Federal Register / Vol. 83, No. 241 / Monday, December 17, 2018 / Proposed Rules 64493 

FR 11034; February 26, 1979); and (3) 

does not warrant preparation of a 

regulatory evaluation as the anticipated 

impact is so minimal. Since this is a 

routine matter that will only affect air 

traffic procedures and air navigation, it 

is certified that this rule, when 

promulgated, would not have a 

significant economic impact on a 

substantial number of small entities 

under the criteria of the Regulatory 

Flexibility Act. 

Environmental Review 

This proposal would be subject to an 

environmental analysis in accordance 

with FAA Order 1050.1F, 

‘‘Environmental Impacts: Policies and 

Procedures’’ prior to any FAA final 

regulatory action. 

List of Subjects in 14 CFR Part 71 

Airspace, Incorporation by reference, 

Navigation (air). 

The Proposed Amendment 

Accordingly, pursuant to the 

authority delegated to me, the Federal 

Aviation Administration proposes to 

amend 14 CFR part 71 as follows: 

PART 71—DESIGNATION OF CLASS A, 

B, C, D, AND E AIRSPACE AREAS; AIR 

TRAFFIC SERVICE ROUTES; AND 

REPORTING POINTS 

■ 1. The authority citation for 14 CFR 

part 71 continues to read as follows: 

Authority: 49 U.S.C. 106(f), 106(g), 40103, 

40113, 40120; E.O. 10854, 24 FR 9565, 3 CFR, 

1959–1963 Comp., p. 389. 

§ 71.1 [Amended] 

■ 2. The incorporation by reference in 

14 CFR 71.1 of FAA Order 7400.11C, 

Airspace Designations and Reporting 

Points, dated August 13, 2018, and 

effective September 15, 2018, is 

amended as follows: 

Paragraph 6005 Class E Airspace Areas 

Extending Upward From 700 Feet or More 

Above the Surface of the Earth. 

* * * * * 

AAL AK E5 Hooper Bay, AK [Amended] 

Hooper Bay Airport, AK 

(Lat. 61°31′26′′ N, long. 166°08′48′′ W) 

That airspace extending upward from 700 

feet above the surface within a 6.3-mile 

radius of Hooper Bay Airport; and that 

airspace extending upward from 1,200 feet 

above the surface within a 45-mile radius of 

Hooper Bay Airport, excluding that airspace 

extending beyond 12 miles from the 

shoreline. 

AAL AK E5 Kaltag, AK [Amended] 

Kaltag Airport, AK 

(Lat. 64°19′08′′ N, long. 158°44′29′′ W) 

That airspace extending upward from 700 

feet above the surface within a 7.6-mile 

radius of Kaltag Airport, and that airspace 

extending upward from 1,200 feet above the 

surface within a 72-mile radius of the Kaltag 

Airport, excluding that airspace extending 

beyond 12 miles from the shoreline. 

AAL AK E5 King Salmon, AK [Amended] 

King Salmon, King Salmon Airport, AK 

(Lat. 58°40′35′′ N, long. 156°38′55′′ W) 

King Salmon VORTAC 

(Lat. 58°43′29′′ N, long. 156°45′08′′ W) 

That airspace extending upward from 700 

feet above the surface within a 6.9-mile 

radius of King Salmon Airport, AK, and 

within 5 miles north and 9 miles south of the 

132° radial of the King Salmon VORTAC, AK, 

extending from the King Salmon VORTAC, 

AK, to 36 miles southeast of the King Salmon 

VORTAC, AK, and within 3.9 miles either 

side of the 312° radial of the King Salmon 

VORTAC, AK, extending from the 6.9-mile 

radius to 13.9 miles northwest of the King 

Salmon VORTAC, AK; and that airspace 

extending upward from 1,200 feet above the 

surface within a 73-mile radius of the King 

Salmon Airport, AK., excluding that airspace 

extending beyond 12 miles of the shoreline. 

AAL AK E5 Kodiak, AK [Amended] 

Kodiak Airport, AK 

(Lat. 57°45′00′′ N, long. 152°29′38′′ W) 

That airspace extending upward from 700 

feet above the surface within an 6.9-mile 

radius of Kodiak Airport, AK, and within 3.1 

miles either side of the 072° bearing from 

Kodiak Airport, AK, extending from the 6.9- 

mile radius from the airport, to 12.2 miles 

east of the airport, and within 1 mile either 

side of the 091° bearing from Kodiak Airport, 

AK, extending from the 6.9-mile radius from 

the airport, to 8.2 miles east of the airport, 

and that airspace extending upward from 

1,200 feet above the surface within a 73-mile 

radius of the Kodiak Airport, AK., excluding 

that airspace extending beyond 12 miles of 

the shoreline. 

AAL AK E5 Manokotak, AK [Amended] 

Manokotak Airport, AK 

(Lat. 58°55′55′′ N, long. 158°54′07′′ W) 

That airspace extending upward from 700 

feet above the surface within a 6.4-mile 

radius of Manokotak Airport, AK; and that 

airspace extending upward from 1,200 feet 

above the surface within a 74-mile radius of 

Manokotak Airport, AK, excluding that 

airspace extending beyond 12 miles of the 

shoreline. 

AAL AK E5 Middleton Island, AK 

[Amended] 

Middleton Island Airport, AK 

(Lat. 59°27′00′′ N, long. 146°18′26′′ W) 

Middleton Island VOR/DME 

(Lat. 59°25′19′′ N, long. 146°21′00′′ W) 

That airspace extending upward from 700 

feet above the surface within a 6.5-mile 

radius of Middleton Island Airport, and 

within 4 miles either side of the 038° radial 

of the Middleton Island VOR/DME extending 

from the 6.5-mile radius to 12 miles northeast 

of the VOR/DME, and that airspace extending 

upward from 1,200 feet above the surface 

within a 42-mile radius of the Middleton 

Island VOR/DME, excluding that airspace 

extending beyond 12 miles of the shoreline. 

Issued in Seattle, Washington, on 

November 30, 2018. 

Shawn M. Kozica, 

Group Manager, Operations Support Group, 

Western Service Center. 

[FR Doc. 2018–26810 Filed 12–14–18; 8:45 am] 

BILLING CODE 4910–13–P 

SOCIAL SECURITY ADMINISTRATION 

20 CFR Parts 404 and 416 

[Docket No. SSA–2018–0017] 

RIN 0960–AI35 

Consideration of Pain in the Disability 

Determination Process 

AGENCY: Social Security Administration. 

ACTION: Advance notice of proposed 

rulemaking (ANPRM). 

SUMMARY: We are soliciting public input 

to ensure that the manner in which we 

consider pain in adult and child 

disability claims under titles II and XVI 

of the Social Security Act (Act) remains 

aligned with contemporary medicine 

and health care delivery practices. 

Specifically, we are requesting public 

comments and supporting data related 

to the consideration of pain and 

documentation of pain in the medical 

evidence we use in connection with 

claims for benefits. We will use the 

responses to the questions below and 

any relevant research and data we 

obtain or receive to determine whether 

and how we should propose revisions to 

our current policy regarding the 

evaluation of pain. 

DATES: To be sure that we consider your 

comments, we must receive them no 

later than February 15, 2019. 

ADDRESSES: You may submit comments 

by any one of three methods—internet, 

fax, or mail. Do not submit the same 

comments multiple times or by more 

than one method. Regardless of which 

method you choose, please state that 

your comments refer to Docket No. 

SSA–2018–0017 so that we may 

associate your comments with this 

ANPRM. 

Caution: You should be careful to 

include in your comments only 

information that you wish to make 

publicly available. We strongly urge you 

not to include in your comments any 

personal information, such as Social 

Security numbers or medical 

information. 

1. Internet: We strongly recommend 

that you submit your comments via the 

internet. Please visit the Federal 

eRulemaking portal at http://

www.regulations.gov. Use the Search 

function to find docket number SSA– 


amozie on DSK3GDR082PROD with PROPOSALS1
64494 Federal Register / Vol. 83, No. 241 / Monday, December 17, 2018 / Proposed Rules 

1 42 U.S.C. 423(d)(1)(A) and 1382c(a)(3)(A); see 

also 20 CFR 404.1505(a) and 416.905(a). 

2 20 CFR 404.1520(a)(4), 416.920(a)(4), and 

416.924. 

3 Id. 

4 Id. 

5 20 CFR 404.1529 and 416.929. 

6 Id. 

7 20 CFR 404.1529(b) and 416.929(b). 

8 20 CFR 404.1529(a), (c) and 416.929(a), (c). 

9 Information regarding the National Disability 

Forum is available on our internet site at: https:// 

www.ssa.gov/ndf/. 

10Pain that ‘‘persist[s] over a long period of 

time.’’ Chronic, Dorland’s Illustrated Medical 

Dictionary (31st ed. 2007). 

11 ‘‘[A] short and relatively severe course’’ of pain. 

Acute, Dorland’s Illustrated Medical Dictionary 

(31st ed. 2007). 

12Pain that pertains to a nociceptor, which is a 

receptor for pain caused by injury to body tissues 

from physical chemical stimuli. Nociceptive, 

Nociceptor, Dorland’s Illustrated Medical 

Dictionary (31stth ed. 2007). 

13Pain that pertains to, or is characterized by, a 

functional disturbance or pathological change in the 

peripheral nervous system. Neuropathic, 

Neuropathy, Dorland’s Illustrated Medical 

Dictionary (31st ed. 2007). 

2018–0017. Once you submit your 

comment, the system will issue a 

tracking number to confirm your 

submission. You will not be able to 

view your comment immediately 

because we must post each comment 

manually. It may take up to a week for 

your comment to be viewable. 

2. Fax: Fax comments to (410) 966– 

2830. 

3. Mail: Address your comments to 

the Office of Regulations and Reports 

Clearance, Social Security 

Administration, 3100 West High Rise 

Building, 6401 Security Boulevard, 

Baltimore, Maryland 21235–6401. 

Comments are available for public 

viewing on the Federal eRulemaking 

portal at http://www.regulations.gov or 

in person, during regular business 

hours, by arranging with the contact 

person identified below. 

FOR FURTHER INFORMATION CONTACT: Dan 

O’Brien, Office of Disability Policy, 

Social Security Administration, 6401 

Security Boulevard, Baltimore, MD 

21235–6401, (410) 597–1632. For 

information on eligibility or filing for 

benefits, call our national toll-free 

number, 1–800–772–1213 or TTY 1– 

800–325–0778, or visit our internet site, 

Social Security Online, at http://

www.socialsecurity.gov. 

SUPPLEMENTARY INFORMATION: 

Background 

The Act defines ‘‘disability’’ for titles 

II and XVI as the inability to engage in 

any substantial gainful activity by 

reason of any medically determinable 

physical or mental impairment which 

can be expected to result in death or 

which has lasted or can be expected to 

last for a continuous period of not less 

than 12 months.1 We use a five-step 

sequential evaluation process to 

determine whether a claimant who files 

an initial claim for benefits is disabled 

under the Act.2 If we can make a 

determination or decision that a 

claimant is disabled or not disabled at 

a step, we do not go on to the next step.3

If we cannot make a determination or 

decision at a step, we continue to the 

next step in the sequential evaluation 

process.4 At various steps of the 

sequential evaluation process, we will 

consider both the medical evidence of 

an impairment and the claimant’s 

descriptions of his or her symptoms, 

including pain.5

Our current regulations prescribe a 

two-stage process for evaluating a 

claimant’s pain.6 At stage one, we 

determine whether there is objective 

medical evidence showing the existence 

of a medically determinable impairment 

that could reasonably be expected to 

produce the pain.7 When the medical 

signs or laboratory findings show that a 

claimant has a medically determinable 

impairment(s) that could reasonably be 

expected to produce the pain, we 

proceed to stage two and evaluate the 

intensity and persistence of a claimant’s 

pain based on all the evidence in the 

record. We consider several factors at 

this second stage, including: 

• The objective medical evidence; 

• the claimant’s medical history, the 

clinical signs and laboratory findings, 

and statements about the pain’s effect 

on the claimant; 

• the claimant’s daily activities; 

• the location, duration, frequency, 

and intensity of the pain; 

• any precipitating or aggravating 

factors; 

• the type, dosage, effectiveness, and 

side effects of medication; 

• any treatments, other than 

medication, the claimant receives or has 

received for relief of pain; 

• any measures the claimant uses or 

has used to relieve pain (e.g., lying flat 

on the back, standing for 15 to 20 

minutes every hour, sleeping on a 

board, etc.); and 

• any other factors concerning 

functional limitations and restrictions 

due to pain.8

What is the purpose of this ANPRM? 

We are soliciting public comments 

about our rules for evaluating the 

intensity and persistence of pain and 

documentation of pain in the medical 

evidence as part of the disability 

determination process. In addition to 

seeking public input on the specific 

questions below, we are also asking for 

public input to help identify research 

and data that will help us ensure our 

policy on the evaluation of pain remains 

aligned with contemporary medicine 

and health care delivery practices. We 

will use the responses to the questions 

below and any relevant research and 

data we obtain or receive to determine 

whether and how we should propose 

revisions to our current policy regarding 

the evaluation of pain. 

What will we consider when we decide 

whether to propose revisions to our 

rules? 

We will consider the public 

comments and any research or data 

identified in response to this 

solicitation. We will also consider any 

information we obtain through research 

or other activities intended to inform 

our policy decisions in this area, such 

as the National Disability Forum.9

What should you comment about? 

When we evaluate the intensity and 

persistence of a claimant’s pain, we 

consider all of the available evidence, 

including the types of evidence 

discussed above. We are soliciting 

public input, research, and data about 

the following: 

1. Are there changes that we should 

consider about how we consider pain in 

the disability evaluation process? If so, 

what changes do you suggest we make? 

Please provide data, research, or any 

other evidence supporting your 

suggestions where applicable. 

2. Within the United States, which 

standard scales, questionnaires, or other 

methods to evaluate the intensity and 

persistence of pain that are commonly 

accepted in the medical community do 

you recommend we consider and why? 

What information exists about the 

efficacy or accuracy of those scales, 

questionnaires, or other methods? 

3. How is pain and documentation of 

pain in the medical evidence assessed 

in other Federal, State, and private 

disability programs? 

4. Should we evaluate chronic 10 pain 

differently than acute 11 pain? If so, why 

and how? 

5. Should we evaluate nociceptive 12

pain differently than neuropathic 13

pain? If so, why and how? Please submit 

research or data that support your 

recommendation. 

6. What information and evidence is 

available on the effectiveness and side 

effects of the traditional and alternative 


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Federal Register / Vol. 83, No. 241 / Monday, December 17, 2018 / Proposed Rules 64495 

modalities for treating pain that we 

should consider? 

7. Can health care utilization and 

treatment regimens employed by 

physicians to manage patient pain 

provide objective insights into the 

intensity and persistence of pain? When 

should those regimens not be an 

indication of the severity of an 

individual’s pain? 

8. Is there any additional information 

that we should consider when we 

evaluate pain in our disability program? 

Will we respond to your comments? 

We will consider all relevant public 

comments we receive in response to this 

notice, but we will not respond directly 

to them. If we decide to propose specific 

revisions to our rules, we will publish 

a notice of proposed rulemaking in the 

Federal Register, and you will have a 

chance to comment on any revisions we 

propose. 

List of Subjects 

20 CFR Part 404 

Administrative practice and 

procedure, Blind, Disability benefits, 

Old-age, Survivors and Disability 

Insurance, Reporting and recordkeeping 

requirements, Social Security. 

List of Subjects in 20 CFR Part 416 

Administrative practice and 

procedure, Blind, Disability benefits, 

Supplemental Security Income, 

Reporting and recordkeeping 

requirements, Social Security. 

Nancy A. Berryhill, 

Acting Commissioner of Social Security. 

[FR Doc. 2018–27169 Filed 12–14–18; 8:45 am] 

BILLING CODE 4191–02–P 

DEPARTMENT OF THE TREASURY 

Alcohol and Tobacco Tax and Trade 

Bureau 

27 CFR Part 9 

[Docket No. TTB–2018–0008; Notice No. 

177] 

RIN 1513–AC40 

Proposed Establishment of the West 

Sonoma Coast Viticultural Area 

Correction 

In proposed rule document C1–2018– 

26321 appearing on page 63824 in the 

issue of Wednesday, December 12, 2018, 

make the following corrections: 

1. On page 63824, in the third 

column, the fourth line from the bottom 

of the page ‘‘January 7, 2018’’ should 

read ‘‘January 7, 2019.’’ 

2. On page 63824, in the third 

column, the third line from the bottom 

of the page ‘‘February 4, 2018’’ should 

read ‘‘February 4, 2019.’’ 

[FR Doc. C2–2018–26321 Filed 12–14–18; 8:45 am] 

BILLING CODE 1301–00–D 

ENVIRONMENTAL PROTECTION 

AGENCY 

40 CFR Part 52 

[EPA–R01–OAR–2018–0790; FRL–9987–51- 

Region 1] 

Air Plan Approval; Massachusetts; 

High Occupancy Vehicle Lanes 

AGENCY: Environmental Protection 

Agency (EPA). 

ACTION: Proposed rule. 

SUMMARY: The Environmental Protection 

Agency (EPA) is proposing to approve a 

State Implementation Plan (SIP) 

revision submitted by the 

Commonwealth of Massachusetts. This 

revision provides for the Massachusetts 

Department of Transportation 

(MassDOT) to construct and operate 

specified transit facilities and high 

occupancy vehicle (HOV) lanes 

established therein. Implementation and 

continued monitoring of these projects 

will help reduce the use of automobiles 

and improve traffic operations on the 

region’s roadways, resulting in 

improved air quality. This action will 

have a beneficial effect on air quality 

because it is intended to reduce vehicle 

miles traveled (VMT) and traffic 

congestion in the Boston Metropolitan 

Area. Massachusetts has adopted these 

revisions to reduce emissions of volatile 

organic compounds (VOC), particulate 

matter (PM), and nitrogen oxides (NOX). 

This action is being taken under the 

Clean Air Act. 

DATES: Written comments must be 

received on or before January 16, 2019. 

ADDRESSES: Submit your comments, 

identified by Docket ID No. EPA–R01– 

OAR–2018–0790 at https://

www.regulations.gov, or via email to 

rackauskas.eric@epa.gov. For comments 

submitted at Regulations.gov, follow the 

online instructions for submitting 

comments. Once submitted, comments 

cannot be edited or removed from 

Regulations.gov. For either manner of 

submission, the EPA may publish any 

comment received to its public docket. 

Do not submit electronically any 

information you consider to be 

Confidential Business Information (CBI) 

or other information whose disclosure is 

restricted by statute. Multimedia 

submissions (audio, video, etc.) must be 

accompanied by a written comment. 

The written comment is considered the 

official comment and should include 

discussion of all points you wish to 

make. The EPA will generally not 

consider comments or comment 

contents located outside of the primary 

submission (i.e. on the web, cloud, or 

other file sharing system). For 

additional submission methods, please 

contact the person identified in the FOR

FURTHER INFORMATION CONTACT section. 

For the full EPA public comment policy, 

information about CBI or multimedia 

submissions, and general guidance on 

making effective comments, please visit 

https://www.epa.gov/dockets/ 

commenting-epa-dockets. Publicly 

available docket materials are available 

at https://www.regulations.gov or at the 

U.S. Environmental Protection Agency, 

EPA New England Regional Office, 

Office of Ecosystem Protection, Air 

Quality Planning Unit, 5 Post Office 

Square, Suite 100, Boston, MA. EPA 

requests that if at all possible, you 

contact the contact listed in the FOR

FURTHER INFORMATION CONTACT section to 

schedule your inspection. The Regional 

Office’s official hours of business are 

Monday through Friday, 8:30 a.m. to 

4:30 p.m., excluding legal holidays. 

FOR FURTHER INFORMATION CONTACT: Eric 

Rackauskas, Air Quality Planning Unit, 

U.S. Environmental Protection Agency, 

EPA New England Regional Office, 5 

Post Office Square, Suite 100 (mail 

code: OEP05–2), Boston, MA 02109– 

3912, telephone number (617) 918– 

1628, fax number (617) 918–0628, email 

rackauskas.eric@epa.gov. 

SUPPLEMENTARY INFORMATION: 

Throughout this document whenever 

‘‘we,’’ ‘‘us,’’ or ‘‘our’’ is used, we mean 

EPA. 

Table of Contents 

I. Background and Purpose 

II. Administrative Changes 

III. Summary of Changes to the Amended 

High Occupancy Vehicle Lanes 

Regulation 

IV. Proposed Action 

V. Incorporation by Reference 

VI. Statutory and Executive Order Reviews 

I. Background and Purpose 

On July 9, 1996, the Massachusetts 

Department of Environmental Protection 

(MassDEP) submitted a revision to the 

Massachusetts State Implementation 

Plan (SIP) consisting of amendments to 

310 CMR 7.37: High Occupancy Vehicle 

Lanes. The submitted amended 310 

CMR 7.37 contains added definitions, 

revised due dates for certain 

requirements, minor technical 

amendments, and clarifying language. 

This regulation is designed to help 


amozie on DSK3GDR082PROD with PROPOSALS1