Revisions to Direct Fee Payment Rules, 395-400 [2014-30921]
Download as PDF
395
Rules and Regulations
Federal Register
Vol. 80, No. 3
Tuesday, January 6, 2015
This section of the FEDERAL REGISTER
contains regulatory documents having general
applicability and legal effect, most of which
are keyed to and codified in the Code of
Federal Regulations, which is published under
50 titles pursuant to 44 U.S.C. 1510.
The Code of Federal Regulations is sold by
the Superintendent of Documents. Prices of
new books are listed in the first FEDERAL
REGISTER issue of each week.
SOCIAL SECURITY ADMINISTRATION
20 CFR Parts 404 and 416
[Docket No. SSA–2010–0025]
RIN 0960–AH21
Revisions to Direct Fee Payment Rules
Social Security Administration.
Final rules.
AGENCY:
ACTION:
We are adopting, with two
revisions, our interim final rules that
implemented amendments to the Social
Security Act (Act) made by the Social
Security Disability Applicants’ Access
to Professional Representation Act of
2010 (PRA). The interim final rules
made permanent the direct fee payment
rules for eligible non-attorney
representatives under titles II and XVI of
the Act and for attorney representatives
under title XVI of the Act. They also
revised some of our eligibility policies
for non-attorney representatives under
titles II and XVI of the Act. Based on
public comment and subsequent
inquiries, we are revising our rules to
clarify that an eligible non-attorney
representative’s liability insurance
policy must include malpractice
coverage. We are also reaffirming that a
business entity legally permitted to
provide the required insurance in the
States in which the non-attorney
representative conducts business must
underwrite the policies.
DATES: These rules are effective
February 5, 2015.
FOR FURTHER INFORMATION CONTACT: Eric
Ice, Office of Income Security Programs,
Social Security Administration, 6401
Security Boulevard, Baltimore, MD
21235–6401, (410) 966–3233. 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.
tkelley on DSK3SPTVN1PROD with RULES
SUMMARY:
VerDate Sep<11>2014
16:17 Jan 05, 2015
Jkt 235001
SUPPLEMENTARY INFORMATION:
Background
We published the interim final rules
‘‘Revisions to Direct Fee Payment
Rules’’ on July 28, 2011 (76 FR 45184),
and the rules became effective on
August 29, 2011.1 In the preamble to the
interim final rules, we explained how
we would implement the revisions
made to the Act by the PRA.2
The PRA established five
requirements that non-attorney
representatives must meet to be eligible
for direct fee payment. A representative
must:
(1) Have a bachelor’s degree from an
accredited institution of higher
education or have been determined by
us to have equivalent qualifications
derived from training and work
experience;
(2) Pass an examination that we write
and administer, which tests knowledge
of the relevant provisions of the Act and
the most recent developments in Social
Security Administration (SSA) and
court decisions affecting titles II and
XVI of the Act;
(3) Secure professional liability
insurance, or equivalent insurance,
which we determine to be adequate to
protect claimants in the event of
malpractice by the representative;
(4) Undergo a criminal background
check to ensure the representative’s
fitness to practice before us; and
(5) Demonstrate ongoing completion
of qualified courses of continuing
education, including education
regarding ethics and professional
conduct, which are designed to enhance
professional knowledge in matters
related to entitlement to, or eligibility
for, benefits based on disability under
titles II and XVI of the Act. The
continuing education courses, and the
instructors providing the education
courses, must meet our prescribed
standards.
Revision to and Clarification of the
Liability Insurance Coverage
Requirement
To fulfill the third requirement
described above, the interim final rules
required an eligible non-attorney
representative to provide proof of and
maintain continuous liability insurance
FR 45184.
Law 111–142, as codified at 42 U.S.C.
406(e).
coverage in an amount we prescribe (20
CFR 404.1717(a)(6) and 416.1517(a)(6)).
We explained in the preamble that we
would accept either business liability
and professional liability insurance to
meet this requirement.3 In response to a
comment, we are clarifying in the final
rule that eligible non-attorney
representatives must provide proof of
and maintain continuous liability
insurance that includes coverage for
malpractice claims against the
representative in an amount we
prescribe.
We are also clarifying our requirement
that insurance policies be underwritten
by a business entity that is legally
permitted to provide the insurance we
require in the States in which the nonattorney representative conducts
business. When we first established the
demonstration project, we required that
insurance policies be underwritten by
firms that are licensed to provide
insurance in the States where the
individuals practice. On August 16,
2007, we published a Federal Register
notice 4 explaining our decision that the
insurance requirement would be met if
the representative’s insurance policy
was underwritten by a business entity
that is legally permitted to provide
professional liability insurance in the
States in which the representative
conducts business. After we published
our interim final rules on July 28, 2011,
some representatives asked us whether
we were continuing the August 2007
policy or whether we were returning to
the original requirement that the
insurance policies be underwritten by
firms that are licensed to provide
insurance in the States where the
individual practices. We did not intend
to change the requirement we explained
in August 2007, and therefore clarified
final sections 404.1717(a)(6) and
416.1517(a)(6) to make this point
clearer.
Other Changes
We also made minor changes to
correct punctuation and wording to the
following sections:
• Corrected final sections 404.903(z)
and 416.1403(a)(24) by deleting ‘‘and’’
after the semicolon.
• Corrected final sections 404.903(aa)
and 416.1403(a)(25) by deleting the
1 76
2 Public
PO 00000
Frm 00001
Fmt 4700
Sfmt 4700
3 76
4 72
E:\FR\FM\06JAR1.SGM
FR 45184, 45187–45188.
FR 46121.
06JAR1
396
Federal Register / Vol. 80, No. 3 / Tuesday, January 6, 2015 / Rules and Regulations
period and adding a semicolon and the
word ‘‘and.’’
• Corrected final sections
404.1717(d)(1)(ii) and 416.1517(d)(1)(ii)
by adding a semicolon after the word
‘‘section.’’
• Corrected final section
416.1517(f)(1) to read ‘‘. . . paragraphs
(a)(1), (a)(2), (a)(3), or (a)(5) of this
section’’ to correspond to the text in 20
CFR 404.1717(f)(1).
Public Comments
The 60-day public comment period
closed on September 26, 2011. We
received comments from three
individuals and two organizations (the
National Association of Disability
Representatives (NADR) and the
National Organization of Social Security
Claimants’ Representatives (NOSSCR).5
We carefully considered the comments.
We have condensed, summarized, and
paraphrased some of the comments due
to their length. We tried to summarize
the commenters’ views accurately and
respond to the significant issues raised
by the commenters that were within the
scope of these rules.
tkelley on DSK3SPTVN1PROD with RULES
Education and Experience
The Social Security Protection Act of
2004 (SSPA) included a requirement
that we determine whether a nonattorney representative has ‘‘equivalent
qualifications derived from training and
work experience’’ if the representative
does not have ‘‘a bachelor’s degree from
an accredited institution of higher
education.’’ 6 In 2005, we published a
notice in the Federal Register in which
we explained that we would use a
formula that balanced the applicant’s
years of education and his or her
relevant professional experience when
we determined whether an applicant
met the ‘‘equivalent qualifications’’
requirement.7 In the 5 years that
followed, we found the balancing
formula difficult to administer and
revised this requirement in the interim
final rules.8 As we explained in the
preamble to the interim final rules, we
required applicants to demonstrate that
they have either a bachelor’s degree
from an accredited institution of higher
learning or at least 4 years of relevant
professional experience and either a
high school diploma or GED certificate.9
Comment: We received a comment
from NADR indicating that it concurred
that relevant professional experience is
5 The comments are available for public viewing
at www.regulations.gov under docket ‘‘SSA–2010–
0025.’’
6 Public Law 108–203, section 303(b)(1) .
7 70 FR 2447, 2448–49.
8 42 U.S.C. 406(e)(2)(A).
9 76 FR 45184, 45186, 45187.
VerDate Sep<11>2014
16:17 Jan 05, 2015
Jkt 235001
essential for representatives who have
not completed a bachelor’s degree.
However, NADR noted that the SSPA
demonstration project included a
formula that balanced undergraduate
education and work experience. NADR
encouraged us to allow for some
flexibility in evaluating relevant work
experience for individuals who have
received credit for undergraduate course
work, but who have not earned a
bachelor’s degree.
Response: It is not practicable for us
to evaluate relevant work experience for
individuals who have received credit for
undergraduate course work but who
have not earned a bachelor’s degree. As
we stated above and in the preamble to
the interim final rule, we found the
balancing formula that considered
various combinations of education and
work experience difficult to administer
and we therefore streamlined the
process and simplified our
administration of this requirement. We
believe requiring a person without a
bachelor’s degree to have at least 4 years
of relevant professional experience is
appropriate because a bachelor’s degree
generally requires 4 years of study. We
believe this requirement appropriately
ensures that the representatives possess
the qualifications called for in the Act.
Comment: NADR asked us to clarify
what constitutes ‘‘relevant work
experience.’’ NADR was concerned that
applicants might lose their application
fee because we will now evaluate their
education or equivalent qualifications
after they pay the application fee and
pass the examination.
Response: In the preamble to the
interim final rules, we stated that
We will continue to consider relevant
professional experience to be work through
which the applicant demonstrates familiarity
with medical reports and the ability to
describe and assess mental or physical
limitations. As in the past, an applicant may
gain this kind of experience in fields such as
teaching, counseling or guidance, social
work, personnel management, public
employment service, nursing, or health care
professions. We will also continue to
consider relevant professional experience to
include work involving claims for benefits
under title II or XVI of the Act.10
We believe that this description
provides sufficient detail for applicants
to determine if their prior experience
qualifies as relevant work experience. It
would not be feasible for us, and
potentially limiting for applicants, if we
attempted to include an exhaustive list
of all qualifying experience in our
regulations. Given the changing job
market and the wide variety of work
10 76
PO 00000
FR 45184, 45187.
Frm 00002
Fmt 4700
experience that may qualify as ‘‘relevant
professional experience,’’ any list we
could develop would necessarily be
under-inclusive. Accordingly, we will
continue to determine on a case-by-case
basis whether an applicant has relevant
professional experience, rather than
attempting to include in our regulations
a list of jobs that would qualify.
Comment: One individual asked how
we will determine equivalent
qualifications derived from training and
work experience when a non-attorney
representative is self-employed and has
begun, but has not yet completed, a
bachelor’s degree. This commenter also
asked what documentation we would
request in this circumstance to show the
non-attorney representative has 4 years
of relevant professional experience.
Response: A self-employed nonattorney representative who does not
have a bachelor’s degree must have at
least 4 years of relevant professional
experience and either a high school
diploma or GED certificate. This
professional experience may be from
relevant self-employment work. In this
situation, we may require copies of the
representative’s tax returns and a
description of job duties that would
enable us to evaluate the applicant’s
relevant professional experience.
Comment: One individual asked how
we will consider a paralegal certificate.
Response: If a non-attorney
representative has a high school
diploma or GED certificate and a
paralegal certificate but not a bachelor’s
degree, he or she must have 4 years of
relevant professional experience, as
described above.
Written Examination
Comment: NADR suggested that we
provide sample test materials. NOSSCR
suggested that we make actual questions
from past examinations available.
NOSSCR asserted that without these
materials there was no way for the
public to assess whether our
examination met the statutory
requirements of testing a
representative’s knowledge of the
relevant provisions of the Act and the
most recent developments in SSA and
court decisions affecting titles II and
XVI of the Act.11
Response: We provide several sample
examination questions for the public to
view. They are currently accessible
through the Direct Payment to Eligible
Non-Attorney Representatives Web page
at https://www.ssa.gov/representation/
nonattyrep.htm by selecting the link to
the contractor’s Web site.
11 42
Sfmt 4700
E:\FR\FM\06JAR1.SGM
U.S.C. 406(e)(2)(B).
06JAR1
tkelley on DSK3SPTVN1PROD with RULES
Federal Register / Vol. 80, No. 3 / Tuesday, January 6, 2015 / Rules and Regulations
However, we do not plan to make any
of our actual tests available to the
public. We have taken a number of
measures to ensure the validity of the
examination and to make sure that it
tests knowledge of the relevant
provisions of the Act and the most
recent developments in agency and
court decisions affecting title II and title
XVI of the Act. Our employees,
including some of our administrative
law judges and other subject matter
experts, develop the scope and content
of the examination questions to ensure
that our test is comprehensive. The
contractor that proctors the examination
has in-depth knowledge in testing
services, including test research and
development; test validation; test
scoring; test logistics and
administration; statistical analysis; and
the design, development, and
administration of assessment centers
and performance examinations. We are
confident these measures ensure that
our test complies with the statutory
requirements cited by the commenter.
Comment: NADR acknowledged our
current budgetary constraints, but
suggested that we administer the
examination electronically using
computers in secure locations, such as
in our field or hearing offices, when
such technological improvements and
enhancements become available. The
commenter believed that this approach
would allow us to offer the
examinations at least twice a year in
more locations.
Response: We are not adopting these
suggestions at this time. As the
commenter recognized, we currently do
not have separate facilities at field and
hearing offices or designated computer
equipment to administer examinations,
nor do we have funds available to adopt
this comment. We are also concerned
that proctoring examinations at field
and hearing offices could disrupt our
service to the public. However, we may
consider offering additional
examinations if demand warrants, and
we have the resources available to do so.
Comment: NADR wanted us to raise
the minimum passing score from 70 to
75 because we discontinued the
requirement that an applicant show he
or she has represented at least five
claimants within a 24-month period.
Response: We are not adopting this
suggestion. We continue to believe that
a representative who attains a score of
at least 70 has demonstrated that he or
she has sufficient knowledge of the Act,
our regulations, and related court
decisions to meet the statutory testing
requirement.
VerDate Sep<11>2014
16:17 Jan 05, 2015
Jkt 235001
Comment: NOSSCR wanted us to
assess advocacy skills in the
examination.
Response: We are not adopting this
suggestion. The Act does not require
that we assess a representative’s
advocacy skills and we believe the
current examination and other criteria
are sufficient measures of a non-attorney
representative’s knowledge.
Liability Insurance
Comment: NADR asked us to require
non-attorney representatives to ask their
insurance companies to notify us when
the non-attorney representative modifies
or terminates his or her insurance
coverage.
Response: We are not adopting this
suggestion. Implementing this proposal
could result in an additional workload
for us to follow up with insurance
companies and to analyze more
correspondence than necessary. It
would be unnecessary and would
impose a significant burden on our
scarce administrative resources to
review these policies every time there is
a slight modification. We believe the
representative should remain
responsible for providing us with proper
proof of current liability insurance
coverage.
Comment: NOSSCR asserted that our
rules allowing non-attorney
representatives to maintain business
liability insurance was not consistent
with the Act’s requirement that nonattorney representatives have
‘‘professional liability insurance, or
equivalent insurance, which the
Commissioner has determined to be
adequate to protect claimants in the
event of malpractice by the
representative.’’ 12 NOSSCR asserted
that most business liability insurance
contracts do not include errors and
omissions coverage for malpractice and
are therefore not equivalent to
professional liability insurance
coverage. NOSSCR asked us to revise
our rules to require eligible non-attorney
representatives to maintain only
professional liability insurance
contracts that include malpractice
coverage.
Response: We agree with NOSSCR
that our rules should specify that all
liability insurance policies must include
malpractice coverage and that our
current regulations do not clearly state
this requirement. Therefore, we are
revising final sections 404.1717(a)(6)
and 416.1517(a)(6) to require that each
eligible non-attorney representative
provide proof of and maintain
continuous liability insurance that
12 42
PO 00000
U.S.C. 406(e)(2)(C).
Frm 00003
Fmt 4700
includes coverage for malpractice
claims against the representative and be
in an amount we prescribe.
Criminal Background Check
Comment: NADR asked which types
of information within a criminal
background check could disqualify a
non-attorney representative from being
eligible to receive direct fee payment.
Response: We explained in sections
20 CFR 404.1717(a) and 416.1517(a) of
the interim final rules that
A non-attorney representative is
eligible to receive direct payment of his
or her fee out of your past due benefits
if he or she:
(4) Passes our criminal background
investigation (including checks of our
administrative records), and attests
under penalty of perjury that he or she:
(i) Has not been suspended or
disqualified from practice before us and
is not suspended or disbarred from the
practice of law in any jurisdiction;
(ii) Has not had a judgment or lien
assessed against him or her by a civil
court for malpractice or fraud;
(iii) Has not had a felony conviction;
and
(iv) Has not misrepresented
information provided on his or her
application or supporting materials for
the application.
We will reject the application if the
applicant fails to meet any of these
criteria. In addition, we list the factors
we consider under this requirement at
the Direct Payment to Eligible NonAttorney Representatives Web page
https://www.ssa.gov/representation/
nonattyrep.htm and selecting the link to
the contractor’s Web site. As we note on
that Web site, we will also reject an
application if the applicant fails to pass
our administrative records check or fails
to provide documentation requested by
the contractor to perform the criminal
background investigation.
Continuing Education
The SSPA included a requirement
that eligible non-attorney
representatives demonstrate ongoing
completion of qualified courses of
continuing education. In 2005, we
published a notice in the Federal
Register under which we required the
non-attorney representative to complete
certain hours of continuing education
requirements during certain time
periods, depending on how long the
representative participated in the
demonstration project and whether the
representative was a course instructor.13
We found that framework unnecessarily
complex and burdensome to administer.
13 See
Sfmt 4700
397
E:\FR\FM\06JAR1.SGM
70 FR 41250.
06JAR1
tkelley on DSK3SPTVN1PROD with RULES
398
Federal Register / Vol. 80, No. 3 / Tuesday, January 6, 2015 / Rules and Regulations
As a result, in sections 404.1717(a)(7)
and 416.1517(a)(7) of the interim final
rules, we required the non-attorney
representative to complete and provide
proof that he or she has completed all
continuing education courses that we
prescribe by the deadline we prescribe
in order to meet the PRA’s continuing
education requirement.
Comment: NADR disagreed with our
decision to end our prior framework of
balancing the continuing education
requirement with the representative’s
length of participation in the
demonstration project.
Response: We do not agree with this
comment. The framework we set out in
the 2005 Federal Register notice was
confusing to many representatives and
unnecessarily complex and burdensome
for us to administer. As a result, a
number of representatives had difficulty
understanding our requirements and
contacted us for guidance throughout
the reporting period. We anticipate that
the streamlined and uniform approach
that we established in the interim final
rules and are making final in these rules
will benefit representatives.
Comment: NADR suggested that the
educational opportunities that will
satisfy the continuing education
requirement should be widely available.
Response: We agree that the courses,
whether our own or from vendors,
should be widely available. We plan to
prescribe courses that will satisfy the
continuing education requirement.
These courses may include a variety of
electronic presentations. We will inform
eligible non-attorney representatives of
the deadline for completing the courses,
and how they should report to us that
they have completed the courses
through alternate methods, e.g. through
our Web site: https://
www.socialsecurity.gov/representation.
Comment: NADR suggested that we
create a process through which we
would pre-approve vendor courses if the
vendor supplied us with certain
information. The commenter asked us to
provide written approval of these
courses so that the vendors can state in
marketing materials that the courses
meet our criteria.
Response: It would be
administratively burdensome to preapprove all potential courses that meet
our standards for satisfying the statutory
requirement for continuing education.14
We will identify either our own courses
or general types of courses and will
provide sufficient information so that
the representative can individually
identify vendors’ courses that meet our
standards and satisfy this requirement.
14 42
U.S.C. 406(e)(2)(E).
VerDate Sep<11>2014
16:17 Jan 05, 2015
We will identify these courses through
alternate methods, e.g. through our Web
site: https://www.socialsecurity.gov/
representation.
Comment: NADR asked us to include
links on our Web site to vendors that
have approved courses.
Response: We will include links on
our Web site or our contractor’s Web
site to our own courses. As noted above,
we will also provide sufficient
information to allow representatives to
identify vendors’ courses that meet our
requirements.
Comment: NADR suggested that we
require non-attorney representatives to
keep proof of course attendance for up
to 3 years so we could conduct audits
of attendance.
Response: We are not adopting this
suggestion because we revised this
criterion to make it less complex and
less burdensome.
Representational Experience
As we discussed in the preamble to
the interim final rule, under the
procedures we followed for the
demonstration project, we required a
non-attorney representative to show that
he or she had specific minimum
representational experience.15 We
required a non-attorney representative
to show that he or she represented at
least five claimants before us within a
24-month period within the 60 months
before the month in which the applicant
filed the application. We eliminated this
requirement in the interim final rules
because we found it complicated the
application process without adding
significant benefit.
Comment: NOSSCR disagreed with
this decision and asked us to add that
at least two of the five required cases
take place at the hearing level.
Response: In our experience
administering the demonstration
project, we found that passing the
written examination is a better
barometer of a representative’s
knowledge and skills than the
representational experience
requirement. The representational
requirement is not one of the statutory
prerequisites to the direct payment of
fees to non-attorney representatives and,
therefore, we have decided to exercise
our discretion not to include it in our
current process.
Protest Procedures
Both the SSPA and the PRA require
that a non-attorney representative meet
the statutory requirements before we
determine that he or she is eligible to
receive direct fee payment. Once we
15 76
Jkt 235001
PO 00000
FR 45184, 45189.
Frm 00004
Fmt 4700
determine that a non-attorney
representative is eligible to receive
direct fee payment, he or she must
continue to meet all of the requirements.
The Federal Register notice we
published to explain the demonstration
project set out protest procedures that
we followed for that project. In the
interim final rules, we also included
rules that explained how we would
handle protests when we determine that
a non-attorney representative is not
eligible to receive direct fee payment.
We explained that the protest
procedures in the interim final rules
were easier to understand, follow, and
administer than the procedures we
followed under the demonstration
project.
Comment: NADR asked us to state
that we would refund an applicant’s
application fee for failing to arrive for an
examination due to weather or travel
disruptions because they are
‘‘circumstances beyond an applicant’s
control.’’
Response: The interim final rules
provided we would refund the
application fee if ‘‘[c]ircumstances
beyond the applicant’s control that
could not have been reasonably
anticipated and planned for prevent an
applicant from taking a scheduled
examination.’’ 16 We believe it is
inappropriate to include in our
regulations the examples the commenter
cited. In our experience, we have found
that including examples in our
regulations inappropriately limits the
application of the rule to the specific
examples cited in a manner that we do
not intend. In addition, it is unclear that
all weather or travel disruptions would
be both beyond the applicant’s control
and constitute circumstances that the
applicant could not have reasonably
anticipated and planned for, as the
regulation requires. If an applicant
requests a refund because he or she did
not take the examination, we will
consider the reasons presented and
make a decision based on the facts of
each individual case. The applicant
retains the responsibility to submit
documentation to support his or her
request.
Comment: One individual and one
organization wanted us to give nonattorney representatives more than 10
calendar days to file a protest. NADR
wanted us to give 10 business days to
file a protest, in addition to 5 days for
mailing. NADR also wanted us to allow
a representative to file a request for an
extension of time to protest when
extenuating circumstances existed. The
individual wanted us to give
16 20
Sfmt 4700
E:\FR\FM\06JAR1.SGM
CFR 404.1717(c)(1)(ii) and 416.1517(c)(1)(ii).
06JAR1
tkelley on DSK3SPTVN1PROD with RULES
Federal Register / Vol. 80, No. 3 / Tuesday, January 6, 2015 / Rules and Regulations
representatives at least 15 days to file a
protest, or, ideally, to provide 30 days
to protest, as we do in our sanctions
procedures.
Response: The definition of the
phrase ‘‘Date we notify him or her’’ in
sections 404.1703 and 416.1503 of the
interim final rules makes it clear that we
begin counting the 10 calendar days to
file a protest 5 days after the date on the
notice. We add 5 days to account for
mail time, although a representative
may show us that he or she received it
after this 5-day period. Therefore, we do
give representatives 15 days to protest
our finding that he or she is ineligible
to receive direct fee payment for the
reasons set out in sections 404.1717(d)
and 416.1517(d) of the rules, as the
second commenter suggested.
We disagree with the comment to
revise the deadline in our protest rules
from 10 calendar days to 10 business
days for two reasons. The majority of
our other rules use calendar days
instead of business days as a basis for
calculating action deadlines.17 Further,
our rules clearly explain how to
calculate a deadline that falls on a nonwork day.18
We also disagree with the comment to
allow for an extension of time to file a
protest based on extenuating
circumstances. We inform non-attorney
representatives who apply for direct fee
payment eligibility about our
requirements and timeframes in the
application materials, on our Web site
or our contractor’s Web site, and in
other correspondence, we send to them.
When there is evidence that a
representative may not meet our
eligibility prerequisites, we will request
the missing documentation from him or
her. It is the representative’s
responsibility to respond to our requests
in a timely manner.
Finally, we disagree with the
comment to extend the time in which to
protest our finding that a non-attorney
representative is ineligible to receive
direct fee payment from 10 to 30
calendar days, to match our sanctions
rules. An adverse decision from a
sanctions proceeding results in the
representative being unable to practice
before us. In contrast, a non-attorney
representative may continue to practice
before us and be paid for his or her
services directly by the claimant even if
we determine he or she is ineligible to
receive direct fee payment from us. For
that reason, a shorter time frame to file
a protest in the direct pay context is
appropriate.
17 See e.g. 20 CFR 404.521(b), 404.1512(d)(1),
405.5, and 411.435(c)(2).
18 20 CFR 404.3(b) and 416.120(d).
VerDate Sep<11>2014
16:17 Jan 05, 2015
Jkt 235001
Terminology
Comment: One individual asked us to
change the title of ‘‘non-attorney
representative’’ to something ‘‘more
dignified.’’ NOSSCR asked us to specify
what designation a non-attorney
representative may use after he or she is
found eligible for direct fee payment.
NOSSCR also asked us to revise our
regulations to clarify that a non-attorney
representative who is eligible for direct
fee payment is not certified or licensed
by us.
Response: We began using the term
‘‘non-attorney representative’’ in 2004
because this is the term used by
Congress in the SSPA, and again in the
PRA. We believe it works well and are
not changing it at this time.
We agree with NOSSCR that being
eligible for direct pay does not mean
that the representative is certified or
licensed by us. Our current rules clearly
state that we only pay fees directly to
non-attorney representatives who
successfully meet the eligibility
requirements in 20 CFR 404.1717(a) and
416.1517(a). This eligibility to receive
direct fee payment does not confer our
certification, license, accreditation, or
endorsement of the individual to be a
representative. Therefore, eligible nonattorney representatives may not
advertise themselves in any way that
may create the appearance that we have
approved or endorsed them as
representatives. Further, a
representative who performs an action
to deceive or knowingly mislead a
claimant or prospective claimant or
beneficiary may violate our rules of
conduct and standards of responsibility
for representatives in 20 CFR 404.1740
and 416.1540. Because we believe that
the purpose of the direct pay
application process is clear and that the
current rules of conduct and standards
of responsibility are sufficient to
discipline any representative who
portrays his or her credentials
deceptively, we are not adopting the
suggestion to revise our rules in this
manner.
Regulatory Procedures
Executive Order 12866, as
Supplemented by Executive Order
135653
We consulted with the Office of
Management and Budget (OMB) and
determined that these final rules meet
the criteria for a significant regulatory
action under Executive Order 12866, as
supplemented by Executive Order
13563. Therefore, OMB reviewed them.
PO 00000
Frm 00005
Fmt 4700
Sfmt 4700
399
Regulatory Flexibility Act
We certify that these final rules will
not have a significant economic impact
on a substantial number of small entities
because they affect individuals only.
Therefore, a regulatory flexibility
analysis as provided in the Regulatory
Flexibility Act, as amended, is not
required.
Paperwork Reduction Act
This rule does not create any new or
affect any existing collections and,
therefore, does not require OMB
approval under the 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; and
96.006, Supplemental Security Income)
List of Subjects
20 CFR Part 404
Administrative practice and
procedure, Aged, Blind, Disability
benefits, Old-age, Survivors and
Disability Insurance, Reporting and
recordkeeping requirements, Social
Security.
20 CFR Part 416
Administrative practice and
procedure, Reporting and recordkeeping
requirements, Supplemental Security
Income (SSI).
Carolyn W. Colvin,
Acting Commissioner of Social Security.
For the reasons stated in the
preamble, we are adopting the interim
rule with request for comments
amending 20 CFR chapter III, part 404,
subparts J and R, and part 416 subparts
N and O that we published on July 28,
2011 at 76 FR 45184 as final with the
following changes:
PART 404—FEDERAL OLD-AGE,
SURVIVORS AND DISABILITY
INSURANCE (1950– )
Subpart J—Determinations,
Administrative Review Process, and
Reopening of Determinations and
Decisions
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).
E:\FR\FM\06JAR1.SGM
06JAR1
400
Federal Register / Vol. 80, No. 3 / Tuesday, January 6, 2015 / Rules and Regulations
2. Amend § 404.903 by revising
paragraphs (z) and (aa) to read as
follows:
■
§ 404.903 Administrative actions that are
not initial determinations.
*
*
*
*
*
(z) Starting or discontinuing a
continuing disability review;
(aa) Issuing a receipt in response to
your report of a change in your work
activity; and
*
*
*
*
*
(25) Issuing a receipt in response to
your report of a change in your earned
income; and
*
*
*
*
*
Subpart O—Representation of Parties
7. The authority citation for subpart O
of part 416 continues to read as follows:
■
Authority: Secs. 702(a)(5), 1127, and
1631(d) of the Social Security Act (42 U.S.C.
902(a)(5), 1320a–6, and 1383(d)).
8. Amend § 416.1517 by revising
paragraphs (a)(6), (d)(1)(ii), and (f)(1) to
read as follows:
■
Subpart R—Representation of Parties
3. The authority citation for subpart R
of part 404 continues to read as follows:
■
Authority: Secs. 205(a), 206, 702(a)(5), and
1127 of the Social Security Act (42 U.S.C.
405(a), 406, 902(a)(5), and 1320a–6).
4. Amend § 404.1717 by revising
paragraphs (a)(6) and (d)(1)(ii) to read as
follows:
■
§ 404.1717 Direct payment of fees to
eligible non-attorney representatives.
(a) * * *
(6) Provides proof of and maintains
continuous liability insurance coverage
that is underwritten by an entity that is
legally permitted to provide
professional liability insurance in the
States in which the representative
conducts business. The policy must
include coverage for malpractice claims
against the representative and be in an
amount we prescribe; and
*
*
*
*
*
(d) * * *
(1) * * *
(ii) Meet at all times the criminal
background investigation criteria, as
described in paragraph (a)(4) of this
section;
*
*
*
*
*
PART 416—SUPPLEMENTAL
SECURITY INCOME FOR THE AGED,
BLIND, AND DISABLED
§ 416.1517 Direct payment of fees to
eligible non-attorney representatives.
(a) * * *
(6) Provides proof of and maintains
continuous liability insurance coverage
that is underwritten by an entity that is
legally permitted to provide
professional liability insurance in the
States in which the representative
conducts business. The policy must
include coverage for malpractice claims
against the representative and be in an
amount we prescribe; and
*
*
*
*
*
(d) * * *
(1) * * *
(ii) Meet at all times the criminal
background investigation criteria, as
described in paragraph (a)(4) of this
section;
*
*
*
*
*
(f) * * *
(1) Did not meet the initial criteria for
eligibility in paragraph (a)(1), (2), (3), or
(5) of this section in a prior application
period; or
*
*
*
*
*
[FR Doc. 2014–30921 Filed 1–5–15; 8:45 am]
BILLING CODE 4191–02–P
DEPARTMENT OF THE TREASURY
Alcohol and Tobacco Tax and Trade
Bureau
Subpart N—Determinations,
Administrative Review Process, and
Reopening of Determinations and
Decisions
27 CFR Part 9
5. 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).
[Docket No. TTB–2014–0005; T.D. TTB–126;
Ref: Notice No. 143]
RIN 1513–AC07
Expansion of the Fair Play Viticultural
Area
Alcohol and Tobacco Tax and
Trade Bureau, Treasury.
ACTION: Final rule; Treasury decision.
tkelley on DSK3SPTVN1PROD with RULES
■
AGENCY:
§ 416.1403 Administrative actions that are
not initial determinations.
SUMMARY:
6. Revise § 416.1403 paragraphs
(a)(24) and (25) to read as follows:
(a) * * *
(24) Starting or discontinuing a
continuing disability review;
VerDate Sep<11>2014
17:16 Jan 05, 2015
Jkt 235001
The Alcohol and Tobacco Tax
and Trade Bureau (TTB) is expanding
the approximately 33-square mile ‘‘Fair
Play’’ viticultural area in El Dorado
PO 00000
Frm 00006
Fmt 4700
Sfmt 4700
County, California, by 1,200 acres
(approximately 2 square miles). The
established viticultural area and the
expansion area are both located entirely
within the larger El Dorado and Sierra
Foothills viticultural areas. TTB
designates viticultural areas to allow
vintners to better describe the origin of
their wines and to allow consumers to
better identify wines they may
purchase.
DATES: This final rule is effective
February 5, 2015.
FOR FURTHER INFORMATION CONTACT:
Karen A. Thornton, Regulations and
Rulings Division, Alcohol and Tobacco
Tax and Trade Bureau, 1310 G Street
NW., Box 12, Washington, DC 20005;
phone 202–453–1039, ext. 175.
SUPPLEMENTARY INFORMATION:
Background on Viticultural Areas
TTB Authority
Section 105(e) of the Federal Alcohol
Administration Act (FAA Act), 27
U.S.C. 205(e), authorizes the Secretary
of the Treasury to prescribe regulations
for the labeling of wine, distilled spirits,
and malt beverages. The FAA Act
provides that these regulations should,
among other things, prohibit consumer
deception and the use of misleading
statements on labels and ensure that
labels provide the consumer with
adequate information as to the identity
and quality of the product. The Alcohol
and Tobacco Tax and Trade Bureau
(TTB) administers the FAA Act
pursuant to section 1111(d) of the
Homeland Security Act of 2002,
codified at 6 U.S.C. 531(d). The
Secretary has delegated various
authorities through Treasury
Department Order 120–01 (Revised),
dated December 10, 2013, to the TTB
Administrator to perform the functions
and duties in the administration and
enforcement of this law.
Part 4 of the TTB regulations (27 CFR
part 4) authorizes the establishment of
definitive viticultural areas and the use
of their names as appellations of origin
on wine labels and in wine
advertisements. Part 9 of the TTB
regulations (27 CFR part 9) sets forth the
standards for the preparation and
submission of petitions for the
establishment or modification of
American viticultural areas (AVAs) and
lists the approved AVAs.
Definition
Section 4.25(e)(1)(i) of the TTB
regulations (27 CFR 4.25(e)(1)(i)) defines
a viticultural area for American wine as
a delimited grape-growing region having
distinguishing features, as described in
part 9 of the regulations, and a name
E:\FR\FM\06JAR1.SGM
06JAR1
Agencies
[Federal Register Volume 80, Number 3 (Tuesday, January 6, 2015)]
[Rules and Regulations]
[Pages 395-400]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: 2014-30921]
========================================================================
Rules and Regulations
Federal Register
________________________________________________________________________
This section of the FEDERAL REGISTER contains regulatory documents
having general applicability and legal effect, most of which are keyed
to and codified in the Code of Federal Regulations, which is published
under 50 titles pursuant to 44 U.S.C. 1510.
The Code of Federal Regulations is sold by the Superintendent of Documents.
Prices of new books are listed in the first FEDERAL REGISTER issue of each
week.
========================================================================
Federal Register / Vol. 80, No. 3 / Tuesday, January 6, 2015 / Rules
and Regulations
[[Page 395]]
-----------------------------------------------------------------------
SOCIAL SECURITY ADMINISTRATION
20 CFR Parts 404 and 416
[Docket No. SSA-2010-0025]
RIN 0960-AH21
Revisions to Direct Fee Payment Rules
AGENCY: Social Security Administration.
ACTION: Final rules.
-----------------------------------------------------------------------
SUMMARY: We are adopting, with two revisions, our interim final rules
that implemented amendments to the Social Security Act (Act) made by
the Social Security Disability Applicants' Access to Professional
Representation Act of 2010 (PRA). The interim final rules made
permanent the direct fee payment rules for eligible non-attorney
representatives under titles II and XVI of the Act and for attorney
representatives under title XVI of the Act. They also revised some of
our eligibility policies for non-attorney representatives under titles
II and XVI of the Act. Based on public comment and subsequent
inquiries, we are revising our rules to clarify that an eligible non-
attorney representative's liability insurance policy must include
malpractice coverage. We are also reaffirming that a business entity
legally permitted to provide the required insurance in the States in
which the non-attorney representative conducts business must underwrite
the policies.
DATES: These rules are effective February 5, 2015.
FOR FURTHER INFORMATION CONTACT: Eric Ice, Office of Income Security
Programs, Social Security Administration, 6401 Security Boulevard,
Baltimore, MD 21235-6401, (410) 966-3233. 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:
Background
We published the interim final rules ``Revisions to Direct Fee
Payment Rules'' on July 28, 2011 (76 FR 45184), and the rules became
effective on August 29, 2011.\1\ In the preamble to the interim final
rules, we explained how we would implement the revisions made to the
Act by the PRA.\2\
---------------------------------------------------------------------------
\1\ 76 FR 45184.
\2\ Public Law 111-142, as codified at 42 U.S.C. 406(e).
---------------------------------------------------------------------------
The PRA established five requirements that non-attorney
representatives must meet to be eligible for direct fee payment. A
representative must:
(1) Have a bachelor's degree from an accredited institution of
higher education or have been determined by us to have equivalent
qualifications derived from training and work experience;
(2) Pass an examination that we write and administer, which tests
knowledge of the relevant provisions of the Act and the most recent
developments in Social Security Administration (SSA) and court
decisions affecting titles II and XVI of the Act;
(3) Secure professional liability insurance, or equivalent
insurance, which we determine to be adequate to protect claimants in
the event of malpractice by the representative;
(4) Undergo a criminal background check to ensure the
representative's fitness to practice before us; and
(5) Demonstrate ongoing completion of qualified courses of
continuing education, including education regarding ethics and
professional conduct, which are designed to enhance professional
knowledge in matters related to entitlement to, or eligibility for,
benefits based on disability under titles II and XVI of the Act. The
continuing education courses, and the instructors providing the
education courses, must meet our prescribed standards.
Revision to and Clarification of the Liability Insurance Coverage
Requirement
To fulfill the third requirement described above, the interim final
rules required an eligible non-attorney representative to provide proof
of and maintain continuous liability insurance coverage in an amount we
prescribe (20 CFR 404.1717(a)(6) and 416.1517(a)(6)). We explained in
the preamble that we would accept either business liability and
professional liability insurance to meet this requirement.\3\ In
response to a comment, we are clarifying in the final rule that
eligible non-attorney representatives must provide proof of and
maintain continuous liability insurance that includes coverage for
malpractice claims against the representative in an amount we
prescribe.
---------------------------------------------------------------------------
\3\ 76 FR 45184, 45187-45188.
---------------------------------------------------------------------------
We are also clarifying our requirement that insurance policies be
underwritten by a business entity that is legally permitted to provide
the insurance we require in the States in which the non-attorney
representative conducts business. When we first established the
demonstration project, we required that insurance policies be
underwritten by firms that are licensed to provide insurance in the
States where the individuals practice. On August 16, 2007, we published
a Federal Register notice \4\ explaining our decision that the
insurance requirement would be met if the representative's insurance
policy was underwritten by a business entity that is legally permitted
to provide professional liability insurance in the States in which the
representative conducts business. After we published our interim final
rules on July 28, 2011, some representatives asked us whether we were
continuing the August 2007 policy or whether we were returning to the
original requirement that the insurance policies be underwritten by
firms that are licensed to provide insurance in the States where the
individual practices. We did not intend to change the requirement we
explained in August 2007, and therefore clarified final sections
404.1717(a)(6) and 416.1517(a)(6) to make this point clearer.
---------------------------------------------------------------------------
\4\ 72 FR 46121.
---------------------------------------------------------------------------
Other Changes
We also made minor changes to correct punctuation and wording to
the following sections:
Corrected final sections 404.903(z) and 416.1403(a)(24) by
deleting ``and'' after the semicolon.
Corrected final sections 404.903(aa) and 416.1403(a)(25)
by deleting the
[[Page 396]]
period and adding a semicolon and the word ``and.''
Corrected final sections 404.1717(d)(1)(ii) and
416.1517(d)(1)(ii) by adding a semicolon after the word ``section.''
Corrected final section 416.1517(f)(1) to read ``. . .
paragraphs (a)(1), (a)(2), (a)(3), or (a)(5) of this section'' to
correspond to the text in 20 CFR 404.1717(f)(1).
Public Comments
The 60-day public comment period closed on September 26, 2011. We
received comments from three individuals and two organizations (the
National Association of Disability Representatives (NADR) and the
National Organization of Social Security Claimants' Representatives
(NOSSCR).\5\ We carefully considered the comments. We have condensed,
summarized, and paraphrased some of the comments due to their length.
We tried to summarize the commenters' views accurately and respond to
the significant issues raised by the commenters that were within the
scope of these rules.
---------------------------------------------------------------------------
\5\ The comments are available for public viewing at
www.regulations.gov under docket ``SSA-2010-0025.''
---------------------------------------------------------------------------
Education and Experience
The Social Security Protection Act of 2004 (SSPA) included a
requirement that we determine whether a non-attorney representative has
``equivalent qualifications derived from training and work experience''
if the representative does not have ``a bachelor's degree from an
accredited institution of higher education.'' \6\ In 2005, we published
a notice in the Federal Register in which we explained that we would
use a formula that balanced the applicant's years of education and his
or her relevant professional experience when we determined whether an
applicant met the ``equivalent qualifications'' requirement.\7\ In the
5 years that followed, we found the balancing formula difficult to
administer and revised this requirement in the interim final rules.\8\
As we explained in the preamble to the interim final rules, we required
applicants to demonstrate that they have either a bachelor's degree
from an accredited institution of higher learning or at least 4 years
of relevant professional experience and either a high school diploma or
GED certificate.\9\
---------------------------------------------------------------------------
\6\ Public Law 108-203, section 303(b)(1) .
\7\ 70 FR 2447, 2448-49.
\8\ 42 U.S.C. 406(e)(2)(A).
\9\ 76 FR 45184, 45186, 45187.
---------------------------------------------------------------------------
Comment: We received a comment from NADR indicating that it
concurred that relevant professional experience is essential for
representatives who have not completed a bachelor's degree. However,
NADR noted that the SSPA demonstration project included a formula that
balanced undergraduate education and work experience. NADR encouraged
us to allow for some flexibility in evaluating relevant work experience
for individuals who have received credit for undergraduate course work,
but who have not earned a bachelor's degree.
Response: It is not practicable for us to evaluate relevant work
experience for individuals who have received credit for undergraduate
course work but who have not earned a bachelor's degree. As we stated
above and in the preamble to the interim final rule, we found the
balancing formula that considered various combinations of education and
work experience difficult to administer and we therefore streamlined
the process and simplified our administration of this requirement. We
believe requiring a person without a bachelor's degree to have at least
4 years of relevant professional experience is appropriate because a
bachelor's degree generally requires 4 years of study. We believe this
requirement appropriately ensures that the representatives possess the
qualifications called for in the Act.
Comment: NADR asked us to clarify what constitutes ``relevant work
experience.'' NADR was concerned that applicants might lose their
application fee because we will now evaluate their education or
equivalent qualifications after they pay the application fee and pass
the examination.
Response: In the preamble to the interim final rules, we stated
that
We will continue to consider relevant professional experience to
be work through which the applicant demonstrates familiarity with
medical reports and the ability to describe and assess mental or
physical limitations. As in the past, an applicant may gain this
kind of experience in fields such as teaching, counseling or
guidance, social work, personnel management, public employment
service, nursing, or health care professions. We will also continue
to consider relevant professional experience to include work
involving claims for benefits under title II or XVI of the Act.\10\
---------------------------------------------------------------------------
\10\ 76 FR 45184, 45187.
We believe that this description provides sufficient detail for
applicants to determine if their prior experience qualifies as relevant
work experience. It would not be feasible for us, and potentially
limiting for applicants, if we attempted to include an exhaustive list
of all qualifying experience in our regulations. Given the changing job
market and the wide variety of work experience that may qualify as
``relevant professional experience,'' any list we could develop would
necessarily be under-inclusive. Accordingly, we will continue to
determine on a case-by-case basis whether an applicant has relevant
professional experience, rather than attempting to include in our
regulations a list of jobs that would qualify.
Comment: One individual asked how we will determine equivalent
qualifications derived from training and work experience when a non-
attorney representative is self-employed and has begun, but has not yet
completed, a bachelor's degree. This commenter also asked what
documentation we would request in this circumstance to show the non-
attorney representative has 4 years of relevant professional
experience.
Response: A self-employed non-attorney representative who does not
have a bachelor's degree must have at least 4 years of relevant
professional experience and either a high school diploma or GED
certificate. This professional experience may be from relevant self-
employment work. In this situation, we may require copies of the
representative's tax returns and a description of job duties that would
enable us to evaluate the applicant's relevant professional experience.
Comment: One individual asked how we will consider a paralegal
certificate.
Response: If a non-attorney representative has a high school
diploma or GED certificate and a paralegal certificate but not a
bachelor's degree, he or she must have 4 years of relevant professional
experience, as described above.
Written Examination
Comment: NADR suggested that we provide sample test materials.
NOSSCR suggested that we make actual questions from past examinations
available. NOSSCR asserted that without these materials there was no
way for the public to assess whether our examination met the statutory
requirements of testing a representative's knowledge of the relevant
provisions of the Act and the most recent developments in SSA and court
decisions affecting titles II and XVI of the Act.\11\
---------------------------------------------------------------------------
\11\ 42 U.S.C. 406(e)(2)(B).
---------------------------------------------------------------------------
Response: We provide several sample examination questions for the
public to view. They are currently accessible through the Direct
Payment to Eligible Non-Attorney Representatives Web page at https://www.ssa.gov/representation/nonattyrep.htm by selecting the link to the
contractor's Web site.
[[Page 397]]
However, we do not plan to make any of our actual tests available
to the public. We have taken a number of measures to ensure the
validity of the examination and to make sure that it tests knowledge of
the relevant provisions of the Act and the most recent developments in
agency and court decisions affecting title II and title XVI of the Act.
Our employees, including some of our administrative law judges and
other subject matter experts, develop the scope and content of the
examination questions to ensure that our test is comprehensive. The
contractor that proctors the examination has in-depth knowledge in
testing services, including test research and development; test
validation; test scoring; test logistics and administration;
statistical analysis; and the design, development, and administration
of assessment centers and performance examinations. We are confident
these measures ensure that our test complies with the statutory
requirements cited by the commenter.
Comment: NADR acknowledged our current budgetary constraints, but
suggested that we administer the examination electronically using
computers in secure locations, such as in our field or hearing offices,
when such technological improvements and enhancements become available.
The commenter believed that this approach would allow us to offer the
examinations at least twice a year in more locations.
Response: We are not adopting these suggestions at this time. As
the commenter recognized, we currently do not have separate facilities
at field and hearing offices or designated computer equipment to
administer examinations, nor do we have funds available to adopt this
comment. We are also concerned that proctoring examinations at field
and hearing offices could disrupt our service to the public. However,
we may consider offering additional examinations if demand warrants,
and we have the resources available to do so.
Comment: NADR wanted us to raise the minimum passing score from 70
to 75 because we discontinued the requirement that an applicant show he
or she has represented at least five claimants within a 24-month
period.
Response: We are not adopting this suggestion. We continue to
believe that a representative who attains a score of at least 70 has
demonstrated that he or she has sufficient knowledge of the Act, our
regulations, and related court decisions to meet the statutory testing
requirement.
Comment: NOSSCR wanted us to assess advocacy skills in the
examination.
Response: We are not adopting this suggestion. The Act does not
require that we assess a representative's advocacy skills and we
believe the current examination and other criteria are sufficient
measures of a non-attorney representative's knowledge.
Liability Insurance
Comment: NADR asked us to require non-attorney representatives to
ask their insurance companies to notify us when the non-attorney
representative modifies or terminates his or her insurance coverage.
Response: We are not adopting this suggestion. Implementing this
proposal could result in an additional workload for us to follow up
with insurance companies and to analyze more correspondence than
necessary. It would be unnecessary and would impose a significant
burden on our scarce administrative resources to review these policies
every time there is a slight modification. We believe the
representative should remain responsible for providing us with proper
proof of current liability insurance coverage.
Comment: NOSSCR asserted that our rules allowing non-attorney
representatives to maintain business liability insurance was not
consistent with the Act's requirement that non-attorney representatives
have ``professional liability insurance, or equivalent insurance, which
the Commissioner has determined to be adequate to protect claimants in
the event of malpractice by the representative.'' \12\ NOSSCR asserted
that most business liability insurance contracts do not include errors
and omissions coverage for malpractice and are therefore not equivalent
to professional liability insurance coverage. NOSSCR asked us to revise
our rules to require eligible non-attorney representatives to maintain
only professional liability insurance contracts that include
malpractice coverage.
---------------------------------------------------------------------------
\12\ 42 U.S.C. 406(e)(2)(C).
---------------------------------------------------------------------------
Response: We agree with NOSSCR that our rules should specify that
all liability insurance policies must include malpractice coverage and
that our current regulations do not clearly state this requirement.
Therefore, we are revising final sections 404.1717(a)(6) and
416.1517(a)(6) to require that each eligible non-attorney
representative provide proof of and maintain continuous liability
insurance that includes coverage for malpractice claims against the
representative and be in an amount we prescribe.
Criminal Background Check
Comment: NADR asked which types of information within a criminal
background check could disqualify a non-attorney representative from
being eligible to receive direct fee payment.
Response: We explained in sections 20 CFR 404.1717(a) and
416.1517(a) of the interim final rules that
A non-attorney representative is eligible to receive direct payment
of his or her fee out of your past due benefits if he or she:
(4) Passes our criminal background investigation (including checks
of our administrative records), and attests under penalty of perjury
that he or she:
(i) Has not been suspended or disqualified from practice before us
and is not suspended or disbarred from the practice of law in any
jurisdiction;
(ii) Has not had a judgment or lien assessed against him or her by
a civil court for malpractice or fraud;
(iii) Has not had a felony conviction; and
(iv) Has not misrepresented information provided on his or her
application or supporting materials for the application.
We will reject the application if the applicant fails to meet any
of these criteria. In addition, we list the factors we consider under
this requirement at the Direct Payment to Eligible Non-Attorney
Representatives Web page https://www.ssa.gov/representation/nonattyrep.htm and selecting the link to the contractor's Web site. As
we note on that Web site, we will also reject an application if the
applicant fails to pass our administrative records check or fails to
provide documentation requested by the contractor to perform the
criminal background investigation.
Continuing Education
The SSPA included a requirement that eligible non-attorney
representatives demonstrate ongoing completion of qualified courses of
continuing education. In 2005, we published a notice in the Federal
Register under which we required the non-attorney representative to
complete certain hours of continuing education requirements during
certain time periods, depending on how long the representative
participated in the demonstration project and whether the
representative was a course instructor.\13\ We found that framework
unnecessarily complex and burdensome to administer.
[[Page 398]]
As a result, in sections 404.1717(a)(7) and 416.1517(a)(7) of the
interim final rules, we required the non-attorney representative to
complete and provide proof that he or she has completed all continuing
education courses that we prescribe by the deadline we prescribe in
order to meet the PRA's continuing education requirement.
---------------------------------------------------------------------------
\13\ See 70 FR 41250.
---------------------------------------------------------------------------
Comment: NADR disagreed with our decision to end our prior
framework of balancing the continuing education requirement with the
representative's length of participation in the demonstration project.
Response: We do not agree with this comment. The framework we set
out in the 2005 Federal Register notice was confusing to many
representatives and unnecessarily complex and burdensome for us to
administer. As a result, a number of representatives had difficulty
understanding our requirements and contacted us for guidance throughout
the reporting period. We anticipate that the streamlined and uniform
approach that we established in the interim final rules and are making
final in these rules will benefit representatives.
Comment: NADR suggested that the educational opportunities that
will satisfy the continuing education requirement should be widely
available.
Response: We agree that the courses, whether our own or from
vendors, should be widely available. We plan to prescribe courses that
will satisfy the continuing education requirement. These courses may
include a variety of electronic presentations. We will inform eligible
non-attorney representatives of the deadline for completing the
courses, and how they should report to us that they have completed the
courses through alternate methods, e.g. through our Web site: https://www.socialsecurity.gov/representation.
Comment: NADR suggested that we create a process through which we
would pre-approve vendor courses if the vendor supplied us with certain
information. The commenter asked us to provide written approval of
these courses so that the vendors can state in marketing materials that
the courses meet our criteria.
Response: It would be administratively burdensome to pre-approve
all potential courses that meet our standards for satisfying the
statutory requirement for continuing education.\14\ We will identify
either our own courses or general types of courses and will provide
sufficient information so that the representative can individually
identify vendors' courses that meet our standards and satisfy this
requirement. We will identify these courses through alternate methods,
e.g. through our Web site: https://www.socialsecurity.gov/representation.
---------------------------------------------------------------------------
\14\ 42 U.S.C. 406(e)(2)(E).
---------------------------------------------------------------------------
Comment: NADR asked us to include links on our Web site to vendors
that have approved courses.
Response: We will include links on our Web site or our contractor's
Web site to our own courses. As noted above, we will also provide
sufficient information to allow representatives to identify vendors'
courses that meet our requirements.
Comment: NADR suggested that we require non-attorney
representatives to keep proof of course attendance for up to 3 years so
we could conduct audits of attendance.
Response: We are not adopting this suggestion because we revised
this criterion to make it less complex and less burdensome.
Representational Experience
As we discussed in the preamble to the interim final rule, under
the procedures we followed for the demonstration project, we required a
non-attorney representative to show that he or she had specific minimum
representational experience.\15\ We required a non-attorney
representative to show that he or she represented at least five
claimants before us within a 24-month period within the 60 months
before the month in which the applicant filed the application. We
eliminated this requirement in the interim final rules because we found
it complicated the application process without adding significant
benefit.
---------------------------------------------------------------------------
\15\ 76 FR 45184, 45189.
---------------------------------------------------------------------------
Comment: NOSSCR disagreed with this decision and asked us to add
that at least two of the five required cases take place at the hearing
level.
Response: In our experience administering the demonstration
project, we found that passing the written examination is a better
barometer of a representative's knowledge and skills than the
representational experience requirement. The representational
requirement is not one of the statutory prerequisites to the direct
payment of fees to non-attorney representatives and, therefore, we have
decided to exercise our discretion not to include it in our current
process.
Protest Procedures
Both the SSPA and the PRA require that a non-attorney
representative meet the statutory requirements before we determine that
he or she is eligible to receive direct fee payment. Once we determine
that a non-attorney representative is eligible to receive direct fee
payment, he or she must continue to meet all of the requirements. The
Federal Register notice we published to explain the demonstration
project set out protest procedures that we followed for that project.
In the interim final rules, we also included rules that explained how
we would handle protests when we determine that a non-attorney
representative is not eligible to receive direct fee payment. We
explained that the protest procedures in the interim final rules were
easier to understand, follow, and administer than the procedures we
followed under the demonstration project.
Comment: NADR asked us to state that we would refund an applicant's
application fee for failing to arrive for an examination due to weather
or travel disruptions because they are ``circumstances beyond an
applicant's control.''
Response: The interim final rules provided we would refund the
application fee if ``[c]ircumstances beyond the applicant's control
that could not have been reasonably anticipated and planned for prevent
an applicant from taking a scheduled examination.'' \16\ We believe it
is inappropriate to include in our regulations the examples the
commenter cited. In our experience, we have found that including
examples in our regulations inappropriately limits the application of
the rule to the specific examples cited in a manner that we do not
intend. In addition, it is unclear that all weather or travel
disruptions would be both beyond the applicant's control and constitute
circumstances that the applicant could not have reasonably anticipated
and planned for, as the regulation requires. If an applicant requests a
refund because he or she did not take the examination, we will consider
the reasons presented and make a decision based on the facts of each
individual case. The applicant retains the responsibility to submit
documentation to support his or her request.
---------------------------------------------------------------------------
\16\ 20 CFR 404.1717(c)(1)(ii) and 416.1517(c)(1)(ii).
---------------------------------------------------------------------------
Comment: One individual and one organization wanted us to give non-
attorney representatives more than 10 calendar days to file a protest.
NADR wanted us to give 10 business days to file a protest, in addition
to 5 days for mailing. NADR also wanted us to allow a representative to
file a request for an extension of time to protest when extenuating
circumstances existed. The individual wanted us to give
[[Page 399]]
representatives at least 15 days to file a protest, or, ideally, to
provide 30 days to protest, as we do in our sanctions procedures.
Response: The definition of the phrase ``Date we notify him or
her'' in sections 404.1703 and 416.1503 of the interim final rules
makes it clear that we begin counting the 10 calendar days to file a
protest 5 days after the date on the notice. We add 5 days to account
for mail time, although a representative may show us that he or she
received it after this 5-day period. Therefore, we do give
representatives 15 days to protest our finding that he or she is
ineligible to receive direct fee payment for the reasons set out in
sections 404.1717(d) and 416.1517(d) of the rules, as the second
commenter suggested.
We disagree with the comment to revise the deadline in our protest
rules from 10 calendar days to 10 business days for two reasons. The
majority of our other rules use calendar days instead of business days
as a basis for calculating action deadlines.\17\ Further, our rules
clearly explain how to calculate a deadline that falls on a non-work
day.\18\
---------------------------------------------------------------------------
\17\ See e.g. 20 CFR 404.521(b), 404.1512(d)(1), 405.5, and
411.435(c)(2).
\18\ 20 CFR 404.3(b) and 416.120(d).
---------------------------------------------------------------------------
We also disagree with the comment to allow for an extension of time
to file a protest based on extenuating circumstances. We inform non-
attorney representatives who apply for direct fee payment eligibility
about our requirements and timeframes in the application materials, on
our Web site or our contractor's Web site, and in other correspondence,
we send to them. When there is evidence that a representative may not
meet our eligibility prerequisites, we will request the missing
documentation from him or her. It is the representative's
responsibility to respond to our requests in a timely manner.
Finally, we disagree with the comment to extend the time in which
to protest our finding that a non-attorney representative is ineligible
to receive direct fee payment from 10 to 30 calendar days, to match our
sanctions rules. An adverse decision from a sanctions proceeding
results in the representative being unable to practice before us. In
contrast, a non-attorney representative may continue to practice before
us and be paid for his or her services directly by the claimant even if
we determine he or she is ineligible to receive direct fee payment from
us. For that reason, a shorter time frame to file a protest in the
direct pay context is appropriate.
Terminology
Comment: One individual asked us to change the title of ``non-
attorney representative'' to something ``more dignified.'' NOSSCR asked
us to specify what designation a non-attorney representative may use
after he or she is found eligible for direct fee payment. NOSSCR also
asked us to revise our regulations to clarify that a non-attorney
representative who is eligible for direct fee payment is not certified
or licensed by us.
Response: We began using the term ``non-attorney representative''
in 2004 because this is the term used by Congress in the SSPA, and
again in the PRA. We believe it works well and are not changing it at
this time.
We agree with NOSSCR that being eligible for direct pay does not
mean that the representative is certified or licensed by us. Our
current rules clearly state that we only pay fees directly to non-
attorney representatives who successfully meet the eligibility
requirements in 20 CFR 404.1717(a) and 416.1517(a). This eligibility to
receive direct fee payment does not confer our certification, license,
accreditation, or endorsement of the individual to be a representative.
Therefore, eligible non-attorney representatives may not advertise
themselves in any way that may create the appearance that we have
approved or endorsed them as representatives. Further, a representative
who performs an action to deceive or knowingly mislead a claimant or
prospective claimant or beneficiary may violate our rules of conduct
and standards of responsibility for representatives in 20 CFR 404.1740
and 416.1540. Because we believe that the purpose of the direct pay
application process is clear and that the current rules of conduct and
standards of responsibility are sufficient to discipline any
representative who portrays his or her credentials deceptively, we are
not adopting the suggestion to revise our rules in this manner.
Regulatory Procedures
Executive Order 12866, as Supplemented by Executive Order 135653
We consulted with the Office of Management and Budget (OMB) and
determined that these final rules meet the criteria for a significant
regulatory action under Executive Order 12866, as supplemented by
Executive Order 13563. Therefore, OMB reviewed them.
Regulatory Flexibility Act
We certify that these final rules will not have a significant
economic impact on a substantial number of small entities because they
affect individuals only. Therefore, a regulatory flexibility analysis
as provided in the Regulatory Flexibility Act, as amended, is not
required.
Paperwork Reduction Act
This rule does not create any new or affect any existing
collections and, therefore, does not require OMB approval under the
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; and 96.006,
Supplemental Security Income)
List of Subjects
20 CFR Part 404
Administrative practice and procedure, Aged, Blind, Disability
benefits, Old-age, Survivors and Disability Insurance, Reporting and
recordkeeping requirements, Social Security.
20 CFR Part 416
Administrative practice and procedure, Reporting and recordkeeping
requirements, Supplemental Security Income (SSI).
Carolyn W. Colvin,
Acting Commissioner of Social Security.
For the reasons stated in the preamble, we are adopting the interim
rule with request for comments amending 20 CFR chapter III, part 404,
subparts J and R, and part 416 subparts N and O that we published on
July 28, 2011 at 76 FR 45184 as final with the following changes:
PART 404--FEDERAL OLD-AGE, SURVIVORS AND DISABILITY INSURANCE
(1950- )
Subpart J--Determinations, Administrative Review Process, and
Reopening of Determinations and Decisions
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).
[[Page 400]]
0
2. Amend Sec. 404.903 by revising paragraphs (z) and (aa) to read as
follows:
Sec. 404.903 Administrative actions that are not initial
determinations.
* * * * *
(z) Starting or discontinuing a continuing disability review;
(aa) Issuing a receipt in response to your report of a change in
your work activity; and
* * * * *
Subpart R--Representation of Parties
0
3. The authority citation for subpart R of part 404 continues to read
as follows:
Authority: Secs. 205(a), 206, 702(a)(5), and 1127 of the Social
Security Act (42 U.S.C. 405(a), 406, 902(a)(5), and 1320a-6).
0
4. Amend Sec. 404.1717 by revising paragraphs (a)(6) and (d)(1)(ii) to
read as follows:
Sec. 404.1717 Direct payment of fees to eligible non-attorney
representatives.
(a) * * *
(6) Provides proof of and maintains continuous liability insurance
coverage that is underwritten by an entity that is legally permitted to
provide professional liability insurance in the States in which the
representative conducts business. The policy must include coverage for
malpractice claims against the representative and be in an amount we
prescribe; and
* * * * *
(d) * * *
(1) * * *
(ii) Meet at all times the criminal background investigation
criteria, as described in paragraph (a)(4) of this section;
* * * * *
PART 416--SUPPLEMENTAL SECURITY INCOME FOR THE AGED, BLIND, AND
DISABLED
Subpart N--Determinations, Administrative Review Process, and
Reopening of Determinations and Decisions
0
5. 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
6. Revise Sec. 416.1403 paragraphs (a)(24) and (25) to read as
follows:
Sec. 416.1403 Administrative actions that are not initial
determinations.
(a) * * *
(24) Starting or discontinuing a continuing disability review;
(25) Issuing a receipt in response to your report of a change in
your earned income; and
* * * * *
Subpart O--Representation of Parties
0
7. The authority citation for subpart O of part 416 continues to read
as follows:
Authority: Secs. 702(a)(5), 1127, and 1631(d) of the Social
Security Act (42 U.S.C. 902(a)(5), 1320a-6, and 1383(d)).
0
8. Amend Sec. 416.1517 by revising paragraphs (a)(6), (d)(1)(ii), and
(f)(1) to read as follows:
Sec. 416.1517 Direct payment of fees to eligible non-attorney
representatives.
(a) * * *
(6) Provides proof of and maintains continuous liability insurance
coverage that is underwritten by an entity that is legally permitted to
provide professional liability insurance in the States in which the
representative conducts business. The policy must include coverage for
malpractice claims against the representative and be in an amount we
prescribe; and
* * * * *
(d) * * *
(1) * * *
(ii) Meet at all times the criminal background investigation
criteria, as described in paragraph (a)(4) of this section;
* * * * *
(f) * * *
(1) Did not meet the initial criteria for eligibility in paragraph
(a)(1), (2), (3), or (5) of this section in a prior application period;
or
* * * * *
[FR Doc. 2014-30921 Filed 1-5-15; 8:45 am]
BILLING CODE 4191-02-P