Evidence of Disability, 4626-4628 [2025-00515]
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4626
Federal Register / Vol. 90, No. 10 / Thursday, January 16, 2025 / Rules and Regulations
(2) The list referred to in paragraph
(b)(1) of this section is:
(i) General Counsel;
(ii) Executive Director;
(iii) Director of the Office of Energy
Market Regulation;
(iv) Director of the Office of Energy
Projects;
(v) Director of the Office of Electric
Reliability;
(vi) Director of the Office of
Enforcement;
(vii) Director of the Office of Energy
Infrastructure Security;
(viii) Deputy General Counsels, in
order of seniority;
(ix) Deputy Directors, Office of Energy
Market Regulation, in order of seniority;
(x) Deputy Directors, Office of Energy
Projects, in order of seniority;
(xi) Deputy Directors, Office of
Electric Reliability, in order of seniority;
(xii) Deputy Directors, Office of
Enforcement, in order of seniority;
(xiii) Deputy Directors, Office of
Energy Infrastructure Security, in order
of seniority;
(xiv) Associate General Counsels and
Solicitor, in order of seniority;
(xv) In order of seniority, Assistant
Directors and Division heads, Office of
Energy Market Regulation; Assistant
Directors and Division heads, Office of
Energy Projects; Assistant Directors and
Division heads, Office of Electric
Reliability; Deputy Associate General
Counsels; Assistant Directors and
Division heads, Office of Enforcement;
Assistant Directors and Division heads,
Office of Energy Infrastructure Security;
(xvi) In order of seniority, Regional
Engineers and Branch Chiefs of the
Office of Energy Projects’ regional
offices; and Deputy Division Directors
and Group Managers of the Office of
Electric Reliability’s regional offices.
(3) For purposes of paragraph
(b)(2)(viii)–(xvi) of this section, order of
seniority shall be based on the highest
grade and longest period of service in
that grade and, furthermore, for
purposes of paragraph (b)(2)(xv)–(xvi) of
this section, order of seniority shall be
without regard to the particular Office
or Division or Branch or Group to which
the member of staff is assigned.
(c) Devolution of authority to
Commission staff during emergencies
affecting the National Capital Region.
(1) To the extent not otherwise provided
by this section, during emergency
conditions when the Chairman is not
available and capable of acting, when no
Commissioner is available and capable
of acting, and when no person listed in
paragraph (b)(2)(i)–(xvi) of this section
who is located in the National Capital
Region is available and capable of
acting, the functions of the Commission
VerDate Sep<11>2014
17:12 Jan 15, 2025
Jkt 265001
are delegated, in order of seniority (as
described in paragraph (b)(3) of this
section), to Regional Engineers and
Branch Chiefs of the Office of Energy
Projects’ regional offices and Deputy
Division Directors and Group Managers
of the Office of Electric Reliability’s
regional offices.
(2) Such delegation shall continue
until such time as the Chairman is
available and capable of acting, one or
more Commissioners are available and
capable of acting, or persons listed in
paragraph (b)(2)(i)–(xvi) of this section
who are located in the National Capital
Region are available and capable of
acting.
(d) Reconsideration of staff action
taken under delegations. Action taken
pursuant to the delegations provided for
in this section shall be subject to
reconsideration by the Commission,
acting with a quorum, within thirty days
after the date upon which public notice
is given that a quorum of the
Commission has been reconstituted and
is functioning.
[FR Doc. 2025–00888 Filed 1–15–25; 8:45 am]
BILLING CODE 6717–01–P
RAILROAD RETIREMENT BOARD
20 CFR Part 220
RIN 3220–AB71
Evidence of Disability
Railroad Retirement Board.
Final rule.
AGENCY:
ACTION:
The Railroad Retirement
Board (RRB) amends its regulations to
designate additional acceptable medical
sources in disability claims under the
Railroad Retirement Act. This change
recognizes the evolution of how medical
care and treatment are delivered and
aligns the RRB’s acceptable medical
sources with recently amended
regulations of the Social Security
Administration (SSA). Additionally, the
changes clarify existing RRB policy
regarding how evidence from medical
sources, other than those designated as
acceptable medical sources, will be
evaluated.
SUMMARY:
DATES:
This rule is effective March 17,
2025.
FOR FURTHER INFORMATION CONTACT:
Peter J. Orlowicz, Senior Counsel, (312)
751–4922, Peter.Orlowicz@rrb.gov.
SUPPLEMENTARY INFORMATION:
I. Background Information
The RRB published a Notice of
Proposed Rulemaking (NPRM) in the
Federal Register on June 21, 2024 (89
PO 00000
Frm 00042
Fmt 4700
Sfmt 4700
FR 51990). The preamble to the NPRM
discussed the changes from our current
rules and our reasons for proposing
those changes. In the NPRM, we
proposed to designate additional
acceptable medical sources (AMS) in
disability claims under the Railroad
Retirement Act. Although the RRB will
accept and evaluate evidence from any
relevant source, including medical
sources not designated as an AMS, the
RRB requires evidence about a
claimant’s impairment from an AMS to
adjudicate a claim of disability.
The additional AMS we proposed to
add are:
(1) Licensed or certified school
psychologists, or other licensed or
certified individuals with another title
who perform the same function as a
school psychologist in a school setting,
for impairments of intellectual
disability, learning disabilities, and
borderline intellectual functioning only;
(2) Licensed podiatrists, for
impairments of the foot or of the foot
and ankle, depending on the scope of
practice in the State in which the
podiatrist practices;
(3) Qualified speech-language
pathologists, for speech and language
impairments only, and when either
licensed by a State professional
licensing agency, fully certified by a
State education agency where the
individual practices, or holding a
Certificate of Clinical Competence in
Speech-Language Pathology from the
American Speech-Language-Hearing
Association;
(4) Licensed audiologists, for
impairments of hearing loss, auditory
processing disorders, and balance
disorders when such disorders are
within the individual’s licensed scope
of practice;
(5) Licensed Advanced Practice
Registered Nurses or other licensed
advance practice nurses with another
title, within the individual’s scope of
practice (this category includes, but is
not limited to, Certified Nurse
Midwives, Nurse Practitioners, Certified
Registered Nurse Anesthetists, and
Clinical Nurse Specialists); and
(6) Licensed Physician Assistants, for
impairments within the individual’s
licensed scope of practice.
We provided 60 days for the public to
comment on the NPRM. We received
three comments: two comments were
submitted by professional organizations
representing medical providers who
would be added as AMS under the
proposed rule, and one comment was
submitted by a public policy research
group. All three comments were
supportive of the proposed changes,
with two commenters providing
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16JAR1
Federal Register / Vol. 90, No. 10 / Thursday, January 16, 2025 / Rules and Regulations
ddrumheller on DSK120RN23PROD with RULES1
additional suggestions as described
below. We also identified and fixed two
minor grammatical errors that do not
affect the substance of the rule.
II. Public Comments
Comment: The American Academy of
Physician Associates (AAPA)
recommended that the regulation
include ‘‘physician assistant’’ and
‘‘physician associate’’ as equivalent
titles and list both in the regulation to
avoid confusion. The AAPA explained
the titles both refer to individuals who
graduate from programs accredited by
the same accrediting body, are certified
by the same certifying organization, and
have the same scope of practice.
Individuals in this profession have
historically been identified as
‘‘physician assistants,’’ but the official
title is now recognized as ‘‘physician
associate’’ as reflected in the title of the
AAPA, other professional organizations,
professional training programs, and
state laws regarding licensure. Because
the title change will take time to be
formalized in all jurisdictions, the
AAPA recommends that both
‘‘physician assistant’’ and ‘‘physician
associate’’ be listed.
Response: We agree with this
comment, and we revised the final
regulatory text accordingly. Specifically,
we revised the proposed regulatory text
for PAs as AMS in final 220.46(a)(9) to
read, ‘‘Licensed Physician Assistants/
Physician Associates (for impairments
within the individual’s licensed scope
of practice).’’ We do not view this as a
substantive change in the scope of
individuals the rule is intended to
cover, nor do we understand the AAPA
to be suggesting such a change in scope.
Comment: One commenter
recommended clarifying who may
qualify as an ‘‘other licensed or certified
individual . . . who perform the same
function as a school psychologist in a
school setting.’’ The commenter
expressed concern that special
education teachers may possess certain
state certifications to teach children
with learning disabilities, but that state
certification standards for special
education teachers vary from state to
state and a significant proportion of
special education teachers may be
teaching with a provisional or
emergency appointment without having
the necessary certification or experience
to provide medical reports of
intellectual disability, learning
disabilities, or borderline intellectual
functioning.
Response: We did not adopt this
comment. Special education teachers
and school psychologists are different
and distinct professions with different
VerDate Sep<11>2014
17:12 Jan 15, 2025
Jkt 265001
certification standards. Section 8002(19)
of the Every Student Succeeds Act,
Public Law 114–95 (Dec. 10, 2015)
identifies school psychologists as
‘‘specialized instructional support
personnel’’ along with school
counselors, school social workers,
school nurses, speech language
pathologists, and school librarians. In
Organizational Principle 3 of its 2020
Professional Standards, the National
Association of School Psychologists
recommends the ratio of school
psychologists to students should not
exceed 1 school psychologist for every
500 students. While school
psychologists work with other school
personnel, including special education
teachers, to perform their function, a
special education teacher would not
normally be performing the same
function as a school psychologist in the
school setting. We believe the residual
clause for other licensed or certified
individuals with different titles who are
performing the same function in a
school setting is sufficiently clear. An
individual who lacks a certification or
license equivalent to a school
psychologist and who does not perform
the same function as a school
psychologist would not qualify as an
AMS under this paragraph.
Comment: One commenter agreed
with the addition of licensed podiatrists
as AMS for impairments of the foot or
foot and ankle, but advocated for the
inclusion of other orthopedic specialists
who are certified and trained to address
issues of other skeletal structures.
Response: We did not adopt this
comment. Many orthopedic specialists
will qualify as an AMS because they are
licensed medical or osteopathic doctors.
To the extent that skeletal structurerelated impairments are within the
scope of practice for an Advanced
Practice Registered Nurse or a Physician
Assistant/Physician Associate, those
individuals would also be qualified as
an AMS without the need for separate
discussion. In the case of other
individuals who hold themselves out as
orthopedic specialists but would not
otherwise qualify as an AMS under
those other categories, § 220.46(b) in the
final rule acknowledges we will accept
and consider evidence from such a
medical source about the claimant’s
impairment(s) and the effect on the
claimant’s ability to work, but the
presence of a medically determinable
physical or mental impairment must be
established with objective medical
evidence from an AMS.
PO 00000
Frm 00043
Fmt 4700
Sfmt 4700
4627
Regulatory Analysis
Executive Order 12866, as
Supplemented by Executive Order
13563
The RRB, with the Office of
Management and Budget, has
determined that this is not a significant
regulatory action under Executive Order
12866, as supplemented by Executive
Order 13563. Therefore, no regulatory
impact analysis is required.
Executive Order 13132 (Federalism)
This proposed rule will not have
substantial direct effects on the States,
on the relationship between the
National Government and the States, or
on the distribution of power and
responsibilities among the various
levels of government. Therefore, in
accordance with section 6 of Executive
Order 13132, the RRB believes that this
proposed rule will not have sufficient
federalism implications to warrant the
preparation of a federalism summary
impact statement.
Regulatory Flexibility Act
The RRB certifies that this rule will
not have a significant economic impact
on a substantial number of small entities
because the rulemaking affects
individuals only. Therefore, a regulatory
flexibility analysis is not required under
the Regulatory Flexibility Act, as
amended.
Paperwork Reduction Act
This rule does not create any new or
affect any existing collections and,
therefore, does not require Office of
Management and Budget approval
under the Paperwork Reduction Act.
List of Subjects in 20 CFR Part 220
Disability benefits, Railroad
employees, Railroad retirement.
For the reasons set out in the
preamble, the Railroad Retirement
Board amends 20 CFR part 220 as
follows:
PART 220—DETERMINING DISABILITY
1. The authority citation for part 220
continues to read as follows:
■
Authority: 45 U.S.C. 231a; 45 U.S.C. 231f.
2. Amend § 220.46 by:
a. Revising paragraph (a);
b. Redesignating paragraphs (b)
through (e) as paragraphs (c) through (f)
respectively;
■ c. Adding new paragraph (b); and
■ d. Revising newly redesignated
paragraphs (c)(6)(i), (c)(6)(ii)
introductory text, (d) introductory text,
(e), and (f).
■
■
■
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16JAR1
4628
Federal Register / Vol. 90, No. 10 / Thursday, January 16, 2025 / Rules and Regulations
The revisions and addition read as
follows:
ddrumheller on DSK120RN23PROD with RULES1
§ 220.46
Medical evidence.
(a) Acceptable medical sources. The
Board needs reports about the
claimant’s impairment(s) from
acceptable medical sources. Acceptable
medical sources are—
(1) Licensed physicians (medical or
osteopathic doctors);
(2) Licensed or certified psychologists
at the independent practice level;
(3) Licensed or certified school
psychologists, or other licensed or
certified individuals with another title
who perform the same function as a
school psychologist in a school setting
(for impairments of intellectual
disability, learning disabilities, and
borderline intellectual functioning
only);
(4) Licensed optometrists (for
impairments of visual disorders, or for
the measurement of visual acuity and
visual fields only, depending on the
scope of practice in the State in which
the optometrist practices);
(5) Licensed podiatrists (for
impairments of the foot only, or foot and
ankle only, depending on the scope of
practice in the State in which the
podiatrist practices);
(6) Qualified speech-language
pathologists (for speech or language
impairments only.) For this source,
qualified means that the speechlanguage pathologist must be licensed
by the State professional licensing
agency, or be fully certified by the State
education agency in the State in which
the speech-language pathologist
practices, or hold a Certificate of
Clinical Competence in SpeechLanguage Pathology from the American
Speech-Language-Hearing Association;
(7) Licensed audiologists (for
impairments of hearing loss, auditory
processing disorders, and balance
disorders within the licensed scope of
practice only);
(8) Licensed Advanced Practice
Registered Nurses or other licensed
advance practice nurses with another
title (for impairments within the
individual’s licensed scope of practice
only);
(9) Licensed Physician Assistants/
Physician Associates (for impairments
within the individual’s licensed scope
of practice); or
(10) Persons authorized to furnish a
copy or summary of the records of a
medical facility. Generally, the copy or
summary should be certified as accurate
by the custodian or by any authorized
employee of the Railroad Retirement
Board, Social Security Administration,
VerDate Sep<11>2014
17:12 Jan 15, 2025
Jkt 265001
Department of Veterans Affairs, or State
agency.
(b) Other medical sources. Individuals
who are licensed as healthcare workers
by a State and are working within the
scope of practice permitted under State
or Federal law, other than acceptable
medical sources identified in paragraph
(a) of this section, are other medical
sources. Examples include licensed
clinical social workers, naturopaths, and
chiropractors. The Board will accept
and consider evidence from other
medical sources about the claimant’s
impairment(s) and the effect on the
claimant’s ability to work, but the
presence of a medically determinable
physical or mental impairment must be
established with objective medical
evidence from an acceptable medical
source as defined in paragraph (a) of
this section.
(c) * * *
(6) * * *
(i) Statements about what the
claimant can still do despite his or her
impairment(s) based on the medical
source’s findings on factors in
paragraphs (c)(1) through (5) of this
section (except in disability claims for
remarried widow’s and surviving
divorced spouses). (See § 220.112).
(ii) Statements about what the
claimant can still do (based on the
medical source’s findings on factors in
paragraphs (c)(1) through (5) of this
section) should describe—
*
*
*
*
*
(d) Completeness. The medical
evidence, including the clinical and
laboratory findings, must be complete
and detailed enough for the Board to
determine whether the claimant is
disabled. Specifically, it must allow the
Board to determine—
*
*
*
*
*
(e) Evidence from treating medical
sources. A statement by or the opinion
of the claimant’s treating medical source
will not determine whether the claimant
is disabled. However, the medical
evidence provided by a treating medical
source will be considered by the Board
in making a disability decision. A
treating medical source is a medical
source to whom the claimant has been
going for treatment on a continuing
basis. The claimant may have more than
one treating medical source. The Board
may use consulting physicians or other
medical consultants for specialized
examinations or tests, to obtain more
complete evidence, and to resolve any
conflicts. A consulting physician is a
doctor (often a specialist) to whom the
claimant is referred for an examination
once or on a limited basis. (See § 220.50
for an explanation of when the Board
PO 00000
Frm 00044
Fmt 4700
Sfmt 4700
may request a consultative
examination.)
(f) Information from non-medical
sources. Information from other sources
may also help the Board understand
how an impairment affects the
claimant’s ability to work. Other sources
include—
(1) Public and private social welfare
agency personnel;
(2) Family members, caregivers,
friends, and neighbors of the claimant;
(3) Educational personnel such as
teachers, counselors, and daycare center
workers;
(4) Railroad and nonrailroad
employers; and,
(5) The claimants themselves.
Dated: January 7, 2025.
By Authority of the Board.
Stephanie Hillyard,
Secretary to the Board.
[FR Doc. 2025–00515 Filed 1–15–25; 8:45 am]
BILLING CODE 7905–01–P
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Food and Drug Administration
21 CFR Part 74
[Docket No. FDA–2023–N–0437]
Color Additive Petition From Center for
Science in the Public Interest, et al.;
Request To Revoke Color Additive
Listing for Use of FD&C Red No. 3 in
Food and Ingested Drugs
AGENCY:
Food and Drug Administration,
HHS.
ACTION:
Final amendment; order.
The Food and Drug
Administration (FDA or we) is granting
a color additive petition submitted by
Center for Science in the Public Interest,
et al., by repealing the color additive
regulations that permit the use of FD&C
Red No. 3 in foods (including dietary
supplements) and in ingested drugs.
The petitioners provided data
demonstrating that this additive induces
cancer in male rats. Therefore, FDA is
revoking the authorized uses in food
and ingested drugs of FD&C Red No. 3
in the color additive regulations.
DATES: This order is effective January
15, 2027, except for amendatory
instruction 4, which is effective January
18, 2028. If any provisions are delayed
or stayed by the filing of proper
objections, FDA will publish such
notification in the Federal Register.
Submit either electronic or written
objections and requests for a hearing on
the order by February 18, 2025. See
SUMMARY:
E:\FR\FM\16JAR1.SGM
16JAR1
Agencies
[Federal Register Volume 90, Number 10 (Thursday, January 16, 2025)]
[Rules and Regulations]
[Pages 4626-4628]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2025-00515]
=======================================================================
-----------------------------------------------------------------------
RAILROAD RETIREMENT BOARD
20 CFR Part 220
RIN 3220-AB71
Evidence of Disability
AGENCY: Railroad Retirement Board.
ACTION: Final rule.
-----------------------------------------------------------------------
SUMMARY: The Railroad Retirement Board (RRB) amends its regulations to
designate additional acceptable medical sources in disability claims
under the Railroad Retirement Act. This change recognizes the evolution
of how medical care and treatment are delivered and aligns the RRB's
acceptable medical sources with recently amended regulations of the
Social Security Administration (SSA). Additionally, the changes clarify
existing RRB policy regarding how evidence from medical sources, other
than those designated as acceptable medical sources, will be evaluated.
DATES: This rule is effective March 17, 2025.
FOR FURTHER INFORMATION CONTACT: Peter J. Orlowicz, Senior Counsel,
(312) 751-4922, [email protected].
SUPPLEMENTARY INFORMATION:
I. Background Information
The RRB published a Notice of Proposed Rulemaking (NPRM) in the
Federal Register on June 21, 2024 (89 FR 51990). The preamble to the
NPRM discussed the changes from our current rules and our reasons for
proposing those changes. In the NPRM, we proposed to designate
additional acceptable medical sources (AMS) in disability claims under
the Railroad Retirement Act. Although the RRB will accept and evaluate
evidence from any relevant source, including medical sources not
designated as an AMS, the RRB requires evidence about a claimant's
impairment from an AMS to adjudicate a claim of disability.
The additional AMS we proposed to add are:
(1) Licensed or certified school psychologists, or other licensed
or certified individuals with another title who perform the same
function as a school psychologist in a school setting, for impairments
of intellectual disability, learning disabilities, and borderline
intellectual functioning only;
(2) Licensed podiatrists, for impairments of the foot or of the
foot and ankle, depending on the scope of practice in the State in
which the podiatrist practices;
(3) Qualified speech-language pathologists, for speech and language
impairments only, and when either licensed by a State professional
licensing agency, fully certified by a State education agency where the
individual practices, or holding a Certificate of Clinical Competence
in Speech-Language Pathology from the American Speech-Language-Hearing
Association;
(4) Licensed audiologists, for impairments of hearing loss,
auditory processing disorders, and balance disorders when such
disorders are within the individual's licensed scope of practice;
(5) Licensed Advanced Practice Registered Nurses or other licensed
advance practice nurses with another title, within the individual's
scope of practice (this category includes, but is not limited to,
Certified Nurse Midwives, Nurse Practitioners, Certified Registered
Nurse Anesthetists, and Clinical Nurse Specialists); and
(6) Licensed Physician Assistants, for impairments within the
individual's licensed scope of practice.
We provided 60 days for the public to comment on the NPRM. We
received three comments: two comments were submitted by professional
organizations representing medical providers who would be added as AMS
under the proposed rule, and one comment was submitted by a public
policy research group. All three comments were supportive of the
proposed changes, with two commenters providing
[[Page 4627]]
additional suggestions as described below. We also identified and fixed
two minor grammatical errors that do not affect the substance of the
rule.
II. Public Comments
Comment: The American Academy of Physician Associates (AAPA)
recommended that the regulation include ``physician assistant'' and
``physician associate'' as equivalent titles and list both in the
regulation to avoid confusion. The AAPA explained the titles both refer
to individuals who graduate from programs accredited by the same
accrediting body, are certified by the same certifying organization,
and have the same scope of practice. Individuals in this profession
have historically been identified as ``physician assistants,'' but the
official title is now recognized as ``physician associate'' as
reflected in the title of the AAPA, other professional organizations,
professional training programs, and state laws regarding licensure.
Because the title change will take time to be formalized in all
jurisdictions, the AAPA recommends that both ``physician assistant''
and ``physician associate'' be listed.
Response: We agree with this comment, and we revised the final
regulatory text accordingly. Specifically, we revised the proposed
regulatory text for PAs as AMS in final 220.46(a)(9) to read,
``Licensed Physician Assistants/Physician Associates (for impairments
within the individual's licensed scope of practice).'' We do not view
this as a substantive change in the scope of individuals the rule is
intended to cover, nor do we understand the AAPA to be suggesting such
a change in scope.
Comment: One commenter recommended clarifying who may qualify as an
``other licensed or certified individual . . . who perform the same
function as a school psychologist in a school setting.'' The commenter
expressed concern that special education teachers may possess certain
state certifications to teach children with learning disabilities, but
that state certification standards for special education teachers vary
from state to state and a significant proportion of special education
teachers may be teaching with a provisional or emergency appointment
without having the necessary certification or experience to provide
medical reports of intellectual disability, learning disabilities, or
borderline intellectual functioning.
Response: We did not adopt this comment. Special education teachers
and school psychologists are different and distinct professions with
different certification standards. Section 8002(19) of the Every
Student Succeeds Act, Public Law 114-95 (Dec. 10, 2015) identifies
school psychologists as ``specialized instructional support personnel''
along with school counselors, school social workers, school nurses,
speech language pathologists, and school librarians. In Organizational
Principle 3 of its 2020 Professional Standards, the National
Association of School Psychologists recommends the ratio of school
psychologists to students should not exceed 1 school psychologist for
every 500 students. While school psychologists work with other school
personnel, including special education teachers, to perform their
function, a special education teacher would not normally be performing
the same function as a school psychologist in the school setting. We
believe the residual clause for other licensed or certified individuals
with different titles who are performing the same function in a school
setting is sufficiently clear. An individual who lacks a certification
or license equivalent to a school psychologist and who does not perform
the same function as a school psychologist would not qualify as an AMS
under this paragraph.
Comment: One commenter agreed with the addition of licensed
podiatrists as AMS for impairments of the foot or foot and ankle, but
advocated for the inclusion of other orthopedic specialists who are
certified and trained to address issues of other skeletal structures.
Response: We did not adopt this comment. Many orthopedic
specialists will qualify as an AMS because they are licensed medical or
osteopathic doctors. To the extent that skeletal structure-related
impairments are within the scope of practice for an Advanced Practice
Registered Nurse or a Physician Assistant/Physician Associate, those
individuals would also be qualified as an AMS without the need for
separate discussion. In the case of other individuals who hold
themselves out as orthopedic specialists but would not otherwise
qualify as an AMS under those other categories, Sec. 220.46(b) in the
final rule acknowledges we will accept and consider evidence from such
a medical source about the claimant's impairment(s) and the effect on
the claimant's ability to work, but the presence of a medically
determinable physical or mental impairment must be established with
objective medical evidence from an AMS.
Regulatory Analysis
Executive Order 12866, as Supplemented by Executive Order 13563
The RRB, with the Office of Management and Budget, has determined
that this is not a significant regulatory action under Executive Order
12866, as supplemented by Executive Order 13563. Therefore, no
regulatory impact analysis is required.
Executive Order 13132 (Federalism)
This proposed rule will not have substantial direct effects on the
States, on the relationship between the National Government and the
States, or on the distribution of power and responsibilities among the
various levels of government. Therefore, in accordance with section 6
of Executive Order 13132, the RRB believes that this proposed rule will
not have sufficient federalism implications to warrant the preparation
of a federalism summary impact statement.
Regulatory Flexibility Act
The RRB certifies that this rule will not have a significant
economic impact on a substantial number of small entities because the
rulemaking affects individuals only. Therefore, a regulatory
flexibility analysis is not required under the Regulatory Flexibility
Act, as amended.
Paperwork Reduction Act
This rule does not create any new or affect any existing
collections and, therefore, does not require Office of Management and
Budget approval under the Paperwork Reduction Act.
List of Subjects in 20 CFR Part 220
Disability benefits, Railroad employees, Railroad retirement.
For the reasons set out in the preamble, the Railroad Retirement
Board amends 20 CFR part 220 as follows:
PART 220--DETERMINING DISABILITY
0
1. The authority citation for part 220 continues to read as follows:
Authority: 45 U.S.C. 231a; 45 U.S.C. 231f.
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2. Amend Sec. 220.46 by:
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a. Revising paragraph (a);
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b. Redesignating paragraphs (b) through (e) as paragraphs (c) through
(f) respectively;
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c. Adding new paragraph (b); and
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d. Revising newly redesignated paragraphs (c)(6)(i), (c)(6)(ii)
introductory text, (d) introductory text, (e), and (f).
[[Page 4628]]
The revisions and addition read as follows:
Sec. 220.46 Medical evidence.
(a) Acceptable medical sources. The Board needs reports about the
claimant's impairment(s) from acceptable medical sources. Acceptable
medical sources are--
(1) Licensed physicians (medical or osteopathic doctors);
(2) Licensed or certified psychologists at the independent practice
level;
(3) Licensed or certified school psychologists, or other licensed
or certified individuals with another title who perform the same
function as a school psychologist in a school setting (for impairments
of intellectual disability, learning disabilities, and borderline
intellectual functioning only);
(4) Licensed optometrists (for impairments of visual disorders, or
for the measurement of visual acuity and visual fields only, depending
on the scope of practice in the State in which the optometrist
practices);
(5) Licensed podiatrists (for impairments of the foot only, or foot
and ankle only, depending on the scope of practice in the State in
which the podiatrist practices);
(6) Qualified speech-language pathologists (for speech or language
impairments only.) For this source, qualified means that the speech-
language pathologist must be licensed by the State professional
licensing agency, or be fully certified by the State education agency
in the State in which the speech-language pathologist practices, or
hold a Certificate of Clinical Competence in Speech-Language Pathology
from the American Speech-Language-Hearing Association;
(7) Licensed audiologists (for impairments of hearing loss,
auditory processing disorders, and balance disorders within the
licensed scope of practice only);
(8) Licensed Advanced Practice Registered Nurses or other licensed
advance practice nurses with another title (for impairments within the
individual's licensed scope of practice only);
(9) Licensed Physician Assistants/Physician Associates (for
impairments within the individual's licensed scope of practice); or
(10) Persons authorized to furnish a copy or summary of the records
of a medical facility. Generally, the copy or summary should be
certified as accurate by the custodian or by any authorized employee of
the Railroad Retirement Board, Social Security Administration,
Department of Veterans Affairs, or State agency.
(b) Other medical sources. Individuals who are licensed as
healthcare workers by a State and are working within the scope of
practice permitted under State or Federal law, other than acceptable
medical sources identified in paragraph (a) of this section, are other
medical sources. Examples include licensed clinical social workers,
naturopaths, and chiropractors. The Board will accept and consider
evidence from other medical sources about the claimant's impairment(s)
and the effect on the claimant's ability to work, but the presence of a
medically determinable physical or mental impairment must be
established with objective medical evidence from an acceptable medical
source as defined in paragraph (a) of this section.
(c) * * *
(6) * * *
(i) Statements about what the claimant can still do despite his or
her impairment(s) based on the medical source's findings on factors in
paragraphs (c)(1) through (5) of this section (except in disability
claims for remarried widow's and surviving divorced spouses). (See
Sec. 220.112).
(ii) Statements about what the claimant can still do (based on the
medical source's findings on factors in paragraphs (c)(1) through (5)
of this section) should describe--
* * * * *
(d) Completeness. The medical evidence, including the clinical and
laboratory findings, must be complete and detailed enough for the Board
to determine whether the claimant is disabled. Specifically, it must
allow the Board to determine--
* * * * *
(e) Evidence from treating medical sources. A statement by or the
opinion of the claimant's treating medical source will not determine
whether the claimant is disabled. However, the medical evidence
provided by a treating medical source will be considered by the Board
in making a disability decision. A treating medical source is a medical
source to whom the claimant has been going for treatment on a
continuing basis. The claimant may have more than one treating medical
source. The Board may use consulting physicians or other medical
consultants for specialized examinations or tests, to obtain more
complete evidence, and to resolve any conflicts. A consulting physician
is a doctor (often a specialist) to whom the claimant is referred for
an examination once or on a limited basis. (See Sec. 220.50 for an
explanation of when the Board may request a consultative examination.)
(f) Information from non-medical sources. Information from other
sources may also help the Board understand how an impairment affects
the claimant's ability to work. Other sources include--
(1) Public and private social welfare agency personnel;
(2) Family members, caregivers, friends, and neighbors of the
claimant;
(3) Educational personnel such as teachers, counselors, and daycare
center workers;
(4) Railroad and nonrailroad employers; and,
(5) The claimants themselves.
Dated: January 7, 2025.
By Authority of the Board.
Stephanie Hillyard,
Secretary to the Board.
[FR Doc. 2025-00515 Filed 1-15-25; 8:45 am]
BILLING CODE 7905-01-P