2003 CFR Title 20, Volume 2

Title 20--Employees' Benefits CHAPTER III--SOCIAL SECURITY ADMINISTRATION PART 416--SUPPLEMENTAL SECURITY INCOME FOR THE AGED, BLIND, AND DISABLED
	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.
	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.
	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.
	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.
	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.
	416.301	Introduction.
	416.302	Definitions.
	416.305	You must file an application to receive supplemental security income benefits.
	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.
	416.330	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.
	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.
	416.351	Deemed filing date in a case of misinformation.
	416.355	Withdrawal of an application.
	416.360	Cancellation of a request to withdraw.
	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 care 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.
	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.
	416.535	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.
	416.558	Notice relating to overpayments and underpayments.
	416.560	Recovery--refund.
	416.570	Adjustment--general rule.
	416.571	10-percent limitation of recoupment rate--overpayment.
	416.572	Are title II benefits and title VIII benefits subject to adjustment to recover title XVI overpayments?
	416.580	Referral of overpayments to the Department of the Treasury for tax refund offset--General.
	416.581	Notice to overpaid individual.
	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?
	416.601	Introduction.
	416.610	When payment will be made to a representative payee.
	416.615	Information considered in determining whether to make representative payment.
	416.620	Information considered in selecting a representative payee.
	416.621	Order of preference in selecting a representative payee.
	416.625	Information to be submitted by a representative payee.
	416.630	Advance notice of the determination to make representative payment.
	416.635	Responsibilities of a representative payee.
	416.640	Use of benefit payments.
	416.640a	Compensation for qualified organizations serving as representative payees.
	416.641	Liability for misuse of benefit payments.
	416.645	Conservation and investment of benefit payments.
	416.650	When a new representative payee will be selected.
	416.655	When representative payment will be stopped.
	416.660	Transfer of accumulated benefit payments.
	416.665	Accounting for benefit payments.
	416.701	Scope of subpart.
	416.702	Definitions.
	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.
	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.
	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.
	416.901	Scope of subpart.
	416.902	General definitions and terms for this subpart.
	416.903	Who makes disability and blindness determinations.
	416.903a	Program integrity.
	416.904	Determinations by other organizations and agencies.
	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.
	416.912	Evidence of your impairment.
	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.
	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.
	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.
	416.919s	Authorizing and monitoring the consultative examination.
	416.919t	Consultative examination oversight.
	416.920	Evaluation of disability of adults, in general.
	416.920a	Evaluation of mental impairments.
	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.
	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.
	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.
	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.
	416.945	Your residual functional capacity.
	416.946	Responsibility for assessing and determining residual functional capacity.
	416.960	When your vocational background will be considered.
	416.961	Your ability to do work depends upon your residual functional capacity.
	416.962	If you have done only arduous unskilled physical labor.
	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.
	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.
	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.
	416.987	Disability redeterminations for individuals who attain age 18.
	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.
	416.993	Medical evidence in continuing disability review cases.
	416.994	How we will decide 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).
	416.1001	Purpose and scope.
	416.1002	Definitions.
	416.1003	Basic responsibilities for us and the State.
	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.