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Code of Federal Regulations (Last Updated: May 6, 2024) |
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Title 20 - Employees' Benefits |
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Chapter III - Social Security Administration |
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Part 416 - Supplemental Security Income for the Aged, Blind, and Disabled |
| 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. |
| Subpart B - 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. |
| § 416.213 - You do not accept vocational rehabilitation services. |
| § 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. |
| 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. |
| 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. |
| 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. |
| Deemed Filing Date Based on Misinformation |
| § 416.351 - Deemed filing date in a case of misinformation. |
| 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. |
| Withdrawal of Application |
| § 416.355 - Withdrawal of an application. |
| § 416.360 - Cancellation of a request to withdraw. |
| 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. |
| 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? |
| 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. |
| § 416.618 - xxx |
| § 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? |
| § 416.626 - xxx |
| § 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. |
| § 416.641 - 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? |
| § 416.640a - Compensation for qualified organizations serving as representative payees. |
| 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. |
| 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. |
| Subpart I - Determining Disability and Blindness |
| 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. |
| § 416.927 - Evaluating opinion evidence for claims filed before March 27, 2017. |
| § 416.928 - [Reserved] |
| § 416.929 - How we evaluate symptoms, including pain. |
| § 416.930 - Need to follow prescribed treatment. |
| § 416.926a - Functional equivalence for children. |
| Determinations |
| § 416.903 - Who makes disability and blindness determinations. |
| § 416.904 - Decisions by other governmental agencies and nongovernmental entities. |
| § 416.903a - Program integrity. |
| § 416.903b - Evidence from excluded medical sources of evidence. |
| 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. |
| § 416.990 - 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. |
| § 416.993 - Medical evidence in continuing disability review cases. |
| § 416.994 - How we will determine whether your disability continues or ends, disabled adults. |
| § 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? |
| §§ 416.992--416.992a - [Reserved] |
| § 416.992a - [Reserved] |
| § 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. |
| § 416.989a - We may conduct a review to find out whether you continue to be blind. |
| § 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? |
| 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 - [Reserved] |
| § 416.909 - How long the impairment must last. |
| § 416.910 - Meaning of substantial gainful activity. |
| § 416.911 - Definition of disabling impairment. |
| 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 medical 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. |
| 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. |
| § 416.975 - Evaluation guides if you are self-employed. |
| § 416.976 - Impairment-related work expenses. |
| § 416.974a - When and how we will average your earnings. |
| 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. |
| 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. |
| Evaluation of Disability |
| § 416.920 - Evaluation of disability of adults, in general. |
| § 416.921 - Establishing that you have a medically determinable impairment(s). |
| § 416.922 - What we mean by an impairment(s) that is not severe in an adult. |
| § 416.923 - Multiple impairments. |
| § 416.924 - How we determine disability for children. |
| § 416.920a - Evaluation of mental impairments. |
| § 416.920b - How we consider evidence. |
| § 416.920c - xxx |
| § 416.924a - Considerations in determining disability for children. |
| § 416.924b - Age as a factor of evaluation in the sequential evaluation process for children. |
| § 416.924c - Other factors we will consider. |
| 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 that may warrant a finding of presumptive disability or presumptive blindness. |
| General |
| § 416.901 - Scope of subpart. |
| § 416.902 - Definitions for this subpart. |
| Authorizing and Monitoring the Referral Process |
| § 416.919s - Authorizing and monitoring the consultative examination. |
| Vocational Considerations |
| § 416.960 - When we will consider your vocational background. |
| § 416.961 - Your ability to do work depends upon your residual functional capacity. |
| § 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. |
| 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. |
| Evidence |
| § 416.912 - Responsibility for evidence. |
| § 416.913 - Categories of evidence. |
| § 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. |
| § 416.913a - xxx |
| Residual Functional Capacity |
| § 416.945 - Your residual functional capacity. |
| § 416.946 - Responsibility for assessing your residual functional capacity. |
| Procedures to Monitor the Consultative Examination |
| § 416.919t - Consultative examination oversight. |
| § 416.903ba - xxx |
| Subpart J - Determinations of Disability |
| 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. |
| 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. |
| 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 consultants and psychological consultants. |
| § 416.1017 - Reasonable efforts to obtain review by a physician, psychiatrist, and psychologist. |
| § 416.1018 - Notifying claimant of the disability determination. |
| 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. |
| General Provisions |
| § 416.1001 - Purpose and scope. |
| § 416.1002 - Definitions. |
| § 416.1003 - Basic responsibilities for us and the State. |
| 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. |
| 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. |
| Quick Disability Determinations |
| § 416.1019 - Quick disability determination process. |
| 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. |
| Subpart K - Income |
| In-Kind Support and Maintenance in Special Circumstances |
| § 416.1147 - How we value in-kind support and maintenance for a couple. |
| § 416.1148 - If you have both in-kind support and maintenance and income that is deemed to you. |
| § 416.1147a - Income rules in change-of-status situations involving in-kind support and maintenance. |
| 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. |
| § 416.1163 - 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. |
| § 416.1167 - 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. |
| § 416.1161a - Income for deeming purposes where Medicaid eligibility is affected. |
| § 416.1166a - How we deem income to you from your sponsor if you are an alien. |
| 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. |
| 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. |
| Earned Income |
| § 416.1110 - What is earned income. |
| § 416.1111 - How we count earned income. |
| § 416.1112 - Earned income we do not count. |
| Alternative Income Counting Rules for Certain Blind Individuals |
| § 416.1170 - General. |
| § 416.1171 - When the alternative rules apply. |
| 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. |
| Temporary Absence |
| § 416.1149 - What is a temporary absence from your living arrangement. |
| 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. |
| 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. |
| 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 |
| 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. |
| § 416.1205 - 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. |
| § 416.1204a - Deeming of resources where Medicaid eligibility is affected. |
| 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. |
| § 416.1328 - Suspension due to refusal to accept vocational rehabilitation services. |
| § 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. |
| 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. |
| 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 written evidence to 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. |
| Appeals Council Review |
| § 416.1466 - [Reserved] |
| § 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 the Appeals Council. |
| § 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. |
| 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. |
| 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. |
| § 416.1414 - 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. |
| § 416.1413a - Reconsiderations of initial determinations on applications. |
| § 416.1413b - Reconsideration procedures for post-eligiblity claims. |
| § 416.1413c - Arrangement for conferences. |
| Court Remand Cases |
| § 416.1483 - Case remanded by a Federal court. |
| § 416.1484 - Appeals Council review of hearing decision in a case remanded by a Federal court. |
| § 416.1485 - Application of circuit court law. |
| 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 - Official record. |
| § 416.1452 - Consolidated hearings before an administrative law judge. |
| § 416.1453 - The decision of an administrative law judge. |
| § 416.1455 - The effect of a hearing decision. |
| § 416.1456 - Removal of a hearing request(s) 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] |
| 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. |
| 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. |
| 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. |
| 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. |
| Subpart Q - Referral of Persons Eligible for Supplemental Security Income to Other Agencies |
| 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. |
| General |
| § 416.1701 - Scope of subpart. |
| § 416.1705 - Definitions. |
| Referral for Vocational Rehabilitation Services |
| § 416.1710 - Whom we refer and when. |
| § 416.1715 - Effect of your rejecting vocational rehabilitation services. |
| Subpart R - Relationship |
| § 416.1801 - Introduction. |
| 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. |
| 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. |
| Subpart S - Interim Assistance Provisions |
| Appeals |
| § 416.1920 - Your appeal rights in the State. |
| § 416.1922 - Your appeal rights in SSA. |
| Authorizations |
| § 416.1904 - Authorization to withhold SSI benefits. |
| § 416.1906 - When your authorization is in effect. |
| § 416.1908 - When we need another authorization. |
| Introduction |
| § 416.1901 - Scope of subpart S. |
| § 416.1902 - Definitions. |
| Interim Assistance Agreements |
| § 416.1910 - Requirements for interim assistance agreement. |
| 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. |
| 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. |
| 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. |
| § 416.2206 - [Reserved] |
| Administrative Provisions |
| § 416.2218 - [Reserved] |
| § 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. |
| 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. |
| § 416.2213 - Payment for VR services in a case of VR refusal. |
| § 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. |