State agencies
Determinations by Commissioner
Review of determination by Commissioner
Hearings and judicial review
section 405(b) of this titlesection 405(g) of this titleAny individual dissatisfied with any determination under subsection (a), (b), (c), or (g) shall be entitled to a hearing thereon by the Commissioner of Social Security to the same extent as is provided in with respect to decisions of the Commissioner of Social Security, and to judicial review of the Commissioner’s final decision after such hearing as is provided in .
State’s right to cost from Trust Funds
section 401 of this titlesection 423 of this titleEach State which is making disability determinations under subsection (a)(1) shall be entitled to receive from the Trust Funds, in advance or by way of reimbursement, as determined by the Commissioner of Social Security, the cost to the State of making disability determinations under subsection (a)(1). The Commissioner of Social Security shall from time to time certify such amount as is necessary for this purpose to the Managing Trustee, reduced or increased, as the case may be, by any sum (for which adjustment hereunder has not previously been made) by which the amount certified for any prior period was greater or less than the amount which should have been paid to the State under this subsection for such period; and the Managing Trustee, prior to audit or settlement by the Government Accountability Office, shall make payment from the Trust Funds at the time or times fixed by the Commissioner of Social Security, in accordance with such certification. Appropriate adjustments between the Federal Old-Age and Survivors Insurance Trust Fund and the Federal Disability Insurance Trust Fund with respect to the payments made under this subsection shall be made in accordance with paragraph (1) of subsection (g) of (but taking into account any refunds under subsection (f) of this section) to insure that the Federal Disability Insurance Trust Fund is charged with all expenses incurred which are attributable to the administration of and the Federal Old-Age and Survivors Insurance Trust Fund is charged with all other expenses.
Use of funds
All money paid to a State under this section shall be used solely for the purposes for which it is paid; and any money so paid which is not used for such purposes shall be returned to the Treasury of the United States for deposit in the Trust Funds.
Regulations governing determinations in certain cases
In the case of individuals in a State which does not undertake to perform disability determinations under subsection (a)(1), or which has been found by the Commissioner of Social Security to have substantially failed to make disability determinations in a manner consistent with the Commissioner’s regulations and guidelines, in the case of individuals outside the United States, and in the case of any class or classes of individuals for whom no State undertakes to make disability determinations, the determinations referred to in subsection (a) shall be made by the Commissioner of Social Security in accordance with regulations prescribed by the Commissioner.
Evaluation of impairments by qualified medical professionals
Review of disability cases to determine continuing eligibility; permanent disability cases; appropriate number of cases reviewed; reporting requirements
Rules and regulations; consultative examinations
Establishment of uniform standards for determination of disability
Special notice to blind individuals with respect to hearings and other official actions
Work activity as basis for review
Aug. 14, 1935, ch. 531Sept. 1, 1954, ch. 120668 Stat. 1081Aug. 1, 1956, ch. 83670 Stat. 818Pub. L. 90–248, title I, § 158(c)(3)81 Stat. 869Pub. L. 96–265, title III94 Stat. 453–456Pub. L. 97–45596 Stat. 2499Pub. L. 98–369, div. B, title VI, § 2663(a)(14)98 Stat. 1164Pub. L. 98–46098 Stat. 1802Pub. L. 99–514, title XVIII, § 1883(a)(9)100 Stat. 2916Pub. L. 100–647, title VIII, § 8012(a)102 Stat. 3789Pub. L. 101–239, title X, § 10306(a)(1)103 Stat. 2484Pub. L. 101–508, title V, § 5128(a)104 Stat. 1388–286Pub. L. 103–296, title I, § 107(a)(4)108 Stat. 1478Pub. L. 106–170, title I113 Stat. 1873Pub. L. 108–271, § 8(b)118 Stat. 814Pub. L. 114–74, title VIII, § 832(a)129 Stat. 613(, title II, § 221, as added , title I, § 106(g), ; amended , title I, § 103(c)(7), (8), (h), , 823; , (4), , ; , §§ 304(a)–(f), 311(a), , , 460; , §§ 3(a), 6, , , 2500; , , ; , §§ 6(a), 8(a), 9(a)(1), 10(a), 17(a), , , 1804, 1805, 1811; , , ; , , ; , , ; , , ; , , ; , §§ 101(b)(1)(A), 111(a), , , 1881; , , ; , , .)
Editorial Notes
Prior Provisions
act Aug. 14, 1935, ch. 531, title II, § 221July 18, 1952, ch. 945, § 3(e)66 Stat. 77267 Stat. 631section 413 of this titleA prior section 421, , as added , ; amended by 1953 Reorg. Plan No. 1, § 5, eff. , 18 F.R. 2053, , relating to disability determinations, ceased to be in effect at the close of . See section 3(g) of act , set out as an Effective and Termination Date of 1952 Amendment note under .
Amendments
Pub. L. 114–742015—Subsec. (h). amended subsec. (h) generally. Prior to amendment, text read as follows: “An initial determination under subsection (a), (c), (g), or (i) that an individual is not under a disability, in any case where there is evidence which indicates the existence of a mental impairment, shall be made only if the Commissioner of Social Security has made every reasonable effort to ensure that a qualified psychiatrist or psychologist has completed the medical portion of the case review and any applicable residual functional capacity assessment.”
Pub. L. 108–2712004—Subsec. (e). substituted “Government Accountability Office” for “General Accounting Office”.
Pub. L. 106–170, § 101(b)(1)(A)1999—Subsec. (i)(5). , added par. (5).
Pub. L. 106–170, § 111(a)Subsec. (m). , added subsec. (m).
Pub. L. 103–2961994— substituted “Commissioner of Social Security” for “Secretary” wherever appearing except where appearing before “of Labor” in subsec. (b)(3)(B) and substituted “the Commissioner deems” for “he deems” and “the Commissioner finds” for “he finds” in subsec. (a)(2), “the Commissioner’s” for “his” wherever appearing in subsecs. (b)(1), (c)(1), and (g), “the Commissioner has complied” for “he has complied” in subsec. (b)(1), “Commissioner’s” for “Secretary’s” in subsec. (d), and “prescribed by the Commissioner” for “prescribed by him” in subsec. (g).
Pub. L. 101–5081990—Subsec. (c)(3). amended par. (3) generally. Prior to amendment, par. (3) read as follows: “In carrying out the provisions of paragraph (2) with respect to the review of determinations, made by State agencies pursuant to this section, that individuals are under disabilities (as defined in section 416(i) or 423(d) of this title), the Secretary shall review—
“(A) at least 15 percent of all such determinations made by State agencies in the fiscal year 1981,
“(B) at least 35 percent of all such determinations made by State agencies in the fiscal year 1982, and
“(C) at least 65 percent of all such determinations made by State agencies in any fiscal year after the fiscal year 1982.”
lPub. L. 101–239l1989—Subsec. (). added subsec. ().
Pub. L. 100–6471988—Subsec. (i)(3). substituted “semiannually” for “annually”.
Pub. L. 99–5141986—Subsec. (e). struck out “under this section” before “shall be entitled”.
Pub. L. 98–460, § 17(a)(2)1984—Subsec. (a)(1)(A). , (b), temporarily substituted “subsection (b)(1)(C)” for “subsection (b)(1)”. See Effective and Termination Dates of 1984 Amendments note below.
Pub. L. 98–460, § 17(a)(1)Subsec. (b)(1). , (b), temporarily amended par. (1) generally. Prior to amendment, par. (1) read as follows: “If the Secretary finds, after notice and opportunity for a hearing, that a State agency is substantially failing to make disability determinations in a manner consistent with his regulations and other written guidelines, the Secretary shall, not earlier than 180 days following his finding, and after he has complied with the requirements of paragraph (3), make the disability determinations referred to in subsection (a)(1).” See Effective and Termination Dates of 1984 Amendments note below.
Pub. L. 98–460, § 17(a)(3)Subsec. (b)(3). , (b), temporarily substituted “Except as provided in subparagraph (D)(i) of paragraph (1), the Secretary” for “The Secretary” in subpars. (A) and (B). See Effective and Termination Dates of 1984 Amendments note below.
Pub. L. 98–460, § 17(a)(4)Subsec. (d). , (b), temporarily substituted “Except as provided in subsection (b)(1)(D), any individual” for “Any individual”. See Effective and Termination Dates of 1984 Amendments note below.
Pub. L. 98–369Subsec. (e). substituted “Federal Disability Insurance Trust Fund is charged” for “Federal Disability Trust Fund is charged”.
Pub. L. 98–460, § 8(a)Subsec. (h). , added subsec. (h).
Pub. L. 98–460, § 6(a)Subsec. (i)(4). , added par. (4).
Pub. L. 98–460, § 9(a)(1)Subsec. (j). , added subsec. (j).
Pub. L. 98–460, § 10(a)Subsec. (k). , added subsec. (k).
Pub. L. 97–4551983—Subsec. (i). designated existing provisions as par. (1), inserted “, subject to paragraph (2)” after “at least once every 3 years”, and added pars. (2) and (3).
Pub. L. 96–265, § 304(a)1980—Subsec. (a). , completely revised provisions under which determinations are to be made by State agencies.
Pub. L. 96–265, § 304(b)Subsec. (b). , substituted provisions covering the making of disability determinations by the Secretary rather than by the State for provisions relating to agreements between the Secretary and the State under which the State would make disability determinations.
Pub. L. 96–265, § 304(c)Subsec. (c). , designated existing provisions as par. (1), inserted provision that a review by the Secretary on his own motion of a State agency determination may be made before or after any action is taken to implement that determination, and added pars. (2) and (3).
Pub. L. 96–265, § 304(d)Subsec. (d). , substituted “subsection (a), (b), (c), or (g)” for “subsection (a), (c), or (g)”.
Pub. L. 96–265, § 304(e)Subsec. (e). , substituted “which is making disability determinations under subsection (a)(1)” for “which has an agreement with the Secretary”, substituted “as determined by the Secretary” for “as may be mutually agreed upon”, and substituted “making disability determinations under subsection (a)(1)” for “carrying out the agreement under this section”.
Pub. L. 96–265, § 304(f)Subsec. (g). , substituted “does not undertake to perform disability determinations under subsection (a)(1), or which has been found by the Secretary to have substantially failed to make disability determinations in a manner consistent with his regulations and guidelines” for “has no agreement under subsection (b)” and “for whom no State undertakes to make disability determinations” for “not included in an agreement under subsection (b)”.
Pub. L. 96–265, § 311(a)Subsec. (i). , added subsec. (i).
Pub. L. 90–248, § 158(c)(3)1968—Subsec. (a). , substituted in first sentence reference to “423(d)” for “423(c)”.
Pub. L. 90–248, § 158(c)(4)Subsec. (c). , substituted reference to “423(d)” for “423(c)”.
section 423(c) of this title1956—Subsec. (a). Act , § 103(c)(7), inserted reference to .
Subsec. (c). Act , § 103(c)(8), restricted disability to definition of such term contained in section 416(i) or 423(c) of this title.
Subsec. (e). Act , § 103(h), substituted “Trust Funds” for “Trust Fund”, and provided for adjustments between the Federal Old-Age and Survivors Insurance Trust Fund and the Federal Disability Insurance Trust Fund with respect to payments made under this subsection.
Subsec. (f). Act , § 103(h), substituted “Trust Funds” for “Trust Fund”.
Statutory Notes and Related Subsidiaries
Effective Date of 2015 Amendment
Pub. L. 114–74, title VIII, § 832(b)129 Stat. 613
Effective Date of 1999 Amendment
section 101(b)(1)(A) of Pub. L. 106–170section 101(d) of Pub. L. 106–170section 101(c) of Pub. L. 106–170section 1320b–19 of this titleAmendment by effective with the first month following one year after , subject to , see , set out as an Effective Date note under .
Pub. L. 106–170, title I, § 111(b)113 Stat. 1881
Effective Date of 1994 Amendment
Pub. L. 103–296section 110(a) of Pub. L. 103–296section 401 of this titleAmendment by effective , see , set out as a note under .
Effective Date of 1990 Amendment
Pub. L. 101–508, title V, § 5128(b)104 Stat. 1388–287
Effective Date of 1989 Amendment
Pub. L. 101–239, title X, § 10306(a)(3)103 Stat. 2484
Effective Date of 1988 Amendment
Pub. L. 100–647, title VIII, § 8012(b)102 Stat. 3789
Effective and Termination Dates of 1984 Amendment
Pub. L. 98–460, § 8(c)98 Stat. 1804
Pub. L. 98–460, § 17(b)98 Stat. 1812
Pub. L. 98–369section 2664(b) of Pub. L. 98–369section 401 of this titleAmendment by effective , but not to be construed as changing or affecting any right, liability, status, or interpretation which existed (under the provisions of law involved) before that date, see , set out as a note under .
Effective Date of 1983 Amendment
Pub. L. 97–455, § 3(b)96 Stat. 2499
Effective Date of 1980 Amendment
Pub. L. 96–265, title III, § 304(h)94 Stat. 456
Pub. L. 96–265, title III, § 311(b)94 Stat. 460
Effective Date of 1968 Amendment
Pub. L. 90–248section 423 of this titlesection 416(i) of this titlesection 158(e) of Pub. L. 90–248section 423 of this titleAmendment by applicable with respect to application for disability insurance benefits under and to disability determinations under , see , set out as a note under .
Expansion of Cooperative Disability Investigations Units
Pub. L. 114–74, title VIII, § 811129 Stat. 601
In General .—
Report .—
Report on Work-Related Continuing Disability Reviews
Pub. L. 114–74, title VIII, § 845(b)129 Stat. 618
“The Commissioner of Social Security shall annually submit to the Committee on Ways and Means of the House of Representatives and the Committee on Finance of the Senate a report on the number of work-related continuing disability reviews conducted each year to determine whether earnings derived from services demonstrate an individual’s ability to engage in substantial gainful activity. Such report shall include—
lElection Under Subsection ()(1) by Current Recipients
Pub. L. 101–239, title X, § 10306(a)(2)103 Stat. 2484
Moratorium on Mental Impairment Reviews
Pub. L. 98–460, § 598 Stat. 1801
Institution of Notification System
Pub. L. 98–460, § 6(c)98 Stat. 1802
Demonstration Projects; Opportunity for Personal Appearance Prior to Disability Determinations; Report to Congressional Committees
Pub. L. 98–460, § 6(d)98 Stat. 180242 U.S.C. 421(i)42 U.S.C. 421(a)42 U.S.C. 138142 U.S.C. 405(b)(2), (e), , , 1803, required the Secretary of Health and Human Services, as soon as practicable after , to implement demonstration projects in at least five States in which the opportunity for a personal appearance prior to a determination of ineligibility for disability benefits under or prior to initial disability determinations under , (c), (g) and title XVI of the Social Security Act ( et seq.) was substituted for the face to face evidentiary hearing required by , and to report to the appropriate committees of Congress by .
Promulgation of Regulations
Pub. L. 98–460, § 9(a)(2)98 Stat. 1805
Frequency of Continuing Eligibility Reviews
Pub. L. 98–460, § 1598 Stat. 1808
Travel Expenses for Medical Examinations, Reconsideration Interviews, and Proceedings Before Administrative Law Judges
Provisions authorizing payment of travel expenses either on an actual cost or commuted basis, to an individual for travel incident to medical examinations, and to parties, their representatives and all reasonably necessary witnesses for travel within the United States, Puerto Rico, and the Virgin Islands, to reconsider interviews and to proceedings before administrative law judges under subchapters II, XVI, and XVIII of this chapter were contained in the following appropriation acts:
Pub. L. 95–480, title II92 Stat. 1582, , .
Pub. L. 94–439, title II90 Stat. 1432, , .
Pub. L. 94–206, title II90 Stat. 17, , .
Pub. L. 93–517, title II88 Stat. 1645, , .
Pub. L. 93–192, title II87 Stat. 759, , .
Pub. L. 92–80, title II85 Stat. 296, , .
Pub. L. 91–667, title II84 Stat. 2013, , .
Pub. L. 91–204, title II84 Stat. 41, , .
Pub. L. 90–557, title II82 Stat. 988, , .
Pub. L. 90–132, title II81 Stat. 402, , .
Pub. L. 89–787, title II80 Stat. 1395, , .
Pub. L. 89–156, title II79 Stat. 604, , .
Pub. L. 88–605, title II78 Stat. 974, , .
Pub. L. 88–136, title II77 Stat. 239, , .
Pub. L. 87–582, title II76 Stat. 375, , .
Pub. L. 87–290, title II75 Stat. 604, , .
Pub. L. 86–703, title II74 Stat. 769, , .
Pub. L. 86–158, title II73 Stat. 352, , .
Pub. L. 85–580, title II72 Stat. 471, , .
Pub. L. 85–67, title II71 Stat. 221, , .
June 29, 1956, ch. 47770 Stat. 434, title II, .
Aug. 1, 1955, ch. 43769 Stat. 408, title II, .
Review of Decisions Rendered by Administrative Law Judges as Result of Disability Hearings; Report to Congress
Pub. L. 96–265, title III, § 304(g)94 Stat. 456, , , required the Secretary of Health and Human Services to implement a program of reviewing decisions rendered by administrative law judges based on hearings under subsec. (d) of this section and to report to Congress by , on its progress.
Assumption by Secretary of Functions and Operations of State Disability Determination Units
Pub. L. 96–265, title III, § 304(i)94 Stat. 45742 U.S.C. 421(b)(3), , , directed Secretary of Health and Human Services to submit to Congress by , a detailed plan on how he intended to assume functions and operations of a State disability determination unit when this became necessary under amendments made by this section [amending this section], and how he intended to meet requirements of section 221(b)(3) of Social Security Act []. Such plan was to assume the uninterrupted operation of disability determination function and utilization of best qualified personnel to carry out such function, and was to include recommendations for any amendment of Federal law or regulation required to carry out such plan.