95-22175. Payment for Vocational Rehabilitation Services Furnished Individuals During Certain Months of Nonpayment of Supplemental Security Income Benefits  

  • [Federal Register Volume 60, Number 175 (Monday, September 11, 1995)]
    [Proposed Rules]
    [Pages 47126-47131]
    From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
    [FR Doc No: 95-22175]
    
    
    
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    SOCIAL SECURITY ADMINISTRATION
    
    20 CFR Parts 404 and 416
    
    RIN 0960-AD39
    
    
    Payment for Vocational Rehabilitation Services Furnished 
    Individuals During Certain Months of Nonpayment of Supplemental 
    Security Income Benefits
    
    AGENCY: Social Security Administration (SSA).
    
    ACTION: Proposed rules.
    
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    SUMMARY: We are proposing to amend our regulations relating to payment 
    for vocational rehabilitation (VR) services provided to recipients of 
    supplemental security income (SSI) benefit payments based on disability 
    or blindness under title XVI of the Social Security Act (the Act). 
    These regulations reflect section 5037 of the Omnibus Budget 
    Reconciliation Act of 1990 (OBRA 1990). Section 5037 of OBRA 1990 added 
    section 1615(e) to the Act which authorizes the Commissioner of Social 
    Security (the Commissioner) to pay a State VR agency for costs incurred 
    in furnishing VR services to an individual during certain months for 
    which the individual did not receive SSI payments based on disability 
    or blindness as well as during months for which the individual did 
    receive such payments. We also propose to amend our regulations on VR 
    payments to clarify certain rules and remove some outdated rules.
    
    DATES: Your comments will be considered if we receive them no later 
    than November 13, 1995.
    
    ADDRESSES: Comments should be submitted in writing to the Commissioner 
    of Social Security, P.O. Box 1585, Baltimore, MD 21235; sent by telefax 
    to (410) 966-2830; sent by E-mail to regulations@ssa.gov;'' or 
    delivered to the Division of Regulations and Rulings, Social Security 
    Administration, 3-B-1 Operations Building, 6401 Security Boulevard, 
    Baltimore, MD 
    
    [[Page 47127]]
    21235 between 8 a.m. and 4:30 p.m. on regular business days. Comments 
    received may be inspected during these same hours by making 
    arrangements with the contact person shown below.
    
    FOR FURTHER INFORMATION CONTACT: Jack Schanberger, Legal Assistant, 3-
    B-1 Operations Building, 6401 Security Boulevard, Baltimore, MD 21235 
    (410) 965-8471.
    
    SUPPLEMENTARY INFORMATION: We are proposing to amend our regulations on 
    payment for VR services provided to individuals receiving SSI benefits 
    based on disability or blindness. These amended regulations will 
    reflect section 5037 of OBRA 1990, Public Law 101-508, which added 
    paragraph (e) to section 1615 of the Act. Our existing regulations 
    concerning payment for such services carry out the provisions of 
    section 1615(d) of the Act.
        In general, section 1615(d) of the Act authorizes the Commissioner 
    to reimburse a State VR agency for the costs incurred in providing VR 
    services to individuals receiving SSI benefits under title XVI of the 
    Act based on disability or blindness in three categories of cases. 
    Specifically, section 1615(d) permits payment for VR services furnished 
    to such individuals only in cases where: (1) The furnishing of such 
    services results in the individual's performance of substantial gainful 
    activity (SGA) for a continuous period of nine months; (2) the 
    individual is continuing to receive benefits, despite his or her 
    medical recovery, under section 1631(a)(6) of the Act because of his or 
    her participation in a VR program; or (3) the individual, without good 
    cause, refuses to continue to accept VR services or fails to cooperate 
    in such a manner as to preclude his or her successful rehabilitation. 
    (In such a case of refusal to continue or cooperate in a VR program, 
    payments are authorized only for the VR services provided prior to the 
    cessation of VR participation. If the individual resumes participation, 
    then payments are authorized for the VR services provided after 
    participation is resumed only if all requirements for payment are met. 
    These cases are described in sections 1615(d)(1), (2) and (3) of the 
    Act, respectively, and in Secs. 416.2211-416.2213 of our regulations.)
        Under section 1615(d) of the Act, payment may be made for VR 
    services furnished by a State VR agency, i.e., an agency administering 
    a State plan for VR services approved under title I of the 
    Rehabilitation Act of 1973, as amended. However, in the case of a State 
    which is unwilling to participate or does not have such a plan for VR 
    services, our regulation at 20 CFR 416.2204 provides that we may 
    arrange for VR services for an SSI recipient who is disabled or blind 
    through an alternative VR service provider (alternate participant) and 
    pay such provider for the costs of services under the same terms and 
    conditions that apply to State VR agencies. This regulation is based in 
    part on section 222(d)(2) of the Act, which provides for the use of 
    alternate participants in the VR payment program under title II of the 
    Act (relating to the rehabilitation of social security disability 
    beneficiaries), and on the authority provided to the Commissioner under 
    section 1633(a) of the Act to make such administrative and other 
    arrangements as may be necessary or appropriate to carry out title XVI 
    of the Act, including making arrangements under title XVI in the same 
    manner as they are made under title II.
        Prior to the enactment of OBRA 1990, SSA was authorized to pay a 
    State VR agency under section 1615(d) of the Act only for VR services 
    that were provided to an individual during months for which the 
    individual received SSI benefits based on disability or blindness, 
    including benefits payable under section 1611 or 1619(a) of the Act or, 
    for cases under section 1615(d)(2), discussed above, continued payment 
    of such benefits under section 1631(a)(6) of the Act. This is reflected 
    in our existing regulations at Secs. 416.2201, 416.2203 and 
    416.2215(a)(2).
        Section 5037 of OBRA 1990 added section 1615(e) to the Act to 
    provide us the authority to pay a State VR agency under section 1615(d) 
    for the costs described in that section that are incurred in providing 
    VR services to an individual during certain months for which the 
    individual was not receiving SSI benefits based on disability or 
    blindness as well as during months for which the individual was 
    receiving such benefits. Under section 1615(e) of the Act, payment may 
    be made for VR services in a case described in section 1615(d)(1), (2) 
    or (3) of the Act which are provided to an individual in a month for 
    which the individual receives, i.e., is eligible for--
         SSI cash benefits under section 1611 or special SSI cash 
    benefits under section 1619(a) of the Act (this is the same as under 
    prior law);
         A special status for medicaid under section 1619(b) of the 
    Act; or
         A federally administered State supplementary payment under 
    section 1616 of the Act or section 212(b) of Public Law 93-66.
        In addition, section 1615(e) of the Act permits payment for VR 
    services provided in a month for which an individual was ineligible for 
    the benefits or special status described above for a reason other than 
    cessation of disability or blindness, if such month occurred prior to 
    the 13th consecutive month of such ineligibility following a month for 
    which the individual was eligible for such benefits or special status. 
    This means that payment may be made for VR services furnished during a 
    month for which an individual's benefit payment or special status for 
    Medicaid under section 1619(b) was suspended.
        Section 1615(e) of the Act became effective November 5, 1990, the 
    date of the enactment of OBRA 1990, and applies to claims for 
    reimbursement pending on or after that date. This amendment to the Act, 
    which allows us to reimburse a State VR agency or alternate participant 
    for VR services furnished during certain months for which an individual 
    was not receiving SSI benefits, responds to a recommendation in the 
    March 1988 Report of the Disability Advisory Council that the Congress 
    amend the Act to permit SSA to pay for VR services provided in months 
    when an individual is in suspension status.
    
    Proposed Changes to the VR Payment Regulations
    
        The proposed rules will amend the existing regulations concerning 
    the SSI VR payment program under title XVI of the Act to take account 
    of the provisions of section 1615(e) of the Act which permit payment 
    for VR services furnished during certain months for which a disabled or 
    blind individual does not receive SSI benefits. The proposed rules also 
    will make some other changes in the existing VR payment regulations to 
    clarify certain rules and delete some obsolete rules. These changes 
    affect the regulations governing the social security VR payment program 
    under title II of the Act as well as the regulations concerning the SSI 
    VR payment program under title XVI. The existing social security VR 
    payment regulations carry out section 222(d) of the Act which contains 
    provisions that are similar to the provisions of section 1615(d) of the 
    Act, except that they apply to payment for VR services provided to 
    individuals entitled to social security benefits based on disability 
    under title II.
    
    Changes to the Regulations to Implement Section 1615(e) of the Act
    
        We are proposing to amend Sec. 416.2201 to explain that, in 
    general, sections 1615(d) and (e) of the Act authorize payment for 
    costs of VR services provided to certain disabled or 
    
    [[Page 47128]]
    blind individuals who are eligible for SSI benefits, special SSI 
    eligibility status, or federally administered State supplementary 
    payments. In the proposed amendment to Sec. 416.2201, we also explain 
    that for the purpose of the SSI VR payment regulations, we refer to SSI 
    benefits, special SSI eligibility status, or federally administered 
    State supplementary payments as ``disability or blindness benefits.'' 
    Additionally, we also propose to add a corresponding definition of 
    ``disability or blindness benefits'' for this purpose in Sec. 416.2203, 
    discussed below.
        The proposed amendment to Sec. 416.2201 further explains that, 
    subject to the other requirements and conditions for payment prescribed 
    in the regulations, payment may be made for VR services which are 
    furnished during a month(s) for which an individual is eligible for 
    disability or blindness benefits or continues to receive such benefits 
    under section 1631(a)(6) of the Act, or which are furnished during a 
    month(s) for which the individual's disability or blindness benefits 
    are suspended. This rule also is reflected in proposed Sec. 416.2215, 
    discussed below.
        In Sec. 416.2203, ``Definitions,'' we propose to delete the 
    paragraph defining ``eligible,'' which discusses eligibility for SSI 
    benefits only, and add a new paragraph to explain the meaning of 
    ``disability or blindness benefits'' when used in the SSI VR payment 
    regulations. The proposed rules provide that ``disability or blindness 
    benefits,'' as defined for the SSI VR payment regulations only, refer 
    to regular SSI benefits under section 1611 of the Act, special SSI cash 
    benefits under section 1619(a) of the Act, special SSI eligibility 
    status under section 1619(b) of the Act, and/or a federally 
    administered State supplementary payment under section 1616 of the Act 
    or section 212(b) of Public Law 93-66, for which an individual is 
    eligible based on disability or blindness, as appropriate. Thus, in the 
    proposed VR payment regulations, when we use the terms ``disability or 
    blindness benefits'' with reference to the SSI program, we mean the 
    benefits, status, or payments referred to in section 1615(e) of the 
    Act. As used in this preamble, ``disability or blindness benefits'' has 
    the same meaning as in the proposed rules. Further, in Sec. 416.2203, 
    we propose to define the phrase ``special SSI eligibility status'' to 
    refer to the special status for Medicaid under section 1619(b) of the 
    Act since this is the phrase we use to describe the special status in 
    our other SSI regulations, e.g., Secs. 416.260 and 416.264.
        We also propose to amend several sections of the SSI VR payment 
    regulations to replace phrases such as ``disability or blindness 
    payment'' with the phrase ``disability or blindness benefits,'' and to 
    substitute the term ``benefits'' for ``payment'' or ``payments,'' as 
    the context requires. We are making these changes to Secs. 416.2201(b), 
    416.2209(b) and (c), 416.2212, 416.2213(c), 416.2215(a) and (b), and 
    416.2216(c)(2).
        Section 416.2215(a) of our existing regulations provides that in 
    order for the State VR agency or alternate participant to be paid, the 
    VR services must have been provided--(1) after September 30, 1981; (2) 
    during months the individual is eligible for SSI disability or 
    blindness payments; and (3) before completion of a continuous 9-month 
    period of SGA. We propose to revise paragraph (a)(2) of Sec. 416.2215 
    to provide that to be payable, the VR services must have been provided 
    during a month or months for which--(i) the individual is eligible for 
    disability or blindness benefits or continues to receive such benefits 
    under section 1631(a)(6) of the Act; or (ii) the disability or 
    blindness benefits of the individual are suspended due to his or her 
    ineligibility for the benefits. We also propose to revise paragraph 
    (a)(3) of Sec. 416.2215 to provide that the VR services must have been 
    provided prior to the completion of a continuous 9-month period of SGA 
    or termination of disability or blindness benefits, whichever occurs 
    first.
        The proposed changes to Sec. 416.2215 (a)(2) and (a)(3) provide 
    cross-references to the regulations in Subpart M of 20 CFR Part 416 
    which contain our rules on suspension and termination of benefits under 
    the SSI program. In general, these regulations provide that unless a 
    termination of an individual's eligibility for benefits is required, an 
    individual's benefits will be suspended for any month for which the 
    individual no longer meets the requirements for eligibility for 
    benefits under the SSI program. Termination of eligibility is required 
    when benefits have been suspended for a period of 12 consecutive 
    months, i.e., the individual remains ineligible for SSI benefits, 
    special status for medicaid, and/or federally administered State 
    supplementary payments for a continuous 12-month period. Eligibility 
    for SSI benefits based on disability or blindness also terminates if 
    the individual's disability or blindness ceases, unless the individual 
    is participating in an approved VR program and the other requirements 
    for the continuation of benefits under section 1631(a)(6) of the Act 
    are met.
        The proposed changes we are making to Sec. 416.2215 (a)(2) and 
    (a)(3) are consistent with the provisions of sections 1615 (d) and (e) 
    of the Act. They permit payment for VR services which are provided 
    either during a month(s) for which an individual is eligible for 
    disability or blindness benefits, including the continuation of such 
    benefits under section 1631(a)(6) of the Act, or during a month(s) for 
    which the individual is ineligible for disability or blindness 
    benefits, for a reason other than cessation of disability or blindness, 
    if such month(s) occurs prior to the 13th consecutive month of such 
    ineligibility, i.e., a month(s) for which benefits are suspended but 
    not terminated.
        We also propose to amend the introductory paragraph of 
    Sec. 416.2217 to add a reference to section 1615(e) of the Act. In 
    addition, we are proposing to make a change to the regulations 
    governing the social security VR payment program under title II of the 
    Act to reflect the expanded scope of the SSI VR payment program under 
    title XVI resulting from section 1615(e) of the Act. We are proposing 
    to amend Sec. 404.2115(b) of the title II regulations to explain that 
    if VR services are provided to an individual who is entitled to title 
    II disability benefits and who also is or has been receiving disability 
    or blindness benefits under the SSI program, the determination as to 
    when VR services must have been provided may be made under either 
    Sec. 404.2115 or Sec. 416.2215, whichever is advantageous to the State 
    VR agency or alternate participant that is participating in both VR 
    programs.
    
    Other Changes to the VR Payment Regulations
    
        In addition to the changes to the regulations discussed above, we 
    are proposing to amend the social security and SSI VR payment 
    regulations to clarify certain rules relating to payment for VR 
    services provided to an individual in a case where the individual, 
    without good cause, refuses to continue or cooperate in a VR program. 
    We also propose to delete some obsolete rules relating to the time 
    periods within which claims for payment for VR services must be filed. 
    We are making a few other nonsubstantive changes to certain provisions 
    of the regulations affected by the proposed changes described above.
        We are proposing to amend Secs. 404.2113(c) and 416.2213(c) to 
    indicate that if deductions are imposed against an individual's social 
    security disability benefits because of VR refusal, or if an 
    individual's disability or blindness benefits under the SSI 
    
    [[Page 47129]]
    program are suspended because of VR refusal, the services for which 
    payment may be made in such a case are those VR services which were 
    provided to the individual prior to his or her VR refusal. If the 
    individual thereafter resumes participation in a VR program and again 
    receives VR services, payment may be made for those services only if 
    the criteria for payment in Sec. 404.2113 or Sec. 416.2213 are again 
    met, or if the services qualify for payment under one of the other 
    provisions of the regulations permitting payment, i.e., Secs. 404.2111, 
    404.2112, 416.2211, or 416.2212.
        We also are proposing to delete the parenthetical phrase 
    ``(suspension of benefits in cases described in Sec. 404.2113)'' in 
    existing Sec. 404.2115(a)(3). This change is appropriate since under 
    section 222(b) of the Act and Sec. 404.422 of the title II regulations, 
    a determination by us that a social security disability beneficiary has 
    refused, without good cause, to accept VR services available to the 
    individual results in our imposing deductions against social security 
    benefits, rather than suspending benefits. This is reflected in 
    existing Secs. 404.2109(c) and 404.2113(c). To be consistent with these 
    sections, we are making a change to Sec. 404.2116(c)(2) to clarify that 
    a beneficiary's VR refusal results in deductions against social 
    security disability benefits, rather than a suspension of benefits.
        Existing Secs. 404.2116 (b)(2) and (c)(2) and 416.2216 (b)(2) and 
    (c)(2) contain provisions which provide for the filing of claims for 
    payment for VR services in certain cases within 12 months after the 
    month of the initial publication of these sections in the Federal 
    Register, 55 FR 8449 (March 8, 1990). This 12-month period ended March 
    31, 1991, the close of the 12th month following the month of 
    publication in the Federal Register. Since this time period for filing 
    a claim is no longer in effect, we are proposing to delete these 
    provisions from the regulations.
        We also are proposing to amend Secs. 404.2116(c)(2) and 
    416.2216(c)(2) to clarify that the other 12-month period described in 
    these sections for filing a claim for payment in the case of an 
    individual's VR refusal begins after the first month for which 
    deductions are imposed against social security disability benefits, or 
    after the first month for which disability or blindness benefits under 
    the SSI program are suspended, because of such VR refusal.
    
    Electronic Versions
    
        The electronic file of this document is available on the Federal 
    Bulletin Board (FBB) at 9 on the date of publication in the Federal 
    Register. To download the file, modem dial (202) 512-1387. The FBB 
    instructions will explain how to download the file and the fee. This 
    file is in Wordperfect and will remain on the FBB during the comment 
    period.
    
    Regulatory Procedures
    
    Executive Order 12866
    
        We have consulted with the Office of Management and Budget (OMB) 
    and determined that these rules do not meet the criteria for a 
    significant regulatory action under Executive Order 12866. Thus, they 
    were not subject to OMB review.
    
    Regulatory Flexibility Act
    
        We certify that these regulations, if promulgated, will not have a 
    significant economic impact on a substantial number of small entities. 
    Therefore, a regulatory flexibility analysis as provided in Public Law 
    96-354, the Regulatory Flexibility Act, is not required.
        These proposed regulations carry out section 1615(e) of the Act 
    which allows payment for VR services under section 1615(d) of the Act 
    provided during certain months for which an individual does not receive 
    SSI benefits based on disability or blindness. They apply to States and 
    certain alternate providers of VR services which are willing to provide 
    services to disabled or blind SSI recipients, or social security 
    disability beneficiaries, under our VR payment programs under the 
    conditions specified in the regulations.
    
    Paperwork Reduction Act
    
        These proposed regulations impose no additional reporting or 
    recordkeeping requirements subject to clearance by OMB.
    
    (Catalog of Federal Domestic Assistance Program Nos. 96.001, Social 
    Security-Disability Insurance; 96.006, Supplemental Security Income)
    
    List of Subjects
    
    20 CFR Part 404
    
        Administrative practice and procedure, Blind, Disability benefits, 
    Old-Age, Survivors and Disability Insurance, Reporting and 
    recordkeeping requirements, Social Security.
    
    20 CFR Part 416
    
        Administrative practice and procedure, Aged, Blind, Disability 
    benefits, Public assistance programs, Supplemental Security Income 
    (SSI), Reporting and recordkeeping requirements.
    
        Dated: August 23, 1995.
    Shirley Chater,
    Commissioner of Social Security.
    
        For the reasons set out in the preamble, we propose to amend 
    subpart V of part 404 and subpart V of part 416 of 20 CFR chapter III 
    as follows:
    
    PART 404--FEDERAL OLD-AGE, SURVIVORS AND DISABILITY INSURANCE 
    (1950-    )
    
    Subpart V--[Amended]
    
        1. The authority citation for Subpart V of Part 404 is revised to 
    read as follows:
    
        Authority: Secs. 205(a), 222, and 702(a)(5) of the Social 
    Security Act; (42 U.S.C. 405(a), 422, and 902(a)(5)).
    
        2. Section 404.2113 is amended by revising the last sentence of 
    paragraph (c) to read as follows:
    
    
    Sec. 404.2113  Payment for VR services in a case of VR refusal.
    
    * * * * *
        (c) * * * A State VR agency or alternate participant may be paid, 
    subject to the provisions of this subpart, for the costs of VR services 
    provided to an individual prior to his or her VR refusal if deductions 
    have been imposed against the individual's monthly disability benefits 
    for a month(s) after October 1984 because of such VR refusal.
        3. Section 404.2115 is amended by revising paragraphs (a)(3) and 
    (b) to read as follows:
    
    
    Sec. 404.2115  When services must have been provided.
    
        (a) * * *
        (3) Before completion of a continuous 9-month period of SGA or 
    termination of entitlement to disability benefits, whichever occurs 
    first.
        (b) If an individual who is entitled to disability benefits under 
    this part also is or has been receiving disability or blindness 
    benefits under part 416 of this chapter, the determination as to when 
    services must have been provided may be made under this section or 
    Sec. 416.2215 of this chapter, whichever is advantageous to the State 
    VR agency or alternate participant that is participating in both VR 
    programs.
        4. Section 404.2116 is amended by revising paragraphs (b)(2) and 
    (c)(2) to read as follows:
    
    
    Sec. 404.2116  When claims for payment for VR services must be made 
    (filing deadlines).
    
    * * * * *
        (b) * * *
        (2) If no written notice was sent to the State VR agency or 
    alternate participant, 
    
    [[Page 47130]]
    a claim must be filed within 12 months after the month in which VR 
    services end.
        (c) * * *
        (2) If no written notice was sent to the State VR agency or 
    alternate participant, a claim must be filed within 12 months after the 
    first month for which deductions are imposed against disability 
    benefits because of such VR refusal.
    
    PART 416--SUPPLEMENTAL SECURITY INCOME FOR THE AGED, BLIND, AND 
    DISABLED
    
    Subpart V--[Amended]
    
        1. The authority citation for subpart V of part 416 is revised to 
    read as follows:
    
        Authority: Secs. 702(a)(5), 1615, 1631(d)(1) and (e), and 
    1633(a) of the Social Security Act; (42 U.S.C. 902(a)(5), 1382d, 
    1383(d)(1) and (e), and 1383b(a)).
    
        2. Section 416.2201 is amended by revising the introductory text of 
    this section and revising paragraph (b) to read as follows:
    
    
    Sec. 416.2201  General.
    
        In general, sections 1615 (d) and (e) of the Social Security Act 
    (the Act) authorize payment from the general fund for the reasonable 
    and necessary costs of vocational rehabilitation (VR) services provided 
    certain disabled or blind individuals who are eligible for supplemental 
    security income (SSI) benefits, special SSI eligibility status, or 
    federally administered State supplementary payments. In this subpart, 
    such benefits, status, or payments are referred to as disability or 
    blindness benefits (see Sec. 416.2203). Subject to the provisions of 
    this subpart, payment may be made for VR services provided an 
    individual during a month(s) for which the individual is eligible for 
    disability or blindness benefits, including the continuation of such 
    benefits under section 1631(a)(6) of the Act, or for which the 
    individual's disability or blindness benefits are suspended (see 
    Sec. 416.2215). Paragraphs (a), (b) and(c) of this section describe the 
    cases in which the State VR agencies and alternate participants can be 
    paid for the VR services provided such an individual under this 
    subpart. The purpose of sections 1615 (d) and (e) of the Act is to make 
    VR services more readily available to disabled or blind individuals, 
    help State VR agencies and alternate participants to recover some of 
    their costs in VR refusal situations, as described in Sec. 416.2213, 
    and ensure that savings accrue to the general fund. Payment will be 
    made for VR services provided on behalf of such an individual in cases 
    where--
    * * * * *
        (b) The individual continues to receive disability or blindness 
    benefits, even though his or her disability or blindness has ceased, 
    under section 1631(a)(6) of the Act because of his or her continued 
    participation in an approved VR program which we have determined will 
    increase the likelihood that he or she will not return to the 
    disability or blindness rolls (see Sec. 416.2212); or
    * * * * *
        3. Section 416.2203 is amended by removing the definition of 
    ``Eligible'' and adding 2 new definitions in alphabetical order to read 
    as follows:
    
    
    Sec. 416.2203  Definitions.
    
    * * * * *
        Disability or blindness benefits, as defined for this subpart only, 
    refers to regular SSI benefits under section 1611 of the Act (see 
    Sec. 416.202), special SSI cash benefits under section 1619(a) of the 
    Act (see Sec. 416.261), special SSI eligibility status under section 
    1619(b) of the Act (see Sec. 416.264), and/or a federally administered 
    State supplementary payment under section 1616 of the Act or section 
    212(b) of Public Law 93-66 (see Sec. 416.2001), for which an individual 
    is eligible based on disability or blindness, as appropriate.
    * * * * *
        Special SSI eligibility status refers to the special status 
    described in Secs. 416.264 through 416.269 relating to eligibility for 
    medicaid.
        4. Section 416.2209 is amended in paragraph (b) by removing 
    ``payments'' and adding ``benefits'' in its place and in paragraph (c) 
    by removing ``payment'' and adding ``benefits'' in its place.
        5. Section 416.2212 is amended by revising the section heading and 
    revising the first and second sentences to read as follows:
    
    
    Sec. 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.
    
        Section 1631(a)(6) of the Act contains the criteria we will use in 
    determining if an individual whose disability or blindness has ceased 
    should continue to receive disability or blindness benefits because of 
    his or her continued participation in an approved VR program. A VR 
    agency or alternate participant can be paid for the cost of VR services 
    provided to an individual if the individual was receiving benefits 
    based on this provision in a month(s) after October 1984 or, in the 
    case of a blindness recipient, in a month(s) after March 1988. * * *
        6. Section 416.2213 is amended by revising the last sentence of 
    paragraph (c) to read as follows:
    
    
    Sec. 416.2213  Payment for VR services in a case of VR refusal.
    
    * * * * *
        (c) * * * A State VR agency or alternate participant may be paid, 
    subject to the provisions of this subpart, for the costs of VR services 
    provided to an individual prior to his or her VR refusal if the 
    individual's disability or blindness benefits have been suspended for a 
    month(s) after October 1984 because of such VR refusal.
        7. Section 416.2215 is revised to read as follows:
    
    
    Sec. 416.2215  When services must have been provided.
    
        (a) In order for the VR agency or alternate participant to be paid, 
    the services must have been provided--
        (1) After September 30, 1981;
        (2) During a month(s) for which--
        (i) The individual is eligible for disability or blindness benefits 
    or continues to receive such benefits under section 1631(a)(6) of the 
    Act (see Sec. 416.2212); or
        (ii) The disability or blindness benefits of the individual are 
    suspended due to his or her ineligibility for the benefits (see subpart 
    M of this part concerning suspension for ineligibility); and
        (3) Before completion of a continuous 9-month period of SGA or 
    termination of disability or blindness benefits, whichever occurs first 
    (see subpart M of this part concerning termination of benefits).
        (b) If an individual who is receiving disability or blindness 
    benefits under this part, or whose benefits under this part are 
    suspended, also is entitled to disability benefits under part 404 of 
    this chapter, the determination as to when services must have been 
    provided may be made under this section or Sec. 404.2115, whichever is 
    advantageous to the State VR agency or alternate participant that is 
    participating in both VR programs.
        8. Section 416.2216 is amended by revising paragraphs (b)(2) and 
    (c)(2) to read as follows:
    
    
    Sec. 416.2216  When claims for payment for VR services must be made 
    (filing deadlines).
    
    * * * * *
        (b) * * *
        (2) If no written notice was sent to the State VR agency or 
    alternate participant, a claim must be filed within 12 months 
    
    [[Page 47131]]
    after the month in which VR services end.
        (c) * * *
        (2) If no written notice was sent to the State VR agency or 
    alternate participant, a claim must be filed within 12 months after the 
    first month for which disability or blindness benefits are suspended 
    because of such VR refusal.
        9. Section 416.2217 is amended in the introductory text of the 
    section by adding ``and (e)'' after ``section 1615(d).''
    
    [FR Doc. 95-22175 Filed 9-8-95; 8:45 am]
    BILLING CODE 4190-29-P
    
    

Document Information

Published:
09/11/1995
Department:
Social Security Administration
Entry Type:
Proposed Rule
Action:
Proposed rules.
Document Number:
95-22175
Dates:
Your comments will be considered if we receive them no later than November 13, 1995.
Pages:
47126-47131 (6 pages)
RINs:
0960-AD39: Supplemental Security Income for the Aged, Blind, and Disabled; Payment for VR Services Furnished Individuals During Certain Months of Nonpayment of SSI Benefits (315F)
RIN Links:
https://www.federalregister.gov/regulations/0960-AD39/supplemental-security-income-for-the-aged-blind-and-disabled-payment-for-vr-services-furnished-indiv
PDF File:
95-22175.pdf
CFR: (12)
20 CFR 416.202)
20 CFR 416.2215)
20 CFR 404.2113
20 CFR 404.2115
20 CFR 404.2116
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