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Electronic Code of Federal Regulations

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e-CFR Data is current as of July 28, 2014

TITLE 20—Employees' Benefits

CHAPTER III—SOCIAL SECURITY ADMINISTRATION

PART 416—SUPPLEMENTAL SECURITY INCOME FOR THE AGED, BLIND, AND DISABLED

rule

Subpart A—INTRODUCTION, GENERAL PROVISIONS AND DEFINITIONS

§416.101
Introduction.
§416.105
Administration.
§416.110
Purpose of program.
§416.120
General definitions and use of terms.
§416.121
Receipt of aid or assistance for December 1973 under an approved State plan under title I, X, XIV, or XVI of the Social Security Act.
rule

Subpart B—ELIGIBILITY

General

§416.200
Introduction.
§416.201
General definitions and terms used in this subpart.
§416.202
Who may get SSI benefits.
§416.203
Initial determinations of SSI eligibility.
§416.204
Redeterminations of SSI eligibility.

Reasons Why You May Not Get SSI Benefits for Which You Are Otherwise Eligible

§416.207
You do not give us permission to contact financial institutions.
§416.210
You do not apply for other benefits.
§416.211
You are a resident of a public institution.
§416.212
Continuation of full benefits in certain cases of medical confinement.
§416.214
You are disabled and drug addiction or alcoholism is a contributing factor material to the determination of disability.
§416.215
You leave the United States.
§416.216
You are a child of armed forces personnel living overseas.

Eligibility for Increased Benefits Because of Essential Persons

§416.220
General.
§416.221
Who is a qualified individual.
§416.222
Who is an essential person.
§416.223
What happens if you are a qualified individual.
§416.250
Experimental, pilot, and demonstration projects in the SSI program.

Special Provisions for People Who Work Despite a Disabling Impairment

§416.260
General.
§416.261
What are special SSI cash benefits and when are they payable.
§416.262
Eligibility requirements for special SSI cash benefits.
§416.263
No additional application needed.
§416.264
When does the special SSI eligibility status apply.
§416.265
Requirements for the special SSI eligibility status.
§416.266
Continuation of SSI status for Medicaid
§416.267
General.
§416.268
What is done to determine if you must have Medicaid in order to work.
§416.269
What is done to determine whether your earnings are too low to provide comparable benefits and services you would receive in the absence of those earnings.
rule

Subpart C—FILING OF APPLICATIONS

General Provisions

§416.301
Introduction.
§416.302
Definitions.
§416.305
You must file an application to receive supplemental security income benefits.

Applications

§416.310
What makes an application a claim for benefits.
§416.315
Who may sign an application.
§416.320
Evidence of authority to sign an application for another.
§416.325
When an application is considered filed.
§416.327
Pilot program for photographic identification of disability benefit applicants in designated geographic areas.

Effective Filing Period of Application

§416.330
Filing before the first month you meet the requirements for eligibility.
§416.335
Filing in or after the month you meet the requirements for eligibility.

Filing Date Based Upon a Written Statement or Oral Inquiry

§416.340
Use of date of written statement as application filing date.
§416.345
Use of date of oral inquiry as application filing date.
§416.350
Treating a title II application as an oral inquiry about SSI benefits.

Deemed Filing Date Based on Misinformation

§416.351
Deemed filing date in a case of misinformation.

Withdrawal of Application

§416.355
Withdrawal of an application.
§416.360
Cancellation of a request to withdraw.
rule

Subpart D—AMOUNT OF BENEFITS

§416.401
Scope of subpart.
§416.405
Cost-of-living adjustments in benefits.
§416.410
Amount of benefits; eligible individual.
§416.412
Amount of benefits; eligible couple.
§416.413
Amount of benefits; qualified individual.
§416.414
Amount of benefits; eligible individual or eligible couple in a medical treatment facility.
§416.415
Amount of benefits; eligible individual is disabled child under age 18.
§416.420
Determination of benefits; general.
§416.421
Determination of benefits; computation of prorated benefits.
§416.426
Change in status involving an individual; ineligibility occurs.
§416.428
Eligible individual without an eligible spouse has an essential person in his home.
§416.430
Eligible individual with eligible spouse; essential person(s) present.
§416.432
Change in status involving a couple; eligibility continues.
§416.435
Change in status involving a couple; ineligibility occurs.
rule

Subpart E—PAYMENT OF BENEFITS, OVERPAYMENTS, AND UNDERPAYMENTS

§416.501
Payment of benefits: General.
§416.502
Manner of payment.
§416.503
Minimum monthly benefit amount.
§416.520
Emergency advance payments.
§416.525
Reimbursement to States for interim assistance payments.
§416.532
Method of payment when the essential person resides with more than one eligible person.
§416.533
Transfer or assignment of benefits.
§416.534
Garnishment of payments after disbursement.
§416.535
Underpayments and overpayments.
§416.536
Underpayments—defined.
§416.537
Overpayments—defined.
§416.538
Amount of underpayment or overpayment.
§416.542
Underpayments—to whom underpaid amount is payable.
§416.543
Underpayments—applied to reduce overpayments.
§416.544
Paying benefits in installments: Drug addiction or alcoholism.
§416.545
Paying large past-due benefits in installments.
§416.546
Payment into dedicated accounts of past-due benefits for eligible individuals under age 18 who have a representative payee.
§416.550
Waiver of adjustment or recovery—when applicable.
§416.551
Waiver of adjustment or recovery—effect of.
§416.552
Waiver of adjustment or recovery—without fault.
§416.553
Waiver of adjustment or recovery—defeat the purpose of the supplemental security income program.
§416.554
Waiver of adjustment or recovery—against equity and good conscience.
§416.555
Waiver of adjustment or recovery—impede administration.
§416.556
Waiver of adjustment or recovery—countable resources in excess of the limits prescribed in §416.1205 by $50 or less.
§416.557
Personal conference.
§416.558
Notice relating to overpayments and underpayments.
§416.560
Recovery—refund.
§416.570
Adjustment.
§416.571
10-percent limitation of recoupment rate—overpayment.
§416.572
Are title II and title VIII benefits subject to adjustment to recover title XVI overpayments?
§416.573
How much will we withhold from your title II and title VIII benefits to recover a title XVI overpayment?
§416.574
Will you receive notice of our intention to apply cross-program recovery?
§416.575
When will we begin cross-program recovery from your current monthly benefits?
§416.580
Referral of overpayments to the Department of the Treasury for tax refund offset—General.
§416.581
Notice to overpaid person.
§416.582
Review within SSA that an overpayment is past due and legally enforceable.
§416.583
Findings by SSA.
§416.584
Review of our records related to the overpayment.
§416.585
Suspension of offset.
§416.586
Tax refund insufficient to cover amount of overpayment.
§416.590
Are there additional methods for recovery of title XVI benefit overpayments?
rule

Subpart F—REPRESENTATIVE PAYMENT

§416.601
Introduction.
§416.610
When payment will be made to a representative payee.
§416.611
What happens to your monthly benefits while we are finding a suitable representative payee for you?
§416.615
Information considered in determining whether to make representative payment.
§416.620
Information considered in selecting a representative payee.
§416.621
What is our order of preference in selecting a representative payee for you?
§416.622
Who may not serve as a representative payee?
§416.624
How do we investigate a representative payee applicant?
§416.625
What information must a representative payee report to us?
§416.630
How will we notify you when we decide you need a representative payee?
§416.635
What are the responsibilities of your representative payee?
§416.640
Use of benefit payments.
§416.640a
Compensation for qualified organizations serving as representative payees.
§416.641
Who is liable if your representative payee misuses your benefits?
§416.645
Conservation and investment of benefit payments.
§416.650
When will we select a new representative payee for you?
§416.655
When representative payment will be stopped.
§416.660
Transfer of accumulated benefit payments.
§416.665
How does your representative payee account for the use of benefits?
rule

Subpart G—REPORTS REQUIRED

Introduction

§416.701
Scope of subpart.
§416.702
Definitions.

Report Provisions

§416.704
Who must make reports.
§416.708
What you must report.
§416.710
What reports must include.
§416.712
Form of the report.
§416.714
When reports are due.

Penalty Deductions

§416.722
Circumstances under which we make a penalty deduction.
§416.724
Amounts of penalty deductions.
§416.726
Penalty period: First failure to report.
§416.728
Penalty period: Second failure to report.
§416.730
Penalty period: Three or more failures to report.
§416.732
No penalty deduction if you have good cause for failure to report timely.
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Subpart H—DETERMINATION OF AGE

§416.801
Evidence as to age—when required.
§416.802
Type of evidence to be submitted.
§416.803
Evaluation of evidence.
§416.804
Certified copy in lieu of original.
§416.805
When additional evidence may be required.
§416.806
Expedited adjudication based on documentary evidence of age.
rule

Subpart I—DETERMINING DISABILITY AND BLINDNESS

General

§416.901
Scope of subpart.
§416.902
General definitions and terms for this subpart.

Determinations

§416.903
Who makes disability and blindness determinations.
§416.903a
Program integrity.
§416.904
Determinations by other organizations and agencies.

Definition of Disability

§416.905
Basic definition of disability for adults.
§416.906
Basic definition of disability for children.
§416.907
Disability under a State plan.
§416.908
What is needed to show an impairment.
§416.909
How long the impairment must last.
§416.910
Meaning of substantial gainful activity.
§416.911
Definition of disabling impairment.

Evidence

§416.912
Evidence.
§416.913
Medical and other evidence of your impairment(s).
§416.914
When we will purchase existing evidence.
§416.915
Where and how to submit evidence.
§416.916
If you fail to submit medical and other evidence.
§416.917
Consultative examination at our expense.
§416.918
If you do not appear at a consultative examination.

Standards To Be Used in Determining When a Consultative Examination Will Be Obtained in Connection With Disability Determinations

§416.919
The consultative examination.
§416.919a
When we will purchase a consultative examination and how we will use it.
§416.919b
When we will not purchase a consultative examination.

Standards for the Type of Referral and for Report Content

§416.919f
Type of purchased examinations.
§416.919g
Who we will select to perform a consultative examination.
§416.919h
Your treating source.
§416.919i
Other sources for consultative examinations.
§416.919j
Objections to the medical source designated to perform the consultative examination.
§416.919k
Purchase of medical examinations, laboratory tests, and other services.
§416.919m
Diagnostic tests or procedures.
§416.919n
Informing the medical source of examination scheduling, report content, and signature requirements.
§416.919o
When a properly signed consultative examination report has not been received.
§416.919p
Reviewing reports of consultative examinations.
§416.919q
Conflict of interest.

Authorizing and Monitoring the Referral Process

§416.919s
Authorizing and monitoring the consultative examination.

Procedures To Monitor the Consultative Examination

§416.919t
Consultative examination oversight.

Evaluation of Disability

§416.920
Evaluation of disability of adults, in general.
§416.920a
Evaluation of mental impairments.
§416.920b
How we consider evidence.
§416.921
What we mean by a not severe impairment(s) in an adult.
§416.922
When you have two or more unrelated impairments—initial claims.
§416.923
Multiple impairments.
§416.924
How we determine disability for children.
§416.924a
Considerations in determining disability for children.
§416.924b
Age as a factor of evaluation in the sequential evaluation process for children.

Medical Considerations

§416.925
Listing of Impairments in appendix 1 of subpart P of part 404 of this chapter.
§416.926
Medical equivalence for adults and children.
§416.926a
Functional equivalence for children.
§416.927
Evaluating opinion evidence.
§416.928
Symptoms, signs, and laboratory findings.
§416.929
How we evaluate symptoms, including pain.
§416.930
Need to follow prescribed treatment.

Presumptive Disability and Blindness

§416.931
The meaning of presumptive disability or presumptive blindness.
§416.932
When presumptive payments begin and end.
§416.933
How we make a finding of presumptive disability or presumptive blindness.
§416.934
Impairments which may warrant a finding of presumptive disability or presumptive blindness.

Drug Addiction and Alcoholism

§416.935
How we will determine whether your drug addiction or alcoholism is a contributing factor material to the determination of disability.
§416.936
Treatment required for individuals whose drug addiction or alcoholism is a contributing factor material to the determination of disability.
§416.937
What we mean by appropriate treatment.
§416.938
What we mean by approved institutions or facilities.
§416.939
How we consider whether treatment is available.
§416.940
Evaluating compliance with the treatment requirements.
§416.941
Establishment and use of referral and monitoring agencies.

Residual Functional Capacity

§416.945
Your residual functional capacity.
§416.946
Responsibility for assessing your residual functional capacity.

Vocational Considerations

§416.960
When we will consider your vocational background.
§416.962
Medical-vocational profiles showing an inability to make an adjustment to other work.
§416.963
Your age as a vocational factor.
§416.964
Your education as a vocational factor.
§416.965
Your work experience as a vocational factor.
§416.966
Work which exists in the national economy.
§416.967
Physical exertion requirements.
§416.968
Skill requirements.
§416.969
Listing of Medical-Vocational Guidelines in appendix 2 of subpart P of part 404 of this chapter.
§416.969a
Exertional and nonexertional limitations.

Substantial Gainful Activity

§416.971
General.
§416.972
What we mean by substantial gainful activity.
§416.973
General information about work activity.
§416.974
Evaluation guides if you are an employee.
§416.974a
When and how we will average your earnings.
§416.975
Evaluation guides if you are self-employed.
§416.976
Impairment-related work expenses.

Blindness

§416.981
Meaning of blindness as defined in the law.
§416.982
Blindness under a State plan.
§416.983
How we evaluate statutory blindness.
§416.984
If you are statutorily blind and still working.
§416.985
How we evaluate other visual impairments.
§416.986
Why and when we will find that you are no longer entitled to benefits based on statutory blindness.

Disability Redeterminations for Individuals Who Attain Age 18

§416.987
Disability redeterminations for individuals who attain age 18.

Continuing or Stopping Disability or Blindness

§416.988
Your responsibility to tell us of events that may change your disability or blindness status.
§416.989
We may conduct a review to find out whether you continue to be disabled.
§416.989a
We may conduct a review to find out whether you continue to be blind.
§416.990
When and how often we will conduct a continuing disability review.
§416.991
If your medical recovery was expected and you returned to work.
§416.992
What happens if you fail to comply with our request for information.
§416.992a
[Reserved]
§416.993
Medical evidence in continuing disability review cases.
§416.994
How we will determine whether your disability continues or ends, disabled adults.
§416.994a
How we will determine whether your disability continues or ends, and whether you are and have been receiving treatment that is medically necessary and available, disabled children.
§416.995
If we make a determination that your physical or mental impairment(s) has ceased, did not exist or is no longer disabling (Medical Cessation Determination).
§416.996
Continued disability or blindness benefits pending appeal of a medical cessation determination.
§416.998
If you become disabled by another impairment(s).
§416.999
What is expedited reinstatement?
§416.999a
Who is eligible for expedited reinstatement?
§416.999b
How do I request reinstatement?
§416.999c
How do we determine provisional benefits?
§416.999d
How do we determine reinstated benefits?
rule

Subpart J—DETERMINATIONS OF DISABILITY

General Provisions

§416.1001
Purpose and scope.
§416.1002
Definitions.
§416.1003
Basic responsibilities for us and the State.

Responsibilities for Performing the Disability Determination Function

§416.1010
How a State notifies us that it wishes to perform the disability determination function.
§416.1011
How we notify a State whether it may perform the disability determination function.
§416.1013
Disability determinations the State makes.
§416.1014
Responsibilities for obtaining evidence to make disability determinations.
§416.1015
Making disability determinations.
§416.1016
Medical or psychological consultants.
§416.1017
Reasonable efforts to obtain review by a qualified psychiatrist or psychologist.
§416.1018
Notifying claimant of the disability determination.

Quick Disability Determinations

§416.1019
Quick disability determination process.

Administrative Responsibilities and Requirements

§416.1020
General administrative requirements.
§416.1021
Personnel.
§416.1022
Training.
§416.1023
Facilities.
§416.1024
Medical and other purchased services.
§416.1025
Records and reports.
§416.1026
Fiscal.
§416.1027
Audits.
§416.1028
Property.
§416.1029
Participation in research and demonstration projects.
§416.1030
Coordination with other agencies.
§416.1031
Confidentiality of information and records.
§416.1032
Other Federal laws and regulations.
§416.1033
Policies and operating instructions.

Performance Standards

§416.1040
General.
§416.1041
Standards of performance.
§416.1042
Processing time standards.
§416.1043
Performance accuracy standard.
§416.1044
How and when we determine whether the processing time standards are met.
§416.1045
How and when we determine whether the performance accuracy standard is met.
§416.1050
Action we will take if a State agency does not meet the standards.

Performance Monitoring and Support

§416.1060
How we will monitor.
§416.1061
When we will provide performance support.
§416.1062
What support we will provide.

Substantial Failure

§416.1070
General.
§416.1071
Good cause for not following the Act, our regulations, or other written guidelines.
§416.1075
Finding of substantial failure.

Hearings and Appeals

§416.1080
Notice of right to hearing on proposed finding of substantial failure.
§416.1081
Disputes on matters other than substantial failure.
§416.1082
Who conducts the hearings.
§416.1083
Hearings and appeals process.

Assumption of Disability Determination Function

§416.1090
Assumption when we make a finding of substantial failure.
§416.1091
Assumption when State no longer wishes to perform the disability determination function.
§416.1092
Protection of State employees.
§416.1093
Limitation on State expenditures after notice.
§416.1094
Final accounting by the State.
rule

Subpart K—INCOME

General

§416.1100
Income and SSI eligibility.
§416.1101
Definition of terms.
§416.1102
What is income?
§416.1103
What is not income?
§416.1104
Income we count.

Earned Income

§416.1110
What is earned income.
§416.1111
How we count earned income.
§416.1112
Earned income we do not count.

Unearned Income

§416.1120
What is unearned income.
§416.1121
Types of unearned income.
§416.1123
How we count unearned income.
§416.1124
Unearned income we do not count.

In-Kind Support and Maintenance

§416.1130
Introduction.
§416.1131
The one-third reduction rule.
§416.1132
What we mean by “living in another person's household”.
§416.1133
What is a pro rata share of household operating expenses.
§416.1140
The presumed value rule.
§416.1141
When the presumed value rule applies.
§416.1142
If you live in a public assistance household.
§416.1143
If you live in a noninstitutional care situation.
§416.1144
If you live in a nonprofit retirement home or similar institution.
§416.1145
How the presumed value rule applies in a nonmedical for-profit institution.

In-Kind Support and Maintenance in Special Circumstances

§416.1147
How we value in-kind support and maintenance for a couple.
§416.1147a
Income rules in change-of-status situations involving in-kind support and maintenance.
§416.1148
If you have both in-kind support and maintenance and income that is deemed to you.

Temporary Absence

§416.1149
What is a temporary absence from your living arrangement.

Disasters

§416.1150
How we treat income received because of a major disaster.
§416.1151
How we treat the repair or replacement of lost, damaged, or stolen resources.

Home Energy Assistance

§416.1157
Support and maintenance assistance.

Deeming of Income

§416.1160
What is deeming of income?
§416.1161
Income of an ineligible spouse, ineligible parent, and essential person for deeming purposes.
§416.1161a
Income for deeming purposes where Medicaid eligibility is affected.
§416.1163
How we deem income to you from your ineligible spouse.
§416.1165
How we deem income to you from your ineligible parent(s).
§416.1166
How we deem income to you and your eligible child from your ineligible spouse.
§416.1166a
How we deem income to you from your sponsor if you are an alien.
§416.1167
Temporary absences and deeming rules.
§416.1168
How we deem income to you from your essential person.
§416.1169
When we stop deeming income from an essential person.

Alternative Income Counting Rules for Certain Blind Individuals

§416.1170
General.
§416.1171
When the alternative rules apply.

Rules for Helping Blind and Disabled Individuals Achieve Self-Support

§416.1180
General.
§416.1181
What is a plan to achieve self-support (PASS)?
§416.1182
When we begin to count the income excluded under the plan.
Appendix
Appendix to Subpart K of Part 416—List of Types of Income Excluded Under the SSI Program as Provided by Federal Laws Other Than the Social Security Act
rule

Subpart L—RESOURCES AND EXCLUSIONS

§416.1201
Resources; general.
§416.1202
Deeming of resources.
§416.1203
Deeming of resources of an essential person.
§416.1204
Deeming of resources of the sponsor of an alien.
§416.1204a
Deeming of resources where Medicaid eligibility is affected.
§416.1205
Limitation on resources.
§416.1207
Resources determinations.
§416.1208
How funds held in financial institution accounts are counted.
§416.1210
Exclusions from resources; general.
§416.1212
Exclusion of the home.
§416.1216
Exclusion of household goods and personal effects.
§416.1218
Exclusion of the automobile.
§416.1220
Property essential to self-support; general.
§416.1222
How income-producing property essential to self-support is counted.
§416.1224
How nonbusiness property used to produce goods or services essential to self-support is counted.
§416.1225
An approved plan to achieve self-support; general.
§416.1226
What is a plan to achieve self-support (PASS)?
§416.1227
When the resources excluded under a plan to achieve self-support begin to count.
§416.1228
Exclusion of Alaskan natives' stock in regional or village corporations.
§416.1229
Exclusion of payments received as compensation for expenses incurred or losses suffered as a result of a crime.
§416.1230
Exclusion of life insurance.
§416.1231
Burial spaces and certain funds set aside for burial expenses.
§416.1232
Replacement of lost, damaged, or stolen excluded resources.
§416.1233
Exclusion of certain underpayments from resources.
§416.1234
Exclusion of Indian lands.
§416.1235
Exclusion of certain payments related to tax credits.
§416.1236
Exclusions from resources; provided by other statutes.
§416.1237
Assistance received on account of major disaster.
§416.1238
Exclusion of certain housing assistance.
§416.1239
Exclusion of State or local relocation assistance payments.
§416.1240
Disposition of resources.
§416.1242
Time limits for disposing of resources.
§416.1244
Treatment of proceeds from disposition of resources.
§416.1245
Exceptions to required disposition of real property.
§416.1246
Disposal of resources at less than fair market value.
§416.1247
Exclusion of a dedicated account in a financial institution.
§416.1248
Exclusion of gifts to children with life-threatening conditions.
§416.1249
Exclusion of payments received as restitution for misuse of benefits by a representative payee.
§416.1250
How we count grants, scholarships, fellowships or gifts.
§416.1260
Special resource provision for recipients under a State plan.
§416.1261
Application of special resource provision.
§416.1262
Special resource provision applicable in cases involving essential persons.
§416.1264
Spouse ineligible under a State plan in December 1973.
§416.1266
Individual under special resource provision dies after December 1973.
rule

Subpart M—SUSPENSIONS AND TERMINATIONS

§416.1320
Suspensions; general.
§416.1321
Suspension for not giving us permission to contact financial institutions.
§416.1322
Suspension due to failure to comply with request for information.
§416.1323
Suspension due to excess income.
§416.1324
Suspension due to excess resources.
§416.1325
Suspension due to status as a resident of a public institution.
§416.1326
Suspension for failure to comply with treatment for drug addiction or alcoholism.
§416.1327
Suspension due to absence from the United States.
§416.1329
Suspension due to loss of United States residency, United States citizenship, or status as an alien lawfully admitted for permanent residence or otherwise permanently residing in the United States under color of law.
§416.1330
Suspension due to failure to apply for and obtain other benefits.
§416.1331
Termination of your disability or blindness payments.
§416.1332
Termination of benefit for disabled individual: Exception.
§416.1333
Termination at the request of the recipient.
§416.1334
Termination due to death of recipient.
§416.1335
Termination due to continuous suspension.
§416.1336
Notice of intended action affecting recipient's payment status.
§416.1337
Exceptions to the continuation of previously established payment level.
§416.1338
If you are participating in an appropriate program of vocational rehabilitation services, employment services, or other support services.
§416.1339
Suspension due to flight to avoid criminal prosecution or custody or confinement after conviction, or due to violation of probation or parole.
§416.1340
Penalty for making false or misleading statements or withholding information.
rule

Subpart N—DETERMINATIONS, ADMINISTRATIVE REVIEW PROCESS, AND REOPENING OF DETERMINATIONS AND DECISIONS

Introduction, Definitions, and Initial Determinations

§416.1400
Introduction.
§416.1401
Definitions.
§416.1402
Administrative actions that are initial determinations.
§416.1403
Administrative actions that are not initial determinations.
§416.1404
Notice of the initial determination.
§416.1405
Effect of an initial determination.
§416.1406
Testing modifications to the disability determination procedures.

Reconsideration

§416.1407
Reconsideration—general.
§416.1408
Parties to a reconsideration.
§416.1409
How to request reconsideration.
§416.1411
Good cause for missing the deadline to request review.
§416.1413
Reconsideration procedures.
§416.1413a
Reconsiderations of initial determinations on applications.
§416.1413b
Reconsideration procedures for post-eligiblity claims.
§416.1413c
Arrangement for conferences.
§416.1414
Disability hearing—general.
§416.1415
Disability hearing—disability hearing officers.
§416.1416
Disability hearing—procedures.
§416.1417
Disability hearing—disability hearing officer's reconsidered determination.
§416.1418
Disability hearing—review of the disability hearing officer's reconsidered determination before it is issued.
§416.1419
Notice of another person's request for reconsideration.
§416.1420
Reconsidered determination.
§416.1421
Effect of a reconsidered determination.
§416.1422
Notice of a reconsidered determination.

Expedited Appeals Process

§416.1423
Expedited appeals process—general.
§416.1424
When the expedited appeals process may be used.
§416.1425
How to request expedited appeals process.
§416.1426
Agreement in expedited appeals process.
§416.1427
Effect of expedited appeals process agreement.
§416.1428
Expedited appeals process request that does not result in agreement.

Hearing Before an Administrative Law Judge

§416.1429
Hearing before an administrative law judge—general.
§416.1430
Availability of a hearing before an administrative law judge.
§416.1432
Parties to a hearing before an administrative law judge.
§416.1433
How to request a hearing before an administrative law judge.
§416.1435
Submitting evidence prior to a hearing before an administrative law judge.
§416.1436
Time and place for a hearing before an administrative law judge.
§416.1437
Protecting the safety of the public and our employees in our hearing process.
§416.1438
Notice of a hearing before an administrative law judge.
§416.1439
Objections to the issues.
§416.1440
Disqualification of the administrative law judge.
§416.1441
Prehearing case review.
§416.1442
Prehearing proceedings and decisions by attorney advisors.
§416.1443
Responsibilities of the adjudication officer.

Administrative Law Judge Hearing Procedures

§416.1444
Administrative law judge hearing procedures—general.
§416.1446
Issues before an administrative law judge.
§416.1448
Deciding a case without an oral hearing before an administrative law judge.
§416.1449
Presenting written statements and oral arguments.
§416.1450
Presenting evidence at a hearing before an administrative law judge.
§416.1451
When a record of a hearing before an administrative law judge is made.
§416.1452
Consolidated hearings before an administrative law judge.
§416.1453
The decision of an administrative law judge.
§416.1455
The effect of an administrative law judge's decision.
§416.1456
Removal of a hearing request from an administrative law judge to the Appeals Council.
§416.1457
Dismissal of a request for a hearing before an administrative law judge.
§416.1458
Notice of dismissal of a request for a hearing before an administrative law judge.
§416.1459
Effect of dismissal of a request for a hearing before an administrative law judge.
§416.1460
Vacating a dismissal of a request for a hearing before an administrative law judge.
§416.1461
Prehearing and posthearing conferences.
§416.1465
[Reserved]

Appeals Council Review

§416.1466
Testing elimination of the request for Appeals Council review.
§416.1467
Appeals Council review—general.
§416.1468
How to request Appeals Council review.
§416.1469
Appeals Council initiates review.
§416.1470
Cases the Appeals Council will review.
§416.1471
Dismissal by Appeals Council.
§416.1472
Effect of dismissal of request for Appeals Council review.
§416.1473
Notice of Appeals Council review.
§416.1474
Obtaining evidence from Appeals Council.
§416.1475
Filing briefs with the Appeals Council.
§416.1476
Procedures before Appeals Council on review.
§416.1477
Case remanded by Appeals Council.
§416.1479
Decision of Appeals Council.
§416.1481
Effect of Appeals Council's decision or denial of review.
§416.1482
Extension of time to file action in Federal district court.

Court Remand Cases

§416.1483
Case remanded by a Federal court.
§416.1484
Appeals Council review of administrative law judge decision in a case remanded by a Federal court.
§416.1485
Application of circuit court law.

Reopening and Revising Determinations and Decisions

§416.1487
Reopening and revising determinations and decisions.
§416.1488
Conditions for reopening.
§416.1489
Good cause for reopening.
§416.1491
Late completion of timely investigation.
§416.1492
Notice of revised determination or decision.
§416.1493
Effect of revised determination or decision.
§416.1494
Time and place to request further review or a hearing on revised determination or decision.

Payment of Certain Travel Expenses

§416.1495
Payment of certain travel expenses—general.
§416.1496
Who may be reimbursed.
§416.1498
What travel expenses are reimbursable.
§416.1499
When and how to claim reimbursement.
rule

Subpart O—REPRESENTATION OF PARTIES

§416.1500
Introduction.
§416.1503
Definitions.
§416.1505
Who may be your representative.
§416.1506
Notification of options for obtaining attorney representation.
§416.1507
Appointing a representative.
§416.1510
Authority of a representative.
§416.1513
Mandatory use of electronic services.
§416.1515
Notice or request to a representative.
§416.1517
Direct payment of fees to eligible non-attorney representatives.
§416.1520
Fee for a representative's services.
§416.1525
Request for approval of a fee.
§416.1528
Proceedings before a State or Federal court.
§416.1530
Payment of fees.
§416.1535
[Reserved]
§416.1540
Rules of conduct and standards of responsibility for representatives.
§416.1545
Violations of our requirements, rules, or standards.
§416.1550
Notice of charges against a representative.
§416.1555
Withdrawing charges against a representative.
§416.1565
Hearing on charges.
§416.1570
Decision by hearing officer.
§416.1575
Requesting review of the hearing officer's decision.
§416.1576
Assignment of request for review of the hearing officer's decision.
§416.1580
Appeals Council's review of hearing officer's decision.
§416.1585
Evidence permitted on review.
§416.1590
Appeals Council's decision.
§416.1595
When the Appeals Council will dismiss a request for review.
§416.1597
Reinstatement after suspension—period of suspension expired.
§416.1599
Reinstatement after suspension or disqualification—period of suspension not expired.
rule

Subpart P—RESIDENCE AND CITIZENSHIP

§416.1600
Introduction.
§416.1601
Definitions and terms used in this subpart.
§416.1603
How to prove you are a resident of the United States.
§416.1610
How to prove you are a citizen or a national of the United States.
§416.1615
How to prove you are lawfully admitted for permanent residence in the United States.
§416.1618
When you are considered permanently residing in the United States under color of law.
§416.1619
When you cannot be considered permanently residing in the United States under color of law.
rule

Subpart Q—REFERRAL OF PERSONS ELIGIBLE FOR SUPPLEMENTAL SECURITY INCOME TO OTHER AGENCIES

General

§416.1701
Scope of subpart.
§416.1705
Definitions.

Referral for Vocational Rehabilitation Services

§416.1710
Whom we refer and when.

Referral for Treatment of Alcoholism or Drug Addiction

§416.1720
Whom we refer.
§416.1725
Effect of your failure to comply with treatment requirements for your drug addiction or alcoholism.
rule

Subpart R—RELATIONSHIP

§416.1801
Introduction.

Who Is Considered Your Spouse

§416.1802
Effects of marriage on eligibility and amount of benefits.
§416.1806
Whether you are married and who is your spouse.
§416.1816
Information we need concerning marriage when you apply for SSI.
§416.1821
Showing that you are married when you apply for SSI.
§416.1826
Showing that you are not married when you apply for SSI.
§416.1830
When we stop considering you and your spouse an eligible couple.
§416.1832
When we consider your marriage ended.
§416.1835
Information we need about separation or end of marriage after you become eligible for SSI.

Who Is Considered a Child

§416.1851
Effects of being considered a child.
§416.1856
Who is considered a child.
§416.1861
Deciding whether you are a child: Are you a student?
§416.1866
Deciding whether you are a child: Are you the head of a household?

Who Is Considered a Student for Purposes of the Student Earned Income Exclusion

§416.1870
Effect of being considered a student.
§416.1872
Who is considered a student.
§416.1874
When we need evidence that you are a student.

Who Is Considered Your Parent

§416.1876
Effects a parent (or parents) can have on the child's benefits.
§416.1881
Deciding whether someone is your parent or stepparent.
rule

Subpart S—INTERIM ASSISTANCE PROVISIONS

Introduction

§416.1901
Scope of subpart S.
§416.1902
Definitions.

Authorizations

§416.1904
Authorization to withhold SSI benefits.
§416.1906
When your authorization is in effect.
§416.1908
When we need another authorization.

Interim Assistance Agreements

§416.1910
Requirements for interim assistance agreement.

Appeals

§416.1920
Your appeal rights in the State.
§416.1922
Your appeal rights in SSA.
rule

Subpart T—STATE SUPPLEMENTATION PROVISIONS; AGREEMENT; PAYMENTS

§416.2001
State supplementary payments; general.
§416.2005
Administration agreements with SSA.
§416.2010
Essentials of the administration agreements.
§416.2015
Establishing eligibility.
§416.2020
Federally administered supplementary payments.
§416.2025
Optional supplementation: Countable income.
§416.2030
Optional supplementation: Variations in payments.
§416.2035
Optional supplementation: Additional State options.
§416.2040
Limitations on eligibility.
§416.2045
Overpayments and underpayments; federally administered supplementation.
§416.2047
Waiver of State supplementary payments.
§416.2050
Mandatory minimum State supplementation.
§416.2055
Mandatory minimum supplementation reduced.
§416.2060
Mandatory minimum supplementary payments not applicable.
§416.2065
Mandatory minimum State supplementation: Agreement deemed.
§416.2070
Mandatory supplementation: State compliance not applicable.
§416.2075
Monitoring of mandatory minimum supplementary payments.
§416.2090
State funds transferred for supplementary payments.
§416.2095
Pass-along of Federal benefit increases.
§416.2096
Basic pass-along rules.
§416.2097
Combined supplementary/SSI payment levels.
§416.2098
Supplementary payment levels.
§416.2099
Compliance with pass-along.
rule

Subpart U—MEDICAID ELIGIBILITY DETERMINATIONS

§416.2101
Introduction.
§416.2111
Conditions for our agreeing to make Medicaid eligibility determinations.
§416.2116
Medicaid eligibility determinations.
§416.2130
Effect of the agreement and responsibilities of States.
§416.2140
Liability for erroneous Medicaid eligibility determinations.
§416.2145
Services other than Medicaid determinations.
§416.2161
Charges to States.
§416.2166
Changing the agreement.
§416.2171
Duration of agreement.
§416.2176
Disagreements between a State and us.
rule

Subpart V—PAYMENTS FOR VOCATIONAL REHABILITATION SERVICES

General Provisions

§416.2201
General.
§416.2202
Purpose and scope.
§416.2203
Definitions.
§416.2204
Participation by State VR agencies or alternate participants.
§416.2206
Basic qualifications for alternate participants.

Payment Provisions

§416.2208
Requirements for payment.
§416.2209
Responsibility for making payment decisions.
§416.2210
What we mean by “SGA” and by “a continuous period of 9 months”.
§416.2211
Criteria for determining when VR services will be considered to have contributed to a continuous period of 9 months.
§416.2212
Payment for VR services in a case where an individual continues to receive disability or blindness benefits based on participation in an approved VR program.
§416.2214
Services for which payment may be made.
§416.2215
When services must have been provided.
§416.2216
When claims for payment for VR services must be made (filing deadlines).
§416.2217
What costs will be paid.

Administrative Provisions

§416.2218
Applicability of these provisions to alternate participants.
§416.2219
Method of payment.
§416.2220
Audits.
§416.2221
Validation reviews.
§416.2222
Confidentiality of information and records.
§416.2223
Other Federal laws and regulations.
§416.2227
Resolution of disputes.


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