PART 416—SUPPLEMENTAL SECURITY INCOME FOR THE AGED, BLIND, AND DISABLED

Table of Contents

Subpart A—Introduction, General Provisions and Definitions

416.101Introduction.
416.105Administration.
416.110Purpose of program.
416.120General definitions and use of terms.
416.121Receipt of aid or assistance for December 1973 under an approved State plan under title I, X, XIV, or XVI of the Social Security Act.

Subpart B—Eligibility

General

416.200Introduction.
416.201General definitions and terms used in this subpart.
416.202Who may get SSI benefits.
416.203Initial determinations of SSI eligibility.
416.204Redeterminations of SSI eligibility.

Reasons Why You May Not Get SSI Benefits for Which You Are Otherwise Eligible

416.207You do not give us permission to contact financial institutions.
416.210You do not apply for other benefits.
416.211You are a resident of a public institution.
416.212Continuation of full benefits in certain cases of medical confinement.
416.214 You are disabled and drug addiction or alcoholism is a contributing factor material to the determination of disability.
416.215You leave the United States.
416.216You are a child of armed forces personnel living overseas.

Eligibility for Increased Benefits Because of Essential Persons

416.220General.
416.221Who is a qualified individual.
416.222Who is an essential person.
416.223What happens if you are a qualified individual.
416.250Experimental, pilot, and demonstration projects in the SSI program.

Special Provisions for People Who Work Despite a Disabling Impairment

416.260General.
416.261What are special SSI cash benefits and when are they payable.
416.262Eligibility requirements for special SSI cash benefits.
416.263No additional application needed.
416.264When does the special SSI eligibility status apply.
416.265Requirements for the special SSI eligibility status.
416.266Continuation of SSI status for Medicaid.
416.267General.
416.268What is done to determine if you must have Medicaid in order to work.
416.269What is done to determine whether your earnings are too low to provide comparable benefits and services you would receive in the absence of those earnings.

Subpart C—Filing of Applications

General Provisions

416.301Introduction.
416.302Definitions.
416.305You must file an application to receive supplemental security income benefits.

Applications

416.310What makes an application a claim for benefits.
416.315Who may sign an application.
416.320Evidence of authority to sign an application for another.
416.325When an application is considered filed.
416.327Pilot program for photographic identification of disability benefit applicants in designated geographic areas.

Effective Filing Period of Application

416.330Filing before the first month you meet the requirements for eligibility.
416.335Filing in or after the month you meet the requirements for eligibility.

Filing Date Based Upon a Written Statement or Oral Inquiry

416.340Use of date of written statement as application filing date.
416.345Use of date of oral inquiry as application filing date.
416.350Treating a title II application as an oral inquiry about SSI benefits.

Deemed Filing Date Based on Misinformation

416.351Deemed filing date in a case of misinformation.

Withdrawal of Application

416.355Withdrawal of an application.
416.360Cancellation of a request to withdraw.

Subpart D—Amount of Benefits

416.401Scope of subpart.
416.405Cost-of-living adjustments in benefits.
416.410Amount of benefits; eligible individual.
416.412Amount of benefits; eligible couple.
416.413Amount of benefits; qualified individual.
416.414Amount of benefits; eligible individual or eligible couple in a medical treatment facility.
416.415Amount of benefits; eligible individual is disabled child under age 18.
416.420Determination of benefits; general.
416.421Determination of benefits; computation of prorated benefits.
416.426Change in status involving an individual; ineligibility occurs.
416.428Eligible individual without an eligible spouse has an essential person in his home.
416.430Eligible individual with eligible spouse; essential person(s) present.
416.432Change in status involving a couple; eligibility continues.
416.435Change in status involving a couple; ineligibility occurs.

Subpart E—Payment of Benefits, Overpayments, and Underpayments

416.501Payment of benefits: General.
416.502Manner of payment.
416.503Minimum monthly benefit amount.
416.520Emergency advance payments.
416.525Reimbursement to States for interim assistance payments.
416.532Method of payment when the essential person resides with more than one eligible person.
416.533Transfer or assignment of benefits.
416.534Garnishment of payments after disbursement.
416.535Underpayments and overpayments.
416.536 Underpayments—defined.
416.537Overpayments—defined.
416.538Amount of underpayment or overpayment.
416.542Underpayments—to whom underpaid amount is payable.
416.543Underpayments—applied to reduce overpayments.
416.544Paying benefits in installments: Drug addiction or alcoholism.
416.545Paying large past-due benefits in installments.
416.546Payment into dedicated accounts of past-due benefits for eligible individuals under age 18 who have a representative payee.
416.550Waiver of adjustment or recovery—when applicable.
416.551Waiver of adjustment or recovery—effect of.
416.552Waiver of adjustment or recovery—without fault.
416.553Waiver of adjustment or recovery—defeat the purpose of the supplemental security income program.
416.554Waiver of adjustment or recovery—against equity and good conscience.
416.555Waiver of adjustment or recovery—impede administration.
416.556Waiver of adjustment or recovery—countable resources in excess of the limits prescribed in § 416.1205 by $50 or less.
416.557Personal conference.
416.558Notice relating to overpayments and underpayments.
416.560Recovery—refund.
416.570Adjustment.
416.57110-percent limitation of recoupment rate—overpayment.
416.572Are title II and title VIII benefits subject to adjustment to recover title XVI overpayments?
416.573How much will we withhold from your title II and title VIII benefits to recover a title XVI overpayment?
416.574Will you receive notice of our intention to apply cross-program recovery?
416.575When will we begin cross-program recovery from your current monthly benefits?
416.580Referral of overpayments to the Department of the Treasury for tax refund offset—General.
416.581Notice to overpaid person.
416.582Review within SSA that an overpayment is past due and legally enforceable.
416.583Findings by SSA.
416.584Review of our records related to the overpayment.
416.585Suspension of offset.
416.586Tax refund insufficient to cover amount of overpayment.
416.590Are there additional methods for recovery of title XVI benefit overpayments?

Subpart F—Representative Payment

416.601Introduction.
416.610When payment will be made to a representative payee.
416.611What happens to your monthly benefits while we are finding a suitable representative payee for you?
416.615Information considered in determining whether to make representative payment.
416.618Advance designation of representative payees.
416.620Information considered in selecting a representative payee.
416.621What is our order of preference in selecting a representative payee for you?
416.622Who may not serve as a representative payee?
416.624How do we investigate a representative payee applicant?
416.625What information must a representative payee report to us?
416.626How do we investigate an appointed representative payee?
416.630How will we notify you when we decide you need a representative payee?
416.635What are the responsibilities of your representative payee?
416.640Use of benefit payments.
416.640aCompensation for qualified organizations serving as representative payees.
416.641Who is liable if your representative payee misuses your benefits?
416.645Conservation and investment of benefit payments.
416.650When will we select a new representative payee for you?
416.655When representative payment will be stopped.
416.660Transfer of accumulated benefit payments.
416.665How does your representative payee account for the use of benefits?

Subpart G—Reports Required

Introduction

416.701Scope of subpart.
416.702Definitions.

Report Provisions

416.704Who must make reports.
416.708What you must report.
416.710What reports must include.
416.712Form of the report.
416.714When reports are due.

Penalty Deductions

416.722Circumstances under which we make a penalty deduction.
416.724Amounts of penalty deductions.
416.726Penalty period: First failure to report.
416.728 Penalty period: Second failure to report.
416.730Penalty period: Three or more failures to report.
416.732No penalty deduction if you have good cause for failure to report timely.

Subpart H—Determination of Age

416.801Evidence as to age—when required.
416.802Type of evidence to be submitted.
416.803Evaluation of evidence.
416.804Certified copy in lieu of original.
416.805When additional evidence may be required.
416.806Expedited adjudication based on documentary evidence of age.

Subpart I—Determining Disability and Blindness

General

416.901Scope of subpart.
416.902Definitions for this subpart.

Determinations

416.903Who makes disability and blindness determinations.
416.903aProgram integrity.
416.903bEvidence from excluded medical sources of evidence.
416.904Decisions by other governmental agencies and nongovernmental entities.

Definition of Disability

416.905Basic definition of disability for adults.
416.906Basic definition of disability for children.
416.907Disability under a State plan.
416.908[Reserved]
416.909How long the impairment must last.
416.910Meaning of substantial gainful activity.
416.911Definition of disabling impairment.

Evidence

416.912Responsibility for evidence.
416.913Categories of evidence.
416.913aEvidence from our Federal or State agency medical or psychological consultants.
416.914When we will purchase existing evidence.
416.915Where and how to submit evidence.
416.916If you fail to submit medical and other evidence.
416.917Consultative examination at our expense.
416.918If 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

416.919The consultative examination.
416.919aWhen we will purchase a consultative examination and how we will use it.
416.919bWhen we will not purchase a consultative examination.

Standards for the Type of Referral and for Report Content

416.919fType of purchased examinations.
416.919gWho we will select to perform a consultative examination.
416.919hYour medical source.
416.919iOther sources for consultative examinations.
416.919jObjections to the medical source designated to perform the consultative examination.
416.919kPurchase of medical examinations, laboratory tests, and other services.
416.919mDiagnostic tests or procedures.
416.919nInforming the medical source of examination scheduling, report content, and signature requirements.
416.919oWhen a properly signed consultative examination report has not been received.
416.919pReviewing reports of consultative examinations.
416.919qConflict of interest.

Authorizing and Monitoring the Referral Process

416.919sAuthorizing and monitoring the consultative examination.

Procedures To Monitor the Consultative Examination

416.919tConsultative examination oversight.

Evaluation of Disability

416.920Evaluation of disability of adults, in general.
416.920aEvaluation of mental impairments.
416.920bHow we consider evidence.
416.920cHow we consider and articulate medical opinions and prior administrative medical findings for claims filed on or after March 27, 2017.
416.921Establishing that you have a medically determinable impairment(s).
416.922What we mean by an impairment(s) that is not severe in an adult.
416.923Multiple impairments.
416.924How we determine disability for children.
416.924aConsiderations in determining disability for children.
416.924bAge as a factor of evaluation in the sequential evaluation process for children.

Medical Considerations

416.925 Listing of Impairments in appendix 1 of subpart P of part 404 of this chapter.
416.926Medical equivalence for adults and children.
416.926aFunctional equivalence for children.
416.927Evaluating opinion evidence for claims filed before March 27, 2017.
416.928[Reserved]
416.929How we evaluate symptoms, including pain.
416.930Need to follow prescribed treatment.

Presumptive Disability and Blindness

416.931The meaning of presumptive disability or presumptive blindness.
416.932When presumptive payments begin and end.
416.933How we make a finding of presumptive disability or presumptive blindness.
416.934Impairments that may warrant a finding of presumptive disability or presumptive blindness.

Drug Addiction and Alcoholism

416.935How we will determine whether your drug addiction or alcoholism is a contributing factor material to the determination of disability.
416.936Treatment required for individuals whose drug addiction or alcoholism is a contributing factor material to the determination of disability.
416.937What we mean by appropriate treatment.
416.938What we mean by approved institutions or facilities.
416.939How we consider whether treatment is available.
416.940Evaluating compliance with the treatment requirements.
416.941Establishment and use of referral and monitoring agencies.

Residual Functional Capacity

416.945Your residual functional capacity.
416.946Responsibility for assessing your residual functional capacity.

Vocational Considerations

416.960When we will consider your vocational background.
416.962Medical-vocational profiles showing an inability to make an adjustment to other work.
416.963Your age as a vocational factor.
416.964Your education as a vocational factor.
416.965Your work experience as a vocational factor.
416.966Work which exists in the national economy.
416.967Physical exertion requirements.
416.968Skill requirements.
416.969Listing of Medical-Vocational Guidelines in appendix 2 of subpart P of part 404 of this chapter.
416.969aExertional and nonexertional limitations.

Substantial Gainful Activity

416.971General.
416.972What we mean by substantial gainful activity.
416.973General information about work activity.
416.974Evaluation guides if you are an employee.
416.974aWhen and how we will average your earnings.
416.975Evaluation guides if you are self-employed.
416.976Impairment-related work expenses.

Blindness

416.981Meaning of blindness as defined in the law.
416.982Blindness under a State plan.
416.983How we evaluate statutory blindness.
416.984If you are statutorily blind and still working.
416.985How we evaluate other visual impairments.
416.986Why and when we will find that you are no longer entitled to benefits based on statutory blindness.

Disability Redeterminations for Individuals Who Attain Age 18

416.987Disability redeterminations for individuals who attain age 18.

Continuing or Stopping Disability or Blindness

416.988Your responsibility to tell us of events that may change your disability or blindness status.
416.989We may conduct a review to find out whether you continue to be disabled.
416.989aWe may conduct a review to find out whether you continue to be blind.
416.990When and how often we will conduct a continuing disability review.
416.991If your medical recovery was expected and you returned to work.
416.992What happens if you fail to comply with our request for information.
416.992a[Reserved]
416.993Medical evidence in continuing disability review cases.
416.994How we will decide whether your disability continues or ends, disabled adults.
416.994aHow we will determine whether your disability continues or ends, and whether you are and have been receiving treatment that is medically necessary and available, disabled children.
416.995 If we make a determination that your physical or mental impairment(s) has ceased, did not exist or is no longer disabling (Medical Cessation Determination).
416.996Continued disability or blindness benefits pending appeal of a medical cessation determination.
416.998If you become disabled by another impairment(s).
416.999What is expedited reinstatement?
416.999aWho is eligible for expedited reinstatement?
416.999bHow do I request reinstatement?
416.999cHow do we determine provisional benefits?
416.999dHow do we determine reinstated benefits?

Subpart J—Determinations of Disability

General Provisions

416.1001Purpose and scope.
416.1002Definitions.
416.1003Basic responsibilities for us and the State.

Responsibilities for Performing the Disability Determination Function

416.1010How a State notifies us that it wishes to perform the disability determination function.
416.1011How we notify a State whether it may perform the disability determination function.
416.1013Disability determinations the State makes.
416.1014Responsibilities for obtaining evidence to make disability determinations.
416.1015Making disability determinations.
416.1016Medical consultants and psychological consultants.
416.1017Reasonable efforts to obtain review by a physician, psychiatrist, and psychologist.
416.1018Notifying claimant of the disability determination.

Quick Disability Determinations

416.1019Quick disability determination process.

Administrative Responsibilities and Requirements

416.1020General administrative requirements.
416.1021Personnel.
416.1022Training.
416.1023Facilities.
416.1024Medical and other purchased services.
416.1025Records and reports.
416.1026Fiscal.
416.1027Audits.
416.1028Property.
416.1029Participation in research and demonstration projects.
416.1030Coordination with other agencies.
416.1031Confidentiality of information and records.
416.1032Other Federal laws and regulations.
416.1033Policies and operating instructions.

Performance Standards

416.1040General.
416.1041Standards of performance.
416.1042Processing time standards.
416.1043Performance accuracy standard.
416.1044How and when we determine whether the processing time standards are met.
416.1045How and when we determine whether the performance accuracy standard is met.
416.1050Action we will take if a State agency does not meet the standards.

Performance Monitoring and Support

416.1060How we will monitor.
416.1061When we will provide performance support.
416.1062What support we will provide.

Substantial Failure

416.1070General.
416.1071Good cause for not following the Act, our regulations, or other written guidelines.
416.1075Finding of substantial failure.

Hearings and Appeals

416.1080Notice of right to hearing on proposed finding of substantial failure.
416.1081Disputes on matters other than substantial failure.
416.1082Who conducts the hearings.
416.1083Hearings and appeals process.

Assumption of Disability Determination Function

416.1090Assumption when we make a finding of substantial failure.
416.1091Assumption when State no longer wishes to perform the disability determination function.
416.1092Protection of State employees.
416.1093Limitation on State expenditures after notice.
416.1094Final accounting by the State.

Subpart K—Income

General

416.1100Income and SSI eligibility.
416.1101Definition of terms.
416.1102What is income?
416.1103What is not income?
416.1104Income we count.

Earned Income

416.1110What is earned income.
416.1111How we count earned income.
416.1112Earned income we do not count.

Unearned Income

416.1120What is unearned income.
416.1121Types of unearned income.
416.1123How we count unearned income.
416.1124Unearned income we do not count.

In-Kind Support and Maintenance

416.1130Introduction.
416.1131The one-third reduction rule.
416.1132What we mean by “living in another person's household”.
416.1133What is a pro rata share of household operating expenses.
416.1140The presumed value rule.
416.1141When the presumed value rule applies.
416.1142If you live in a public assistance household.
416.1143If you live in a noninstitutional care situation.
416.1144If you live in a nonprofit retirement home or similar institution.
416.1145How the presumed value rule applies in a nonmedical for-profit institution.

In-Kind Support and Maintenance in Special Circumstances

416.1147How we value in-kind support and maintenance for a couple.
416.1147aIncome rules in change-of-status situations involving in-kind support and maintenance.
416.1148If you have both in-kind support and maintenance and income that is deemed to you.

Temporary Absence

416.1149What is a temporary absence from your living arrangement.

Disasters

416.1150How we treat income received because of a major disaster.
416.1151How we treat the repair or replacement of lost, damaged, or stolen resources.

Home Energy Assistance

416.1157Support and maintenance assistance.

Deeming of Income

416.1160What is deeming of income?
416.1161Income of an ineligible spouse, ineligible parent, and essential person for deeming purposes.
416.1161aIncome for deeming purposes where Medicaid eligibility is affected.
416.1163How we deem income to you from your ineligible spouse.
416.1165How we deem income to you from your ineligible parent(s).
416.1166How we deem income to you and your eligible child from your ineligible spouse.
416.1166aHow we deem income to you from your sponsor if you are an alien.
416.1167Temporary absences and deeming rules.
416.1168How we deem income to you from your essential person.
416.1169When we stop deeming income from an essential person.

Alternative Income Counting Rules for Certain Blind Individuals

416.1170General.
416.1171When the alternative rules apply.

Rules for Helping Blind and Disabled Individuals Achieve Self-Support

416.1180General.
416.1181What is a plan to achieve self-support (PASS)?
416.1182When we begin to count the income excluded under the plan.
Appendix to Subpart K of Part 416—List of Types of Income Excluded Under the SSI Program as Provided by Federal Laws Other Than the Social Security Act

Subpart L—Resources and Exclusions

416.1201Resources; general.
416.1202Deeming of resources.
416.1203Deeming of resources of an essential person.
416.1204Deeming of resources of the sponsor of an alien.
416.1204aDeeming of resources where Medicaid eligibility is affected.
416.1205Limitation on resources.
416.1207Resources determinations.
416.1208How funds held in financial institution accounts are counted.
416.1210Exclusions from resources; general.
416.1212Exclusion of the home.
416.1216Exclusion of household goods and personal effects.
416.1218Exclusion of the automobile.
416.1220Property essential to self-support; general.
416.1222How income-producing property essential to self-support is counted.
416.1224How nonbusiness property used to produce goods or services essential to self-support is counted.
416.1225An approved plan to achieve self-support; general.
416.1226What is a plan to achieve self-support(PASS)?
416.1227When the resources excluded under a plan to achieve self-support begin to count.
416.1228 Exclusion of Alaskan natives' stock in regional or village corporations.
416.1229Exclusion of payments received as compensation for expenses incurred or losses suffered as a result of a crime.
416.1230Exclusion of life insurance.
416.1231Burial spaces and certain funds set aside for burial expenses.
416.1232Replacement of lost, damaged, or stolen excluded resources.
416.1233Exclusion of certain underpayments from resources.
416.1234Exclusion of Indian lands.
416.1235Exclusion of certain payments related to tax credits.
416.1236Exclusions from resources; provided by other statutes.
416.1237Assistance received on account of major disaster.
416.1238Exclusion of certain housing assistance.
416.1239Exclusion of State or local relocation assistance payments.
416.1240Disposition of resources.
416.1242Time limits for disposing of resources.
416.1244Treatment of proceeds from disposition of resources.
416.1245Exceptions to required disposition of real property.
416.1246Disposal of resources at less than fair market value.
416.1247Exclusion of a dedicated account in a financial institution.
416.1248Exclusion of gifts to children with life-threatening conditions.
416.1249Exclusion of payments received as restitution for misuse of benefits by a representative payee.
416.1250How we count grants, scholarships, fellowships or gifts.
416.1260Special resource provision for recipients under a State plan.
416.1261Application of special resource provision.
416.1262Special resource provision applicable in cases involving essential persons.
416.1264Spouse ineligible under a State plan in December 1973.
416.1266Individual under special resource provision dies after December 1973.

Subpart M—Suspensions and Terminations

416.1320Suspensions; general.
416.1321Suspension for not giving us permission to contact financial institutions.
416.1322Suspension due to failure to comply with request for information.
416.1323Suspension due to excess income.
416.1324Suspension due to excess resources.
416.1325Suspension due to status as a resident of a public institution.
416.1326Suspension for failure to comply with treatment for drug addiction or alcoholism.
416.1327Suspension due to absence from the United States.
416.1329Suspension due to loss of United States residency, United States citizenship, or status as an alien lawfully admitted for permanent residence or otherwise permanently residing in the United States under color of law.
416.1330Suspension due to failure to apply for and obtain other benefits.
416.1331Termination of your disability or blindness payments.
416.1332Termination of benefit for disabled individual: Exception.
416.1333Termination at the request of the recipient.
416.1334Termination due to death of recipient.
416.1335Termination due to continuous suspension.
416.1336Notice of intended action affecting recipient's payment status.
416.1337Exceptions to the continuation of previously established payment level.
416.1338If you are participating in an appropriate program of vocational rehabilitation services, employment services, or other support services.
416.1339Suspension due to flight to avoid criminal prosecution or custody or confinement after conviction, or due to violation of probation or parole.
416.1340Penalty for making false or misleading statements or withholding information.

Subpart N—Determinations, Administrative Review Process, and Reopening of Determinations and Decisions

Introduction, Definitions, and Initial Determinations

416.1400Introduction.
416.1401Definitions.
416.1402Administrative actions that are initial determinations.
416.1403Administrative actions that are not initial determinations.
416.1404Notice of the initial determination.
416.1405Effect of an initial determination.
416.1406Testing modifications to the disability determination procedures.

Reconsideration

416.1407Reconsideration—general.
416.1408Parties to a reconsideration.
416.1409How to request reconsideration.
416.1411Good cause for missing the deadline to request review.
416.1413Reconsideration procedures.
416.1413aReconsiderations of initial determinations on applications.
416.1413bReconsideration procedures for post-eligibility claims.
416.1413cArrangement for conferences.
416.1414Disability hearing—general.
416.1415 Disability hearing—disability hearing officers.
416.1416Disability hearing—procedures.
416.1417Disability hearing—disability hearing officer's reconsidered determination.
416.1418Disability hearing—review of the disability hearing officer's reconsidered determination before it is issued.
416.1419Notice of another person's request for reconsideration.
416.1420Reconsidered determination.
416.1421Effect of a reconsidered determination.
416.1422Notice of a reconsidered determination.

Expedited Appeals Process

416.1423Expedited appeals process—general.
416.1424When the expedited appeals process may be used.
416.1425How to request expedited appeals process.
416.1426Agreement in expedited appeals process.
416.1427Effect of expedited appeals process agreement.
416.1428Expedited appeals process request that does not result in agreement.

Hearing Before an Administrative Law Judge

416.1429Hearing before an administrative law judge-general.
416.1430Availability of a hearing before an administrative law judge.
416.1432Parties to a hearing before an administrative law judge.
416.1433How to request a hearing before an administrative law judge.
416.1435Submitting evidence prior to a hearing before an administrative law judge.
416.1436Time and place for a hearing before an administrative law judge.
416.1437Protecting the safety of the public and our employees in our hearing process.
416.1438Notice of a hearing before an administrative law judge.
416.1439Objections to the issues.
416.1440Disqualification of the administrative law judge.
416.1441Prehearing case review.
416.1442Prehearing proceedings and decisions by attorney advisors.
416.1443Responsibilities of the adjudication officer.

Administrative Law Judge Hearing Procedures

416.1444Administrative law judge hearing procedures—general.
416.1446Issues before an administrative law judge.
416.1448Deciding a case without an oral hearing before an administrative law judge.
416.1449Presenting written statements and oral arguments.
416.1450Presenting evidence at a hearing before an administrative law judge.
416.1451When a record of a hearing before an administrative law judge is made.
416.1452Consolidated hearings before an administrative law judge.
416.1453The decision of an administrative law judge.
416.1455The effect of a hearing decision.
416.1456Removal of a hearing request to the Appeals Council.
416.1457Dismissal of a request for a hearing before an administrative law judge.
416.1458Notice of dismissal of a request for a hearing before an administrative law judge.
416.1459Effect of dismissal of a request for a hearing before an administrative law judge.
416.1460Vacating a dismissal of a request for a hearing before an administrative law judge.
416.1461Prehearing and posthearing conferences.
416.1465[Reserved]

Appeals Council Review

416.1466[Reserved]
416.1467Appeals Council review—general.
416.1468How to request Appeals Council review.
416.1469Appeals Council initiates review.
416.1470Cases the Appeals Council will review.
416.1471Dismissal by Appeals Council.
416.1472Effect of dismissal of request for Appeals Council review.
416.1473Notice of Appeals Council review.
416.1474Obtaining evidence from Appeals Council.
416.1475Filing briefs with the Appeals Council.
416.1476Procedures before the Appeals Council.
416.1477Case remanded by Appeals Council.
416.1479Decision of Appeals Council.
416.1481Effect of Appeals Council's decision or denial of review.
416.1482Extension of time to file action in Federal district court.

Court Remand Cases

416.1483Case remanded by a Federal court.
416.1484Appeals Council review of hearing decision in a case remanded by a Federal court.
416.1485Application of circuit court law.

Reopening and Revising Determinations and Decisions

416.1487Reopening and revising determinations and decisions.
416.1488Conditions for reopening.
416.1489 Good cause for reopening.
416.1491Late completion of timely investigation.
416.1492Notice of revised determination or decision.
416.1493Effect of revised determination or decision.
416.1494Time and place to request further review or a hearing on revised determination or decision.

Payment of Certain Travel Expenses

416.1495Payment of certain travel expenses—general.
416.1496Who may be reimbursed.
416.1498What travel expenses are reimbursable.
416.1499When and how to claim reimbursement.

Subpart O—Representation of Parties

416.1500Introduction.
416.1503Definitions.
416.1505Who may be your representative.
416.1506Notification of options for obtaining attorney representation.
416.1507Appointing a representative.
416.1510Authority of a representative.
416.1513Mandatory use of electronic services.
416.1515Notice or request to a representative.
416.1517Direct payment of fees to eligible non-attorney representatives.
416.1520Fee for a representative's services.
416.1525Request for approval of a fee.
416.1528Proceedings before a State or Federal court.
416.1530Payment of fees.
416.1535[Reserved]
416.1540Rules of conduct and standards of responsibility for representatives.
416.1545Violations of our requirements, rules, or standards.
416.1550Notice of charges against a representative.
416.1555Withdrawing charges against a representative.
416.1565Hearing on charges.
416.1570Decision by hearing officer.
416.1575Requesting review of the hearing officer's decision.
416.1576Assignment of request for review of the hearing officer's decision.
416.1580Appeals Council's review of hearing officer's decision.
416.1585Evidence permitted on review.
416.1590Appeals Council's decision.
416.1595When the Appeals Council will dismiss a request for review.
416.1597Reinstatement after suspension—period of suspension expired.
416.1599Reinstatement after suspension or disqualification—period of suspension not expired.

Subpart P—Residence and Citizenship

416.1600Introduction.
416.1601Definitions and terms used in this subpart.
416.1603How to prove you are a resident of the United States.
416.1610How to prove you are a citizen or a national of the United States.
416.1615How to prove you are lawfully admitted for permanent residence in the United States.
416.1618When you are considered permanently residing in the United States under color of law.
416.1619When you cannot be considered permanently residing in the United States under color of law.

Subpart Q—Referral of Persons Eligible for Supplemental Security Income to Other Agencies

General

416.1701Scope of subpart.
416.1705Definitions.

Referral for Vocational Rehabilitation Services

416.1710Whom we refer and when.

Referral for Treatment of Alcoholism or Drug Addiction

416.1720Whom we refer.
416.1725Effect of your failure to comply with treatment requirements for your drug addiction or alcoholism.

Subpart R—Relationship

416.1801Introduction.

Who Is Considered Your Spouse

416.1802Effects of marriage on eligibility and amount of benefits.
416.1806Whether you are married and who is your spouse.
416.1816Information we need concerning marriage when you apply for SSI.
416.1821Showing that you are married when you apply for SSI.
416.1826Showing that you are not married when you apply for SSI.
416.1830When we stop considering you and your spouse an eligible couple.
416.1832When we consider your marriage ended.
416.1835Information we need about separation or end of marriage after you become eligible for SSI.

Who Is Considered a Child

416.1851Effects of being considered a child.
416.1856Who is considered a child.
416.1861 Deciding whether you are a child: Are you a student?
416.1866Deciding whether you are a child: Are you the head of a household?

Who Is Considered a Student for Purposes of the Student Earned Income Exclusion

416.1870Effect of being considered a student.
416.1872Who is considered a student.
416.1874When we need evidence that you are a student.

Who Is Considered Your Parent

416.1876Effects a parent (or parents) can have on the child's benefits.
416.1881Deciding whether someone is your parent or stepparent.

Subpart S—Interim Assistance Provisions

Introduction

416.1901Scope of subpart S.
416.1902Definitions.

Authorizations

416.1904Authorization to withhold SSI benefits.
416.1906When your authorization is in effect.
416.1908When we need another authorization.

Interim Assistance Agreements

416.1910Requirements for interim assistance agreement.

Appeals

416.1920Your appeal rights in the State.
416.1922Your appeal rights in SSA.

Subpart T—State Supplementation Provisions; Agreement; Payments

416.2001State supplementary payments; general.
416.2005Administration agreements with SSA.
416.2010Essentials of the administration agreements.
416.2015Establishing eligibility.
416.2020Federally administered supplementary payments.
416.2025Optional supplementation: Countable income.
416.2030Optional supplementation: Variations in payments.
416.2035Optional supplementation: Additional State options.
416.2040Limitations on eligibility.
416.2045Overpayments and underpayments; federally administered supplementation.
416.2047Waiver of State supplementary payments.
416.2050Mandatory minimum State supplementation.
416.2055Mandatory minimum supplementation reduced.
416.2060Mandatory minimum supplementary payments not applicable.
416.2065Mandatory minimum State supplementation: Agreement deemed.
416.2070Mandatory supplementation: State compliance not applicable.
416.2075Monitoring of mandatory minimum supplementary payments.
416.2090State funds transferred for supplementary payments.
416.2095Pass-along of Federal benefit increases.
416.2096Basic pass-along rules.
416.2097Combined supplementary/SSI payment levels.
416.2098Supplementary payment levels.
416.2099Compliance with pass-along.

Subpart U—Medicaid Eligibility Determinations

416.2101Introduction.
416.2111Conditions for our agreeing to make Medicaid eligibility determinations.
416.2116Medicaid eligibility determinations.
416.2130Effect of the agreement and responsibilities of States.
416.2140Liability for erroneous Medicaid eligibility determinations.
416.2145Services other than Medicaid determinations.
416.2161Charges to States.
416.2166Changing the agreement.
416.2171Duration of agreement.
416.2176Disagreements between a State and us.

Subpart V—Payments for Vocational Rehabilitation Services

General Provisions

416.2201General.
416.2202Purpose and scope.
416.2203Definitions.
416.2204Participation by State VR agencies.
416.2206[Reserved]

Payment Provisions

416.2208Requirements for payment.
416.2209Responsibility for making payment decisions.
416.2210What we mean by “SGA” and by “a continuous period of 9 months”.
416.2211Criteria for determining when VR services will be considered to have contributed to a continuous period of 9 months.
416.2212Payment for VR services in a case where an individual continues to receive disability or blindness benefits based on participation in an approved VR program.
416.2214 Services for which payment may be made.
416.2215When services must have been provided.
416.2216When claims for payment for VR services must be made (filing deadlines).
416.2217What costs will be paid.

Administrative Provisions

416.2218[Reserved]
416.2219Method of payment.
416.2220Audits.
416.2221Validation reviews.
416.2222Confidentiality of information and records.
416.2223Other Federal laws and regulations.
416.2227Resolution of disputes.