Title 20, Part 404 — Federal Old-age, Survivors and Disability Insurance (1950- )

Introduction.

General definitions and use of terms.

General provisions.

Introduction.

Definitions.

How we determine fully insured status.

When we consider a person fully insured based on World War II active military or naval service.

When we consider certain employees of private nonprofit organizations to be fully insured.

Table for determining the quarters of coverage you need to be fully insured.

How we determine currently insured status.

How we determine disability insured status.

When you must have disability insured status.

How we determine fully insured status for a period of disability or disability insurance benefits.

When we give you quarters of coverage based on military service to establish a period of disability.

What is a quarter of coverage.

How we credit quarters of coverage for calendar years before 1978.

How we credit self-employment income to calendar quarters for taxable years beginning before 1978.

How we credit quarters of coverage for calendar years after 1977.

How we credit self-employment income to calendar years for taxable years beginning after 1977.

When you acquire a quarter of coverage.

When a calendar quarter cannot be a quarter of coverage.

What is included in this subpart?

Other regulations related to this subpart.

Definitions.

Methods of computing primary insurance amounts—general.

Average-indexed-monthly-earnings method.

Computing your average indexed monthly earnings.

Computing your primary insurance amount from your average indexed monthly earnings.

Computation where you are eligible for a pension based on your noncovered employment.

Average-monthly-wage method.

Computing your average monthly wage.

Use of benefit table in finding your primary insurance amount from your average monthly wage.

Guaranteed alternative.

Steps in computing your primary insurance amount under the guaranteed alternative—general.

Computing your average monthly wage under the guaranteed alternative.

Adjustment of your guaranteed alternative when you become entitled after age 62.

Old-start method—general.

1977 simplified old-start method.

Use of old-start primary insurance amount as guaranteed alternative.

Computation where you are eligible for a pension based on noncovered employment.

Special computation rules for people who had a period of disability.

Subsequent entitlement to benefits less than 12 months after entitlement to disability benefits ended.

Subsequent entitlement to benefits 12 months or more after entitlement to disability benefits ended.

Special minimum primary insurance amounts.

Computing your special minimum primary insurance amount.

Cost-of-living increases.

When automatic cost-of-living increases apply.

Indexes we use to measure the rise in the cost-of-living.

When are automatic cost-of-living increases effective?

What are the measuring periods we use to calculate cost-of-living increases?

How is an automatic cost-of-living increase calculated?

Publication of notice of increase.

When does the frozen minimum primary insurance amount increase because of cost-of-living adjustments?

Additional cost-of-living increase.

Recomputations.

Why your primary insurance amount may be recomputed.

Effective date of recomputations.

Recomputation under method other than that used to find your primary insurance amount.

Recomputations for people who reach age 62, or become disabled, or die before age 62 after 1978.

Recomputations performed automatically.

How to request an immediate recomputation.

Waiver of recomputation.

Recomputing when you are entitled to a monthly pension based on noncovered employment.

Recalculations.

Introduction.

Other regulations related to this subpart.

Definitions.

What are the general rules on benefit amounts?

When you may not be entitled to benefits.

When am I entitled to old-age benefits?

When does my entitlement to old-age benefits begin and end?

How is my old-age benefit amount calculated?

What are delayed retirement credits and how do they increase my old-age benefit amount?

Who is entitled to disability benefits?

When entitlement to disability benefits begins and ends.

How is the amount of my disability benefit calculated?

Who is entitled to a period of disability.

When a period of disability begins and ends.

When you may apply for a period of disability after a delay due to a physical or mental condition.

The termination month.

When you are participating in an appropriate program of vocational rehabilitation services, employment services, or other support services.

When your completion of the program, or your continuation in the program for a specified period of time, will increase the likelihood that you will not have to return to the disability benefit rolls.

Who is entitled to wife's or husband's benefits.

Who is entitled to wife's or husband's benefits as a divorced spouse.

When wife's and husband's benefits begin and end.

Wife's and husband's benefit amounts.

How do I become entitled to widow's or widower's benefits?

How do I become entitled to widow's or widower's benefits as a surviving divorced spouse?

When does my entitlement to widow's and widower's benefits start and end?

Widow's and widower's benefits amounts.

How do I become entitled to mother's or father's benefits as a surviving spouse?

How do I become entitled to mother's or father's benefits as a surviving divorced spouse?

When mother's and father's benefits begin and end.

Mother's and father's benefit amounts.

Your relationship by marriage to the insured.

Your relationship as wife, husband, widow, or widower under State law.

Your relationship as wife, husband, widow, or widower based upon a deemed valid marriage.

“Living in the same household” defined.

When is a child living with me in my care?

When is a child living apart from me in my care?

Who is entitled to child's benefits?

Who may be reentitled to child's benefits?

When does my entitlement to child's benefits begin and end?

Child's benefit amounts.

Your relationship to the insured.

Who is the insured's natural child?

Who is the insured's legally adopted child?

Who is the insured's stepchild?

Who is the insured's grandchild or stepgrandchild?

Who is the insured's equitably adopted child?

When a child is dependent upon the insured person.

When a natural child is dependent.

When a legally adopted child is dependent.

When is a stepchild dependent?

When is a grandchild or stepgrandchild dependent?

When an equitably adopted child is dependent.

“Contributions for support,” “one-half support,” and “living with” the insured defined—determining first month of entitlement.

When you are a “full-time elementary or secondary school student”.

When you are considered a full-time student during a period of nonattendance.

Who is entitled to parent's benefits?

When parent's benefits begin and end.

Parent's benefit amounts.

Parent's relationship to the insured.

§§ 404.380-404.384 [Reserved]

General.

Who is entitled to the lump-sum death payment as a widow or widower who was living in the same household?

Who is entitled to the lump-sum death payment when there is no widow(er) who was living in the same household?

Deduction, reduction, and nonpayment of monthly benefits or lump-sum death payments.

When we do not pay benefits because of a disability beneficiary's work activity.

Interrelationship of deductions, reductions, adjustments, and nonpayment of benefits.

Reduction where total monthly benefits exceed maximum family benefits payable.

How reduction for maximum affects insured individual and other persons entitled on his earnings record.

Situations where total benefits can exceed maximum because of “savings clause.”

Reduction for maximum because of retroactive effect of application for monthly benefits.

Reduction because of entitlement to other benefits.

Reduction of benefits based on disability on account of receipt of certain other disability benefits provided under Federal, State, or local laws or plans.

Reduction where spouse is receiving a Government pension.

Reduction of retroactive monthly social security benefits where supplemental security income (SSI) payments were received for the same period.

What is full retirement age?

How does SSA reduce my benefits when my entitlement begins before full retirement age?

How are benefits reduced for age when a person is entitled to two or more benefits?

After my benefits are reduced for age when and how will adjustments to that reduction be made?

After my benefits are reduced for age what happens if there is an increase in my primary insurance amount?

Deductions because of excess earnings.

Deductions because of noncovered remunerative activity outside the United States; 45 hour and 7-day work test.

“Noncovered remunerative activity outside the United States,” defined.

Persons deemed entitled to benefits based on an individual's earnings record.

How are deductions made when a beneficiary fails to have a child in his or her care?

Manner of making deductions.

Total amount of deductions where more than one deduction event occurs in a month.

Total amount of deductions where deduction events occur in more than 1 month.

Earnings in a taxable year.

Earnings; defined.

Monthly and annual exempt amounts defined; excess earnings defined.

Excess earnings; method of charging.

Excess earnings; months to which excess earnings can or cannot be charged; grace year defined.

Excess earnings; months to which excess earnings cannot be charged because individual is deemed not entitled to benefits.

Excess earnings; benefit rate subject to deductions because of excess earnings.

Partial monthly benefits; excess earnings of the individual charged against his benefits and the benefits of persons entitled (or deemed entitled) to benefits on his earnings record.

Partial monthly benefits; pro-rated share of partial payment exceeds the benefit before deduction for excess earnings.

Partial monthly benefits; insured individual and another person entitled (or deemed entitled) on the same earnings record both have excess earnings.

Definition of “substantial services” and “services.”

Evaluation of factors involved in substantial services test.

Required reports of work outside the United States or failure to have care of a child.

Penalty deductions for failure to report within prescribed time limit noncovered remunerative activity outside the United States or not having care of a child.

Reports to Social Security Administration of earnings; wages; net earnings from self-employment.

Penalty deductions for failure to report earnings timely.

Good cause for failure to make required reports.

Request by Social Security Administration for reports of earnings and estimated earnings; effect of failure to comply with request.

Current suspension of benefits because an individual works or engages in self-employment.

Deductions where taxes neither deducted from wages of certain maritime employees nor paid.

Limiting deductions where total family benefits payable would not be affected or would be only partly affected.

Penalty for making false or misleading statements or withholding information.

Nonpayment of monthly benefits to aliens outside the United States.

Nonpayment of lump sum after death of alien outside United States for more than 6 months.

Nonpayment of hospital and medical insurance benefits of alien outside United States for more than 6 months.

Nonpayment of benefits of aliens outside the United States; “foreign social insurance system,” and “treaty obligation” exceptions defined.

How does deportation or removal from the United States affect the receipt of benefits?

Conviction for subversive activities; effect on monthly benefits and entitlement to hospital insurance benefits.

Conviction for subversive activities; effect on enrollment for supplementary medical insurance benefits.

Nonpayment of benefits; individual entitled to disability insurance benefits or childhood disability benefits based on statutory blindness is engaging in substantial gainful activity.

Nonpayment of benefits to prisoners.

Nonpayment of benefits where individual has not furnished or applied for a Social Security number.

Nonpayment of disability benefits due to noncompliance with rules regarding treatment for drug addiction or alcoholism.

Nonpayment of disability benefits for trial work period service months upon a conviction of fraudulently concealing work activity.

Paying benefits in installments: Drug addiction or alcoholism.

General applicability of section 204 of the Act.

Overpayments.

Notice of right to waiver consideration.

Underpayments.

Relation to provisions for reductions and increases.

Relationship to provisions requiring deductions.

When waiver may be applied and how to process the request.

Fault.

Defeat the purpose of Title II.

Against equity and good conscience; defined.

When an individual is “without fault” in a deduction overpayment.

When an individual is “without fault” in an entitlement overpayment.

When an individual is at “fault” in a deduction overpayment.

When adjustment or recovery of an overpayment will be waived.

Liability of a certifying officer.

Collection and compromise of claims for overpayment.

Referral of overpayments to the Department of the Treasury for tax refund offset—General.

Notice to overpaid persons.

Review within SSA that an overpayment is past due and legally enforceable.

Findings by SSA.

Review of our records related to the overpayment.

Suspension of offset.

Tax refund insufficient to cover amount of overpayment.

Additional methods for recovery of title II benefit overpayments.

Are title VIII and title XVI benefits subject to adjustment to recover title II overpayments?

How much will we withhold from your title VIII and title XVI benefits to recover a title II overpayment?

Will you receive notice of our intention to apply cross-program recovery?

When will we begin cross-program recovery from current monthly benefits?

Introduction.

Definitions.

You must file an application to receive benefits.

What makes an application a claim for benefits?

How do I file an application for Social Security benefits?

Who may sign an application.

Evidence of authority to sign an application for another.

When an application or other form is considered filed.

Claimant must be alive when an application is filed.

Pilot program for photographic identification of disability benefit applicants in designated geographic areas.

Filing before the first month you meet the requirements for benefits.

What happens if I file after the first month I meet the requirements for benefits?

Limiting an application.

Am I required to file for all benefits if I am eligible for old-age and husband's or wife's benefits?

Use of date of written statement as filing date.

Statements filed with the Railroad Retirement Board.

Statements filed with a hospital.

Deemed filing date in a case of misinformation.

Withdrawal of an application.

Cancellation of a request to withdraw.

Introduction.

Definitions.

When evidence is needed.

Your responsibility for giving evidence.

Failure to give requested evidence.

Where to give evidence.

Original records or copies as evidence.

How we decide what is enough evidence.

Preferred evidence and other evidence.

When evidence of age is needed.

Type of evidence of age to be given.

Evidence of a person's death.

Evidence to presume a person is dead.

Rebuttal of a presumption of death.

When evidence of marriage is required.

Evidence of a valid ceremonial marriage.

Evidence of common-law marriage.

Evidence of a deemed valid marriage.

Evidence a marriage has ended.

When evidence of a parent or child relationship is needed.

Evidence you are a natural parent or child.

Evidence you are a stepparent or stepchild.

Evidence you are the legally adopting parent or legally adopted child.

Evidence you are an equitably adopted child.

Evidence you are the grandchild or stepgrandchild.

Evidence of a child's dependency.

Evidence of school attendance for child age 18 or older.

Evidence of a parent's support.

Evidence of living in the same household with insured person.

What is acceptable evidence of having a child in my care?

Evidence of where the insured person had a permanent home.

Evidence of “good cause” for exceeding time limits on accepting proof of support or application for a lump-sum death payment.

Introduction.

Definitions.

Conclusiveness of the record of your earnings.

How to obtain a statement of earnings and a benefit estimate statement.

The statement of earnings and benefit estimates you requested.

Statement of earnings and benefit estimates sent without request.

Filing a request for correction of the record of your earnings.

Correction of the record of your earnings before the time limit ends.

Correction of the record of your earnings after the time limit ends.

Correction of the record of your earnings for work in the employ of the United States.

Notice of removal or reduction of your wages.

Notice of removal or reduction of your self-employment income.

Introduction.

Definitions.

Administrative actions that are initial determinations.

Administrative actions that are not initial determinations.

Notice of the initial determination.

Effect of an initial determination.

Testing modifications to the disability determination procedures.

Reconsideration—general.

Parties to a reconsideration.

How to request reconsideration.

Good cause for missing the deadline to request review.

Reconsideration procedures.

Disability hearing—general.

Disability hearing—disability hearing officers.

Disability hearing—procedures.

Disability hearing—disability hearing officer's reconsidered determination.

Disability hearing—review of the disability hearing officer's reconsidered determination before it is issued.

Notice of another person's request for reconsideration.

Reconsidered determination.

Effect of a reconsidered determination.

Notice of a reconsidered determination.

Expedited appeals process—general.

When the expedited appeals process may be used.

How to request expedited appeals process.

Agreement in expedited appeals process.

Effect of expedited appeals process agreement.

Expedited appeals process request that does not result in agreement.

Hearing before an administrative law judge—general.

Availability of a hearing before an administrative law judge.

Parties to a hearing before an administrative law judge.

How to request a hearing before an administrative law judge.

Submitting written evidence to an administrative law judge.

Time, place, and manner of appearance for a hearing before an administrative law judge.

Protecting the safety of the public and our employees in our hearing process.

Notice of a hearing before an administrative law judge.

Objections to the issues.

Disqualification of the administrative law judge.

Prehearing case review.

Prehearing proceedings and decisions by attorney advisors.

Responsibilities of the adjudication officer.

Administrative law judge hearing procedures—general.

Issues before an administrative law judge.

Deciding a case without an oral hearing before an administrative law judge.

Presenting written statements and oral arguments.

Presenting evidence at a hearing before an administrative law judge.

Official record.

Consolidated hearing before an administrative law judge.

The decision of an administrative law judge.

The effect of a hearing decision.

Removal of a hearing request(s) to the Appeals Council.

Dismissal of a request for a hearing before an administrative law judge.

Notice of dismissal of a request for a hearing before an administrative law judge.

Effect of dismissal of a request for a hearing before an administrative law judge.

Vacating a dismissal of a request for a hearing before an administrative law judge.

Prehearing and posthearing conferences.

[Reserved]

[Reserved]

Appeals Council review—general.

How to request Appeals Council review.

Appeals Council initiates review.

Cases the Appeals Council will review.

Dismissal by Appeals Council.

Effect of dismissal of request for Appeals Council review.

Notice of Appeals Council review.

Obtaining evidence from Appeals Council.

Filing briefs with the Appeals Council.

Procedures before the Appeals Council.

Case remanded by Appeals Council.

Decision of Appeals Council.

Effect of Appeals Council's decision or denial of review.

Extension of time to file action in Federal district court.

Case remanded by a Federal court.

Appeals Council review of hearing decision in a case remanded by a Federal court.

Application of circuit court law.

Reopening and revising determinations and decisions.

Conditions for reopening.

Good cause for reopening.

Finality of determinations and decisions on revision of an earnings record.

Finality of determinations and decisions to suspend benefit payments for entire taxable year because of earnings.

Late completion of timely investigation.

Notice of revised determination or decision.

Effect of revised determination or decision.

Time and place to request a hearing on revised determination or decision.

Finality of findings when later claim is filed on same earnings record.

Increase in future benefits where time period for reopening expires.

Payment of certain travel expenses—general.

Who may be reimbursed.

What travel expenses are reimbursable.

When and how to claim reimbursement.

Introduction.

Definitions.

Employment.

What work is covered as employment?

Who is an employee.

Corporation officer.

Common-law employee.

Agent-driver or commission-driver, full-time life insurance salesman, home worker, or traveling or city salesman.

Who is an employer.

Farm crew leader as employer.

Work excluded from employment.

Included-excluded rule.

Domestic service by a student for a local college club, fraternity or sorority.

Family services.

Foreign agricultural workers.

Sharefarmers.

Work by civilians for the United States Government or its instrumentalities—wages paid after 1983.

Work by civilians for the United States Government or its instrumentalities—remuneration paid prior to 1984.

Medicare qualified government employment.

Work as a member of a uniformed service of the United States.

Work for States and their political subdivisions and instrumentalities.

Work for the District of Columbia.

American Samoa, Guam, or the Commonwealth of the Northern Mariana Islands.

Ministers of churches and members of religious orders.

Election of coverage by religious orders.

Work for religious, charitable, educational, or certain other organizations exempt from income tax.

Work for a church or qualified church-controlled organization.

Railroad work.

Student working for a school, college, or university.

Student nurses.

Delivery and distribution or sale of newspapers, shopping news, and magazines.

Fishing.

Work for a foreign government.

Work for a wholly owned instrumentality of a foreign government.

Work for an international organization.

Work for a communist organization.

Certain nonresident aliens.

Work on or in connection with a non-American vessel or aircraft.

Domestic employees under age 18.

Employers (including partnerships) and employees who are both members of certain religious groups opposed to insurance.

Wages.

Wages when paid and received.

Facilities or privileges—meals and lodging.

Vacation pay.

Employee expenses.

Pay for work by certain members of religious orders.

Annual wage limitation.

Contribution and benefit base after 1992.

Payments under an employer plan or system.

Retirement payments.

Payments on account of sickness or accident disability, or related medical or hospitalization expenses.

Payments from or to certain tax-exempt trusts or payments under or into certain annuity plans.

“Qualified benefits” under a cafeteria plan.

Payments by an employer of employee's tax or employee's contribution under State law.

Payments for agricultural labor.

Explanation of agricultural labor.

Domestic service in the employer's home.

Special situations.

Deemed wages for certain individuals interned during World War II.

[Reserved]

Self-employment coverage.

Trade or business in general.

Employees who are considered self-employed.

Real estate agents and direct sellers.

Christian Science practitioners.

Ministers and members of religious orders.

Public office.

Farm crew leader who is self-employed.

Members of certain religious groups opposed to insurance.

Individuals under railroad retirement system.

Net earnings from self-employment.

General rules for figuring net earnings from self-employment.

Rentals from real estate; material participation.

Dividends and interest.

Gain or loss from disposition of property; capital assets; timber, coal, and iron ore; involuntary conversion.

Net operating loss deduction.

Community income.

Figuring partner's net earnings from self-employment for taxable year which ends as a result of death.

Retirement payment to retired partners.

Figuring net earnings for residents and nonresidents of Puerto Rico.

Personal exemption deduction.

Figuring net earnings for ministers and members of religious orders.

Figuring net earnings for U.S. citizens or residents living outside the United States.

Possession of the United States.

Options available for figuring net earnings from self-employment.

Agricultural trade or business.

Self-employment income.

General.

Scope of this subpart regarding coverage and wage reports and adjustments.

Definitions.

Evidence—for wages paid prior to 1987.

Designating officials to act on behalf of the State.

Absolute coverage groups.

Retirement system coverage groups.

Divided retirement system coverage groups.

Ineligible employees.

Mandatorily excluded services.

Optionally excluded services.

Interstate instrumentalities.

Police officers and firefighters.

Agreement for coverage.

Modification of agreement.

Modification of agreement to correct an error.

Continuation of coverage.

Resumption of coverage.

Dissolution of political subdivision.

Identification numbers.

Records—for wages paid prior to 1987.

Onsite review program.

Scope of review.

Conduct of review.

Reports of review's findings.

Wage reports and contribution returns—general—for wages paid prior to 1987.

Wage reports for employees performing services in more than one coverage group—for wages paid prior to 1987.

Back pay.

Use of reporting forms—for wages paid prior to 1987.

When to report wages—for wages paid prior to 1987.

When and where to make deposits of contributions and to file contribution returns and wage reports—for wages paid prior to 1987.

Final reports—for wages paid prior to 1987.

State's liability for contributions—for wages paid prior to 1987.

Limitation on State's liability for contributions for multiple employment situations—for wages paid prior to 1987.

Amount of contributions—for wages paid prior to 1987.

Manner of payment of contributions by State—for wages paid prior to 1987.

When fractional part of a cent may be disregarded—for wages paid prior to 1987.

Addition of interest to contributions—for wages paid prior to 1987.

Failure to make timely payments—for wages paid prior to 1987.

Adjustments in general—for wages paid prior to 1987.

Adjustment of overpayment of contributions—for wages paid prior to 1987.

Refund or recomputation of overpayments which are not adjustable—for wages paid prior to 1987.

Adjustment of employee contributions—for wages paid prior to 1987.

Reports and payments erroneously made to Internal Revenue Service-transfer of funds—for wages paid prior to 1987.

Allowance of credits or refunds—for wages paid prior to 1987.

Credits or refunds for periods of time during which no liability exists—for wages paid prior to 1987.

Time limitations on credits or refunds—for wages paid prior to 1987.

Exceptions to the time limitations on credits or refunds—for wages paid prior to 1987.

Offsetting underpayments against overpayments—for wages paid prior to 1987.

Assessments of amounts due—for wages paid prior to 1987.

Time limitations on assessments—for wages paid prior to 1987.

Exceptions to the time limitations on assessments—for wages paid prior to 1987.

Payment after expiration of time limitation for assessment—for wages paid prior to 1987.

Review of decisions by the Secretary—for wages paid prior to 1987.

Reconsideration—for wages paid prior to 1987.

How to request review—for wages paid prior to 1987.

Time for filing request for review—for wages paid prior to 1987.

Notification to State after reconsideration—for wages paid prior to 1987.

Commissioner's review—for wages paid prior to 1987.

Commissioner's notification to the State—for wages paid prior to 1987.

Review by court—for wages paid prior to 1987.

Time for filing civil action—for wages paid prior to 1987.

Final judgments—for wages paid prior to 1987.

Introduction.

Definitions.

Who is a World War II veteran.

Ninety-day active service requirement for World War II veterans.

World War II service included.

World War II service excluded.

Who is a post-World War II veteran.

Ninety-day active service requirement for post-World War II veterans.

Post-World War II service included.

Post-World War II service excluded.

Separation from active service under conditions other than dishonorable.

Who is a member of a uniformed service.

Wage credits for World War II and post-World War II veterans.

Wage credits for a member of a uniformed service.

Limits on granting World War II and post-World War II wage credits.

When the limits on granting World War II and post-World War II wage credits do not apply.

Deemed insured status.

When deemed insured status does not apply.

Benefits and payments based on deemed insured status.

Veterans Administration pension or compensation payable.

Federal benefit payable other than by Veterans Administration.

Treatment of social security benefits or payments where Veterans Administration pension or compensation payable.

Treatment of social security benefits or payments where Federal benefit payable other than by Veterans Administration.

Evidence of active service and separation from active service.

Evidence of membership in a uniformed service during the years 1957 through 1967.

What is the interrelationship between the Railroad Retirement Act and the Old-Age, Survivors and Disability Insurance Program of the Social Security Act?

When are railroad industry services by a non-vested worker covered under Social Security?

Effective date of coverage of railroad services under the act.

If you have been considered a non-vested worker, what are the situations when your railroad industry work will not be covered under Social Security?

Eligibility to railroad retirement benefits as a bar to payment of social security benefits.

When railroad retirement benefits do not bar payment of social security benefits.

Compensation to be treated as wages.

Purposes of using compensation.

Presumption on basis of certified compensation record.

Compensation quarters of coverage.

When will we certify payment to the Railroad Retirement Board (RRB)?

Scope of subpart.

Definitions for this subpart.

Who makes disability and blindness determinations.

Program integrity.

Evidence from excluded medical sources of evidence.

Decisions by other governmental agencies and nongovernmental entities.

Basic definition of disability.

When we will not consider your impairment.

[Reserved]

How long the impairment must last.

Meaning of substantial gainful activity.

Definition of a disabling impairment.

Responsibility for evidence.

Categories of evidence.

Evidence from our Federal or State agency medical or psychological consultants.

When we will purchase existing evidence.

Where and how to submit evidence.

If you fail to submit medical and other evidence.

Consultative examination at our expense.

If you do not appear at a consultative examination.

The consultative examination.

When we will purchase a consultative examination and how we will use it.

When we will not purchase a consultative examination.

Type of purchased examinations.

Who we will select to perform a consultative examination.

Your medical source.

Other sources for consultative examinations.

Objections to the medical source designated to perform the consultative examination.

Purchase of medical examinations, laboratory tests, and other services.

Diagnostic tests or procedures.

Informing the medical source of examination scheduling, report content, and signature requirements.

When a properly signed consultative examination report has not been received.

Reviewing reports of consultative examinations.

Conflict of interest.

Authorizing and monitoring the consultative examination.

Consultative examination oversight.

Evaluation of disability in general.

Evaluation of mental impairments.

How we consider evidence.

How we consider and articulate medical opinions and prior administrative medical findings for claims filed on or after March 27, 2017.

Establishing that you have a medically determinable impairment(s).

What we mean by an impairment(s) that is not severe.

Multiple impairments.

Listing of Impairments in appendix 1.

Medical equivalence.

Evaluating opinion evidence for claims filed before March 27, 2017.

[Reserved]

How we evaluate symptoms, including pain.

Need to follow prescribed treatment.

How we will determine whether your drug addiction or alcoholism is a contributing factor material to the determination of disability.

Treatment required for individuals whose drug addiction or alcoholism is a contributing factor material to the determination of disability.

What we mean by appropriate treatment.

What we mean by approved institutions or facilities.

How we consider whether treatment is available.

Evaluating compliance with the treatment requirements.

Establishment and use of referral and monitoring agencies.

Your residual functional capacity.

Responsibility for assessing your residual functional capacity.

When we will consider your vocational background.

Medical-vocational profiles showing an inability to make an adjustment to other work.

Your age as a vocational factor.

Your education as a vocational factor.

Your work experience as a vocational factor.

Work which exists in the national economy.

Physical exertion requirements.

Skill requirements.

Listing of Medical-Vocational Guidelines in appendix 2.

Exertional and nonexertional limitations.

General.

What we mean by substantial gainful activity.

General information about work activity.

Evaluation guides if you are an employee.

When and how we will average your earnings.

Evaluation guides if you are self-employed.

Impairment-related work expenses.

Disability defined for widows, widowers, and surviving divorced spouses for monthly benefits payable for months prior to January 1991.

How we determine disability for widows, widowers, and surviving divorced spouses for monthly benefits payable for months prior to January 1991.

How we will determine whether your disability continues or ends.

Meaning of blindness as defined in the law.

A period of disability based on blindness.

How we determine disability for blind persons who are age 55 or older.

Evaluation of work activity of blind people.

Trial work period for persons age 55 or older who are blind.

Why and when we will stop your cash benefits.

Circumstances under which we may suspend and terminate your benefits before we make a determination.

Your responsibility to tell us of events that may change your disability status.

We may conduct a review to find out whether you continue to be disabled.

When and how often we will conduct a continuing disability review.

If your medical recovery was expected and you returned to work.

The trial work period.

The reentitlement period.

What is expedited reinstatement?

Who is entitled to expedited reinstatement?

How do I request reinstatement?

How do we determine provisional benefits?

How do we determine reinstated benefits?

Medical evidence in continuing disability review cases.

How we will determine whether your disability continues or ends.

When we determine that you are not now disabled.

Circumstances under which we may suspend and terminate your benefits before we make a determination.

After we make a determination that you are not now disabled.

Continued benefits pending appeal of a medical cessation determination.

If you become disabled by another impairment(s).

Work incentive experiments and rehabilitation demonstration projects in the disability program.

Purpose and scope.

Definitions.

Basic responsibilities for us and the State.

How a State notifies us that it wishes to perform the disability determination function.

How we notify a State whether it may perform the disability determination function.

Disability determinations the State makes.

Responsibilities for obtaining evidence to make disability determinations.

Making disability determinations.

Medical consultants and psychological consultants.

Reasonable efforts to obtain review by a physician, psychiatrist, and psychologist.

Notifying claimants of the disability determination.

Quick disability determination process.

General administrative requirements.

Personnel.

Training.

Facilities.

Medical and other purchased services.

Records and reports.

Fiscal.

Audits.

Property.

Participation in research and demonstration projects.

Coordination with other agencies.

Confidentiality of information and records.

Other Federal laws and regulations.

Policies and operating instructions.

General.

Standards of performance.

Processing time standards.

Performance accuracy standard.

How and when we determine whether the processing time standards are met.

How and when we determine whether the performance accuracy standard is met.

Action we will take if a State agency does not meet the standards.

How we will monitor.

When we will provide performance support.

What support we will provide.

General.

Good cause for not following the Act, our regulations, or other written guidelines.

Finding of substantial failure.

Notice of right to hearing on proposed finding of substantial failure.

Disputes on matters other than substantial failure.

Who conducts the hearings.

Hearings and appeals process.

Assumption when we make a finding of substantial failure.

Assumption when State no longer wishes to perform the disability determination function.

Protection of State employees.

Limitation on State expenditures after notice.

Final accounting by the State.

Introduction.

Definitions.

Who may be your representative.

Notification of options for obtaining attorney representation.

Appointing a representative.

Authority of a representative.

Mandatory use of electronic services.

Notice or request to a representative.

Direct payment of fees to eligible non-attorney representatives.

Fee for a representative's services.

Request for approval of a fee.

Proceedings before a State or Federal court.

Payment of fees.

Entity eligible for direct payment of fees.

Rules of conduct and standards of responsibility for representatives.

Violations of our requirements, rules, or standards.

Notice of charges against a representative.

Withdrawing charges against a representative.

Hearing on charges.

Decision by hearing officer.

Requesting review of the hearing officer's decision.

Assignment of request for review of the hearing officer's decision.

Appeals Council's review of hearing officer's decision.

Evidence permitted on review.

Appeals Council's decision.

When the Appeals Council will dismiss a request for review.

Reinstatement after suspension—period of suspension expired.

Reinstatement after suspension or disqualification—period of suspension not expired.

Introduction.

Paying benefits.

Monthly payment day.

Expediting benefit payments.

Withholding certification or payments.

Transfer or assignment of payments.

Garnishment of payments after disbursement.

Joint payments to a family.

Introduction.

Definitions.

Negotiating totalization agreements.

Effective date of a totalization agreement.

Termination of agreements.

Crediting foreign periods of coverage.

Person qualifies under more than one totalization agreement.

Effects of a totalization agreement on entitlement to hospital insurance benefits.

Precluding dual coverage.

Certificate of coverage.

Payment of contributions.

How benefits are computed.

How benefits are recomputed.

Supplementing the U.S. benefit if the total amount of the combined benefits is less than the U.S. minimum benefit.

Benefits of less than $1 due.

Applications.

Evidence.

Appeals.

Effect of the alien non-payment provision.

Overpayments.

Disclosure of information.

Introduction.

When payment will be made to a representative payee.

What happens to your monthly benefits while we are finding a suitable representative payee for you?

Information considered in determining whether to make representative payments.

Advance designation of representative payees.

Information considered in selecting a representative payee.

What is our order of preference in selecting a representative payee for you?

Who may not serve as a representative payee?

How do we investigate a representative payee applicant?

What information must a representative payee report to us?

How do we investigate an appointed representative payee?

How will we notify you when we decide you need a representative payee?

What are the responsibilities of your representative payee?

Use of benefit payments.

Compensation for qualified organizations serving as representative payees.

Who is liable if your representative payee misuses your benefits?

Conservation and investment of benefit payments.

When will we select a new representative payee for you?

When representative payment will be stopped.

Transfer of accumulated benefit payments.

How does your representative payee account for the use of benefits?

General.

Purpose and scope.

Definitions.

Participation by State VR agencies.

[Reserved]

Requirements for payment.

Responsibility for making payment decisions.

What we mean by “SGA” and by “a continuous period of 9 months”.

Criteria for determining when VR services will be considered to have contributed to a continuous period of 9 months.

Payment for VR services in a case where an individual continues to receive disability payments based on participation in an approved VR program.

Services for which payment may be made.

When services must have been provided.

When claims for payment for VR services must be made (filing deadlines).

What costs will be paid.

[Reserved]

Method of payment.

Audits.

Validation reviews.

Confidentiality of information and records.

Other Federal laws and regulations.

Resolution of disputes.