has the burden of proof at
each of the five steps of the sequential
evaluation process that we use to decide
whether a person is disabled. See 20
CFR 404.1520 and 416.920.
Response: We are not adopting this
comment. These final rules concern the
appropriate standard of proof, not who
has the burden of proof at any stage of
our sequential evaluation process. Our
current regulations explain the burden
of proof in disability claims.10 We
10 See 20 CFR 404.1512, 404.1560(c)(2),
404.1566(c), 416.912, 416.960(c)(2), and 416.966(c).
PO 00000
Frm 00096
Fmt 4700
Sfmt 4700
previously explained the concept of
how the burden of proof, a term
traditionally associated with adversarial
litigation, applies in the context of our
nonadversarial system. 68 FR 51153,
51154–51155 (Aug. 26, 2003). We do not
believe that it is appropriate to make the
changes suggested by the commenters
because these final rules do not change
the allocation of the burden of proof in
our adjudications.
Comment: One commenter said that
our use of the word ‘‘review’’ in several
of the proposed sections was
ambiguous. The commenter thought that
it was unclear whether we meant a
review of the evidence or a review of the
determination or decision. The
commenter suggested that we use a
phrase such as ‘‘again look’’ instead of
‘‘review’’ when we refer to reviewing
evidence.
Response: We are not adopting this
comment. In many sections of our rules,
we use the word ‘‘review’’ to refer
generally to a consideration of evidence.
With regard to the Appeals Council’s
review of a decision or a dismissal, we
use the word ‘‘review’’ as a term of art.11
We believe that the plain meaning of the
word is readily apparent in the context
of the sections of the regulations in
which we use it, and we are not aware
that these longstanding usages have
confused either adjudicators or the
public.
Comment: One commenter suggested
changes to our proposed language for 20
CFR 404.979, 404.984, 416.1479, and
416.1484. Specifically, the commenter
suggested amending those sections to
state that the Appeals Council uses the
substantial evidence standard when it
remands a case to an ALJ, and that the
Appeals Council will remand a case it
reviewed to an ALJ for further
proceedings unless the decision being
appealed is supported by substantial
evidence.
Response: We are not adopting this
comment because it is inconsistent with
our existing regulations, which provide
that the Appeals Council may grant a
request for review and remand a case for
reasons other than a lack of substantial
evidence to support a decision. See 20
A claimant has the burden of providing proof of his
disability under each of the first four steps in the
sequential evaluation process. In the fifth and final
step of the sequential evaluation process, we
become responsible for providing evidence that
demonstrates that other work exists in significant
numbers in the national economy that the claimant
can perform after considering the claimant’s
residual functional capacity, age, education, and
work experience. However, a claimant must
persuade us that he is disabled at each step of the
sequential evaluation process. See Bowen v.
Yuckert, 482 U.S. 137, 146 (1987).
11 See, e.g., 20 CFR 404.967 and 416.1467.
E:\FR\FM\18DER1.SGM
18DER1
Federal Register / Vol. 73, No. 244 / Thursday, December 18, 2008 / Rules and Regulations
CFR 404.970 and 416.1470. The Appeals
Council may also remand a case to an
ALJ pursuant to a Federal court’s
instructions without conducting its own
review. See 20 CFR 404.983 and
416.1483.
Comment: One commenter suggested
that we change both of our proposed
definitions. He also suggested that we
adopt a new term— ‘‘substantial
evidence standard of review’’— that
would address when a reviewing body
may remand a decision based on an
adjudicator’s failure to discuss evidence
and that we amend 20 CFR 404.902 and
416.1492 accordingly.
Response: We are not adopting this
comment. As we noted above, our
definitions of the terms ‘‘preponderance
of the evidence’’ and ‘‘substantial
evidence’’ are taken directly from our
existing rule in 20 CFR 405.5. The
definitions in that rule are based on
accepted definitions and are consistent
with our longstanding usage. The
commenter’s proposed additions to
these definitions would not appreciably
clarify our rules, and some of the
language the commenter proposed could
raise questions among the public and
our adjudicators. We also believe that
our adjudicators and the public are
familiar with the concept of substantial
evidence because our subregulatory
instructions have included a definition
of ‘‘substantial evidence’’ for
approximately 37 years. See SSR 71–
53c.
The commenter’s other proposals are
beyond the scope of this rulemaking
because they focus on how the Appeals
Council or a Federal court can
determine whether a decision is
supported by substantial evidence. If we
decide that it would be appropriate to
adopt rules along the lines proposed by
the commenter, we would first follow
the Administrative Procedure Act’s
rulemaking procedures.
Regulatory Procedures
Executive Order 12866, as Amended
We have consulted with the Office of
Management and Budget (OMB) and
determined that these rules do not meet
the criteria for a significant regulatory
action under Executive Order 12866, as
amended. Thus, they were not subject to
OMB review.
rwilkins on PROD1PC63 with RULES
Regulatory Flexibility Act
We certify that these rules will not
have a significant economic impact on
a substantial number of small entities as
they affect individuals only. Therefore,
a regulatory flexibility analysis as
provided in the Regulatory Flexibility
Act, as amended, is not required.
VerDate Aug<31>2005
17:41 Dec 17, 2008
Jkt 217001
Paperwork Reduction Act
(Catalog of Federal Domestic Assistance
Program Nos. 96.001, Social Security—
Disability Insurance; 96.002, Social
Security—Retirement Insurance; 96.004,
Social Security—Survivors Insurance;
96.006, Supplemental Security Income)
List of Subjects
20 CFR Part 404
Administrative practice and
procedure, Blind, Disability benefits,
Old-Age, Survivors, and Disability
Insurance, Reporting and recordkeeping
requirements, Social Security.
20 CFR Part 408
Administrative practice and
procedure, Aged, Reporting and
recordkeeping requirements, Social
Security, Supplemental Security Income
(SSI), Veterans.
20 CFR Part 416
Administrative practice and
procedure, Aged, Blind, Disability
benefits, Public assistance programs,
Reporting and recordkeeping
requirements, Supplemental Security
Income (SSI).
20 CFR Part 422
Administrative practice and
procedure, Organization and functions
(Government agencies), Reporting and
recordkeeping requirements, Social
Security.
Dated: December 12, 2008.
Michael J. Astrue,
Commissioner of Social Security.
For the reasons set forth in the
preamble, we are amending subpart J of
part 404, subpart J of part 408, subpart
N of part 416, and subparts B and C of
part 422 of chapter III of title 20 of the
Code of Federal Regulations as set forth
below:
■
PART 404—FEDERAL OLD-AGE,
SURVIVORS AND DISABILITY
INSURANCE (1950–)
Subpart J—[Amended]
1. The authority citation for subpart J
of part 404 continues to read as follows:
■
Authority: Secs. 201(j), 204(f), 205(a), (b),
(d)–(h), and (j), 221, 223(i), 225, and 702(a)(5)
of the Social Security Act (42 U.S.C. 401(j),
404(f), 405(a), (b), (d)–(h), and (j), 421, 423(i),
425, and 902(a)(5)); sec. 5, Pub. L. 97–455, 96
Stat. 2500 (42 U.S.C. 405 note); secs. 5, 6(c)–
(e), and 15, Pub. L. 98–460, 98 Stat. 1802 (42
U.S.C. 421 note); sec. 202, Pub. L. 108–203,
118 Stat. 509 (42 U.S.C. 902 note).
Frm 00097
Fmt 4700
Sfmt 4700
2. Amend § 404.901 by adding the
definitions for ‘‘Preponderance of the
evidence’’ and ‘‘Substantial evidence’’
in alphabetical order to read as follows:
■
These rules will impose no additional
reporting or recordkeeping requirements
requiring OMB clearance.
PO 00000
76943
§ 404.901
Definitions.
*
*
*
*
*
Preponderance of the evidence means
such relevant evidence that as a whole
shows that the existence of the fact to
be proven is more likely than not.
*
*
*
*
*
Substantial evidence means such
relevant evidence as a reasonable mind
might accept as adequate to support a
conclusion.
*
*
*
*
*
■ 3. Amend § 404.902 by revising the
second sentence and adding a new
sentence before the existing third
sentence in the introductory text to read
as follows:
§ 404.902 Administrative actions that are
initial determinations.
* * * We will base our initial
determination on the preponderance of
the evidence. We will state the
important facts and give the reasons for
our conclusions in the initial
determination. * * *
*
*
*
*
*
■ 4. Amend § 404.917 by revising the
second sentence of paragraph (b) to read
as follows:
§ 404.917 Disability hearing–disability
hearing officer’s reconsidered
determination.
*
*
*
*
*
(b) * * * The disability hearing
officer must base the reconsidered
determination on the preponderance of
the evidence offered at the disability
hearing or otherwise included in your
case file.
*
*
*
*
*
■ 5. Revise § 404.920 to read as follows:
§ 404.920
Reconsidered determination.
After you or another person requests
a reconsideration, we will review the
evidence we considered in making the
initial determination and any other
evidence we receive. We will make our
determination based on the
preponderance of the evidence.
■ 6. Amend § 404.941 by revising the
second sentence of paragraph (a) to read
as follows:
§ 404.941
Prehearing case review.
(a) * * * That component will decide
whether it should revise the
determination based on the
preponderance of the evidence. * * *
*
*
*
*
*
E:\FR\FM\18DER1.SGM
18DER1
76944
Federal Register / Vol. 73, No. 244 / Thursday, December 18, 2008 / Rules and Regulations
7. Amend § 404.942 by revising the
second sentence of paragraph (a) to read
as follows:
■
§ 404.942 Prehearing proceedings and
decisions by attorney advisors.
(a) * * * If after the completion of
these proceedings we can make a
decision that is wholly favorable to you
and all other parties based on the
preponderance of the evidence, an
attorney advisor, instead of an
administrative law judge, may issue the
decision. * * *
*
*
*
*
*
■ 8. Amend § 404.948 by revising the
first sentence of paragraph (a) to read as
follows:
§ 404.948 Deciding a case without an oral
hearing before an administrative law judge.
(a) * * * If the evidence in the
hearing record supports a finding in
favor of you and all the parties on every
issue, the administrative law judge may
issue a hearing decision based on a
preponderance of the evidence without
holding an oral hearing. * * *
*
*
*
*
*
■ 9. Amend § 404.953 by revising the
second sentence of paragraph (a), the
first sentence of paragraph (b), and the
first sentence of paragraph (c) to read as
follows:
§ 404.953 The decision of an
administrative law judge.
(a) * * * The administrative law
judge must base the decision on the
preponderance of the evidence offered
at the hearing or otherwise included in
the record. * * *
(b) * * * The administrative law
judge may enter a wholly favorable oral
decision based on the preponderance of
the evidence into the record of the
hearing proceedings. * * *
(c) * * * Although an administrative
law judge will usually make a decision,
the administrative law judge may send
the case to the Appeals Council with a
recommended decision based on a
preponderance of the evidence when
appropriate. * * *
■ 10. Amend § 404.979 by adding a new
third sentence to read as follows:
rwilkins on PROD1PC63 with RULES
§ 404.979
Decision of Appeals Council.
* * * If the Appeals Council issues
its own decision, it will base its
decision on the preponderance of the
evidence. * * *
■ 11. Amend § 404.984 by revising the
last sentence of paragraph (a), the
second sentence of paragraph (b)(3), and
the last sentence of paragraph (c) to read
as follows:
VerDate Aug<31>2005
17:41 Dec 17, 2008
Jkt 217001
§ 404.984 Appeals Council review of
administrative law judge decision in a case
remanded by a Federal court.
■
(a) * * * The Appeals Council will
either make a new, independent
decision based on the preponderance of
the evidence in the record that will be
the final decision of the Commissioner
after remand, or it will remand the case
to an administrative law judge for
further proceedings.
(b) * * *
(3) * * * If the Appeals Council
assumes jurisdiction, it will make a
new, independent decision based on the
preponderance of the evidence in the
entire record affirming, modifying, or
reversing the decision of the
administrative law judge, or it will
remand the case to an administrative
law judge for further proceedings,
including a new decision. * * *
(c) * * * After the Appeals Council
receives the briefs or other written
statements, or the time allowed (usually
30 days) for submitting them has
expired, the Appeals Council will either
issue a final decision of the
Commissioner based on the
preponderance of the evidence
affirming, modifying, or reversing the
decision of the administrative law
judge, or remand the case to an
administrative law judge for further
proceedings, including a new decision.
*
*
*
*
*
§ 408.1020 How do we make our
reconsidered determination?
PART 408—SPECIAL BENEFITS FOR
CERTAIN WORLD WAR II VETERANS
Subpart J—[Amended]
12. The authority citation for subpart
J of part 408 continues to read as
follows:
■
Authority: Secs. 702(a)(5) and 809 of the
Social Security Act (42 U.S.C. 902(a)(5) and
1009).
13. Amend § 408.1001 by adding the
definition for ‘‘Preponderance of the
evidence’’ in alphabetical order to read
as follows:
■
§ 408.1001
Definitions.
*
*
*
*
*
Preponderance of the evidence means
such relevant evidence that as a whole
shows that the existence of the fact to
be proven is more likely than not.
*
*
*
*
*
■ 14. Amend § 408.1002 by adding a
new third sentence to read as follows:
* * * We will base our initial
determination on the preponderance of
the evidence.
Frm 00098
Fmt 4700
Sfmt 4700
* * * We will make our
determination based on the
preponderance of the evidence in the
record. * * *
PART 416—SUPPLEMENTAL
SECURITY INCOME FOR THE AGED,
BLIND, AND DISABLED
Subpart N—[Amended]
16. The authority citation for subpart
N of part 416 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).
17. Amend § 416.1401 by adding the
definitions for ‘‘Preponderance of the
evidence’’ and ‘‘Substantial evidence’’
in alphabetical order to read as follows:
■
§ 416.1401
Definitions.
*
*
*
*
*
Preponderance of the evidence means
such relevant evidence that as a whole
shows that the existence of the fact to
be proven is more likely than not.
*
*
*
*
*
Substantial evidence means such
relevant evidence as a reasonable mind
might accept as adequate to support a
conclusion.
*
*
*
*
*
18. Amend § 416.1402 by revising the
second sentence and adding a new
sentence before the existing third
sentence in the introductory text to read
as follows:
■
§ 416.1402 Administrative actions that are
initial determinations.
* * * We will base our initial
determination on the preponderance of
the evidence. We will state the
important facts and give the reasons for
our conclusions in the initial
determination. * * *
*
*
*
*
*
19. Amend § 416.1417 by revising the
second sentence of paragraph (b) to read
as follows:
■
§ 416.1417 Disability hearing—disability
hearing officer’s reconsidered
determination.
*
§ 408.1002 What is an initial
determination?
PO 00000
15. Amend § 408.1020 by revising the
second sentence to read as follows:
*
*
*
*
(b) * * * The disability hearing
officer must base the reconsidered
determination on the preponderance of
the evidence offered at the disability
E:\FR\FM\18DER1.SGM
18DER1
Federal Register / Vol. 73, No. 244 / Thursday, December 18, 2008 / Rules and Regulations
hearing or otherwise included in your
case file.
*
*
*
*
*
■ 20. Revise § 416.1420 to read as
follows:
§ 416.1420
Reconsidered determination.
After you or another person requests
a reconsideration, we will review the
evidence we considered in making the
initial determination and any other
evidence we receive. We will make our
determination based on the
preponderance of the evidence. The
person who makes the reconsidered
determination will have had no prior
involvement with the initial
determination.
■ 21. Amend § 416.1441 by revising the
second sentence of paragraph (a) to read
as follows:
§ 416.1441
Prehearing case review.
(a) * * * That component will decide
whether it should revise the
determination based on the
preponderance of the evidence. * * *
*
*
*
*
*
■ 22. Amend § 416.1442 by revising the
second sentence of paragraph (a) to read
as follows:
§ 416.1442 Prehearing proceedings and
decisions by attorney advisors.
(a) * * * If after the completion of
these proceedings we can make a
decision that is wholly favorable to you
and all other parties based on the
preponderance of the evidence, an
attorney advisor, instead of an
administrative law judge, may issue the
decision. * * *
*
*
*
*
*
■ 23. Amend § 416.1448 by revising the
first sentence of paragraph (a) to read as
follows:
§ 416.1448 Deciding a case without an oral
hearing before an administrative law judge.
rwilkins on PROD1PC63 with RULES
(a) * * * If the evidence in the
hearing record supports a finding in
favor of you and all the parties on every
issue, the administrative law judge may
issue a hearing decision based on a
preponderance of the evidence without
holding an oral hearing. * * *
*
*
*
*
*
■ 24. Amend § 416.1453 by revising the
second sentence of paragraph (a), the
first sentence of paragraph (b), and the
first sentence of paragraph (d) to read as
follows:
§ 416.1453 The decision of an
administrative law judge.
(a) * * * The administrative law
judge must base the decision on the
preponderance of the evidence offered
VerDate Aug<31>2005
17:41 Dec 17, 2008
Jkt 217001
at the hearing or otherwise included in
the record. * * *
(b) * * * The administrative law
judge may enter a wholly favorable oral
decision based on the preponderance of
the evidence into the record of the
hearing proceedings. * * *
*
*
*
*
*
(d) * * * Although an administrative
law judge will usually make a decision,
the administrative law judge may send
the case to the Appeals Council with a
recommended decision based on a
preponderance of the evidence when
appropriate. * * *
25. Amend § 416.1479 by adding a
new third sentence to read as follows:
■
PART 422—ORGANIZATION AND
PROCEDURES
Subpart B—[Amended]
27. The authority citation for subpart
B of part 422 continues to read as
follows:
■
Authority: Secs. 205, 232, 702(a)(5), 1131,
and 1143 of the Social Security Act (42
U.S.C. 405, 432, 902(a)(5), 1320b–1, and
1320b–13), and sec. 7213(a)(1)(A) of Pub. L.
108–458.
28. Amend § 422.130 by revising the
first sentence of paragraph (c) to read as
follows:
■
§ 422.130
§ 416.1479
Decision of Appeals Council.
* * * If the Appeals Council issues
its own decision, it will base its
decision on the preponderance of the
evidence. * * *
26. Amend § 416.1484 by revising the
last sentence of paragraph (a), the
second sentence of paragraph (b)(3), and
the last sentence of paragraph (c) to read
as follows:
■
§ 416.1484 Appeals Council review of
administrative law judge decision in a case
remanded by a Federal court.
(a) * * * The Appeals Council will
either make a new, independent
decision based on the preponderance of
the evidence in the record that will be
the final decision of the Commissioner
after remand, or it will remand the case
to an administrative law judge for
further proceedings.
(b) * * *
(3) * * * If the Appeals Council
assumes jurisdiction, it will make a
new, independent decision based on the
preponderance of the evidence in the
entire record affirming, modifying, or
reversing the decision of the
administrative law judge, or it will
remand the case to an administrative
law judge for further proceedings,
including a new decision. * * *
(c) * * * After the Appeals Council
receives the briefs or other written
statements, or the time allowed (usually
30 days) for submitting them has
expired, the Appeals Council will either
issue a final decision of the
Commissioner based on the
preponderance of the evidence
affirming, modifying, or reversing the
decision of the administrative law
judge, or remand the case to an
administrative law judge for further
proceedings, including a new decision.
*
*
*
*
*
PO 00000
Frm 00099
Fmt 4700
Sfmt 4700
76945
Claim procedure.
*
*
*
*
*
(c) * * * In the case of an application
for benefits, the establishment of a
period of disability, a lump-sum death
payment, a recomputation of a primary
insurance amount, or entitlement to
hospital insurance benefits or
supplementary medical insurance
benefits, after obtaining the necessary
evidence, we will determine, based on
the preponderance of the evidence (see
§§ 404.901 and 416.1401 of this chapter)
as to the entitlement of the individual
claiming or for whom is claimed such
benefits, and will notify the applicant of
the determination and of his right to
appeal. * * *
Subpart C—[Amended]
29. The authority citation for subpart
C of part 422 continues to read as
follows:
■
Authority: Secs. 205, 221, and 702(a)(5) of
the Social Security Act (42 U.S.C. 405, 421,
and 902(a)(5)); 30 U.S.C. 923(b).
30. Revise the last sentence of
§ 422.203(c) to read as follows:
■
§ 422.203
Hearings.
*
*
*
*
*
(c) * * * The administrative law
judge, or an attorney advisor under
§§ 404.942 or 416.1442 of this chapter,
must base the hearing decision on the
preponderance of the evidence offered
at the hearing or otherwise included in
the record.
[FR Doc. E8–30056 Filed 12–17–08; 8:45 am]
BILLING CODE 4191–02–P
E:\FR\FM\18DER1.SGM
18DER1
Agencies
[Federal Register Volume 73, Number 244 (Thursday, December 18, 2008)]
[Rules and Regulations]
[Pages 76940-76945]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: E8-30056]
=======================================================================
-----------------------------------------------------------------------
SOCIAL SECURITY ADMINISTRATION
20 CFR Parts 404, 408, 416, and 422
[Docket No. SSA-2008-0005]
RIN 0960-AG75
Clarification of Evidentiary Standard for Determinations and
Decisions
AGENCY: Social Security Administration.
ACTION: Final Rules.
-----------------------------------------------------------------------
SUMMARY: We are amending our rules to clarify that we apply the
preponderance of the evidence standard when we make determinations and
decisions at all levels of our administrative review
[[Page 76941]]
process. These rules do not change our policy that the Appeals Council
applies the substantial evidence standard when it reviews a decision by
an administrative law judge (ALJ) to determine whether to grant a
request for review. We are also adding definitions of the terms
``substantial evidence'' and ``preponderance of the evidence'' for use
in applying these rules.
DATES: These final rules are effective on January 20, 2009.
FOR FURTHER INFORMATION CONTACT: Joshua Silverman, Office of
Regulations, Social Security Administration, 6401 Security Boulevard,
Baltimore, MD 21235-6401, (410) 594-2128, for information about these
rules. 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.
Explanation of Changes
Our Administrative Review Process
We currently decide claims for benefits using an administrative
review process that consists of four levels: Initial determination,
reconsideration, hearing before an ALJ, and Appeals Council review. See
20 CFR 404.900, 408.1000, and 416.1400. We make an initial
determination at the first level. If a person is dissatisfied with the
initial determination, he may request reconsideration.\1\ If a person
is dissatisfied with the reconsidered determination, he may request a
hearing before an ALJ.\2\ Finally, if a person is dissatisfied with the
ALJ's decision,\3\ he may request that the Appeals Council review that
decision. Once a person has completed these administrative steps and
received our final decision, the person may request judicial review of
the final decision in Federal district court.
---------------------------------------------------------------------------
\1\ For disability claims, there are ten States that are
participating in a ``prototype'' test under 20 CFR 404.906 and
416.1406. In these States, the second step for people who are
dissatisfied with their initial determinations in disability cases
is a hearing before an ALJ. The ten States are: Alabama, Alaska,
California (Los Angeles North and West Branches), Colorado,
Louisiana, Michigan, Missouri, New Hampshire, New York, and
Pennsylvania.
\2\ In some cases, attorney advisors in our Office of Disability
Adjudication and Review make wholly favorable decisions before an
ALJ hearing is conducted. 20 CFR 404.942 and 416.1442.
\3\ The words ``determination'' and ``decision'' are defined in
20 CFR 404.900 and 416.1400. At the initial and reconsideration
levels of the administrative review process, we issue
``determinations.'' At the ALJ hearing and Appeals Council levels,
we issue ``decisions.''
---------------------------------------------------------------------------
Each adjudicator reviewing a claim in the administrative process
makes an independent (or de novo) determination or decision based on
the evidence in the record.\4\ For example, an ALJ would not simply
review a State agency's initial and reconsideration disability
determinations to determine whether they were correct. Rather, the ALJ
would review the evidence in the record and make an independent
decision.
---------------------------------------------------------------------------
\4\ In some States, adjudicators must consider, and sometimes
adopt, certain findings made in prior disability adjudications under
acquiescence rulings (ARs) that we have issued to address circuit
court holdings. See AR 97-4(9), 62 FR 64038, available at: https://
www.socialsecurity.gov/OP_Home/rulings/ar/09/AR97-04-ar-09.html; AR
98-3(6), 63 FR 29770, available at: https://www.socialsecurity.gov/
OP_Home/rulings/ar/06/AR98-03-ar-06.html; AR 98-4(6), 63 FR 29771,
corrected at 63 FR 31266, available at: https://
www.socialsecurity.gov/OP_Home/rulings/ar/06/AR98-04-ar-06.html;
and AR 00-1(4), 65 FR 1936, available at: https://
www.socialsecurity.gov/OP_Home/rulings/ar/04/AR2000-01-ar-04.html.
---------------------------------------------------------------------------
In contrast, in deciding whether to grant a person's request for
Appeals Council review of an ALJ's decision, the Appeals Council first
considers the ALJ's decision and the evidence before the ALJ using the
substantial evidence standard of review, which we discuss below. If the
Appeals Council does not grant a request for review, the ALJ's decision
becomes our final decision.\5\ If the Appeals Council grants the
request for review, it will usually either remand the case to an ALJ
for additional proceedings and a new decision or issue its own
decision.
---------------------------------------------------------------------------
\5\ The Appeals Council may also dismiss the request for review
either with or without first granting the request. Additionally, the
Appeals Council may review a case on its own motion without an
individual asking it to do so. See 20 CFR 404.967, 404.969, 404.984,
416.1467, 416.1469, and 416.1484. See also 20 CFR 408.1050, which
incorporates the relevant provisions of 20 CFR 416.1467-416.1482 by
reference.
---------------------------------------------------------------------------
Our Standard of Proof
A claimant has the burden of proving his claim with us.
Adjudicators at each level of the administrative review process,
including the Appeals Council, consider whether a claimant has proven
his claim using an evidentiary standard called the ``preponderance of
the evidence'' when they make a determination or decision. We define
preponderance of the evidence as ``such relevant evidence that as a
whole shows that the existence of the fact to be proven is more likely
than not.'' 20 CFR 405.5.
The Social Security Act does not specify the standard of proof to
use when we make a determination or decision. Courts and scholars have
long recognized that the preponderance of the evidence standard is the
traditional standard of proof in a civil or an administrative
adjudicatory proceeding.\6\ Our longstanding policy has been that the
preponderance of the evidence standard applies to determinations or
decisions on claims under parts 404, 408, and 416.\7\ Prior to these
final rules, we did not have regulations in parts 404, 408, and 416
that clearly stated that we use the preponderance of the evidence
standard when we make a determination or decision. The absence of
explicit language in these parts explaining the standards we use at
each level of the administrative process caused some confusion about
the applicable standard. By issuing these final rules, we intend to
resolve any confusion about the applicable standard.
---------------------------------------------------------------------------
\6\ Federal courts apply a substantial evidence standard when
they review our final decisions. 42 U.S.C. 405(g), 1009(b), and
1383(c)(3).
\7\ A claimant must give us ``convincing'' evidence to prove
that he meets certain requirements for eligibility, as described in
subpart H of parts 404 and 416. Because these final rules address
the appropriate standard of proof to be applied in making
determinations or decisions rather than the burden of proving
eligibility for benefits, these final rules are not applicable to
subpart H of parts 404 and 416.
---------------------------------------------------------------------------
Our Standard of Review at the Appeals Council
When the Appeals Council considers whether to grant a request for
review of an ALJ's decision, it does not use a preponderance of the
evidence standard. Instead, it considers, among other things, whether
the action, findings, or conclusions of the ALJ are supported by
substantial evidence.\8\ 20 CFR 404.970(a) and 416.1470(a). The
definition of substantial evidence in these final rules is ``such
relevant evidence as a reasonable mind might accept as adequate to
support a conclusion.'' The substantial evidence standard of review
gives deference to the findings of the ALJ rather than requiring a
decision based on a new evaluation of the evidence.\9\
---------------------------------------------------------------------------
\8\ The Appeals Council also reviews any new and material
evidence under 20 CFR 404.970(b) and 416.1470(b).
\9\ Our regulations also provide that the Associate Commissioner
for Disability Determinations or his delegate may use the
substantial evidence standard of review when reviewing a sample of
disability hearing officers' reconsideration determinations. 20 CFR
404.918 and 416.1418. In general, disability hearing officers make
reconsideration determinations in cases of beneficiaries who we have
determined are no longer disabled. See 20 CFR 404.914-404.918 and
416.1414-416.1418.
---------------------------------------------------------------------------
[[Page 76942]]
As stated earlier, the Appeals Council uses the substantial
evidence standard to decide whether to review an ALJ's decision. If it
grants review and then issues its own decision, the Appeals Council
uses the preponderance of the evidence standard when it issues its
decision.
Explanation of Changes
We are revising several regulation sections in parts 404, 408, 416,
and 422 to clarify that we use the preponderance of the evidence
standard of proof to adjudicate claims at all levels of the
administrative review process. We also are adding a definition of the
term ``preponderance of the evidence'' in 20 CFR 404.901, 408.1001, and
416.1401, and a definition of the term ``substantial evidence'' in 20
CFR 404.901 and 416.1401. These are the same definitions we currently
use in 20 CFR 405.5.
We are also making additional changes from the language proposed in
the NPRM. None of these changes alter the meaning of these sections.
First, we are revising several of the affected regulatory sections in
these final rules to put them in active voice and to use consistent
language. Second, we are making two changes to 20 CFR 422.203(c). We
are adding a reference to attorney advisor decisions under 20 CFR
404.942 and 416.1142 and deleting the phrase ``under applicable
provisions of the law and regulations and appropriate precedents.''
These changes make the language in section 20 CFR 422.203(c) consistent
with the language in final 20 CFR 404.953(a) and 416.1453(a), and they
acknowledge that, under certain circumstances, attorney advisors can
make decisions instead of an ALJ under 20 CFR 404.942 and 416.1442.
We believe these clarifications will improve the accuracy and
consistency of the decision-making process.
We have the authority to make these changes under 42 U.S.C. 405(a),
902(a)(5), 1010(a), and 1383(d)(1).
Public Comments
In the notice of proposed rulemaking published at 73 FR 33745 (June
13, 2008), we provided the public with a 60-day period in which to
comment on the proposed changes. That comment period ended on August
12, 2008. We received comments from four people. We carefully
considered each comment. Because some of the comments were long and
quite detailed, we have condensed, summarized, and paraphrased them in
the following discussions. However, we have tried to present all views
adequately and to address carefully all of the significant issues
raised by the commenters that are within the scope of the proposed
rules. We generally have not addressed comments that are outside the
scope of the rulemaking proceeding.
Comment: One commenter generally supported the proposed rules and
said that there should be only one evidentiary standard used by our
adjudicators at all levels of the adjudication process.
Response: We agree with the commenter that adjudicators at each
level of the administrative review process, including the Appeals
Council, should use the same evidentiary standard. These rules provide
that they will all use the preponderance of the evidence standard of
proof when they make determinations or decisions. As stated above, the
Appeals Council only uses the substantial evidence standard of review
when it considers whether to grant a request for review of an ALJ's
decision. Although it is unclear from the commenter's letter, to the
extent that the commenter suggested that the Appeals Council should
apply the preponderance of the evidence standard of proof when it
reviews an ALJ's decision, we are not adopting the comment. Our rules
governing the Appeals Council's use of the substantial evidence
standard to review ALJ decisions have worked well, and we do not
believe that there is any reason to change them.
Comment: Two commenters were concerned that the proposed changes
could create an ambiguity about who has the burden of proof. One of
these commenters also said that our determinations and decisions should
be made based on substantial evidence and that the burden of a party is
to provide proof by a preponderance of the evidence. Both commenters
expressed concern that the proposed changes could appear to shift the
burden of proof in disability cases to us by requiring that we base our
determinations and decisions on a preponderance of the evidence. One of
these commenters suggested that we add regulatory text to explain who
has the burden of proof at each of the five steps of the sequential
evaluation process that we use to decide whether a person is disabled.
See 20 CFR 404.1520 and 416.920.
Response: We are not adopting this comment. These final rules
concern the appropriate standard of proof, not who has the burden of
proof at any stage of our sequential evaluation process. Our current
regulations explain the burden of proof in disability claims.\10\ We
previously explained the concept of how the burden of proof, a term
traditionally associated with adversarial litigation, applies in the
context of our nonadversarial system. 68 FR 51153, 51154-51155 (Aug.
26, 2003). We do not believe that it is appropriate to make the changes
suggested by the commenters because these final rules do not change the
allocation of the burden of proof in our adjudications.
---------------------------------------------------------------------------
\10\ See 20 CFR 404.1512, 404.1560(c)(2), 404.1566(c), 416.912,
416.960(c)(2), and 416.966(c). A claimant has the burden of
providing proof of his disability under each of the first four steps
in the sequential evaluation process. In the fifth and final step of
the sequential evaluation process, we become responsible for
providing evidence that demonstrates that other work exists in
significant numbers in the national economy that the claimant can
perform after considering the claimant's residual functional
capacity, age, education, and work experience. However, a claimant
must persuade us that he is disabled at each step of the sequential
evaluation process. See Bowen v. Yuckert, 482 U.S. 137, 146 (1987).
---------------------------------------------------------------------------
Comment: One commenter said that our use of the word ``review'' in
several of the proposed sections was ambiguous. The commenter thought
that it was unclear whether we meant a review of the evidence or a
review of the determination or decision. The commenter suggested that
we use a phrase such as ``again look'' instead of ``review'' when we
refer to reviewing evidence.
Response: We are not adopting this comment. In many sections of our
rules, we use the word ``review'' to refer generally to a consideration
of evidence. With regard to the Appeals Council's review of a decision
or a dismissal, we use the word ``review'' as a term of art.\11\ We
believe that the plain meaning of the word is readily apparent in the
context of the sections of the regulations in which we use it, and we
are not aware that these longstanding usages have confused either
adjudicators or the public.
---------------------------------------------------------------------------
\11\ See, e.g., 20 CFR 404.967 and 416.1467.
---------------------------------------------------------------------------
Comment: One commenter suggested changes to our proposed language
for 20 CFR 404.979, 404.984, 416.1479, and 416.1484. Specifically, the
commenter suggested amending those sections to state that the Appeals
Council uses the substantial evidence standard when it remands a case
to an ALJ, and that the Appeals Council will remand a case it reviewed
to an ALJ for further proceedings unless the decision being appealed is
supported by substantial evidence.
Response: We are not adopting this comment because it is
inconsistent with our existing regulations, which provide that the
Appeals Council may grant a request for review and remand a case for
reasons other than a lack of substantial evidence to support a
decision. See 20
[[Page 76943]]
CFR 404.970 and 416.1470. The Appeals Council may also remand a case to
an ALJ pursuant to a Federal court's instructions without conducting
its own review. See 20 CFR 404.983 and 416.1483.
Comment: One commenter suggested that we change both of our
proposed definitions. He also suggested that we adopt a new term--
``substantial evidence standard of review''-- that would address when a
reviewing body may remand a decision based on an adjudicator's failure
to discuss evidence and that we amend 20 CFR 404.902 and 416.1492
accordingly.
Response: We are not adopting this comment. As we noted above, our
definitions of the terms ``preponderance of the evidence'' and
``substantial evidence'' are taken directly from our existing rule in
20 CFR 405.5. The definitions in that rule are based on accepted
definitions and are consistent with our longstanding usage. The
commenter's proposed additions to these definitions would not
appreciably clarify our rules, and some of the language the commenter
proposed could raise questions among the public and our adjudicators.
We also believe that our adjudicators and the public are familiar with
the concept of substantial evidence because our subregulatory
instructions have included a definition of ``substantial evidence'' for
approximately 37 years. See SSR 71-53c.
The commenter's other proposals are beyond the scope of this
rulemaking because they focus on how the Appeals Council or a Federal
court can determine whether a decision is supported by substantial
evidence. If we decide that it would be appropriate to adopt rules
along the lines proposed by the commenter, we would first follow the
Administrative Procedure Act's rulemaking procedures.
Regulatory Procedures
Executive Order 12866, as Amended
We have consulted with the Office of Management and Budget (OMB)
and determined that these rules do not meet the criteria for a
significant regulatory action under Executive Order 12866, as amended.
Thus, they were not subject to OMB review.
Regulatory Flexibility Act
We certify that these rules will not have a significant economic
impact on a substantial number of small entities as they affect
individuals only. Therefore, a regulatory flexibility analysis as
provided in the Regulatory Flexibility Act, as amended, is not
required.
Paperwork Reduction Act
These rules will impose no additional reporting or recordkeeping
requirements requiring OMB clearance.
(Catalog of Federal Domestic Assistance Program Nos. 96.001, Social
Security--Disability Insurance; 96.002, Social Security--Retirement
Insurance; 96.004, Social Security--Survivors Insurance; 96.006,
Supplemental Security Income)
List of Subjects
20 CFR Part 404
Administrative practice and procedure, Blind, Disability benefits,
Old-Age, Survivors, and Disability Insurance, Reporting and
recordkeeping requirements, Social Security.
20 CFR Part 408
Administrative practice and procedure, Aged, Reporting and
recordkeeping requirements, Social Security, Supplemental Security
Income (SSI), Veterans.
20 CFR Part 416
Administrative practice and procedure, Aged, Blind, Disability
benefits, Public assistance programs, Reporting and recordkeeping
requirements, Supplemental Security Income (SSI).
20 CFR Part 422
Administrative practice and procedure, Organization and functions
(Government agencies), Reporting and recordkeeping requirements, Social
Security.
Dated: December 12, 2008.
Michael J. Astrue,
Commissioner of Social Security.
0
For the reasons set forth in the preamble, we are amending subpart J of
part 404, subpart J of part 408, subpart N of part 416, and subparts B
and C of part 422 of chapter III of title 20 of the Code of Federal
Regulations 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. 404.901 by adding the definitions for ``Preponderance of
the evidence'' and ``Substantial evidence'' in alphabetical order to
read as follows:
Sec. 404.901 Definitions.
* * * * *
Preponderance of the evidence means such relevant evidence that as
a whole shows that the existence of the fact to be proven is more
likely than not.
* * * * *
Substantial evidence means such relevant evidence as a reasonable
mind might accept as adequate to support a conclusion.
* * * * *
0
3. Amend Sec. 404.902 by revising the second sentence and adding a new
sentence before the existing third sentence in the introductory text to
read as follows:
Sec. 404.902 Administrative actions that are initial determinations.
* * * We will base our initial determination on the preponderance
of the evidence. We will state the important facts and give the reasons
for our conclusions in the initial determination. * * *
* * * * *
0
4. Amend Sec. 404.917 by revising the second sentence of paragraph (b)
to read as follows:
Sec. 404.917 Disability hearing-disability hearing officer's
reconsidered determination.
* * * * *
(b) * * * The disability hearing officer must base the reconsidered
determination on the preponderance of the evidence offered at the
disability hearing or otherwise included in your case file.
* * * * *
0
5. Revise Sec. 404.920 to read as follows:
Sec. 404.920 Reconsidered determination.
After you or another person requests a reconsideration, we will
review the evidence we considered in making the initial determination
and any other evidence we receive. We will make our determination based
on the preponderance of the evidence.
0
6. Amend Sec. 404.941 by revising the second sentence of paragraph (a)
to read as follows:
Sec. 404.941 Prehearing case review.
(a) * * * That component will decide whether it should revise the
determination based on the preponderance of the evidence. * * *
* * * * *
[[Page 76944]]
0
7. Amend Sec. 404.942 by revising the second sentence of paragraph (a)
to read as follows:
Sec. 404.942 Prehearing proceedings and decisions by attorney
advisors.
(a) * * * If after the completion of these proceedings we can make
a decision that is wholly favorable to you and all other parties based
on the preponderance of the evidence, an attorney advisor, instead of
an administrative law judge, may issue the decision. * * *
* * * * *
0
8. Amend Sec. 404.948 by revising the first sentence of paragraph (a)
to read as follows:
Sec. 404.948 Deciding a case without an oral hearing before an
administrative law judge.
(a) * * * If the evidence in the hearing record supports a finding
in favor of you and all the parties on every issue, the administrative
law judge may issue a hearing decision based on a preponderance of the
evidence without holding an oral hearing. * * *
* * * * *
0
9. Amend Sec. 404.953 by revising the second sentence of paragraph
(a), the first sentence of paragraph (b), and the first sentence of
paragraph (c) to read as follows:
Sec. 404.953 The decision of an administrative law judge.
(a) * * * The administrative law judge must base the decision on
the preponderance of the evidence offered at the hearing or otherwise
included in the record. * * *
(b) * * * The administrative law judge may enter a wholly favorable
oral decision based on the preponderance of the evidence into the
record of the hearing proceedings. * * *
(c) * * * Although an administrative law judge will usually make a
decision, the administrative law judge may send the case to the Appeals
Council with a recommended decision based on a preponderance of the
evidence when appropriate. * * *
0
10. Amend Sec. 404.979 by adding a new third sentence to read as
follows:
Sec. 404.979 Decision of Appeals Council.
* * * If the Appeals Council issues its own decision, it will base
its decision on the preponderance of the evidence. * * *
0
11. Amend Sec. 404.984 by revising the last sentence of paragraph (a),
the second sentence of paragraph (b)(3), and the last sentence of
paragraph (c) to read as follows:
Sec. 404.984 Appeals Council review of administrative law judge
decision in a case remanded by a Federal court.
(a) * * * The Appeals Council will either make a new, independent
decision based on the preponderance of the evidence in the record that
will be the final decision of the Commissioner after remand, or it will
remand the case to an administrative law judge for further proceedings.
(b) * * *
(3) * * * If the Appeals Council assumes jurisdiction, it will make
a new, independent decision based on the preponderance of the evidence
in the entire record affirming, modifying, or reversing the decision of
the administrative law judge, or it will remand the case to an
administrative law judge for further proceedings, including a new
decision. * * *
(c) * * * After the Appeals Council receives the briefs or other
written statements, or the time allowed (usually 30 days) for
submitting them has expired, the Appeals Council will either issue a
final decision of the Commissioner based on the preponderance of the
evidence affirming, modifying, or reversing the decision of the
administrative law judge, or remand the case to an administrative law
judge for further proceedings, including a new decision.
* * * * *
PART 408--SPECIAL BENEFITS FOR CERTAIN WORLD WAR II VETERANS
Subpart J--[Amended]
0
12. The authority citation for subpart J of part 408 continues to read
as follows:
Authority: Secs. 702(a)(5) and 809 of the Social Security Act
(42 U.S.C. 902(a)(5) and 1009).
0
13. Amend Sec. 408.1001 by adding the definition for ``Preponderance
of the evidence'' in alphabetical order to read as follows:
Sec. 408.1001 Definitions.
* * * * *
Preponderance of the evidence means such relevant evidence that as
a whole shows that the existence of the fact to be proven is more
likely than not.
* * * * *
0
14. Amend Sec. 408.1002 by adding a new third sentence to read as
follows:
Sec. 408.1002 What is an initial determination?
* * * We will base our initial determination on the preponderance
of the evidence.
0
15. Amend Sec. 408.1020 by revising the second sentence to read as
follows:
Sec. 408.1020 How do we make our reconsidered determination?
* * * We will make our determination based on the preponderance of
the evidence in the record. * * *
PART 416--SUPPLEMENTAL SECURITY INCOME FOR THE AGED, BLIND, AND
DISABLED
Subpart N--[Amended]
0
16. The authority citation for subpart N of part 416 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
17. Amend Sec. 416.1401 by adding the definitions for ``Preponderance
of the evidence'' and ``Substantial evidence'' in alphabetical order to
read as follows:
Sec. 416.1401 Definitions.
* * * * *
Preponderance of the evidence means such relevant evidence that as
a whole shows that the existence of the fact to be proven is more
likely than not.
* * * * *
Substantial evidence means such relevant evidence as a reasonable
mind might accept as adequate to support a conclusion.
* * * * *
0
18. Amend Sec. 416.1402 by revising the second sentence and adding a
new sentence before the existing third sentence in the introductory
text to read as follows:
Sec. 416.1402 Administrative actions that are initial determinations.
* * * We will base our initial determination on the preponderance
of the evidence. We will state the important facts and give the reasons
for our conclusions in the initial determination. * * *
* * * * *
0
19. Amend Sec. 416.1417 by revising the second sentence of paragraph
(b) to read as follows:
Sec. 416.1417 Disability hearing--disability hearing officer's
reconsidered determination.
* * * * *
(b) * * * The disability hearing officer must base the reconsidered
determination on the preponderance of the evidence offered at the
disability
[[Page 76945]]
hearing or otherwise included in your case file.
* * * * *
0
20. Revise Sec. 416.1420 to read as follows:
Sec. 416.1420 Reconsidered determination.
After you or another person requests a reconsideration, we will
review the evidence we considered in making the initial determination
and any other evidence we receive. We will make our determination based
on the preponderance of the evidence. The person who makes the
reconsidered determination will have had no prior involvement with the
initial determination.r
0
21. Amend Sec. 416.1441 by revising the second sentence of paragraph
(a) to read as follows:
Sec. 416.1441 Prehearing case review.
(a) * * * That component will decide whether it should revise the
determination based on the preponderance of the evidence. * * *
* * * * *
0
22. Amend Sec. 416.1442 by revising the second sentence of paragraph
(a) to read as follows:
Sec. 416.1442 Prehearing proceedings and decisions by attorney
advisors.
(a) * * * If after the completion of these proceedings we can make
a decision that is wholly favorable to you and all other parties based
on the preponderance of the evidence, an attorney advisor, instead of
an administrative law judge, may issue the decision. * * *
* * * * *
0
23. Amend Sec. 416.1448 by revising the first sentence of paragraph
(a) to read as follows:
Sec. 416.1448 Deciding a case without an oral hearing before an
administrative law judge.
(a) * * * If the evidence in the hearing record supports a finding
in favor of you and all the parties on every issue, the administrative
law judge may issue a hearing decision based on a preponderance of the
evidence without holding an oral hearing. * * *
* * * * *
0
24. Amend Sec. 416.1453 by revising the second sentence of paragraph
(a), the first sentence of paragraph (b), and the first sentence of
paragraph (d) to read as follows:
Sec. 416.1453 The decision of an administrative law judge.
(a) * * * The administrative law judge must base the decision on
the preponderance of the evidence offered at the hearing or otherwise
included in the record. * * *
(b) * * * The administrative law judge may enter a wholly favorable
oral decision based on the preponderance of the evidence into the
record of the hearing proceedings. * * *
* * * * *
(d) * * * Although an administrative law judge will usually make a
decision, the administrative law judge may send the case to the Appeals
Council with a recommended decision based on a preponderance of the
evidence when appropriate. * * *
0
25. Amend Sec. 416.1479 by adding a new third sentence to read as
follows:
Sec. 416.1479 Decision of Appeals Council.
* * * If the Appeals Council issues its own decision, it will base
its decision on the preponderance of the evidence. * * *
0
26. Amend Sec. 416.1484 by revising the last sentence of paragraph
(a), the second sentence of paragraph (b)(3), and the last sentence of
paragraph (c) to read as follows:
Sec. 416.1484 Appeals Council review of administrative law judge
decision in a case remanded by a Federal court.
(a) * * * The Appeals Council will either make a new, independent
decision based on the preponderance of the evidence in the record that
will be the final decision of the Commissioner after remand, or it will
remand the case to an administrative law judge for further proceedings.
(b) * * *
(3) * * * If the Appeals Council assumes jurisdiction, it will make
a new, independent decision based on the preponderance of the evidence
in the entire record affirming, modifying, or reversing the decision of
the administrative law judge, or it will remand the case to an
administrative law judge for further proceedings, including a new
decision. * * *
(c) * * * After the Appeals Council receives the briefs or other
written statements, or the time allowed (usually 30 days) for
submitting them has expired, the Appeals Council will either issue a
final decision of the Commissioner based on the preponderance of the
evidence affirming, modifying, or reversing the decision of the
administrative law judge, or remand the case to an administrative law
judge for further proceedings, including a new decision.
* * * * *
PART 422--ORGANIZATION AND PROCEDURES
Subpart B--[Amended]
0
27. The authority citation for subpart B of part 422 continues to read
as follows:
Authority: Secs. 205, 232, 702(a)(5), 1131, and 1143 of the
Social Security Act (42 U.S.C. 405, 432, 902(a)(5), 1320b-1, and
1320b-13), and sec. 7213(a)(1)(A) of Pub. L. 108-458.
0
28. Amend Sec. 422.130 by revising the first sentence of paragraph (c)
to read as follows:
Sec. 422.130 Claim procedure.
* * * * *
(c) * * * In the case of an application for benefits, the
establishment of a period of disability, a lump-sum death payment, a
recomputation of a primary insurance amount, or entitlement to hospital
insurance benefits or supplementary medical insurance benefits, after
obtaining the necessary evidence, we will determine, based on the
preponderance of the evidence (see Sec. Sec. 404.901 and 416.1401 of
this chapter) as to the entitlement of the individual claiming or for
whom is claimed such benefits, and will notify the applicant of the
determination and of his right to appeal. * * *
Subpart C--[Amended]
0
29. The authority citation for subpart C of part 422 continues to read
as follows:
Authority: Secs. 205, 221, and 702(a)(5) of the Social Security
Act (42 U.S.C. 405, 421, and 902(a)(5)); 30 U.S.C. 923(b).
0
30. Revise the last sentence of Sec. 422.203(c) to read as follows:
Sec. 422.203 Hearings.
* * * * *
(c) * * * The administrative law judge, or an attorney advisor
under Sec. Sec. 404.942 or 416.1442 of this chapter, must base the
hearing decision on the preponderance of the evidence offered at the
hearing or otherwise included in the record.
[FR Doc. E8-30056 Filed 12-17-08; 8:45 am]
BILLING CODE 4191-02-P