Social Security Acquiescence Ruling 19-1(6), Hicks v. Commissioner of Social Security: Disregarding Evidence During Redeterminations Under Sections 205(u) and 1631(e)(7) of the Social Security Act, 6255-6256 [2020-02114]
Download as PDF
<![CDATA[
Federal Register / Vol. 85, No. 23 / Tuesday, February 4, 2020 / Notices
the SBA announces the meetings of the
National SBDC Advisory Board. This
Board provides advice and counsel to
1.500 the SBA Administrator and Associate
Administrator for Small Business
7.750 Development Centers.
Purpose: The purpose of the meeting
3.875
is to onboard the new members and
2.750 discuss the following issues pertaining
to the SBDC Program:
• SBA Briefing
2.750 • Member Introductions
• Annual Meetings
• Board Assignments
Percent
Homeowners without Credit
Available Elsewhere ..............
Businesses with Credit Available Elsewhere ......................
Businesses
without
Credit
Available Elsewhere ..............
Non-Profit Organizations with
Credit Available Elsewhere ...
Non-Profit Organizations without Credit Available Elsewhere .....................................
For Economic Injury:
Businesses & Small Agricultural
Cooperatives without Credit
Available Elsewhere ..............
Non-Profit Organizations without Credit Available Elsewhere .....................................
3.875
2.750
The number assigned to this disaster
for physical damage is 16259 C and for
economic injury is 16260 0.
The State which received an EIDL
Declaration # is Mississippi.
(Catalog of Federal Domestic Assistance
Number 59008)
Dated: January 29, 2020.
Nicole Nelson,
Committee Management Officer (Acting).
[FR Doc. 2020–02081 Filed 2–3–20; 8:45 am]
BILLING CODE P
SOCIAL SECURITY ADMINISTRATION
[Docket No. SSA–2019–0033]
Social Security Acquiescence Ruling
19–1(6), Hicks v. Commissioner of
Social Security: Disregarding Evidence
During Redeterminations Under
Sections 205(u) and 1631(e)(7) of the
Social Security Act
Jovita Carranza,
Administrator.
[FR Doc. 2020–02127 Filed 2–3–20; 8:45 am]
BILLING CODE 8026–03–P
Social Security Administration.
Notice of Social Security
Acquiescence Ruling (AR).
AGENCY:
SMALL BUSINESS ADMINISTRATION
ACTION:
National Small Business Development
Centers Advisory Board
SUMMARY:
Small Business Administration.
Notice of open Federal Advisory
Committee meeting.
AGENCY:
ACTION:
The SBA is issuing this notice
to announce the location, date, time,
and agenda for a meeting of the National
Small Business Development Center
Advisory Board. The meeting will be
open to the public; however, advance
notice of attendance is required.
DATES: Wednesday, February 12, 2020 at
11:00 a.m. EST.
ADDRESSES: U.S. Small Business
Administration, 409 Third Street SW,
Washington, DC 20416.
FOR FURTHER INFORMATION CONTACT:
Alanna Falcone, Office of Small
Business Development Centers, U.S.
Small Business Administration, 409
Third Street SW, Washington, DC
20416; alanna.falcone@sba.gov; 202–
619–1612. If anyone wishes to be a
listening participant or would like to
request accommodations, please contact
Alanna Falcone at the information
above.
khammond on DSKJM1Z7X2PROD with NOTICES
SUMMARY:
Pursuant
to section 10(a) of the Federal Advisory
Committee Act (5 U.S.C. Appendix 2),
SUPPLEMENTARY INFORMATION:
VerDate Sep<11>2014
17:48 Feb 03, 2020
Jkt 250001
This Social Security AR
explains how we will apply a holding
in a decision of the United States Court
of Appeals for the Sixth Circuit. We
have determined that the court’s
holding conflicts with our interpretation
of the provisions of the Social Security
Act (Act) that require us to disregard
evidence when we conduct a
redetermination or make an initial
determination of entitlement or
eligibility, in cases in which there is a
reason to believe that fraud or similar
fault was involved in the providing of
evidence.
DATES: We will apply this notice on
February 4, 2020.
FOR FURTHER INFORMATION CONTACT:
Amanda Gilman, Office of the General
Counsel, Office of Program Law, Social
Security Administration, 6401 Security
Boulevard, Baltimore, MD 21235–6401,
(410) 965–9641, or TTY 410–966–5609,
for information about this notice. For
information on eligibility or filing for
benefits, call our national toll-free
number, 1–800–772–1213 or TTY 1–
800–325–0778, or visit our internet site,
Social Security Online, at https://
www.socialsecurity.gov.
We are
publishing this Social Security AR in
SUPPLEMENTARY INFORMATION:
PO 00000
Frm 00115
Fmt 4703
Sfmt 4703
6255
accordance with 20 CFR 402.35(b)(2),
404.985(a), (b), and 416.1485(a), (b) to
explain how we will apply the holding
in Hicks v. Commissioner of Social
Security, 909 F.3d 786 (6th Cir. 2018),
rehearing en banc denied (March 29,
2019). Hicks addressed the procedures
we apply when we make a decision at
the hearings level of our administrative
review process and disregard evidence
under sections 205(u) and 1631(e)(7) of
the Act.
An AR explains how we will apply a
holding in a decision of a United States
Court of Appeals that we determine
conflicts with our interpretation of a
provision of the Act or regulations when
the Government has decided not to seek
further review of that decision or is
unsuccessful on further review.
This AR explains how we will apply
the holding in Hicks v. Commissioner of
Social Security when we disregard
evidence under sections 205(u) and
1631(e)(7) of the Act at the hearings
level of our administrative review
process. We will apply this AR to all
decisions we make under sections
205(u) and 1631(e)(7) of the Act on or
after February 4, 2020 for individuals
who reside in one of the States within
the Sixth Circuit. If we made a decision
at the hearings level of our
administrative review process and
disregarded evidence under sections
205(u) or 1631(e)(7) of the Act between
November 21, 2018, the date of the court
of appeals’ decision, and February 4,
2020, the date we will begin to apply
this AR, the affected individual may
request that we apply the AR to the
prior decision. The affected individual
must show, pursuant to 20 CFR
404.985(b)(2) or 416.1485(b)(2), that
applying the AR could change our prior
decision in the case.
When we received this precedential
court of appeals’ decision and
determined that an AR might be
required, we began to identify those
claims that were pending before us
within the circuit that might be subject
to readjudication if we subsequently
issued an AR. Because we have
determined that an AR is required and
are publishing this AR, we will send a
notice to those individuals whose
claims we have identified. However, a
claimant does not need to receive a
notice in order to request that we apply
this AR to our prior determination or
decision on his or her claim, as
provided in 20 CFR 404.985(b)(2) and
416.1485(b)(2). If we later rescind this
AR as obsolete, we will publish a notice
in the Federal Register to that effect, as
provided in 20 CFR 404.985(e) and
416.1485(e). If we decide to relitigate
the issue covered by this AR, as
E:\FR\FM\04FEN1.SGM
04FEN1
6256
Federal Register / Vol. 85, No. 23 / Tuesday, February 4, 2020 / Notices
provided by 20 CFR 404.985(c) and
416.1485(c), we will publish a notice in
the Federal Register stating that we will
apply our interpretation of the Act or
regulations involved and explaining
why we have decided to relitigate the
issue.
(Catalog of Federal Domestic Assistance,
Program Nos. 96.001 Social Security—
Disability Insurance; 96.002 Social
Security—Retirement Insurance; 96.004
Social Security—Survivors Insurance; 96.006
Supplemental Security Income)
Dated: December 23, 2019.
Andrew Saul,
Commissioner of Social Security.
khammond on DSKJM1Z7X2PROD with NOTICES
Acquiescence Ruling 19–1(6)
Hicks v. Commissioner of Social
Security, 909 F.3d 786 (6th Cir. 2018),
reh’g en banc den. (Mar. 29, 2019):
Disregarding Evidence During
Redeterminations under Sections 205(u)
and 1631(e)(7) of the Social Security
Act.
Issue: Sections 205(u) and 1631(e)(7)
of the Act require us to redetermine
entitlement to or eligibility for benefits
if there is reason to believe fraud or
similar fault was involved in an
application for benefits. When we
redetermine entitlement or eligibility, or
we make an initial determination of
entitlement or eligibility, these sections
of the Act also require that we disregard
any evidence if there is reason to believe
that fraud or similar fault was involved
in providing that evidence. Do we have
to consider an individual’s objection to
disregarding the evidence before we
disregard the evidence?
Statute/Regulation/Ruling Citation:
Sections 205(u) and 1631(e)(7) of the
Social Security Act (42 U.S.C. 405(u)
and 1383(e)(7)); Social Security Ruling
(‘‘SSR’’) 16–1p, 81 FR 13436 (Mar. 14,
2016); SSR 16–2p, 81 FR 13440 (March
14, 2016).
Circuit: Sixth (Kentucky, Michigan,
Ohio, Tennessee).
Applicability of Ruling: This ruling
applies to decisions we make when we
disregard evidence under sections
205(u) and 1631(e)(7) of the Social
Security Act (Act) at the hearings level
of our administrative review process for
individuals who reside in a State within
the Sixth Circuit.
Description of Case: Plaintiff Amy Jo
Hicks and several other plaintiffs whose
cases were consolidated for purposes of
appeal applied for and were awarded
Social Security Disability Insurance
Benefits (DIB) or Supplemental Security
Income (SSI) payments based on
disability, after being represented by an
attorney who provided evidence on
their behalf. After the plaintiffs and
VerDate Sep<11>2014
17:48 Feb 03, 2020
Jkt 250001
nearly 2000 other claimants had been
found disabled and entitled to or
eligible for benefits, the Office of the
Inspector General (OIG) informed us, in
accordance with section 1129(l) of the
Act, that it had reason to believe fraud
was involved in the applications and in
the providing of evidence. The United
States District Court for the Eastern
District of Kentucky subsequently
convicted the plaintiffs’ attorney, the
administrative law judge who decided
the plaintiffs’ claims, and a doctor who
provided evidence in support of the
applications of perpetrating a large-scale
fraud scheme on the agency. Based on
these criminal convictions, the district
court sentenced each defendant to terms
in Federal prison for their respective
roles in this massive fraud scheme.
As required by sections 205(u) and
1631(e)(7) of the Act, we redetermined
the entitlement to and eligibility for
benefits of the individuals whom the
OIG referred to us. During the
redeterminations, we held new hearings
and in each case disregarded evidence
OIG told us that it had reason to believe
involved fraud. In making the
redetermination, we considered the rest
of the evidence in the plaintiffs’ claims
files, any new evidence related to the
relevant period that plaintiffs submitted,
and we heard argument regarding each
plaintiff’s entitlement to DIB or
eligibility for SSI payments based on
disability.
Plaintiffs argued that during the
redeterminations, they should have
been given the opportunity to show that
fraud was not involved in providing
evidence in their claims.
Holding
In Hicks v. Commissioner of Social
Security, 909 F.3d 786 (6th Cir. 2018),
reh’g denied (Mar. 29, 2019), the Court
of Appeals for the Sixth Circuit held, in
a 2–1 decision, that before disregarding
evidence during a redetermination, we
must provide a factual basis for the
reason to believe fraud was involved in
providing evidence, and plaintiffs must
have a chance to rebut our assertions
before a neutral decisionmaker.
Statement as to How Hicks Differs From
the Agency’s Policy
Under our interpretation of sections
205(u) and 1631(e)(7) of the Act, when
we disregard evidence in cases OIG
refers to us because there is a reason to
believe fraud was involved in the
application and in the providing of
evidence, we do not consider the
individual’s objection to disregarding
the evidence.
The court of appeals’ decision differs
from our policy because it held that
PO 00000
Frm 00116
Fmt 4703
Sfmt 4703
when we disregard evidence under
sections 205(u) and 1631(e)(7) of the
Act, we must provide the affected
individual the opportunity to challenge
the reason to believe that fraud or
similar fault was involved in the
provision of evidence in his or her case.
Explanation of How We Will Apply
Hicks Within the Circuit
This Ruling applies only to cases in
which we disregard evidence based on
a referral from OIG under section
1129(l) of the Act and the affected
individual resides in Kentucky,
Michigan, Ohio, or Tennessee at the
time we make the decision at the
hearings level of our administrative
review process.
In these States, before we disregard
the evidence pursuant to sections
205(u)(1)(B) and 1631(e)(7)(A)(ii) of the
Act at the hearings level of our
administrative review process, we will
consider the individual’s objection to
the disregarding of that evidence.
Our adjudicators will decide whether
there is a reason to believe that fraud or
similar fault was involved in providing
evidence in the individual’s case. We
define a ‘‘reason to believe’’ as
reasonable grounds to suspect that fraud
or similar fault was involved in the
application or in the provision of
evidence. The ‘‘reason to believe’’
standard requires more than a mere
suspicion, speculation or a hunch, but
it does not require a preponderance of
evidence. Adjudicators may make
reasonable inferences based on the
totality of circumstances, such as facts
or case characteristics common to
patterns of known or suspected
fraudulent activity. For us to disregard
evidence, it is not necessary that the
affected beneficiary or recipient had
knowledge of or participated in the
fraud or similar fault.
[FR Doc. 2020–02114 Filed 2–3–20; 8:45 am]
BILLING CODE 4191–02–P
DEPARTMENT OF STATE
[Public Notice: 11020]
United States Proposals and Positions
for the U.S. Delegation to the 2020
World Telecommunication
Standardization Assembly (WTSA–
2020)
Notice and request for public
comment.
ACTION:
The U.S. Government seeks
input from stakeholders and interested
parties to help develop its proposals and
positions for the U.S. Delegation
SUMMARY:
E:\FR\FM\04FEN1.SGM
04FEN1
]]>Agencies
[Federal Register Volume 85, Number 23 (Tuesday, February 4, 2020)]
[Notices]
[Pages 6255-6256]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2020-02114]
=======================================================================
-----------------------------------------------------------------------
SOCIAL SECURITY ADMINISTRATION
[Docket No. SSA-2019-0033]
Social Security Acquiescence Ruling 19-1(6), Hicks v.
Commissioner of Social Security: Disregarding Evidence During
Redeterminations Under Sections 205(u) and 1631(e)(7) of the Social
Security Act
AGENCY: Social Security Administration.
ACTION: Notice of Social Security Acquiescence Ruling (AR).
-----------------------------------------------------------------------
SUMMARY: This Social Security AR explains how we will apply a holding
in a decision of the United States Court of Appeals for the Sixth
Circuit. We have determined that the court's holding conflicts with our
interpretation of the provisions of the Social Security Act (Act) that
require us to disregard evidence when we conduct a redetermination or
make an initial determination of entitlement or eligibility, in cases
in which there is a reason to believe that fraud or similar fault was
involved in the providing of evidence.
DATES: We will apply this notice on February 4, 2020.
FOR FURTHER INFORMATION CONTACT: Amanda Gilman, Office of the General
Counsel, Office of Program Law, Social Security Administration, 6401
Security Boulevard, Baltimore, MD 21235-6401, (410) 965-9641, or TTY
410-966-5609, for information about this notice. For information on
eligibility or filing for benefits, call our national toll-free number,
1-800-772-1213 or TTY 1-800-325-0778, or visit our internet site,
Social Security Online, at https://www.socialsecurity.gov.
SUPPLEMENTARY INFORMATION: We are publishing this Social Security AR in
accordance with 20 CFR 402.35(b)(2), 404.985(a), (b), and 416.1485(a),
(b) to explain how we will apply the holding in Hicks v. Commissioner
of Social Security, 909 F.3d 786 (6th Cir. 2018), rehearing en banc
denied (March 29, 2019). Hicks addressed the procedures we apply when
we make a decision at the hearings level of our administrative review
process and disregard evidence under sections 205(u) and 1631(e)(7) of
the Act.
An AR explains how we will apply a holding in a decision of a
United States Court of Appeals that we determine conflicts with our
interpretation of a provision of the Act or regulations when the
Government has decided not to seek further review of that decision or
is unsuccessful on further review.
This AR explains how we will apply the holding in Hicks v.
Commissioner of Social Security when we disregard evidence under
sections 205(u) and 1631(e)(7) of the Act at the hearings level of our
administrative review process. We will apply this AR to all decisions
we make under sections 205(u) and 1631(e)(7) of the Act on or after
February 4, 2020 for individuals who reside in one of the States within
the Sixth Circuit. If we made a decision at the hearings level of our
administrative review process and disregarded evidence under sections
205(u) or 1631(e)(7) of the Act between November 21, 2018, the date of
the court of appeals' decision, and February 4, 2020, the date we will
begin to apply this AR, the affected individual may request that we
apply the AR to the prior decision. The affected individual must show,
pursuant to 20 CFR 404.985(b)(2) or 416.1485(b)(2), that applying the
AR could change our prior decision in the case.
When we received this precedential court of appeals' decision and
determined that an AR might be required, we began to identify those
claims that were pending before us within the circuit that might be
subject to readjudication if we subsequently issued an AR. Because we
have determined that an AR is required and are publishing this AR, we
will send a notice to those individuals whose claims we have
identified. However, a claimant does not need to receive a notice in
order to request that we apply this AR to our prior determination or
decision on his or her claim, as provided in 20 CFR 404.985(b)(2) and
416.1485(b)(2). If we later rescind this AR as obsolete, we will
publish a notice in the Federal Register to that effect, as provided in
20 CFR 404.985(e) and 416.1485(e). If we decide to relitigate the issue
covered by this AR, as
[[Page 6256]]
provided by 20 CFR 404.985(c) and 416.1485(c), we will publish a notice
in the Federal Register stating that we will apply our interpretation
of the Act or regulations involved and explaining why we have decided
to relitigate the issue.
(Catalog of Federal Domestic Assistance, Program Nos. 96.001 Social
Security--Disability Insurance; 96.002 Social Security--Retirement
Insurance; 96.004 Social Security--Survivors Insurance; 96.006
Supplemental Security Income)
Dated: December 23, 2019.
Andrew Saul,
Commissioner of Social Security.
Acquiescence Ruling 19-1(6)
Hicks v. Commissioner of Social Security, 909 F.3d 786 (6th Cir.
2018), reh'g en banc den. (Mar. 29, 2019): Disregarding Evidence During
Redeterminations under Sections 205(u) and 1631(e)(7) of the Social
Security Act.
Issue: Sections 205(u) and 1631(e)(7) of the Act require us to
redetermine entitlement to or eligibility for benefits if there is
reason to believe fraud or similar fault was involved in an application
for benefits. When we redetermine entitlement or eligibility, or we
make an initial determination of entitlement or eligibility, these
sections of the Act also require that we disregard any evidence if
there is reason to believe that fraud or similar fault was involved in
providing that evidence. Do we have to consider an individual's
objection to disregarding the evidence before we disregard the
evidence?
Statute/Regulation/Ruling Citation: Sections 205(u) and 1631(e)(7)
of the Social Security Act (42 U.S.C. 405(u) and 1383(e)(7)); Social
Security Ruling (``SSR'') 16-1p, 81 FR 13436 (Mar. 14, 2016); SSR 16-
2p, 81 FR 13440 (March 14, 2016).
Circuit: Sixth (Kentucky, Michigan, Ohio, Tennessee).
Applicability of Ruling: This ruling applies to decisions we make
when we disregard evidence under sections 205(u) and 1631(e)(7) of the
Social Security Act (Act) at the hearings level of our administrative
review process for individuals who reside in a State within the Sixth
Circuit.
Description of Case: Plaintiff Amy Jo Hicks and several other
plaintiffs whose cases were consolidated for purposes of appeal applied
for and were awarded Social Security Disability Insurance Benefits
(DIB) or Supplemental Security Income (SSI) payments based on
disability, after being represented by an attorney who provided
evidence on their behalf. After the plaintiffs and nearly 2000 other
claimants had been found disabled and entitled to or eligible for
benefits, the Office of the Inspector General (OIG) informed us, in
accordance with section 1129(l) of the Act, that it had reason to
believe fraud was involved in the applications and in the providing of
evidence. The United States District Court for the Eastern District of
Kentucky subsequently convicted the plaintiffs' attorney, the
administrative law judge who decided the plaintiffs' claims, and a
doctor who provided evidence in support of the applications of
perpetrating a large-scale fraud scheme on the agency. Based on these
criminal convictions, the district court sentenced each defendant to
terms in Federal prison for their respective roles in this massive
fraud scheme.
As required by sections 205(u) and 1631(e)(7) of the Act, we
redetermined the entitlement to and eligibility for benefits of the
individuals whom the OIG referred to us. During the redeterminations,
we held new hearings and in each case disregarded evidence OIG told us
that it had reason to believe involved fraud. In making the
redetermination, we considered the rest of the evidence in the
plaintiffs' claims files, any new evidence related to the relevant
period that plaintiffs submitted, and we heard argument regarding each
plaintiff's entitlement to DIB or eligibility for SSI payments based on
disability.
Plaintiffs argued that during the redeterminations, they should
have been given the opportunity to show that fraud was not involved in
providing evidence in their claims.
Holding
In Hicks v. Commissioner of Social Security, 909 F.3d 786 (6th Cir.
2018), reh'g denied (Mar. 29, 2019), the Court of Appeals for the Sixth
Circuit held, in a 2-1 decision, that before disregarding evidence
during a redetermination, we must provide a factual basis for the
reason to believe fraud was involved in providing evidence, and
plaintiffs must have a chance to rebut our assertions before a neutral
decisionmaker.
Statement as to How Hicks Differs From the Agency's Policy
Under our interpretation of sections 205(u) and 1631(e)(7) of the
Act, when we disregard evidence in cases OIG refers to us because there
is a reason to believe fraud was involved in the application and in the
providing of evidence, we do not consider the individual's objection to
disregarding the evidence.
The court of appeals' decision differs from our policy because it
held that when we disregard evidence under sections 205(u) and
1631(e)(7) of the Act, we must provide the affected individual the
opportunity to challenge the reason to believe that fraud or similar
fault was involved in the provision of evidence in his or her case.
Explanation of How We Will Apply Hicks Within the Circuit
This Ruling applies only to cases in which we disregard evidence
based on a referral from OIG under section 1129(l) of the Act and the
affected individual resides in Kentucky, Michigan, Ohio, or Tennessee
at the time we make the decision at the hearings level of our
administrative review process.
In these States, before we disregard the evidence pursuant to
sections 205(u)(1)(B) and 1631(e)(7)(A)(ii) of the Act at the hearings
level of our administrative review process, we will consider the
individual's objection to the disregarding of that evidence.
Our adjudicators will decide whether there is a reason to believe
that fraud or similar fault was involved in providing evidence in the
individual's case. We define a ``reason to believe'' as reasonable
grounds to suspect that fraud or similar fault was involved in the
application or in the provision of evidence. The ``reason to believe''
standard requires more than a mere suspicion, speculation or a hunch,
but it does not require a preponderance of evidence. Adjudicators may
make reasonable inferences based on the totality of circumstances, such
as facts or case characteristics common to patterns of known or
suspected fraudulent activity. For us to disregard evidence, it is not
necessary that the affected beneficiary or recipient had knowledge of
or participated in the fraud or similar fault.
[FR Doc. 2020-02114 Filed 2-3-20; 8:45 am]
BILLING CODE 4191-02-P
