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Subpart A—Introduction, General Provisions and Definitions | |
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Sec. | |
| Introduction. |
| General definitions and use of terms. |
| General provisions. |
Subpart B—Insured Status and Quarters of Coverage | |
General | |
| Introduction. |
| Definitions. |
Fully Insured Status | |
| 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. |
Currently Insured Status | |
| How we determine currently insured status. |
Disability 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. |
Quarters of Coverage | |
| 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. |
Appendix to Subpart B—Quarter of Coverage Amounts for Calendar Years After 1978 | |
Subpart C—Computing Primary Insurance Amounts | |
General | |
| 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 of Computing Primary Insurance Amounts | |
| 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 of Computing Primary Insurance Amounts | |
| 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 for People Reaching Age 62 After 1978 but Before 1984 | |
| 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 of Computing Primary Insurance Amounts | |
| 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 | |
| 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 | |
| Special minimum primary insurance amounts. |
| Computing your special minimum primary insurance amount. |
Cost-of-Living Increases | |
| 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. |
Recomputing Your Primary Insurance Amount | |
| 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 of Primary Insurance Amounts | |
| Recalculations. |
Appendixes to Subpart C—Note | |
Appendix I to Subpart C—Average of the Total Wages for Years After 1950 | |
Appendix II to Subpart C—Benefit Formulas Used With Average Indexed Monthly Earnings | |
Appendix III to Subpart C—Benefit Table | |
Appendix IV to Subpart C—Earnings Needed for a Year of Coverage After 1950 | |
Appendix V to Subpart C—Computing the Special Minimum Primary Insurance Amount and Related Maximum Family Benefits | |
Appendix VI to Subpart C—Percentage of Automatic Increases in Primary Insurance Amounts Since 1978 | |
Appendix VII to Subpart C—"Old-Law" Contribution and Benefit Base | |
Subpart D—Old-Age, Disability, Dependents' and Survivors' Insurance Benefits; Period of Disability | |
General | |
| Introduction. |
| Other regulations related to this subpart. |
| Definitions. |
| What are the general rules on benefit amounts? |
| When you may not be entitled to benefits. |
Old-Age and Disability 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. |
Rules Relating to Continuation of Benefits After Your Impairment Is No Longer Disabling | |
| 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. |
Benefits for Spouses and Divorced Spouses | |
| 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. |
| Who is entitled to mother's or father's benefits. |
| Who is 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 a child living with you is "in your care". |
| When a child living apart from you is "in your care". |
Child's Benefits | |
| 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 a stepchild is dependent. |
| When a grandchild or stepgrandchild is 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. |
Parent's Benefits | |
| Who is entitled to parent's benefits. |
| When parent's benefits begin and end. |
| Parent's benefit amounts. |
| Parent's relationship to the insured. |
Special Payments at Age 72 | |
| General. |
| Who is entitled to special age 72 payments. |
| When special age 72 payments begin and end. |
| Special age 72 payment amounts. |
| Reductions, suspensions, and nonpayments of special age 72 payments. |
Lump-Sum Death Payment | |
| 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. |
Subpart E—Deductions; Reductions; and Nonpayments of Benefits | |
| 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; prorated 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 of 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. |
Subpart F—Overpayments, Underpayments, Waiver of Adjustment or Recovery of Overpayments, and Liability of a Certifying Officer | |
| 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 individual. |
| 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? |
Subpart G—Filing of Applications and Other Forms | |
General Provisions | |
| Introduction. |
| Definitions. |
| You must file an application to receive benefits. |
Applications | |
| 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. |
Effective Filing Period of Application | |
| 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? |
Filing Date Based on Written Statement | |
| Use of date of written statement as filing date. |
| Statements filed with the Railroad Retirement Board. |
| Statements filed with a hospital. |
Deemed Filing Date Based on Misinformation | |
| Deemed filing date in a case of misinformation. |
Withdrawal of Application | |
| Withdrawal of an application. |
| Cancellation of a request to withdraw. |
Subpart H—Evidence | |
General | |
| 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. |
Evidence of Age, Marriage, and Death | |
| 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. |
Evidence for Child's and Parent's Benefits | |
| 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. |
Other Evidence Requirements | |
| Evidence of living in the same household with insured person. |
| Evidence of having a child in your 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. |
Subpart I—Records of Earnings | |
General Provisions | |
| Introduction. |
| Definitions. |
| Conclusiveness of the record of your earnings. |
Obtaining Earnings Information | |
| 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. |
Correcting the Earnings Record | |
| 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 an Entry of Earnings | |
| Notice of removal or reduction of your wages. |
| Notice of removal or reduction of your self-employment income. |
Subpart J—Determinations, Administrative Review Process, and Reopening of Determinations and Decisions | |
Introduction, Definitions, and Initial Determinations | |
| 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 | |
| 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 | |
| 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 | |
| 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 evidence prior to a hearing before an administrative law judge. |
| Time and place for a hearing before an administrative law judge. |
| 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 | |
| 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. |
| When a record of a hearing before an administrative law judge is made. |
| Consolidated hearing before an administrative law judge. |
| The decision of an administrative law judge. |
| The effect of an administrative law judge's decision. |
| Removal of a hearing request from an administrative law judge 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] |
Appeals Council Review | |
| Testing elimination of the request for Appeals Council review. |
| 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 Appeals Council on review. |
| 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. |
Court Remand Cases | |
| Case remanded by a Federal court. |
| Appeals Council review of administrative law judge decision in a case remanded by a Federal court. |
| Application of circuit court law. |
Reopening and Revising Determinations and Decisions | |
| 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 | |
| Payment of certain travel expenses—general. |
| Who may be reimbursed. |
| What travel expenses are reimbursable. |
| When and how to claim reimbursement. |
Subpart K—Employment, Wages, Self-Employment, and Self-Employment Income | |
| Introduction. |
| Definitions. |
Employment | |
| 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 | |
| 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. |
Exemption From Social Security by Reason of Religous Belief | |
| Employers (including partnerships) and employees who are both members of certain religious groups opposed to insurance. |
Wages | |
| 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 | |
| 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. |
Self-Employment Income | |
| 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. |
Subpart L [Reserved] | |
Subpart M—Coverage of Employees of State and Local Governments | |
General | |
| 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. |
What Groups of Employees May Be Covered | |
| 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. |
How Coverage Under Agreements Is Obtained and Continues | |
| Agreement for coverage. |
| Modification of agreement. |
| Modification of agreement to correct an error. |
| Continuation of coverage. |
| Resumption of coverage. |
| Dissolution of political subdivision. |
How To Identify Covered Employees | |
| Identification numbers. |
What Records of Coverage Must Be Kept | |
| Records—for wages paid prior to 1987. |
Review of Compliance by State With Its Agreement | |
| Onsite review program. |
| Scope of review. |
| Conduct of review. |
| Reports of review's findings. |
How To Report Wages and Contributions—for Wages Paid Prior to 1987 | |
| 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. |
What Is a State's Liability for Contributions—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. |
Figuring the Amount of the State's Contributions—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. |
If a State Fails To Make Timely Payments—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. |
How Errors in Reports and Contributions Are Adjusted—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. |
How Overpayments of Contributions Are Credited or Refunded—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. |
How Assessments for Underpayments of Contributions Are Made—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. |
Secretary's Review of Decisions on Credits, Refunds, or Assessments—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. |
How a State May Seek Court Review of Secretary's Decision—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. |
Subpart N—Wage Credits for Veterans and Members of the Uniformed Services | |
General | |
| Introduction. |
| Definitions. |
World War II Veterans | |
| 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. |
Post-World War II Veterans | |
| 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 | |
| Separation from active service under conditions other than dishonorable. |
Members of the Uniformed Services | |
| Who is a member of a uniformed service. |
Amounts of Wage Credits and Limits on Their Use | |
| 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 for World War II Veterans | |
| Deemed insured status. |
| When deemed insured status does not apply. |
| Benefits and payments based on deemed insured status. |
Effect of Other Benefits on Payment of Social Security Benefits and Payments | |
| 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 Membership in a Uniformed Service | |
| Evidence of active service and separation from active service. |
| Evidence of membership in a uniformed service during the years 1957 through 1967. |
Subpart O—Interrelationship of Old-Age, Survivors and Disability Insurance Program With the Railroad Retirement Program | |
| 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)? |
Subpart P—Determining Disability and Blindness | |
General | |
| Scope of subpart. |
| General definitions and terms for this subpart. |
Determinations | |
| Who makes disability and blindness determinations. |
| Program integrity. |
| Determinations by other organizations and agencies. |
Definition of Disability | |
| Basic definition of disability. |
| When we will not consider your impairment. |
| What is needed to show an impairment. |
| How long the impairment must last. |
| Meaning of substantial gainful activity. |
| Definition of disabling impairment. |
Evidence | |
| Evidence. |
| Medical and other evidence of your impairment(s). |
| 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. |
Standards To Be Used in Determining When a Consultative Examination Will Be Obtained in Connection With Disability Determinations | |
| The consultative examination. |
| When we will purchase a consultative examination and how we will use it. |
| When we will not purchase a consultative examination. |
Standards for the Type of Referral and for Report Content | |
| Type of purchased examinations. |
| Who we will select to perform a consultative examination. |
| Your treating 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 Referral Process | |
| Authorizing and monitoring the consultative examination. |
Procedures To Monitor the Consultative Examination | |
| Consultative examination oversight. |
Evaluation of Disability | |
| Evaluation of disability in general. |
| Evaluation of mental impairments. |
| What we mean by an impairment(s) that is not severe. |
| When you have two or more unrelated impairments—initial claims. |
| Multiple impairments. |
Medical Considerations | |
| Listing of Impairments in appendix 1. |
| Medical equivalence. |
| Evaluating opinion evidence. |
| Symptoms, signs, and laboratory findings. |
| 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. |
Residual Functional Capacity | |
| Your residual functional capacity. |
| Responsibility for assessing your residual functional capacity. |
Vocational Considerations | |
| 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. |
Substantial Gainful Activity | |
| 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. |
Widows, Widowers, and Surviving Divorced Spouses | |
| 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. |
Blindness | |
| 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. |
Continuing or Stopping Disability | |
| 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. |
Appendix 1 to Subpart P—Listing of Impairments | |
Appendix 2 to Subpart P—Medical-Vocational Guidelines | |
Subpart Q—Determinations of Disability | |
General Provisions | |
| Purpose and scope. |
| Definitions. |
| Basic responsibilities for us and the State. |
Responsibilities for Performing the Disability Determination Function | |
| 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 or psychological consultants. |
| Reasonable efforts to obtain review by a qualified psychiatrist or psychologist. |
| Notifying claimants of the disability determination. |
Quick Disability Determinations | |
| Quick disability determination process. |
Administrative Responsibilities and Requirements | |
| 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. |
Performance Standards | |
| 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. |
Performance Monitoring and Support | |
| How we will monitor. |
| When we will provide performance support. |
| What support we will provide. |
Substantial Failure | |
| General. |
| Good cause for not following the Act, our regulations, or other written guidelines. |
| Finding of substantial failure. |
Hearings and Appeals | |
| 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 of Disability Determination Function | |
| 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. |
Subpart R—Representation of Parties | |
| Introduction. |
| Definitions. |
| Who may be your representative. |
| Notification of options for obtaining attorney representation. |
| Appointing a representative. |
| Authority of a representative. |
| Notice or request to a representative. |
| Demonstration project on direct payment of fees to non-attorneys. |
| Fee for a representative's services. |
| Request for approval of a fee. |
| Proceedings before a State or Federal court. |
| Payment of fees. |
| Services in a proceeding under title II of the Act. |
| 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. |
Subpart S—Payment Procedures | |
| Introduction. |
| Paying benefits. |
| Monthly payment day. |
| Expediting benefit payments. |
| Withholding certification or payments. |
| Transfer or assignment of payments. |
| Joint payments to a family. |
Subpart T—Totalization Agreements | |
General Provisions | |
| Introduction. |
| Definitions. |
| Negotiating totalization agreements. |
| Effective date of a totalization agreement. |
| Termination of agreements. |
Benefit Provisions | |
| Crediting foreign periods of coverage. |
| Person qualifies under more than one totalization agreement. |
| Effects of a totalization agreement on entitlement to hospital insurance benefits. |
Coverage Provisions | |
| Precluding dual coverage. |
| Certificate of coverage. |
| Payment of contributions. |
Computation Provisions | |
| 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. |
Other Provisions | |
| Applications. |
| Evidence. |
| Appeals. |
| Effect of the alien non-payment provision. |
| Overpayments. |
| Disclosure of information. |
Subpart U—Representative Payment | |
| 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. |
| 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 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? |
Subpart V—Payments for Vocational Rehabilitation Services | |
General Provisions | |
| General. |
| Purpose and scope. |
| Definitions. |
| Participation by State VR agencies or alternate participants. |
| Basic qualifications for alternate participants. |
Payment Provisions | |
| 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. |
Administrative Provisions | |
| Applicability of these provisions to alternate participants. |
| Method of payment. |
| Audits. |
| Validation reviews. |
| Confidentiality of information and records. |
| Other Federal laws and regulations. |
| Resolution of disputes. |
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