[Federal Register Volume 65, Number 115 (Wednesday, June 14, 2000)]
[Proposed Rules]
[Pages 37321-37322]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 00-14841]


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SOCIAL SECURITY ADMINISTRATION

20 CFR Parts 404 and 416

RIN 0960-AF18


Federal Old-Age, Survivors and Disability Insurance; Supplemental 
Security Income; Determining Disability and Blindness; Revisions to the 
Growth Impairment Listings

AGENCY: Social Security Administration (SSA).

ACTION: Notice of intent to issue regulations and request for comments.

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SUMMARY: This document ask experts on growth impairments in children, 
and other interested members of the public, for comments on how we 
should revise the growth impairment listings in our ``Listing of 
Impairments,'' in appendix 1 to subpart P of 20 CFR part 404 (``the 
listings''). The growth impairment listings contain the medical 
criteria we use to evaluate disability claims for children with linear 
growth impairments at the third step of our sequential evaluation of 
disability for children.

DATES: To be sure your comments are considered, we must receive them no 
later than August 14, 2000.

ADDRESSES: Comments should be submitted in writing to the Commissioner 
of Social Security, P.O. Box 17703, Baltimore, MD 21235-7703, sent by 
telefax to (410) 966-2830; sent by e-mail to <a href="/cdn-cgi/l/email-protection#fd8f989a88919c899492938ebd8e8e9cd39a928b"><span class="__cf_email__" data-cfemail="e99b8c8e9c85889d8086879aa99a9a88c78e869f">[email protected]</span></a>, or 
delivered to the Office of Process and Innovation Management, Social 
Security Administration, L2109 West Low Rise Building, 6401 Security 
Boulevard, Baltimore, MD 21235-6401, between 8:00 A.M. and 4:30 P.M. on 
regular business days. Comments may be inspected during these hours by 
making arrangements with the contact person shown below.

FOR FURTHER INFORMATION CONTACT: Regina Connell, Social Insurance 
Specialist, Office of Disability, 3-A-9 Operations Building, Social 
Security Administration, 6401 Security Boulevard, Baltimore, MD 21235-
6401; (410) 965-1891 or TTY (410) 966-5609 for information about this 
notice. For information on eligibility or claiming benefits, call our 
national toll-free numbers, 1-800-772-1213 or TTY 1-800-325-0778.

SUPPLEMENTARY INFORMATION:

Background

    This notice ask experts on growth impairments in children, and 
other interested members of the public, for comments that will help us 
decide how we should revise section 100.00 of the listings. We use the 
criteria in the listings to evaluate disability claims under both the 
Social Security disability insurance (title II) and Supplemental 
Security Income (SSI) (title XVI) programs at the third step of the 
sequential evaluation processes for adults and children. The listings 
describe impairments that are considered severe enough to prevent a 
person from doing any gainful activity. In the case of a child under 
age 18 seeking SSI benefits based on disability, the listings describe 
impairments that are considered severe enough to cause marked and 
severe functional limitations. For more information on the definitions 
of disability and on the sequential evaluation processes, see 20

[[Page 37322]]

CFR Sec. Sec. 404.1505 and 404.1520 (for title II), 416.905 and 416.920 
(for SSI adults), and 416.906 and 416.924 (for children claiming SSI 
benefits based on disability).
    The listings are divided into Part A and Part B. Part A contains 
medical criteria that we use to evaluate claims filed by individuals 
age 18 and over. The Part A listings can also apply to children if the 
disease processes have a similar effect on adults and younger persons. 
Part B contains medical criteria that apply only to children. In both 
parts, the impairments are grouped by major body systems; e.g., 
musculoskeletal, cardiovascular, and mental. More complete explanations 
of the listings and their role in the disability evaluation process are 
set out in 20 CFR Sec. Sec. 404.1525 and 404.1526 (for title II) and 20 
CFR Sec. Sec. 416.925, 416.926, and 416.926a (for SSI).
    Section 100.00 of the listings is in Part B and contains the 
medical criteria we use to evaluate linear growth impairments in 
children. Section 100.00 consists of a preface that explains key 
concepts used in the section, and two growth impairment listings: 
100.02 and 100.03. Listings 100.02 and 100.03 involve only linear 
growth impairments; i.e., impairments that affect a child's length or 
height. We also refer to the growth impairment listings in other Part B 
body systems listings for cases in which certain specified disease 
processes cause impaired linear growth. For example, in the 
cardiovascular body system, listing 104.06G provides criteria for 
evaluating congenital heart disease that is accompanied by growth 
failure ``as described in 100.00.'' When we revise the current growth 
impairment listings, we may also have to revise the body system 
listings that refer to the growth impairment listings.
    Other listings do not refer to the linear growth impairment 
listings in section 100.00, but include weight-related growth criteria. 
For example, listing 103.02E.6 contains criteria for evaluating 
bronchopulmonary dysplasia that is accompanied by involuntary weight 
loss or failure to gain weight at an appropriate rate for the child's 
age. Several other listings, including listings 104.02D, 105.08, and 
114.08I, also include weight-related growth criteria. If we include 
weight-related criteria in the revised growth impairment listings, we 
may also have to revise those body system listings that now include 
weight-related criteria.
    We first published the Part B childhood listings, including the 
growth impairment listings, in the Federal Register on March 16, 1977 
(42 FR 14705). We made minor changes to the growth impairment listings 
on December 6, 1985 (50 FR 50068). Since 1985, we have extended the 
expiration date for the growth impairment listings without making 
further revisions. Currently, the growth impairment listings will no 
longer be effective on July 2, 2001, unless we extend, revise or 
promulgate them again by publication of a final rule in the Federal 
Register (64 FR 29786). We plan to revise the current growth impairment 
listings before they expire on July 2, 2001.
    We will make revisions to ensure that the criteria in the listings 
reflect any advances in medical knowledge regarding children with 
linear growth impairments, and to ensure that the criteria in the 
listings reflect a level of severity that results in ``marked and 
severe functional limitations.''

Request for Comments

    Information about growth impairments in children, especially the 
functional consequences of such impairments, is not readily available. 
Therefore, we are using this method of requesting comments before 
formally proposing any revisions to the listings. We want to give 
interested members of the public an early opportunity to provide us 
with information about growth impairments in children as we begin the 
rulemaking process. We are asking experts on growth impairments in 
children and other interested members of the public for ideas about how 
we should revise the existing growth impairment listings, including the 
material in the preface. We are particularly interested in determining 
if any scientific research shows a relationship between growth 
impairments and loss of functioning, and whether and how impaired 
linear growth affects a child's functioning.
    In addition, we are interested in comments on whether the criteria 
for evaluating weight-related impaired growth or failure to thrive in 
children should be included in revised growth impairment listings, or 
included in other body system listings as they are now. We are 
interested in any suggestions about revising those portions of the 
other body system listings that directly reference the linear growth 
impairment listings, or that mention a child's growth (including 
weight) without specifying linear growth or the growth impairment 
listings.
    We will consider your comments along with other information, such 
as medical research, and our program experience. Based on all of that 
information, we will decide how to revise the growth impairment 
listings. We will not respond to your comments directly. However, when 
we propose revisions to the growth impairment listings, we will publish 
a Notice of Proposed Rulemaking (NPRM) in the Federal Register and 
include a formal request for comments. In that case, we will consider 
and respond to significant comments that we receive in response to the 
NPRM when we issue any final rules.

Electronic Version

    The electronic file of this document is available on the Internet 
at http://www.access.gpo.gov/su__docs/aces/aces140. It is also 
available on the Internet site for SSA (i.e., SSA Online) at http://www.ssa.gov/.

(Catalog of Federal Domestic Assistance Programs Nos. 96.001, Social 
Security-Disability Insurance; and 96.006, Supplemental Security 
Income)

List of Subjects

20 CFR Part 404

    Administrative practice and procedure. Blind, Old-age, Survivors 
and Disability benefits, Old-age, Survivors and Disability Insurance, 
Reporting and recordkeeping requirements, Social Security.

20 CFR Part 416

    Administrative practice and procedure, Aged, Blind, Disability 
benefits, Public assistance programs, Reporting and recordkeeping 
requirements, Supplemental Security Income (SSI).

    Dated: June 5, 2000.
Kenneth S. Apfel,
Commissioner of Social Security.
[FR Doc. 00-14841 Filed 6-13-00; 8:45 am]
BILLING CODE 4191-02-P


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