Public Safety Officers' Benefits Program, 46019-46026 [2016-16086]
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Federal Register / Vol. 81, No. 136 / Friday, July 15, 2016 / Proposed Rules
Treasury decision adopting these
regulations as final regulations is
published in the Federal Register and at
all times thereafter;
(ii) Described in a ruling request
submitted to the Internal Revenue
Service on or before July 15, 2016; or
(iii) Described in a public
announcement or filing with the
Securities and Exchange Commission on
or before the date the Treasury decision
adopting these regulations as final
regulations is published in the Federal
Register.
John Dalrymple,
Deputy Commissioner for Services and
Enforcement.
[FR Doc. 2016–16512 Filed 7–14–16; 8:45 am]
BILLING CODE 4830–01–P
DEPARTMENT OF JUSTICE
28 CFR Part 32
[Docket No.: OJP (BJA) 1716]
RIN 1121–AA85
Public Safety Officers’ Benefits
Program
AGENCY:
Office of Justice Programs,
Justice.
ACTION:
Notice of proposed rulemaking.
This rule proposes to make
the following changes to current
regulations implementing the Public
Safety Officers’ Benefits (PSOB) Act:
Adopting the World Trade Center
(WTC) Health Program’s List of WTCRelated Health Conditions (List), the
WTC Health Program’s standards for
certifying that an injury is covered for
treatment under the Program, and
related regulatory provisions,
establishing payment offset provisions
between the PSOB Program and the
September 11th Victim Compensation
Fund, and revising the provisions that
define when the statutory presumption
of line-of-duty death resulting from
certain heart attacks, strokes, and
vascular ruptures is rebutted. The
proposed changes based on the WTC
Health Program’s List and related
provisions would provide a means for
claimants to establish that certain public
safety officers with chronic, often latent,
health conditions sustained a line-ofduty injury under the PSOB Act. The
proposed payment offset provisions are
intended to implement statutory
amendments to the PSOB Act requiring
such offset and to facilitate claims
processing. Similarly, the proposed rule
implementing the statutory presumption
associated with certain heart attacks,
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strokes, and vascular ruptures is
intended to amend the current
regulation to conform to recent
amendments to the PSOB Act and to
improve the processing of such claims.
DATES: Written comments must be
postmarked and electronic comments
must be submitted on or before
September 13, 2016. Comments received
by mail will be considered timely if they
are postmarked on or before that date.
The electronic Federal Docket
Management System (FDMS) will accept
comments until Midnight Eastern Time
at the end of that day.
ADDRESSES: Please address all
comments regarding this rule by U.S.
mail, to: Hope Janke, Bureau of Justice
Assistance, Office of Justice Programs,
810 7th Street NW., Washington, DC
20531; or by telefacsimile to (202) 354–
4135. To ensure proper handling, please
reference OJP Docket No. 1716 on your
correspondence. Comments may also be
sent electronically through https://
regulations.gov using the electronic
comment form provided on that site. An
electronic copy of this document is also
available at the https://regulations.gov
Web site. OJP will accept attachments to
electronic comments in Microsoft Word,
WordPerfect, or Adobe PDF formats
only.
FOR FURTHER INFORMATION CONTACT:
Hope Janke, BJA, OJP, at (202) 514–
6278, or toll-free at 1 (888) 744–6513.
SUPPLEMENTARY INFORMATION:
I. Posting of Public Comments
Please note that all comments
received are considered part of the
public record and made available for
public inspection online at https://
www.regulations.gov. Information made
available for public inspection includes
personal identifying information (such
as your name, address, etc.) voluntarily
submitted by the commenter.
The Office of Justice Programs (OJP)
does not require commenters to submit
personal identifying information (such
as your name, address, medical
information, etc.) as part of your
comment. However, if you wish to
submit such information, but do not
wish it to be posted online, you must
include the phrase ‘‘PERSONAL
IDENTIFYING INFORMATION’’ in the
first paragraph of your comment. You
must also locate all the personal
identifying information that you do not
want posted online in the first
paragraph of your comment and identify
what information you want the agency
to redact. Personal identifying
information identified and located as set
forth above will be placed in the
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46019
agency’s public docket file, but not
posted online.
If you wish to submit confidential
business information as part of your
comment but do not wish it to be posted
online, you must include the phrase
‘‘CONFIDENTIAL BUSINESS
INFORMATION’’ in the first paragraph
of your comment. You must also
prominently identify confidential
business information to be redacted
within the comment. If a comment has
so much confidential business
information that it cannot be effectively
redacted, the agency may choose not to
post that comment (or to only partially
post that comment) on https://
www.regulations.gov. Confidential
business information identified and
located as set forth above will not be
placed in the public docket file, nor will
it be posted online.
If you wish to inspect the agency’s
public docket file in person by
appointment, please see the FOR
FURTHER INFORMATION CONTACT
paragraph.
II. Background
A. General
The Public Safety Officers’ Benefits
(PSOB) Program, 42 U.S.C. 3796 et seq.
(established pursuant to the Public
Safety Officers’ Benefits Act of 1976), is
administered by the Bureau of Justice
Assistance (BJA) of the Office of Justice
Programs (OJP), U.S. Department of
Justice. Generally speaking, the PSOB
Program provides a one-time financial
payment to the statutorily-eligible
survivors of public safety officers who
die as the direct and proximate result of
personal injuries sustained in the line of
duty, as well as educational assistance
for their spouses and eligible children.
Alternatively, the PSOB Program also
provides a one-time financial payment
directly to public safety officers
determined to be permanently and
totally disabled as the direct and
proximate result of personal injury
sustained in the line of duty, as well as
educational assistance for their spouses
and eligible children.
B. Establishing a Line-of-Duty Injury
Under the PSOB Act and Implementing
Regulations
42 U.S.C. 3796(a) authorizes the
payment, to statutory survivors, of a
benefit of $250,000, currently adjusted
for inflation at $339,881, when the
administering agency determines, under
its regulations ‘‘that a public safety
officer has died as the direct and
proximate result of a personal injury
sustained in the line of duty.’’ Similarly,
42 U.S.C. 3796(b) authorizes the agency
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to pay the same inflation-adjusted
benefit, when it determines, under its
regulations, that a public safety officer
has ‘‘become permanently and totally
disabled as the direct and proximate
result of a personal injury sustained in
the line of duty.’’ The agency has
exercised its regulatory authority in
regulations published in 28 CFR part 32
defining, among other things, ‘‘injury,’’
‘‘line of duty injury,’’ and ‘‘direct and
proximate result of an injury.’’ Those
regulations specify the criteria that must
be met in the ordinary course for a
claimant to establish that a public safety
officer sustained a line-of-duty injury
and that the injury caused the officer’s
death or permanent and total disability.
Under the definition of injury in 28
CFR 32.3, a claimant must establish that
a public safety officer sustained a
‘‘traumatic physical wound (or a
traumatized physical condition of the
body) directly and proximately caused
by external force.’’ Under definitions
related to causation in 28 CFR 32.3
(defining direct and proximate result of
an injury and substantial factor), a
claimant must also establish that the
injury was the ‘‘substantial factor’’ in
the officer’s death or disability. ‘‘A
factor substantially brings about a death,
injury, [or] disability’’ if it was sufficient
in and of itself to cause the death,
injury, or disability, or no other factor
(or combination of factors) ‘‘contributed
to the death, injury, [or] disability . . .
to so great a degree as it did.’’ 28 CFR
32.3 (defining substantial factor). Taken
together, these regulations require that a
claimant seeking benefits establish an
injury, i.e., a traumatic physical wound
or traumatized physical condition of the
body directly and proximately caused
by an external force or other agent, e.g.,
chemicals, as well as a death or
disability, and a direct and proximate
causal nexus between the injury and the
death or disability.
In PSOB claims involving acute
injuries caused by readily identifiable
external forces such as a gunshot, motor
vehicle accident, or other trauma with
death occurring simultaneously or
closely following injury, a claimant’s
burden in establishing the injury and
causal link between injury and death
may be straightforward and readily
demonstrated. In such cases, a death
certificate or an autopsy is generally
sufficient to establish a traumatic
wound or traumatized condition, the
external force that caused the wound or
condition, the officer’s death, and a
direct and proximate causal link
between the injury and death.
In PSOB claims asserting injury or
death resulting from exposure to
unspecified toxins or hazards associated
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with line-of-duty activity, however, an
autopsy may not sufficiently identify
the mechanism of the injury, or
adequately establish the direct and
proximate causal link between the
injury and the death (or permanent and
total disability) necessary to support the
approval of a claim under the PSOB Act.
In such claims, more detailed medical
evaluation may be required, and
substantial medical evidence may need
to be gathered and produced before
PSOB determining officials may make
the necessary findings to find the PSOB
Act standards are met. For example, an
autopsy usually is not sufficient
evidence when the claims are based on
the chronic, often latent, illnesses and
conditions of 9/11 first responders; e.g.,
respiratory disorders and certain
cancers. Similar burdens in gathering,
producing, and evaluating medical
evidence exist for 9/11 first responders
claiming to be permanently and totally
disabled as a result of exposure to
unidentified toxins or hazards
encountered in responding to the
September 11, 2001, terrorist attacks.
C. Establishing Injury Under the James
Zadroga 9/11 Health and Compensation
Act of 2010
Pursuant to the James Zadroga 9/11
Health and Compensation Act of 2010
(Pub. L. 111–347), as amended, the
World Trade Center (WTC) Health
Program, which is administered by the
Director of the National Institute for
Occupational Safety and Health
(NIOSH), within the Centers for Disease
Control and Prevention (a component of
the U.S. Department of Health and
Human Services), provides medical
monitoring and treatment for WTC
Health Program members with certain
health conditions that are certified as
related to the unique circumstances of
the 9/11 explosions, ensuing
conflagrations, and clean-up (9/11
disaster).1 In so doing, the
Administrator of the WTC Health
Program has an advisory committee
including medical and scientific experts
appointed to review and consider the
latest research on connections that may
exist between various medical
conditions and exposure to the 9/11
disaster. The Administrator of the WTC
Health Program may seek guidance and
recommendations from these medical
and scientific experts, in determining
whether to propose adding conditions to
1 The James Zadroga 9/11 Health and
Compensation Act of 2010 was amended by the
Consolidated Appropriations Act, 2016, Public Law
114–113 (Dec. 18, 2015) (The James Zadroga 9/11
Health and Compensation Reauthorization Act)
(available at gpo.gov).
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the List of WTC-Related Health
Conditions through rulemaking.
The List of WTC-Related Health
Conditions is a list of illnesses or health
conditions that, pursuant to an
examination by a medical professional
with expertise in treating or diagnosing
the listed conditions, may be found to
be related to a WTC Health Program
member’s exposure to airborne toxins,
any other hazards, or any other adverse
conditions resulting from the September
11, 2001, terrorist attacks. That a WTC
Health Program member has a health
condition or illness on the List of WTCRelated Health Conditions does not, by
itself, establish that such health
condition or illness was related to the 9/
11 disaster and, therefore, is eligible for
treatment in the WTC Health Program.
Rather, the WTC Health Program also
makes a specific decision as to whether
a particular WTC Health Program
member’s exposure to the toxins,
hazards, or other adverse conditions
associated with the 9/11 disaster was
‘‘substantially likely to be a significant
factor in aggravating, contributing to, or
causing the illness or health condition.’’
42 U.S.C. 300mm–22(a)(1)(A)(1). By
law, such decision is based on an
assessment of: (1) The individual’s
exposure to airborne toxins, any other
hazard, or any other condition resulting
from the terrorist attacks; and (2) the
type of symptoms and temporal
sequence of symptoms. 42 U.S.C.
300mm–22(a)(2). Together, the List of
WTC-Related Health Conditions and
individual assessment as to exposure
and symptomatology comprise the
general and specific findings that the
WTC Health Program makes in
establishing that a WTC Health Program
member’s particular illness or health
condition is related to the 9/11 disaster.
D. Fatal Heart Attacks, Strokes, and
Vascular Ruptures Under 42 U.S.C.
3796(k)
To establish eligibility for death
benefits under the PSOB Act, claimants
must establish that a public safety
officer suffered a personal injury in the
line of duty that directly and
proximately caused the officer’s death.
This statutory requirement excluded
from coverage those conditions caused
by stress and strain and occupational
disease, such as practically speaking,
most heart attacks and strokes.
The Hometown Heroes Survivors’
Benefits Act of 2003 (Pub. L. 108–182)
(Hometown Heroes Act) amended the
PSOB Act by creating a statutory
presumption in 42 U.S.C. 3796(k) of
death by a line-of-duty injury, which
may be rebutted by ‘‘competent medical
evidence to the contrary,’’ in cases
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where a public safety officer dies of
heart attack or stroke while engaging in,
(or within 24 hours of engaging in)
‘‘nonroutine stressful or strenuous
physical [line-of-duty] activity.’’
Implementation of the rebuttal language
has proved challenging for OJP. In fact,
the House Judiciary Committee in 2012
noted that ‘‘[one] particular term
introduced into the PSOBA in 2003,
‘competent medical evidence to the
contrary,’ has not proven workable as
introduced.’’ 2
In 2006 and 2008, OJP published final
rules implementing the Hometown
Heroes Act. The 2008 rule provided that
the presumption attaches ‘‘unless it . . .
is overcome by competent medical
evidence to the contrary, when evidence
indicates to a degree of medical
probability that extrinsic circumstances,
considered in combination (as one
circumstance) or alone, were a
substantial factor in bringing the heart
attack or stroke about.’’ 3 The rule
defined extrinsic circumstances as ‘‘[a]n
event or events; or . . . [a]n intentional
risky behavior or intentional risky
behaviors.’’ Thus, under regulations
implementing the previous
presumption, the presumption was
rebutted when competent medical
evidence of record established that an
event(s) or intentional risky
behavior(s) 4 (as defined in the
regulations) were the substantial factor
in an officer’s fatal heart attack or
stroke.
OJP’s experience is that consideration
of cardiovascular disease risk factors
and the concept of ‘‘risky behavior’’
have largely proven unworkable. In
practice, medical examiners, even with
a complete medical record, are rarely
able to determine with medical
precision whether an inadequately
treated cardiovascular disease risk
factor(s) was the substantial factor in the
officer’s fatal condition. As a result, the
PSOB Program has expended significant
time and resources on inconclusive
results, i.e., claims in which a
recognized cardiovascular disease risk
factor is found to have somehow
contributed to the officer’s fatal
2 H.R.
Rpt. 112–548 at 14 (June 25, 2012).
CFR 32.13 (defining Competent medical
evidence to the contrary).
4 In general, ‘‘risky behavior’’ was defined as (1)
an officer’s failure to undertake treatment, without
reasonable excuse, of any known commonly
accepted cardiovascular disease risk factor
exceeding minimum high-risk levels or of diseases
associated with increased risk of cardiovascular
disease, or where certain biological relatives had a
history of cardiovascular disease, (2) consumption
over certain levels of cigarettes or alcohol, and (3)
use or abuse of certain controlled substances
associated with increased risk of cardiovascular
disease.
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condition but not to the degree that it
rebutted the presumption. OJP’s
conclusion that the current
interpretation is unworkable is further
reflected in the low numbers of claims
it has denied based on ‘‘risky
behaviors.’’ Despite routinely seeking
from claimants additional medical
evidence and engaging in timeconsuming independent medical review
of such evidence, from Fiscal Year 2011
to date, BJA denied at the PSOB Office
level less than 1% of all Hometown
Heroes claims determined on the basis
that an officer’s ‘‘risky behaviors’’ were
a substantial factor in bringing about the
heart attack, stroke, or vascular rupture.
In January 2013, the Dale Long Public
Safety Officers’ Benefits Improvement
Act of 2012 (Section 1086 of Pub. L.
112–239) (Dale Long Act) amended the
rebuttal language in section 3796(k). As
amended, the presumption is rebutted
when ‘‘competent medical evidence
establishes that the [public safety
officer’s] heart attack, stroke, or vascular
rupture was unrelated to the [officer’s]
engagement or participation or was
directly and proximately caused by
something other than the mere presence
of cardiovascular-disease risk factors.’’
As the amendment repealed the
statutory language upon which OJP
regulations implementing the
presumption are based, e.g., Competent
medical evidence to the contrary, such
regulations are now obsolete.
III. Provisions of the Proposed Rule
A. Adoption of the WTC Health
Program’s List of WTC-Related Health
Conditions and Standards
Because of the medical and scientific
evaluation that informs the List of WTCRelated Health Conditions (List), BJA
proposes to use the List as a means for
streamlining its own claim-specific
evaluation, where a claim for PSOB
Program benefits is based on a medical
condition (not otherwise excluded from
coverage under the PSOB Program)
included in the List. Similarly, BJA also
proposes, consistent with the law,
regulations, policies, and procedures
governing the WTC Health Program’s
certification of an individual’s injuries
as covered for treatment under the
Program, and in conjunction with the
List, to assess the individual public
safety officer’s exposure to toxins,
hazards, and other adverse conditions
resulting from the terrorist attacks as
well as the type of symptoms and
temporal sequence of symptoms. Under
the proposed rule, BJA will
independently use the WTC Health
Program’s ‘‘standards’’ for certification,
which includes the Program’s
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regulations, policies, and procedures, to
establish an injury under the PSOB Act.
The proposed rule would establish a
means by which claimants could
establish that a public safety officer who
suffered physical injury as a result of
line-of-duty activity at a 9/11 crash site
sustained an injury under the PSOB Act.
More specifically, the rule would adopt
the WTC Health Program standards for
establishing injury or illness for public
safety officers who responded to the
9/11 disaster based on the medical and
scientific evidence underlying those
standards and to promote consistency in
the process for determining claims
resulting from exposure to a 9/11 crash
site. Under the proposed rule, evidence
demonstrating that a public safety
officer (1) performed line-of-duty
activity at a 9/11 crash site, (2) was
diagnosed with a physical illness or
condition on the List of WTC-Related
Health Conditions as defined in 42 CFR
part 88, (3) whose physical injury was
directly and proximately caused by an
illness or condition on the List, and (4)
whose exposure to the hazards, toxins,
and adverse conditions of the 9/11
disaster are found by the PSOB
determining official to be substantially
likely to have been a significant factor
in aggravating, contributing to, or
causing the responder’s health
condition, would establish an injury for
purposes of the PSOB Act. Consistent
with the VCF, which payments are
treated by law as duplicative of PSOB
Program payments and required to be
offset, 42 U.S.C. 3796(f)(3), a claimant’s
injury would be limited to ‘‘physical
harm’’ as defined 28 CFR 104.2(c).
BJA proposes to adopt the List of
WTC-Related Health Conditions (other
than mental health conditions) because
these are illnesses or health conditions
for which exposure to airborne toxins,
any other hazard, or any other adverse
condition resulting from the September
11, 2001, terrorist attacks, have been
found by another federal program to
potentially be related to 9/11 exposures.
Because the PSOB Program already
excludes mental health conditions from
its coverage, the proposed rule would
not extend its application to any mental
health conditions on the List.
In addition, the adoption of the List
and the WTC Health Program standards
for assessing injury is warranted based
on the unique circumstances associated
with the response to the 9/11 disaster,
the chronic, often latent, nature of
health conditions linked to the
response, and the rigorous evidentiary
burden faced by PSOB claimants in
establishing an injury under current
regulations implementing the PSOB Act.
PSOB claimants would still be required
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to satisfy the statutory requirement that
such injury have been the direct and
proximate cause of the public safety
officer’s death or permanent and total
disability.
The proposed rule would cover those
circumstances in which a claimant
lacked a WTC Health Program
certification or its equivalent, e.g., a
determination by the Victim
Compensation Fund that an individual’s
injury was eligible for compensation,
that a public safety officer’s 9/11
exposure is substantially likely to have
been a significant factor in aggravating,
contributing to, or causing a particular
health condition. The proposed rule
would also codify OJP’s interpretation
that its current regulations providing
that a PSOB determining official may
consider the factual findings of a public
agency, 28 CFR 32.5(b), enable the
PSOB Program to accept as evidence of
a line-of-duty injury a ‘‘certification’’ by
the WTC Program Administrator, as
defined in 42 CFR 88.1, or its
equivalent, that a particular public
safety officer’s exposure to airborne
toxins, any other hazards, or any other
adverse conditions resulting from the
September 11, 2001, terrorist attacks is
substantially likely to be a significant
factor in aggravating, contributing to, or
causing the condition.
This regulatory approach would
promote the efficient resolution of
issues related to injury (and in some
cases, causation) without the need for
the PSOB Program to conduct an
individual review and investigation of
the available medical literature in every
claim associated with a 9/11 injury. It
would promote consistency in federal
decision making by allowing the
complex medical decisions of another
federal program (the WTC Health
Program) to streamline the PSOB
Program’s own evaluation of the same
medical issues. It also would lessen the
burden on claimants who otherwise
may face significant challenges in
obtaining and producing significant
medical documentation necessary to
establish an injury.
Under the proposed rule, the PSOB
Program would rely upon and apply the
List and WTC Health Program standards
to its independent determination of
injury only where the claimant
otherwise has established all of the
applicable elements normally required
for a PSOB claim; e.g., proof of status as
a public safety officer and line-of-duty
activity.
To maintain consistency with the
September 11th Victim Compensation
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Fund of 2001 (VCF), as amended,5 the
proposed rule would incorporate certain
relevant definitions found in the James
Zadroga 9/11 Health and Compensation
Act of 2010, Public Law 111–347, as
amended, and definitions found in
implementing regulations: ‘‘Physical
harm, and ‘‘WTC-related health
condition.’’ In particular, OJP proposes
to adopt the physical harm provision,
which requires that the physical
condition upon which the claim of
injury is based was treated by a medical
professional and may be verified by
medical records that were created by or
at the direction of the medical care
provider, for purposes of maintaining
the integrity of the PSOB Program.
B. Prohibition Against Duplicate (Dual)
Payments
The 2013 amendment to the PSOB
Act established, in the PSOB Act itself,
a limitation on payments by declaring
that benefit payments made under the
PSOB Act are in addition generally to
any other benefit except payments
under the VCF. 42 U.S.C. 3796(f)(3).
Therefore, OJP proposes to add a new
provision in 28 CFR 32.6, describing
how and when the PSOB Program
would pay benefits under the PSOB Act
to persons who have received payments
from the VCF.
Under the proposed rule, no death or
disability benefits under the PSOB
program would be payable when the
VCF has made payments to or with
respect to a public safety officer that are
equal to or exceed the amount of such
benefits payable under the PSOB Act.
To account for circumstances when a
PSOB claimant has a pending claim for
VCF benefits, or the VCF has made
payment to a PSOB claimant that is less
than the amount payable under the
PSOB Act, the proposed rule would
clarify that nothing in the PSOB Act or
the rule itself precludes payment of
PSOB benefits before the VCF makes
payment of compensation. In so doing,
the PSOB Program could pay benefits to
VCF claimants without waiting for the
VCF to issue its payments. To prevent
overpayments and ensure the offset is
applied, before the PSOB Program pays
any benefits based on injuries sustained
in the 9/11 disaster, it would verify with
the VCF the amount of any payments
made or payable to a VCF claimant.
The proposed rule would also clarify
that the offset does not extend to
educational assistance payable under
5 The September 11th Victim Compensation Fund
of 2001 was amended by the by the Consolidated
Appropriations Act, 2016, Public L. 114–113 (Dec.
18, 2015) (The James Zadroga 9/11 Victim
Compensation Fund Reauthorization Act) (available
at gpo.gov).
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the PSOB Act, 42 U.S.C. 3796d—3796d–
7. When viewed in the context of a
statutory scheme providing for the
payment of a particular one-time death
or disability benefit, the agency believes
that the ordinary meaning of ‘‘the
benefit payable under this subchapter’’
suggests that the scope of the offset is
limited to the death and disability
benefit payable under 42 U.S.C. 3796.
However, under current regulations that
were promulgated before the offset
statute was enacted, educational
assistance may, with one exception, be
paid only when PSOB Program death or
disability benefits have been paid. As
OJP has determined the offset does not
extend to educational assistance, the
proposed rule would revise the
definition of ‘‘Eligible public safety
officer’’ in current § 32.33 to authorize
payment of educational assistance
where death or disability benefits would
have been paid but for the operation of
the offset in 42 U.S.C. 3796(f).
C. Fatal Heart Attacks, Strokes, and
Vascular Ruptures Under 42 U.S.C.
3796(k)
As the Dale Long Act has amended 42
U.S.C. 3796(k), OJP proposes to amend
its implementing regulations in 28 CFR
32.13 and 32.14 to reflect the revised
statutory language. In implementing
revised section 3796(k), the proposed
rule would define in proposed § 32.13
the two circumstances when the
presumption of death directly and
proximately resulting from a line-ofduty injury associated with certain heart
attacks, strokes, and vascular ruptures
as provided in section 3796(k) is
rebutted—i.e., when ‘‘competent
medical evidence establishes that the
[officer’s] heart attack, stroke, or
vascular rupture [1] was unrelated to the
[officer’s] engagement or participation
or [2] was directly and proximately
caused by something other than the
mere presence of cardiovascular-disease
risk factors.’’
Under the proposed rule, an officer’s
heart attack, stroke, or vascular rupture
would be considered as ‘‘unrelated to an
[officer’s] engagement or participation’’
if competent medical evidence
established that an independent event
or occurrence significantly contributed
in bringing about the officer’s heart
attack, stroke, or vascular rupture. OJP
believes that defining this rebuttal factor
in terms of ‘‘an independent event or
occurrence,’’ that is, something that
happens to an officer, appropriately
ensures that an off-duty heart attack,
stroke, or vascular rupture caused by a
clearly unrelated event, such as an offduty officer’s accident, is not covered by
the presumption.
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For example, a police officer’s fatal
heart attack due to electrocution
suffered while performing home repair,
established by competent medical
evidence, would not be covered by the
presumption despite occurring only 12
hours after the officer engaged in a
situation involving nonroutine stressful
or strenuous physical law enforcement
activity. The heart attack is not covered
by the presumption because competent
medical evidence establishes that an
independent event or occurrence
(electrocution sustained while repairing
home wiring) separate and apart from
the officer’s qualifying activity, i.e.,
engagement in a situation involving
nonroutine stressful or strenuous
physical law enforcement activity,
significantly contributed in bringing
about the officer’s fatal heart attack. At
the same time, such a construction
would ensure that an officer’s ordinary
and routine off-duty activities such as
yard work or exercise, that take place
following qualifying, on-duty
engagement or participation, would not
be evaluated for their contribution to the
officer’s fatal heart attack, stroke, or
vascular rupture.
Turning to the other rebuttal factor in
the proposed rule, an officer’s heart
attack, stroke, or vascular rupture would
be considered to be caused by
‘‘something other than the mere
presence of cardiovascular-disease risk
factors’’ when competent medical
evidence establishes that the officer’s
heart attack, stroke, or vascular rupture
was directly and proximately caused by
the officer’s ingestion of controlled
substances on Schedule I of the drug
control and enforcement laws or the
officer’s abuse of controlled substances
on Schedules II–V of the drug control
and enforcement laws. OJP believes that
by defining this particular rebuttal
factor in terms of intentional behaviors
that are well established as adversely
affecting cardiovascular health, that
exceed the mere presence of
cardiovascular disease risk factors, and
that are readily attributable to an
officer’s actions, the proposed rule
would appropriately rebut the
presumption and preclude payment
consistent with the language of the
statute.
In addition to implementing the
amended statutory language of the
presumption, the proposed changes to
§ 32.13 would reduce the evidentiary
burden on claimants seeking death
benefits under section 3796(k) and
streamline the processing of such claims
by reducing the circumstances under
which the PSOB Program would seek
expert medical review and additional
medical evidence. Towards this end, the
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proposed rule would eliminate as a
basis for rebutting the presumption
certain actions of the officer previously
defined in regulations as ‘‘risky
behaviors,’’ e.g., an officer’s failure to
adequately treat known cardiovasculardisease risk factors. OJP believes that
eliminating this basis for rebuttal is
justified based on its experience
implementing the previous regulation
which revealed that medical examiners,
even with a complete medical record,
itself a rare occurrence, were rarely able
to determine whether a public safety
officer was sufficiently non-compliant
with treatment such that it could be said
to be the direct and proximate cause of
the officer’s fatal heart attack, stroke, or
vascular rupture. By omitting from the
proposed rule those rebuttal factors
which often required the collection and
evaluation of extensive medical records
as part of an independent medical
examination and produced largely
inconclusive results, the proposed rule
would measurably reduce the burden on
claimants and the agency.
Consistent with the amendments to
the statutory rebuttal provision, the
proposed rule would also eliminate
from § 32.13 provisions defining
‘‘Competent medical evidence to the
contrary,’’ ‘‘Excessive consumption of
alcohol,’’ ‘‘Extrinsic circumstances,’’
‘‘Risky behavior,’’ and ‘‘Undertaking of
treatment.’’ In addition, the proposed
rule would eliminate § 32.14(c),
requiring the PSOB Office to provide
notice to claimants when it determines
the existence of competent medical
evidence to the contrary. As the statute
no longer includes such language, the
provision is unnecessary.
IV. Regulatory Requirements
Executive Order 12866 and 13563—
Regulatory Planning and Review
This proposed rule has been drafted
and reviewed in accordance with
Executive Order 12866, ‘‘Regulatory
Planning and Review,’’ section 1(b),
Principles of Regulation, and in
accordance with Executive Order 13563,
‘‘Improving Regulation and Regulatory
Review,’’ section 1(b), General
Principles of Regulation. Executive
Orders 12866 and 13563 direct agencies
to assess all costs and benefits of
available regulatory alternatives and, if
regulation is necessary, to select
regulatory approaches that maximize
net benefits (including potential
economic, environmental, public health
and safety effects, distributive impacts,
and equity). As explained below, OJP
has assessed the costs and benefits of
this proposed rule as required by
Executive Order 12866 and has
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determined that the benefits of the
proposed rule justify the costs.
A. Adoption of the WTC Health
Program’s List and Standards
OJP’s experience is that PSOB
claimants have been largely
unsuccessful in establishing an ‘‘injury’’
for delayed-onset medical conditions or
illnesses, particularly cancer. As the
proposed rule establishes an evidentiary
standard intended for the unique
circumstances of public safety officers
who sustained an injury related to the
9/11 disaster, OJP estimates that the
proposed rule would likely affect all of
the 29 claims based on 9/11 injury (27
death/2 disability) currently pending in
the PSOB Program without a WTC
Health Program certification or its
equivalent by enabling these claimants
to establish an ‘‘injury’’ under the PSOB
Act. Although there are currently 161
total PSOB death and disability claims
pending with assertions of injuries
based on 9/11 exposure, this estimate
pertains only to the 29 claims not
covered under OJP’s current regulatory
authority, as benefits paid through OJP’s
process of determining PSOB claims
based on ‘‘certifications’’ issued by the
WTC Health Program Administrator (or
equivalent) under 28 CFR 32.5(b) would
not be impacted as a result of this
regulatory change.
If all 29 such claims were paid, the
total PSOB Program death and disability
benefit cost would be $8,778,198.80.
Based on amounts appropriated in
FY2016 for PSOB Program death
benefits (‘‘such sums as necessary’’—
estimated at $71,323,000) and disability
and education benefits ($16,300,000),
OJP knows that it could pay the death
claims from its current appropriations,
and estimates that it could pay the
disability claims from its current
appropriations. OJP’s estimate does not
account for any offset to PSOB Program
payments based on VCF payments,
which would reduce the amount of
PSOB Program payments made;
however, OJP is unable to estimate how
many of the 29 claims would be
approved by VCF. Regardless of whether
a PSOB payment were offset by a VCF
payment, there is no additional benefit
cost, as the amounts that would be
required are covered by current
appropriations (with respect to death
claims) and appear to be covered by
such appropriations with respect to
disability claims, and, barring
unforeseen circumstances, would not
exceed such amounts. As PSOB claims
based on 9/11 injury would be
processed by existing staff, OJP would
not incur additional administrative or
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personnel costs in processing these
claims.
OJP would not incur additional costs in
processing these claims.
B. Provisions Implementing the Offset at
42 U.S.C. 3796(f)(3)
C. Fatal Heart Attacks, Strokes, and
Vascular Ruptures Under 42 U.S.C.
3796(k)
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The primary benefit of the proposed
rule is that, pursuant to statute, it
permits the PSOB Program to pay
benefits to PSOB claimants who are
awaiting a decision on eligibility for
VCF benefits, pending receipt of VCF
payments, or are in receipt of VCF
payments less than the maximum PSOB
Program death or disability payment. A
secondary benefit is that it clarifies that
claimants who would be eligible for
payment of death or disability benefits
under the PSOB Act but for the
operation of the offset, would be eligible
for educational assistance.
Estimating annual costs for public
safety officers’ educational assistance is
difficult because of the nature of the
payment.6 If all of the 29 currently
pending claims based on 9/11 injury
and lacking a WTC Health Program
certification, or its equivalent, were
approved, thereby creating potential
eligibility for educational assistance,
OJP estimates that the impact could be
to add approximately 49 educational
assistance claimants for FY2016 and
beyond. Using the current maximum
monthly payment rate of $1,021/month,
OJP estimates that annual benefit costs
could increase by approximately
$450,261, annually (based on 49
claimants completing 9 months of
educational assistance payable at the
current maximum rate of $1,021/
month).7 Based on the amount of funds
appropriated for disability benefits and
educational assistance in FY2016
($16,300,000), OJP estimates that,
barring unforeseen circumstances, it
could pay these additional education
claims from its current appropriation.
As PSOB claims based on 9/11 injury
would be processed by existing staff,
6 The educational assistance benefit is payable
only as a reimbursement to spouses and children
of eligible public safety officers for eligible
educational expenses such as tuition and fees.
Further complicating matters related to estimation,
eligible children have until they are 27 to complete
qualifying coursework and spouses of eligible
public safety officers have no age cutoff for
completing qualifying coursework. In addition,
claimants may submit claims for educational
assistance up to six months before attending
qualifying coursework, or at any time after a course
has been completed. On occasion, the PSOB
Program receives a single claim for all 45 months
of benefits; however, the majority of claims are
submitted on an academic-term by academic-term
basis.
7 Payments for PSOB educational assistance are
calculated on the basis prescribed in 38 U.S.C. 3532
and are subject to increase based on increases in
certain consumer price indexes as provided in 38
U.S.C. 3564.
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The primary benefit of the proposed
rule is the reduced burden on both
claimants and the agency in
determining claims under 42 U.S.C.
3796(k). In defining the circumstances
that warrant rebuttal in terms of readily
ascertainable facts, OJP believes that the
PSOB Program will, in most cases, be
able to rely upon the evidence of injury
and death ordinarily submitted with a
claim, e.g., a death certificate or
autopsy. Based on its experience, OJP
estimates that, under the previous
regulatory interpretation, it seeks
additional evidence from claimants and
independent medical review of medical
evidence in approximately 50 percent of
claims. Under the proposed rule, OJP
estimates that the PSOB Program would
need to seek additional evidence from
claimants and independent medical
review of medical evidence in less than
5 percent of claims. As the PSOB
Program receives on average
approximately 92 claims for benefits
under 42 U.S.C. 3796(k) annually, OJP
estimates that it would need to seek
additional evidence and review in fewer
than 1 in 20 such claims, which is
significantly fewer than it seeks under
the previous rule.
This reduction in evidentiary
development is also expected to result
in cost savings for medical reviews as
well as the costs associated with
obtaining medical records for such
reviews. For every claim that does not
require independent medical review,
OJP estimates a savings of $1,652, which
represents the average cost to the
program of obtaining certain medical
opinions in claims for PSOB Program
death benefits from 2009 through 2015.
OJP also estimates a savings to the
claimant of $603 for the cost of
obtaining medical records (an average of
900 pages in the claims sampled). This
estimate is based on the maximum fees
permitted by law, which vary by state,8
and the number of pages of medical
records in claims for PSOB Program
death benefits as determined in a
random sampling of claims involving
medical issues that require a claimant to
8 See e.g., Joy Pritts, et al., Privacy and Security
Solutions for Interoperable Health Information
Exchange: Report on State Medical Record Access
Laws, https://www.healthit.gov/sites/default/files/
290-05-0015-state-law-access-report-1.pdf; Table A–
5, Overview of State Law: Maximum Fees Doctors
and Hospitals May Charge Patients for Copies of
Medical Records https://www.healthit.gov/sites/
default/files/appa5-1.pdf. (accessed June 16, 2016).
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provide such records. In addition, OJP
believes that the streamlined criteria
would increase the rate at which such
claims are processed, however, it is
difficult to quantify any additional cost
savings resulting from such efficiencies.
In terms of benefit costs, OJP
estimates that there will not be a
significant increase in claims approved
as compared to the previous regulatory
criteria. Accordingly, the proposed rule
does not significantly increase benefit
costs. And, as these claims would be
processed by existing staff, OJP would
not incur additional administrative or
personnel costs in processing these
claims.
This proposed rule would impose no
costs on state, local, or tribal
governments, or on the private sector.
Although not an economically
significant rulemaking under Executive
Orders 12866 and 13563, The Office of
Justice Programs has determined that
this proposed rule is a ‘‘significant
regulatory action’’ under section 3(f) of
the Executive Order, and accordingly
this rule has been reviewed by the
Office of Management and Budget
(OMB).
Executive Order 13132—Federalism
This proposed rule would not have
substantial direct effects on the States,
on the relationship between the federal
government and the States, or on
distribution of power and
responsibilities among the various
levels of government. The PSOB
program statutes provide benefits to
individuals and do not impose any
special or unique requirements on
States or localities. Therefore, in
accordance with Executive Order No.
13132, it is determined that this
proposed rule does not have sufficient
federalism implications to warrant the
preparation of a Federalism Assessment.
Executive Order 12988—Civil Justice
Reform
This proposed rule meets the
applicable standards set forth in
sections 3(a) & (b)(2) of Executive Order
No. 12988. Pursuant to section 3(b)(1)(I)
of the Executive Order, nothing in this
proposed rule or any previous rule (or
in any administrative policy, directive,
ruling, notice, guideline, guidance, or
writing) directly relating to the Program
that is the subject of this rule is
intended to create any legal or
procedural rights enforceable against the
United States, except as the same may
be contained within part 32 of title 28
of the Code of Federal Regulations.
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Regulatory Flexibility Act
The Office of Justice Programs hereby
certifies that this proposed rule would
not have a significant economic impact
on a substantial number of small entities
for the following reasons: This proposed
rule addresses federal agency
procedures; furthermore, this proposed
rule would make amendments to clarify
existing regulations and agency practice
concerning public safety officers’ death,
disability, and education benefits and
would do nothing to increase the
financial burden on any small entities.
Therefore, an analysis of the impact of
this proposed rule on such entities is
not required under the Regulatory
Flexibility Act (5 U.S.C. 601 et seq.).
Paperwork Reduction Act of 1995
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This proposed rule would impose
reporting or recordkeeping requirements
under the Paperwork Reduction Act of
1995 (PRA) (44 U.S.C. 3501 et seq.). The
PRA requires certain actions before an
agency can adopt or revise a collection
of information, including publishing a
summary of the collection of
information and a brief description of
the need for and proposed use of the
information. 44 U.S.C. 3507.
The proposed rule includes
paperwork requirements in three
collections of information previously
approved by OMB for the PSOB
Program. OJP published in the Federal
Register on January 11, 2016, a 60-day
notice of ‘‘Agency Information
Collection Activities’’ for each of the
following forms: Claim for Death
Benefits (OMB Number 1121–0024),
Report of Public Safety Officer’s Death
(OMB Number 1121–0025), and Public
Safety Officers’ Disability Benefits (OMB
Number 1121–0166). In calculating the
burden associated with these forms/
collections, OJP reviewed its previous
burden estimates and updated these to
reflect the time required for claimants to
gather the many different documents
necessary to establish eligibility for
these benefits, e.g., birth certificates,
marriage certificates, divorce decrees
(where applicable), public agency
determinations as to death or disability
benefits, medical records, etc.
Information about the proposed
collections is as follows:
Claim for Death Benefits—Overview of
Information Collection
1. Type of Information Collection:
Reinstatement with change of a
previously approved collection.
2. The Title of the Form/Collection:
Claim for Death Benefits.
3. The agency form number, if any,
and the applicable component of the
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Department sponsoring the collection:
Bureau of Justice Assistance. Office of
Justice Programs, United States
Department of Justice.
4. Affected public who will be asked
or required to respond, as well as a brief
abstract:Primary: Eligible survivors of
fallen public safety officers.
Abstract: BJA’s Public Safety Officers’
Benefits (PSOB) Office will use the
Claim Form information to confirm the
eligibility of applicants to receive Public
Safety Officers’ Death Benefits.
Eligibility is dependent on several
factors, including public safety officer
status, an injury sustained in the line of
duty, and the claimant status in the
beneficiary hierarchy according to the
PSOB Act. In addition, information to
help the PSOB Office identify an
individual is collected, such as Social
Security numbers, telephone numbers,
and email addresses. Changes to the
claim form have been made in an effort
to streamline the application process
and eliminate requests for information
that are either irrelevant or already
being collected by other means.
OJP estimates that no more than 350
respondents will apply each year. Each
application takes approximately 120
minutes to complete. OJP estimates that
the total public burden (in hours)
associated with the collection can be
calculated as follows: Total Annual
Reporting Burden: 350 x 120 minutes
per application = 42,000 minutes/by 60
minutes per hour = 700 hours.
Public Safety Officer’s Death—Overview
of Information Collection
1. Type of Information Collection:
Reinstatement with change of a
previously approved collection.
2. The Title of the Form/Collection:
Report of Public Safety Offices Death.
3. The agency form number, if any,
and the applicable component of the
Department sponsoring the collection:
Bureau of Justice Assistance. Office of
Justice Programs, United States
Department of Justice.
4. Affected public who will be asked
or required to respond, as well as a brief
abstract: Primary: Public safety agencies
experiencing the death of a public safety
officer according to the PSOB Act.
Abstract: BJA’s Public Safety Officers’
Benefits (PSOB) Office will use the
Report of Public Safety Officer’s Death
Form information to confirm the
eligibility of applicants to receive Public
Safety Officers’ Death Benefits.
Eligibility is dependent on several
factors, including public safety officer
status, an injury sustained in the line of
duty, and the claimant status in the
beneficiary hierarchy according to the
Act. In addition, information to help the
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PSOB Office identify an individual is
collected, such as Social Security
numbers, telephone numbers, and email
addresses. Changes to the report form
have been made in an effort to
streamline the application process and
eliminate requests for information that
are either irrelevant or already being
collected by other means.
OJP estimates that no more than 350
respondents will apply each year. Each
application takes approximately 240
minutes to complete. OJP estimates that
the total public burden (in hours)
associated with the collection can be
calculated as follows: Total Annual
Reporting Burden: 350 × 240 minutes
per application = 84,000 minutes/by 60
minutes per hour = 1400 hours.
Public Safety Officers’ Disability
Benefits—Overview of Information
Collection
1. Type of Information Collection:
Reinstatement with change of a
previously approved collection.
2. The Title of the Form/Collection:
Public Safety Officer’s Disability
Benefits.
3. The agency form number, if any,
and the applicable component of the
Department sponsoring the collection:
Bureau of Justice Assistance. Office of
Justice Programs, United States
Department of Justice.
4. Affected public who will be asked
or required to respond, as well as a brief
abstract: Primary: Public safety officers
who were permanently and totally
disabled in the line of duty.
Abstract: BJA’s Public Safety Officers’
Benefits (PSOB) Office will use the
PSOB Disability Application
information to confirm the eligibility of
applicants to receive Public Safety
Officers’ Disability Benefits. Eligibility
is dependent on several factors,
including public safety officer status,
injury sustained in the line of duty, and
the total and permanent nature of the
line-of-duty injury. In addition,
information to help the PSOB Office
identify individuals is collected, such as
Social Security numbers, telephone
numbers, and email addresses. Changes
to the application form have been made
in an effort to streamline the application
process and eliminate requests for
information that are either irrelevant or
already being collected by other means.
OJP estimates that no more than 100
respondents will apply each year. Each
application takes approximately 300
minutes to complete. OJP estimates that
the total public burden (in hours)
associated with the collection can be
calculated as follows: Total Annual
Reporting Burden: 100 × 300 minutes
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per application = 30,000 minutes/by 60
minutes per hour = 500 hours.
■
Unfunded Mandates Reform Act of 1995
This proposed rule would not result
in the expenditure by State, local, and
tribal governments, in the aggregate, or
by the private sector, of $100,000,000 or
more in any one year, and it will not
significantly or uniquely affect small
governments. The PSOB program is a
federal benefits program that provides
benefits directly to qualifying
individuals. Therefore, no actions were
deemed necessary under the provisions
of the Unfunded Mandates Reform Act
of 1995.
§ 32.5
List of Subjects in 28 CFR Part 32
Administrative practice and
procedure, Claims, Disability benefits,
Education, Emergency medical services,
Firefighters, Law enforcement officers,
Reporting and recordkeeping
requirements, Rescue squad.
Accordingly, for the reasons set forth
in the preamble, part 32 of chapter I of
Title 28 of the Code of Federal
Regulations is proposed to be amended
as follows:
PART 32—PUBLIC SAFETY OFFICERS’
DEATH, DISABILITY, AND
EDUCATIONAL ASSISTANCE
BENEFITS CLAIMS
1. The authority citation for 28 CFR
part 32 continues to read as follows:
■
Authority: 42 U.S.C. ch. 46, subch. XII; 42
U.S.C. 3782(a), 3787, 3788, 3791(a),
3793(a)(4) & (b), 3795a, 3796c–1, 3796c–2;
sec. 1601, title XI, Pub. L. 90–351, 82 Stat.
239; secs. 4 through 6, Pub. L. 94–430, 90
Stat. 1348; secs. 1 and 2, Pub. L. 107–37, 115
Stat. 219.
2. Amend § 32.3 as follows:
a. Amend the definition of Act by
removing ‘‘and Apr. 5, 2006 (designated
beneficiaries))’’ and adding in its place
‘‘Apr. 5, 2006 (designated beneficiaries);
and Jan. 2, 2013)’’.
■ b. Add definitions of List of WTCrelated health conditions and Physical
harm in alphabetical order to read as
follows:
■
■
§ 32.3
Definitions.
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*
*
*
*
*
List of WTC-related health conditions
means the list of health conditions
(other than a mental-health condition)
listed—
(1) At 42 U.S.C. 300mm–22(a)(3); or
(2) On the List of WTC-Related Health
Conditions in 42 CFR part 88.
*
*
*
*
*
Physical harm means physical harm
as defined at 28 CFR 104.2(c).
*
*
*
*
*
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3. Amend § 32.5 by adding paragraph
(j) to read as follows:
Evidence.
*
*
*
*
*
(j) Physical harm suffered by a public
safety officer as a direct and proximate
result of a condition on the List of WTCRelated Health Conditions shall be
understood to be a line-of-duty injury if,
as determined by the PSOB determining
official, and pursuant to the standards
governing the World Trade Center
Health Program’s certification of injuries
as covered by the program, such
officer’s exposure to airborne toxins,
any other hazards, and any other
adverse conditions resulting from the
September 11, 2001, terrorist attacks is
substantially likely to have been a
significant factor in aggravating,
contributing to, or causing the illness or
health condition.
■ 4. Amend § 32.6 by adding paragraph
(f) to read as follows:
§ 32.6
Payment and repayment.
*
*
*
*
*
(f)(1) If compensation under the
September 11th Victim Compensation
Fund of 2001 (49 U.S.C. 40101 note))
has been paid with respect to an injury,
the total amount payable under subpart
B or C of this part, with respect to the
same injury, shall be reduced by the
amount of such payment of
compensation.
(2) Nothing in paragraph (f)(1) of this
section, or in the Act, at 42 U.S.C.
3796(f)(3), shall be understood to
preclude payment under this part before
the final payment of compensation
under such Fund.
(3) Nothing in the Act, at 42 U.S.C.
3796(f)(3), shall be understood to
require reduction of any amount
payable under subpart D of this part.
■ 5. Amend § 32.13 as follows:
■ a. Add definitions of Something other
than the mere presence of
cardiovascular disease risk factors and
Unrelated in alphabetical order.
■ b. Remove the definitions of
Competent medical evidence to the
contrary, Excessive consumption of
alcohol, Extrinsic circumstances, Risky
behavior, and Undertaking of treatment.
The additions read as follows:
§ 32.13
Definitions.
*
*
*
*
*
Something other than the mere
presence of cardiovascular disease risk
factors means—
(1) Ingestion of controlled substances
included on Schedule I of the drug
control and enforcement laws (see 21
U.S.C. 812(a)); or
(2) Abuse of controlled substances
included on Schedule II, III, IV, or V of
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the drug control and enforcement laws
(see 21 U.S.C. 812(a)).
*
*
*
*
*
Unrelated—A public safety officer’s
heart attack, stroke, or vascular rupture
is unrelated to the officer’s engagement
in a situation or participation in a
training exercise, as described in 42
U.S.C. 3796(k)(1), when an independent
event or occurrence significantly
contributes in bringing about the
officer’s heart attack, stroke, or vascular
rupture.
§ 32.14
[Amended]
6. In § 32.14, remove paragraph (c).
7. In § 32.33, the definition of Eligible
public safety officer is revised to read as
follows:
■
■
§ 32.33
Definitions.
*
*
*
*
*
Eligible public safety officer means a
public safety officer—
(1) With respect to whose death,
benefits under subpart B of this part
properly—
(i) Have been paid; or
(ii) Would have been paid but for
operation of the Act, at 42 U.S.C.
3796(f); or
(2) With respect to whose disability,
benefits under subpart C of this part
properly—
(i) Have been paid; or
(ii) Would have been paid, but for
operation of—
(A) Paragraph (b)(1) of § 32.6; or
(B) The Act, at 42 U.S.C. 3796(f).
*
*
*
*
*
Dated: June 30, 2016.
Karol V. Mason,
Assistant Attorney General.
[FR Doc. 2016–16086 Filed 7–14–16; 8:45 am]
BILLING CODE P
DEPARTMENT OF HOMELAND
SECURITY
Coast Guard
33 CFR Part 110
[Docket Number USCG–2016–0110]
RIN 1625–AA01
Anchorage Grounds; Delaware Bay
and River, Philadelphia, PA
Coast Guard, DHS.
Notice of proposed rulemaking.
AGENCY:
ACTION:
The Coast Guard proposes to
amend the anchorage regulations for
Delaware Bay and River. The Coast
Guard conducted a review of the
Delaware Bay and River anchorage
SUMMARY:
E:\FR\FM\15JYP1.SGM
15JYP1
Agencies
[Federal Register Volume 81, Number 136 (Friday, July 15, 2016)]
[Proposed Rules]
[Pages 46019-46026]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2016-16086]
=======================================================================
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DEPARTMENT OF JUSTICE
28 CFR Part 32
[Docket No.: OJP (BJA) 1716]
RIN 1121-AA85
Public Safety Officers' Benefits Program
AGENCY: Office of Justice Programs, Justice.
ACTION: Notice of proposed rulemaking.
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SUMMARY: This rule proposes to make the following changes to current
regulations implementing the Public Safety Officers' Benefits (PSOB)
Act: Adopting the World Trade Center (WTC) Health Program's List of
WTC-Related Health Conditions (List), the WTC Health Program's
standards for certifying that an injury is covered for treatment under
the Program, and related regulatory provisions, establishing payment
offset provisions between the PSOB Program and the September 11th
Victim Compensation Fund, and revising the provisions that define when
the statutory presumption of line-of-duty death resulting from certain
heart attacks, strokes, and vascular ruptures is rebutted. The proposed
changes based on the WTC Health Program's List and related provisions
would provide a means for claimants to establish that certain public
safety officers with chronic, often latent, health conditions sustained
a line-of-duty injury under the PSOB Act. The proposed payment offset
provisions are intended to implement statutory amendments to the PSOB
Act requiring such offset and to facilitate claims processing.
Similarly, the proposed rule implementing the statutory presumption
associated with certain heart attacks, strokes, and vascular ruptures
is intended to amend the current regulation to conform to recent
amendments to the PSOB Act and to improve the processing of such
claims.
DATES: Written comments must be postmarked and electronic comments must
be submitted on or before September 13, 2016. Comments received by mail
will be considered timely if they are postmarked on or before that
date. The electronic Federal Docket Management System (FDMS) will
accept comments until Midnight Eastern Time at the end of that day.
ADDRESSES: Please address all comments regarding this rule by U.S.
mail, to: Hope Janke, Bureau of Justice Assistance, Office of Justice
Programs, 810 7th Street NW., Washington, DC 20531; or by telefacsimile
to (202) 354-4135. To ensure proper handling, please reference OJP
Docket No. 1716 on your correspondence. Comments may also be sent
electronically through https://regulations.gov using the electronic
comment form provided on that site. An electronic copy of this document
is also available at the https://regulations.gov Web site. OJP will
accept attachments to electronic comments in Microsoft Word,
WordPerfect, or Adobe PDF formats only.
FOR FURTHER INFORMATION CONTACT: Hope Janke, BJA, OJP, at (202) 514-
6278, or toll-free at 1 (888) 744-6513.
SUPPLEMENTARY INFORMATION:
I. Posting of Public Comments
Please note that all comments received are considered part of the
public record and made available for public inspection online at https://www.regulations.gov. Information made available for public inspection
includes personal identifying information (such as your name, address,
etc.) voluntarily submitted by the commenter.
The Office of Justice Programs (OJP) does not require commenters to
submit personal identifying information (such as your name, address,
medical information, etc.) as part of your comment. However, if you
wish to submit such information, but do not wish it to be posted
online, you must include the phrase ``PERSONAL IDENTIFYING
INFORMATION'' in the first paragraph of your comment. You must also
locate all the personal identifying information that you do not want
posted online in the first paragraph of your comment and identify what
information you want the agency to redact. Personal identifying
information identified and located as set forth above will be placed in
the agency's public docket file, but not posted online.
If you wish to submit confidential business information as part of
your comment but do not wish it to be posted online, you must include
the phrase ``CONFIDENTIAL BUSINESS INFORMATION'' in the first paragraph
of your comment. You must also prominently identify confidential
business information to be redacted within the comment. If a comment
has so much confidential business information that it cannot be
effectively redacted, the agency may choose not to post that comment
(or to only partially post that comment) on https://www.regulations.gov.
Confidential business information identified and located as set forth
above will not be placed in the public docket file, nor will it be
posted online.
If you wish to inspect the agency's public docket file in person by
appointment, please see the FOR FURTHER INFORMATION CONTACT paragraph.
II. Background
A. General
The Public Safety Officers' Benefits (PSOB) Program, 42 U.S.C. 3796
et seq. (established pursuant to the Public Safety Officers' Benefits
Act of 1976), is administered by the Bureau of Justice Assistance (BJA)
of the Office of Justice Programs (OJP), U.S. Department of Justice.
Generally speaking, the PSOB Program provides a one-time financial
payment to the statutorily-eligible survivors of public safety officers
who die as the direct and proximate result of personal injuries
sustained in the line of duty, as well as educational assistance for
their spouses and eligible children.
Alternatively, the PSOB Program also provides a one-time financial
payment directly to public safety officers determined to be permanently
and totally disabled as the direct and proximate result of personal
injury sustained in the line of duty, as well as educational assistance
for their spouses and eligible children.
B. Establishing a Line-of-Duty Injury Under the PSOB Act and
Implementing Regulations
42 U.S.C. 3796(a) authorizes the payment, to statutory survivors,
of a benefit of $250,000, currently adjusted for inflation at $339,881,
when the administering agency determines, under its regulations ``that
a public safety officer has died as the direct and proximate result of
a personal injury sustained in the line of duty.'' Similarly, 42 U.S.C.
3796(b) authorizes the agency
[[Page 46020]]
to pay the same inflation-adjusted benefit, when it determines, under
its regulations, that a public safety officer has ``become permanently
and totally disabled as the direct and proximate result of a personal
injury sustained in the line of duty.'' The agency has exercised its
regulatory authority in regulations published in 28 CFR part 32
defining, among other things, ``injury,'' ``line of duty injury,'' and
``direct and proximate result of an injury.'' Those regulations specify
the criteria that must be met in the ordinary course for a claimant to
establish that a public safety officer sustained a line-of-duty injury
and that the injury caused the officer's death or permanent and total
disability.
Under the definition of injury in 28 CFR 32.3, a claimant must
establish that a public safety officer sustained a ``traumatic physical
wound (or a traumatized physical condition of the body) directly and
proximately caused by external force.'' Under definitions related to
causation in 28 CFR 32.3 (defining direct and proximate result of an
injury and substantial factor), a claimant must also establish that the
injury was the ``substantial factor'' in the officer's death or
disability. ``A factor substantially brings about a death, injury, [or]
disability'' if it was sufficient in and of itself to cause the death,
injury, or disability, or no other factor (or combination of factors)
``contributed to the death, injury, [or] disability . . . to so great a
degree as it did.'' 28 CFR 32.3 (defining substantial factor). Taken
together, these regulations require that a claimant seeking benefits
establish an injury, i.e., a traumatic physical wound or traumatized
physical condition of the body directly and proximately caused by an
external force or other agent, e.g., chemicals, as well as a death or
disability, and a direct and proximate causal nexus between the injury
and the death or disability.
In PSOB claims involving acute injuries caused by readily
identifiable external forces such as a gunshot, motor vehicle accident,
or other trauma with death occurring simultaneously or closely
following injury, a claimant's burden in establishing the injury and
causal link between injury and death may be straightforward and readily
demonstrated. In such cases, a death certificate or an autopsy is
generally sufficient to establish a traumatic wound or traumatized
condition, the external force that caused the wound or condition, the
officer's death, and a direct and proximate causal link between the
injury and death.
In PSOB claims asserting injury or death resulting from exposure to
unspecified toxins or hazards associated with line-of-duty activity,
however, an autopsy may not sufficiently identify the mechanism of the
injury, or adequately establish the direct and proximate causal link
between the injury and the death (or permanent and total disability)
necessary to support the approval of a claim under the PSOB Act. In
such claims, more detailed medical evaluation may be required, and
substantial medical evidence may need to be gathered and produced
before PSOB determining officials may make the necessary findings to
find the PSOB Act standards are met. For example, an autopsy usually is
not sufficient evidence when the claims are based on the chronic, often
latent, illnesses and conditions of 9/11 first responders; e.g.,
respiratory disorders and certain cancers. Similar burdens in
gathering, producing, and evaluating medical evidence exist for 9/11
first responders claiming to be permanently and totally disabled as a
result of exposure to unidentified toxins or hazards encountered in
responding to the September 11, 2001, terrorist attacks.
C. Establishing Injury Under the James Zadroga 9/11 Health and
Compensation Act of 2010
Pursuant to the James Zadroga 9/11 Health and Compensation Act of
2010 (Pub. L. 111-347), as amended, the World Trade Center (WTC) Health
Program, which is administered by the Director of the National
Institute for Occupational Safety and Health (NIOSH), within the
Centers for Disease Control and Prevention (a component of the U.S.
Department of Health and Human Services), provides medical monitoring
and treatment for WTC Health Program members with certain health
conditions that are certified as related to the unique circumstances of
the 9/11 explosions, ensuing conflagrations, and clean-up (9/11
disaster).\1\ In so doing, the Administrator of the WTC Health Program
has an advisory committee including medical and scientific experts
appointed to review and consider the latest research on connections
that may exist between various medical conditions and exposure to the
9/11 disaster. The Administrator of the WTC Health Program may seek
guidance and recommendations from these medical and scientific experts,
in determining whether to propose adding conditions to the List of WTC-
Related Health Conditions through rulemaking.
---------------------------------------------------------------------------
\1\ The James Zadroga 9/11 Health and Compensation Act of 2010
was amended by the Consolidated Appropriations Act, 2016, Public Law
114-113 (Dec. 18, 2015) (The James Zadroga 9/11 Health and
Compensation Reauthorization Act) (available at gpo.gov).
---------------------------------------------------------------------------
The List of WTC-Related Health Conditions is a list of illnesses or
health conditions that, pursuant to an examination by a medical
professional with expertise in treating or diagnosing the listed
conditions, may be found to be related to a WTC Health Program member's
exposure to airborne toxins, any other hazards, or any other adverse
conditions resulting from the September 11, 2001, terrorist attacks.
That a WTC Health Program member has a health condition or illness on
the List of WTC-Related Health Conditions does not, by itself,
establish that such health condition or illness was related to the 9/11
disaster and, therefore, is eligible for treatment in the WTC Health
Program. Rather, the WTC Health Program also makes a specific decision
as to whether a particular WTC Health Program member's exposure to the
toxins, hazards, or other adverse conditions associated with the 9/11
disaster was ``substantially likely to be a significant factor in
aggravating, contributing to, or causing the illness or health
condition.'' 42 U.S.C. 300mm-22(a)(1)(A)(1). By law, such decision is
based on an assessment of: (1) The individual's exposure to airborne
toxins, any other hazard, or any other condition resulting from the
terrorist attacks; and (2) the type of symptoms and temporal sequence
of symptoms. 42 U.S.C. 300mm-22(a)(2). Together, the List of WTC-
Related Health Conditions and individual assessment as to exposure and
symptomatology comprise the general and specific findings that the WTC
Health Program makes in establishing that a WTC Health Program member's
particular illness or health condition is related to the 9/11 disaster.
D. Fatal Heart Attacks, Strokes, and Vascular Ruptures Under 42 U.S.C.
3796(k)
To establish eligibility for death benefits under the PSOB Act,
claimants must establish that a public safety officer suffered a
personal injury in the line of duty that directly and proximately
caused the officer's death. This statutory requirement excluded from
coverage those conditions caused by stress and strain and occupational
disease, such as practically speaking, most heart attacks and strokes.
The Hometown Heroes Survivors' Benefits Act of 2003 (Pub. L. 108-
182) (Hometown Heroes Act) amended the PSOB Act by creating a statutory
presumption in 42 U.S.C. 3796(k) of death by a line-of-duty injury,
which may be rebutted by ``competent medical evidence to the
contrary,'' in cases
[[Page 46021]]
where a public safety officer dies of heart attack or stroke while
engaging in, (or within 24 hours of engaging in) ``nonroutine stressful
or strenuous physical [line-of-duty] activity.'' Implementation of the
rebuttal language has proved challenging for OJP. In fact, the House
Judiciary Committee in 2012 noted that ``[one] particular term
introduced into the PSOBA in 2003, `competent medical evidence to the
contrary,' has not proven workable as introduced.'' \2\
---------------------------------------------------------------------------
\2\ H.R. Rpt. 112-548 at 14 (June 25, 2012).
---------------------------------------------------------------------------
In 2006 and 2008, OJP published final rules implementing the
Hometown Heroes Act. The 2008 rule provided that the presumption
attaches ``unless it . . . is overcome by competent medical evidence to
the contrary, when evidence indicates to a degree of medical
probability that extrinsic circumstances, considered in combination (as
one circumstance) or alone, were a substantial factor in bringing the
heart attack or stroke about.'' \3\ The rule defined extrinsic
circumstances as ``[a]n event or events; or . . . [a]n intentional
risky behavior or intentional risky behaviors.'' Thus, under
regulations implementing the previous presumption, the presumption was
rebutted when competent medical evidence of record established that an
event(s) or intentional risky behavior(s) \4\ (as defined in the
regulations) were the substantial factor in an officer's fatal heart
attack or stroke.
---------------------------------------------------------------------------
\3\ 28 CFR 32.13 (defining Competent medical evidence to the
contrary).
\4\ In general, ``risky behavior'' was defined as (1) an
officer's failure to undertake treatment, without reasonable excuse,
of any known commonly accepted cardiovascular disease risk factor
exceeding minimum high-risk levels or of diseases associated with
increased risk of cardiovascular disease, or where certain
biological relatives had a history of cardiovascular disease, (2)
consumption over certain levels of cigarettes or alcohol, and (3)
use or abuse of certain controlled substances associated with
increased risk of cardiovascular disease.
---------------------------------------------------------------------------
OJP's experience is that consideration of cardiovascular disease
risk factors and the concept of ``risky behavior'' have largely proven
unworkable. In practice, medical examiners, even with a complete
medical record, are rarely able to determine with medical precision
whether an inadequately treated cardiovascular disease risk factor(s)
was the substantial factor in the officer's fatal condition. As a
result, the PSOB Program has expended significant time and resources on
inconclusive results, i.e., claims in which a recognized cardiovascular
disease risk factor is found to have somehow contributed to the
officer's fatal condition but not to the degree that it rebutted the
presumption. OJP's conclusion that the current interpretation is
unworkable is further reflected in the low numbers of claims it has
denied based on ``risky behaviors.'' Despite routinely seeking from
claimants additional medical evidence and engaging in time-consuming
independent medical review of such evidence, from Fiscal Year 2011 to
date, BJA denied at the PSOB Office level less than 1% of all Hometown
Heroes claims determined on the basis that an officer's ``risky
behaviors'' were a substantial factor in bringing about the heart
attack, stroke, or vascular rupture.
In January 2013, the Dale Long Public Safety Officers' Benefits
Improvement Act of 2012 (Section 1086 of Pub. L. 112-239) (Dale Long
Act) amended the rebuttal language in section 3796(k). As amended, the
presumption is rebutted when ``competent medical evidence establishes
that the [public safety officer's] heart attack, stroke, or vascular
rupture was unrelated to the [officer's] engagement or participation or
was directly and proximately caused by something other than the mere
presence of cardiovascular-disease risk factors.'' As the amendment
repealed the statutory language upon which OJP regulations implementing
the presumption are based, e.g., Competent medical evidence to the
contrary, such regulations are now obsolete.
III. Provisions of the Proposed Rule
A. Adoption of the WTC Health Program's List of WTC-Related Health
Conditions and Standards
Because of the medical and scientific evaluation that informs the
List of WTC-Related Health Conditions (List), BJA proposes to use the
List as a means for streamlining its own claim-specific evaluation,
where a claim for PSOB Program benefits is based on a medical condition
(not otherwise excluded from coverage under the PSOB Program) included
in the List. Similarly, BJA also proposes, consistent with the law,
regulations, policies, and procedures governing the WTC Health
Program's certification of an individual's injuries as covered for
treatment under the Program, and in conjunction with the List, to
assess the individual public safety officer's exposure to toxins,
hazards, and other adverse conditions resulting from the terrorist
attacks as well as the type of symptoms and temporal sequence of
symptoms. Under the proposed rule, BJA will independently use the WTC
Health Program's ``standards'' for certification, which includes the
Program's regulations, policies, and procedures, to establish an injury
under the PSOB Act.
The proposed rule would establish a means by which claimants could
establish that a public safety officer who suffered physical injury as
a result of line-of-duty activity at a 9/11 crash site sustained an
injury under the PSOB Act. More specifically, the rule would adopt the
WTC Health Program standards for establishing injury or illness for
public safety officers who responded to the 9/11 disaster based on the
medical and scientific evidence underlying those standards and to
promote consistency in the process for determining claims resulting
from exposure to a 9/11 crash site. Under the proposed rule, evidence
demonstrating that a public safety officer (1) performed line-of-duty
activity at a 9/11 crash site, (2) was diagnosed with a physical
illness or condition on the List of WTC-Related Health Conditions as
defined in 42 CFR part 88, (3) whose physical injury was directly and
proximately caused by an illness or condition on the List, and (4)
whose exposure to the hazards, toxins, and adverse conditions of the 9/
11 disaster are found by the PSOB determining official to be
substantially likely to have been a significant factor in aggravating,
contributing to, or causing the responder's health condition, would
establish an injury for purposes of the PSOB Act. Consistent with the
VCF, which payments are treated by law as duplicative of PSOB Program
payments and required to be offset, 42 U.S.C. 3796(f)(3), a claimant's
injury would be limited to ``physical harm'' as defined 28 CFR
104.2(c).
BJA proposes to adopt the List of WTC-Related Health Conditions
(other than mental health conditions) because these are illnesses or
health conditions for which exposure to airborne toxins, any other
hazard, or any other adverse condition resulting from the September 11,
2001, terrorist attacks, have been found by another federal program to
potentially be related to 9/11 exposures. Because the PSOB Program
already excludes mental health conditions from its coverage, the
proposed rule would not extend its application to any mental health
conditions on the List.
In addition, the adoption of the List and the WTC Health Program
standards for assessing injury is warranted based on the unique
circumstances associated with the response to the 9/11 disaster, the
chronic, often latent, nature of health conditions linked to the
response, and the rigorous evidentiary burden faced by PSOB claimants
in establishing an injury under current regulations implementing the
PSOB Act. PSOB claimants would still be required
[[Page 46022]]
to satisfy the statutory requirement that such injury have been the
direct and proximate cause of the public safety officer's death or
permanent and total disability.
The proposed rule would cover those circumstances in which a
claimant lacked a WTC Health Program certification or its equivalent,
e.g., a determination by the Victim Compensation Fund that an
individual's injury was eligible for compensation, that a public safety
officer's 9/11 exposure is substantially likely to have been a
significant factor in aggravating, contributing to, or causing a
particular health condition. The proposed rule would also codify OJP's
interpretation that its current regulations providing that a PSOB
determining official may consider the factual findings of a public
agency, 28 CFR 32.5(b), enable the PSOB Program to accept as evidence
of a line-of-duty injury a ``certification'' by the WTC Program
Administrator, as defined in 42 CFR 88.1, or its equivalent, that a
particular public safety officer's exposure to airborne toxins, any
other hazards, or any other adverse conditions resulting from the
September 11, 2001, terrorist attacks is substantially likely to be a
significant factor in aggravating, contributing to, or causing the
condition.
This regulatory approach would promote the efficient resolution of
issues related to injury (and in some cases, causation) without the
need for the PSOB Program to conduct an individual review and
investigation of the available medical literature in every claim
associated with a 9/11 injury. It would promote consistency in federal
decision making by allowing the complex medical decisions of another
federal program (the WTC Health Program) to streamline the PSOB
Program's own evaluation of the same medical issues. It also would
lessen the burden on claimants who otherwise may face significant
challenges in obtaining and producing significant medical documentation
necessary to establish an injury.
Under the proposed rule, the PSOB Program would rely upon and apply
the List and WTC Health Program standards to its independent
determination of injury only where the claimant otherwise has
established all of the applicable elements normally required for a PSOB
claim; e.g., proof of status as a public safety officer and line-of-
duty activity.
To maintain consistency with the September 11th Victim Compensation
Fund of 2001 (VCF), as amended,\5\ the proposed rule would incorporate
certain relevant definitions found in the James Zadroga 9/11 Health and
Compensation Act of 2010, Public Law 111-347, as amended, and
definitions found in implementing regulations: ``Physical harm, and
``WTC-related health condition.'' In particular, OJP proposes to adopt
the physical harm provision, which requires that the physical condition
upon which the claim of injury is based was treated by a medical
professional and may be verified by medical records that were created
by or at the direction of the medical care provider, for purposes of
maintaining the integrity of the PSOB Program.
---------------------------------------------------------------------------
\5\ The September 11th Victim Compensation Fund of 2001 was
amended by the by the Consolidated Appropriations Act, 2016, Public
L. 114-113 (Dec. 18, 2015) (The James Zadroga 9/11 Victim
Compensation Fund Reauthorization Act) (available at gpo.gov).
---------------------------------------------------------------------------
B. Prohibition Against Duplicate (Dual) Payments
The 2013 amendment to the PSOB Act established, in the PSOB Act
itself, a limitation on payments by declaring that benefit payments
made under the PSOB Act are in addition generally to any other benefit
except payments under the VCF. 42 U.S.C. 3796(f)(3). Therefore, OJP
proposes to add a new provision in 28 CFR 32.6, describing how and when
the PSOB Program would pay benefits under the PSOB Act to persons who
have received payments from the VCF.
Under the proposed rule, no death or disability benefits under the
PSOB program would be payable when the VCF has made payments to or with
respect to a public safety officer that are equal to or exceed the
amount of such benefits payable under the PSOB Act. To account for
circumstances when a PSOB claimant has a pending claim for VCF
benefits, or the VCF has made payment to a PSOB claimant that is less
than the amount payable under the PSOB Act, the proposed rule would
clarify that nothing in the PSOB Act or the rule itself precludes
payment of PSOB benefits before the VCF makes payment of compensation.
In so doing, the PSOB Program could pay benefits to VCF claimants
without waiting for the VCF to issue its payments. To prevent
overpayments and ensure the offset is applied, before the PSOB Program
pays any benefits based on injuries sustained in the 9/11 disaster, it
would verify with the VCF the amount of any payments made or payable to
a VCF claimant.
The proposed rule would also clarify that the offset does not
extend to educational assistance payable under the PSOB Act, 42 U.S.C.
3796d--3796d-7. When viewed in the context of a statutory scheme
providing for the payment of a particular one-time death or disability
benefit, the agency believes that the ordinary meaning of ``the benefit
payable under this subchapter'' suggests that the scope of the offset
is limited to the death and disability benefit payable under 42 U.S.C.
3796. However, under current regulations that were promulgated before
the offset statute was enacted, educational assistance may, with one
exception, be paid only when PSOB Program death or disability benefits
have been paid. As OJP has determined the offset does not extend to
educational assistance, the proposed rule would revise the definition
of ``Eligible public safety officer'' in current Sec. 32.33 to
authorize payment of educational assistance where death or disability
benefits would have been paid but for the operation of the offset in 42
U.S.C. 3796(f).
C. Fatal Heart Attacks, Strokes, and Vascular Ruptures Under 42 U.S.C.
3796(k)
As the Dale Long Act has amended 42 U.S.C. 3796(k), OJP proposes to
amend its implementing regulations in 28 CFR 32.13 and 32.14 to reflect
the revised statutory language. In implementing revised section
3796(k), the proposed rule would define in proposed Sec. 32.13 the two
circumstances when the presumption of death directly and proximately
resulting from a line-of-duty injury associated with certain heart
attacks, strokes, and vascular ruptures as provided in section 3796(k)
is rebutted--i.e., when ``competent medical evidence establishes that
the [officer's] heart attack, stroke, or vascular rupture [1] was
unrelated to the [officer's] engagement or participation or [2] was
directly and proximately caused by something other than the mere
presence of cardiovascular-disease risk factors.''
Under the proposed rule, an officer's heart attack, stroke, or
vascular rupture would be considered as ``unrelated to an [officer's]
engagement or participation'' if competent medical evidence established
that an independent event or occurrence significantly contributed in
bringing about the officer's heart attack, stroke, or vascular rupture.
OJP believes that defining this rebuttal factor in terms of ``an
independent event or occurrence,'' that is, something that happens to
an officer, appropriately ensures that an off-duty heart attack,
stroke, or vascular rupture caused by a clearly unrelated event, such
as an off-duty officer's accident, is not covered by the presumption.
[[Page 46023]]
For example, a police officer's fatal heart attack due to
electrocution suffered while performing home repair, established by
competent medical evidence, would not be covered by the presumption
despite occurring only 12 hours after the officer engaged in a
situation involving nonroutine stressful or strenuous physical law
enforcement activity. The heart attack is not covered by the
presumption because competent medical evidence establishes that an
independent event or occurrence (electrocution sustained while
repairing home wiring) separate and apart from the officer's qualifying
activity, i.e., engagement in a situation involving nonroutine
stressful or strenuous physical law enforcement activity, significantly
contributed in bringing about the officer's fatal heart attack. At the
same time, such a construction would ensure that an officer's ordinary
and routine off-duty activities such as yard work or exercise, that
take place following qualifying, on-duty engagement or participation,
would not be evaluated for their contribution to the officer's fatal
heart attack, stroke, or vascular rupture.
Turning to the other rebuttal factor in the proposed rule, an
officer's heart attack, stroke, or vascular rupture would be considered
to be caused by ``something other than the mere presence of
cardiovascular-disease risk factors'' when competent medical evidence
establishes that the officer's heart attack, stroke, or vascular
rupture was directly and proximately caused by the officer's ingestion
of controlled substances on Schedule I of the drug control and
enforcement laws or the officer's abuse of controlled substances on
Schedules II-V of the drug control and enforcement laws. OJP believes
that by defining this particular rebuttal factor in terms of
intentional behaviors that are well established as adversely affecting
cardiovascular health, that exceed the mere presence of cardiovascular
disease risk factors, and that are readily attributable to an officer's
actions, the proposed rule would appropriately rebut the presumption
and preclude payment consistent with the language of the statute.
In addition to implementing the amended statutory language of the
presumption, the proposed changes to Sec. 32.13 would reduce the
evidentiary burden on claimants seeking death benefits under section
3796(k) and streamline the processing of such claims by reducing the
circumstances under which the PSOB Program would seek expert medical
review and additional medical evidence. Towards this end, the proposed
rule would eliminate as a basis for rebutting the presumption certain
actions of the officer previously defined in regulations as ``risky
behaviors,'' e.g., an officer's failure to adequately treat known
cardiovascular-disease risk factors. OJP believes that eliminating this
basis for rebuttal is justified based on its experience implementing
the previous regulation which revealed that medical examiners, even
with a complete medical record, itself a rare occurrence, were rarely
able to determine whether a public safety officer was sufficiently non-
compliant with treatment such that it could be said to be the direct
and proximate cause of the officer's fatal heart attack, stroke, or
vascular rupture. By omitting from the proposed rule those rebuttal
factors which often required the collection and evaluation of extensive
medical records as part of an independent medical examination and
produced largely inconclusive results, the proposed rule would
measurably reduce the burden on claimants and the agency.
Consistent with the amendments to the statutory rebuttal provision,
the proposed rule would also eliminate from Sec. 32.13 provisions
defining ``Competent medical evidence to the contrary,'' ``Excessive
consumption of alcohol,'' ``Extrinsic circumstances,'' ``Risky
behavior,'' and ``Undertaking of treatment.'' In addition, the proposed
rule would eliminate Sec. 32.14(c), requiring the PSOB Office to
provide notice to claimants when it determines the existence of
competent medical evidence to the contrary. As the statute no longer
includes such language, the provision is unnecessary.
IV. Regulatory Requirements
Executive Order 12866 and 13563--Regulatory Planning and Review
This proposed rule has been drafted and reviewed in accordance with
Executive Order 12866, ``Regulatory Planning and Review,'' section
1(b), Principles of Regulation, and in accordance with Executive Order
13563, ``Improving Regulation and Regulatory Review,'' section 1(b),
General Principles of Regulation. Executive Orders 12866 and 13563
direct agencies to assess all costs and benefits of available
regulatory alternatives and, if regulation is necessary, to select
regulatory approaches that maximize net benefits (including potential
economic, environmental, public health and safety effects, distributive
impacts, and equity). As explained below, OJP has assessed the costs
and benefits of this proposed rule as required by Executive Order 12866
and has determined that the benefits of the proposed rule justify the
costs.
A. Adoption of the WTC Health Program's List and Standards
OJP's experience is that PSOB claimants have been largely
unsuccessful in establishing an ``injury'' for delayed-onset medical
conditions or illnesses, particularly cancer. As the proposed rule
establishes an evidentiary standard intended for the unique
circumstances of public safety officers who sustained an injury related
to the 9/11 disaster, OJP estimates that the proposed rule would likely
affect all of the 29 claims based on 9/11 injury (27 death/2
disability) currently pending in the PSOB Program without a WTC Health
Program certification or its equivalent by enabling these claimants to
establish an ``injury'' under the PSOB Act. Although there are
currently 161 total PSOB death and disability claims pending with
assertions of injuries based on 9/11 exposure, this estimate pertains
only to the 29 claims not covered under OJP's current regulatory
authority, as benefits paid through OJP's process of determining PSOB
claims based on ``certifications'' issued by the WTC Health Program
Administrator (or equivalent) under 28 CFR 32.5(b) would not be
impacted as a result of this regulatory change.
If all 29 such claims were paid, the total PSOB Program death and
disability benefit cost would be $8,778,198.80. Based on amounts
appropriated in FY2016 for PSOB Program death benefits (``such sums as
necessary''--estimated at $71,323,000) and disability and education
benefits ($16,300,000), OJP knows that it could pay the death claims
from its current appropriations, and estimates that it could pay the
disability claims from its current appropriations. OJP's estimate does
not account for any offset to PSOB Program payments based on VCF
payments, which would reduce the amount of PSOB Program payments made;
however, OJP is unable to estimate how many of the 29 claims would be
approved by VCF. Regardless of whether a PSOB payment were offset by a
VCF payment, there is no additional benefit cost, as the amounts that
would be required are covered by current appropriations (with respect
to death claims) and appear to be covered by such appropriations with
respect to disability claims, and, barring unforeseen circumstances,
would not exceed such amounts. As PSOB claims based on 9/11 injury
would be processed by existing staff, OJP would not incur additional
administrative or
[[Page 46024]]
personnel costs in processing these claims.
B. Provisions Implementing the Offset at 42 U.S.C. 3796(f)(3)
The primary benefit of the proposed rule is that, pursuant to
statute, it permits the PSOB Program to pay benefits to PSOB claimants
who are awaiting a decision on eligibility for VCF benefits, pending
receipt of VCF payments, or are in receipt of VCF payments less than
the maximum PSOB Program death or disability payment. A secondary
benefit is that it clarifies that claimants who would be eligible for
payment of death or disability benefits under the PSOB Act but for the
operation of the offset, would be eligible for educational assistance.
Estimating annual costs for public safety officers' educational
assistance is difficult because of the nature of the payment.\6\ If all
of the 29 currently pending claims based on 9/11 injury and lacking a
WTC Health Program certification, or its equivalent, were approved,
thereby creating potential eligibility for educational assistance, OJP
estimates that the impact could be to add approximately 49 educational
assistance claimants for FY2016 and beyond. Using the current maximum
monthly payment rate of $1,021/month, OJP estimates that annual benefit
costs could increase by approximately $450,261, annually (based on 49
claimants completing 9 months of educational assistance payable at the
current maximum rate of $1,021/month).\7\ Based on the amount of funds
appropriated for disability benefits and educational assistance in
FY2016 ($16,300,000), OJP estimates that, barring unforeseen
circumstances, it could pay these additional education claims from its
current appropriation. As PSOB claims based on 9/11 injury would be
processed by existing staff, OJP would not incur additional costs in
processing these claims.
---------------------------------------------------------------------------
\6\ The educational assistance benefit is payable only as a
reimbursement to spouses and children of eligible public safety
officers for eligible educational expenses such as tuition and fees.
Further complicating matters related to estimation, eligible
children have until they are 27 to complete qualifying coursework
and spouses of eligible public safety officers have no age cutoff
for completing qualifying coursework. In addition, claimants may
submit claims for educational assistance up to six months before
attending qualifying coursework, or at any time after a course has
been completed. On occasion, the PSOB Program receives a single
claim for all 45 months of benefits; however, the majority of claims
are submitted on an academic-term by academic-term basis.
\7\ Payments for PSOB educational assistance are calculated on
the basis prescribed in 38 U.S.C. 3532 and are subject to increase
based on increases in certain consumer price indexes as provided in
38 U.S.C. 3564.
---------------------------------------------------------------------------
C. Fatal Heart Attacks, Strokes, and Vascular Ruptures Under 42 U.S.C.
3796(k)
The primary benefit of the proposed rule is the reduced burden on
both claimants and the agency in determining claims under 42 U.S.C.
3796(k). In defining the circumstances that warrant rebuttal in terms
of readily ascertainable facts, OJP believes that the PSOB Program
will, in most cases, be able to rely upon the evidence of injury and
death ordinarily submitted with a claim, e.g., a death certificate or
autopsy. Based on its experience, OJP estimates that, under the
previous regulatory interpretation, it seeks additional evidence from
claimants and independent medical review of medical evidence in
approximately 50 percent of claims. Under the proposed rule, OJP
estimates that the PSOB Program would need to seek additional evidence
from claimants and independent medical review of medical evidence in
less than 5 percent of claims. As the PSOB Program receives on average
approximately 92 claims for benefits under 42 U.S.C. 3796(k) annually,
OJP estimates that it would need to seek additional evidence and review
in fewer than 1 in 20 such claims, which is significantly fewer than it
seeks under the previous rule.
This reduction in evidentiary development is also expected to
result in cost savings for medical reviews as well as the costs
associated with obtaining medical records for such reviews. For every
claim that does not require independent medical review, OJP estimates a
savings of $1,652, which represents the average cost to the program of
obtaining certain medical opinions in claims for PSOB Program death
benefits from 2009 through 2015. OJP also estimates a savings to the
claimant of $603 for the cost of obtaining medical records (an average
of 900 pages in the claims sampled). This estimate is based on the
maximum fees permitted by law, which vary by state,\8\ and the number
of pages of medical records in claims for PSOB Program death benefits
as determined in a random sampling of claims involving medical issues
that require a claimant to provide such records. In addition, OJP
believes that the streamlined criteria would increase the rate at which
such claims are processed, however, it is difficult to quantify any
additional cost savings resulting from such efficiencies.
---------------------------------------------------------------------------
\8\ See e.g., Joy Pritts, et al., Privacy and Security Solutions
for Interoperable Health Information Exchange: Report on State
Medical Record Access Laws, https://www.healthit.gov/sites/default/files/290-05-0015-state-law-access-report-1.pdf; Table A-5, Overview
of State Law: Maximum Fees Doctors and Hospitals May Charge Patients
for Copies of Medical Records https://www.healthit.gov/sites/default/files/appa5-1.pdf. (accessed June 16, 2016).
---------------------------------------------------------------------------
In terms of benefit costs, OJP estimates that there will not be a
significant increase in claims approved as compared to the previous
regulatory criteria. Accordingly, the proposed rule does not
significantly increase benefit costs. And, as these claims would be
processed by existing staff, OJP would not incur additional
administrative or personnel costs in processing these claims.
This proposed rule would impose no costs on state, local, or tribal
governments, or on the private sector.
Although not an economically significant rulemaking under Executive
Orders 12866 and 13563, The Office of Justice Programs has determined
that this proposed rule is a ``significant regulatory action'' under
section 3(f) of the Executive Order, and accordingly this rule has been
reviewed by the Office of Management and Budget (OMB).
Executive Order 13132--Federalism
This proposed rule would not have substantial direct effects on the
States, on the relationship between the federal government and the
States, or on distribution of power and responsibilities among the
various levels of government. The PSOB program statutes provide
benefits to individuals and do not impose any special or unique
requirements on States or localities. Therefore, in accordance with
Executive Order No. 13132, it is determined that this proposed rule
does not have sufficient federalism implications to warrant the
preparation of a Federalism Assessment.
Executive Order 12988--Civil Justice Reform
This proposed rule meets the applicable standards set forth in
sections 3(a) & (b)(2) of Executive Order No. 12988. Pursuant to
section 3(b)(1)(I) of the Executive Order, nothing in this proposed
rule or any previous rule (or in any administrative policy, directive,
ruling, notice, guideline, guidance, or writing) directly relating to
the Program that is the subject of this rule is intended to create any
legal or procedural rights enforceable against the United States,
except as the same may be contained within part 32 of title 28 of the
Code of Federal Regulations.
[[Page 46025]]
Regulatory Flexibility Act
The Office of Justice Programs hereby certifies that this proposed
rule would not have a significant economic impact on a substantial
number of small entities for the following reasons: This proposed rule
addresses federal agency procedures; furthermore, this proposed rule
would make amendments to clarify existing regulations and agency
practice concerning public safety officers' death, disability, and
education benefits and would do nothing to increase the financial
burden on any small entities. Therefore, an analysis of the impact of
this proposed rule on such entities is not required under the
Regulatory Flexibility Act (5 U.S.C. 601 et seq.).
Paperwork Reduction Act of 1995
This proposed rule would impose reporting or recordkeeping
requirements under the Paperwork Reduction Act of 1995 (PRA) (44 U.S.C.
3501 et seq.). The PRA requires certain actions before an agency can
adopt or revise a collection of information, including publishing a
summary of the collection of information and a brief description of the
need for and proposed use of the information. 44 U.S.C. 3507.
The proposed rule includes paperwork requirements in three
collections of information previously approved by OMB for the PSOB
Program. OJP published in the Federal Register on January 11, 2016, a
60-day notice of ``Agency Information Collection Activities'' for each
of the following forms: Claim for Death Benefits (OMB Number 1121-
0024), Report of Public Safety Officer's Death (OMB Number 1121-0025),
and Public Safety Officers' Disability Benefits (OMB Number 1121-0166).
In calculating the burden associated with these forms/collections, OJP
reviewed its previous burden estimates and updated these to reflect the
time required for claimants to gather the many different documents
necessary to establish eligibility for these benefits, e.g., birth
certificates, marriage certificates, divorce decrees (where
applicable), public agency determinations as to death or disability
benefits, medical records, etc. Information about the proposed
collections is as follows:
Claim for Death Benefits--Overview of Information Collection
1. Type of Information Collection: Reinstatement with change of a
previously approved collection.
2. The Title of the Form/Collection: Claim for Death Benefits.
3. The agency form number, if any, and the applicable component of
the Department sponsoring the collection: Bureau of Justice Assistance.
Office of Justice Programs, United States Department of Justice.
4. Affected public who will be asked or required to respond, as
well as a brief abstract:Primary: Eligible survivors of fallen public
safety officers.
Abstract: BJA's Public Safety Officers' Benefits (PSOB) Office will
use the Claim Form information to confirm the eligibility of applicants
to receive Public Safety Officers' Death Benefits. Eligibility is
dependent on several factors, including public safety officer status,
an injury sustained in the line of duty, and the claimant status in the
beneficiary hierarchy according to the PSOB Act. In addition,
information to help the PSOB Office identify an individual is
collected, such as Social Security numbers, telephone numbers, and
email addresses. Changes to the claim form have been made in an effort
to streamline the application process and eliminate requests for
information that are either irrelevant or already being collected by
other means.
OJP estimates that no more than 350 respondents will apply each
year. Each application takes approximately 120 minutes to complete. OJP
estimates that the total public burden (in hours) associated with the
collection can be calculated as follows: Total Annual Reporting Burden:
350 x 120 minutes per application = 42,000 minutes/by 60 minutes per
hour = 700 hours.
Public Safety Officer's Death--Overview of Information Collection
1. Type of Information Collection: Reinstatement with change of a
previously approved collection.
2. The Title of the Form/Collection: Report of Public Safety
Offices Death.
3. The agency form number, if any, and the applicable component of
the Department sponsoring the collection: Bureau of Justice Assistance.
Office of Justice Programs, United States Department of Justice.
4. Affected public who will be asked or required to respond, as
well as a brief abstract: Primary: Public safety agencies experiencing
the death of a public safety officer according to the PSOB Act.
Abstract: BJA's Public Safety Officers' Benefits (PSOB) Office will
use the Report of Public Safety Officer's Death Form information to
confirm the eligibility of applicants to receive Public Safety
Officers' Death Benefits. Eligibility is dependent on several factors,
including public safety officer status, an injury sustained in the line
of duty, and the claimant status in the beneficiary hierarchy according
to the Act. In addition, information to help the PSOB Office identify
an individual is collected, such as Social Security numbers, telephone
numbers, and email addresses. Changes to the report form have been made
in an effort to streamline the application process and eliminate
requests for information that are either irrelevant or already being
collected by other means.
OJP estimates that no more than 350 respondents will apply each
year. Each application takes approximately 240 minutes to complete. OJP
estimates that the total public burden (in hours) associated with the
collection can be calculated as follows: Total Annual Reporting Burden:
350 x 240 minutes per application = 84,000 minutes/by 60 minutes per
hour = 1400 hours.
Public Safety Officers' Disability Benefits--Overview of Information
Collection
1. Type of Information Collection: Reinstatement with change of a
previously approved collection.
2. The Title of the Form/Collection: Public Safety Officer's
Disability Benefits.
3. The agency form number, if any, and the applicable component of
the Department sponsoring the collection: Bureau of Justice Assistance.
Office of Justice Programs, United States Department of Justice.
4. Affected public who will be asked or required to respond, as
well as a brief abstract: Primary: Public safety officers who were
permanently and totally disabled in the line of duty.
Abstract: BJA's Public Safety Officers' Benefits (PSOB) Office will
use the PSOB Disability Application information to confirm the
eligibility of applicants to receive Public Safety Officers' Disability
Benefits. Eligibility is dependent on several factors, including public
safety officer status, injury sustained in the line of duty, and the
total and permanent nature of the line-of-duty injury. In addition,
information to help the PSOB Office identify individuals is collected,
such as Social Security numbers, telephone numbers, and email
addresses. Changes to the application form have been made in an effort
to streamline the application process and eliminate requests for
information that are either irrelevant or already being collected by
other means.
OJP estimates that no more than 100 respondents will apply each
year. Each application takes approximately 300 minutes to complete. OJP
estimates that the total public burden (in hours) associated with the
collection can be calculated as follows: Total Annual Reporting Burden:
100 x 300 minutes
[[Page 46026]]
per application = 30,000 minutes/by 60 minutes per hour = 500 hours.
Unfunded Mandates Reform Act of 1995
This proposed rule would not result in the expenditure by State,
local, and tribal governments, in the aggregate, or by the private
sector, of $100,000,000 or more in any one year, and it will not
significantly or uniquely affect small governments. The PSOB program is
a federal benefits program that provides benefits directly to
qualifying individuals. Therefore, no actions were deemed necessary
under the provisions of the Unfunded Mandates Reform Act of 1995.
List of Subjects in 28 CFR Part 32
Administrative practice and procedure, Claims, Disability benefits,
Education, Emergency medical services, Firefighters, Law enforcement
officers, Reporting and recordkeeping requirements, Rescue squad.
Accordingly, for the reasons set forth in the preamble, part 32 of
chapter I of Title 28 of the Code of Federal Regulations is proposed to
be amended as follows:
PART 32--PUBLIC SAFETY OFFICERS' DEATH, DISABILITY, AND EDUCATIONAL
ASSISTANCE BENEFITS CLAIMS
0
1. The authority citation for 28 CFR part 32 continues to read as
follows:
Authority: 42 U.S.C. ch. 46, subch. XII; 42 U.S.C. 3782(a),
3787, 3788, 3791(a), 3793(a)(4) & (b), 3795a, 3796c-1, 3796c-2; sec.
1601, title XI, Pub. L. 90-351, 82 Stat. 239; secs. 4 through 6,
Pub. L. 94-430, 90 Stat. 1348; secs. 1 and 2, Pub. L. 107-37, 115
Stat. 219.
0
2. Amend Sec. 32.3 as follows:
0
a. Amend the definition of Act by removing ``and Apr. 5, 2006
(designated beneficiaries))'' and adding in its place ``Apr. 5, 2006
(designated beneficiaries); and Jan. 2, 2013)''.
0
b. Add definitions of List of WTC-related health conditions and
Physical harm in alphabetical order to read as follows:
Sec. 32.3 Definitions.
* * * * *
List of WTC-related health conditions means the list of health
conditions (other than a mental-health condition) listed--
(1) At 42 U.S.C. 300mm-22(a)(3); or
(2) On the List of WTC-Related Health Conditions in 42 CFR part 88.
* * * * *
Physical harm means physical harm as defined at 28 CFR 104.2(c).
* * * * *
0
3. Amend Sec. 32.5 by adding paragraph (j) to read as follows:
Sec. 32.5 Evidence.
* * * * *
(j) Physical harm suffered by a public safety officer as a direct
and proximate result of a condition on the List of WTC-Related Health
Conditions shall be understood to be a line-of-duty injury if, as
determined by the PSOB determining official, and pursuant to the
standards governing the World Trade Center Health Program's
certification of injuries as covered by the program, such officer's
exposure to airborne toxins, any other hazards, and any other adverse
conditions resulting from the September 11, 2001, terrorist attacks is
substantially likely to have been a significant factor in aggravating,
contributing to, or causing the illness or health condition.
0
4. Amend Sec. 32.6 by adding paragraph (f) to read as follows:
Sec. 32.6 Payment and repayment.
* * * * *
(f)(1) If compensation under the September 11th Victim Compensation
Fund of 2001 (49 U.S.C. 40101 note)) has been paid with respect to an
injury, the total amount payable under subpart B or C of this part,
with respect to the same injury, shall be reduced by the amount of such
payment of compensation.
(2) Nothing in paragraph (f)(1) of this section, or in the Act, at
42 U.S.C. 3796(f)(3), shall be understood to preclude payment under
this part before the final payment of compensation under such Fund.
(3) Nothing in the Act, at 42 U.S.C. 3796(f)(3), shall be
understood to require reduction of any amount payable under subpart D
of this part.
0
5. Amend Sec. 32.13 as follows:
0
a. Add definitions of Something other than the mere presence of
cardiovascular disease risk factors and Unrelated in alphabetical
order.
0
b. Remove the definitions of Competent medical evidence to the
contrary, Excessive consumption of alcohol, Extrinsic circumstances,
Risky behavior, and Undertaking of treatment.
The additions read as follows:
Sec. 32.13 Definitions.
* * * * *
Something other than the mere presence of cardiovascular disease
risk factors means--
(1) Ingestion of controlled substances included on Schedule I of
the drug control and enforcement laws (see 21 U.S.C. 812(a)); or
(2) Abuse of controlled substances included on Schedule II, III,
IV, or V of the drug control and enforcement laws (see 21 U.S.C.
812(a)).
* * * * *
Unrelated--A public safety officer's heart attack, stroke, or
vascular rupture is unrelated to the officer's engagement in a
situation or participation in a training exercise, as described in 42
U.S.C. 3796(k)(1), when an independent event or occurrence
significantly contributes in bringing about the officer's heart attack,
stroke, or vascular rupture.
Sec. 32.14 [Amended]
0
6. In Sec. 32.14, remove paragraph (c).
0
7. In Sec. 32.33, the definition of Eligible public safety officer is
revised to read as follows:
Sec. 32.33 Definitions.
* * * * *
Eligible public safety officer means a public safety officer--
(1) With respect to whose death, benefits under subpart B of this
part properly--
(i) Have been paid; or
(ii) Would have been paid but for operation of the Act, at 42
U.S.C. 3796(f); or
(2) With respect to whose disability, benefits under subpart C of
this part properly--
(i) Have been paid; or
(ii) Would have been paid, but for operation of--
(A) Paragraph (b)(1) of Sec. 32.6; or
(B) The Act, at 42 U.S.C. 3796(f).
* * * * *
Dated: June 30, 2016.
Karol V. Mason,
Assistant Attorney General.
[FR Doc. 2016-16086 Filed 7-14-16; 8:45 am]
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