I

103D CONGRESS

1ST SESSION H. R. 2895

To amend the Social Security Act to provide for timely review of disability

claims and to provide for presumed disability in cases of delayed disposition of such claims.

IN THE HOUSE OF REPRESENTATIVES

AUGUST 5, 1993

Mr. NEAL of North Carolina introduced the following bill; which was referred

to the Committee on Ways and Means

A BILL

To amend the Social Security Act to provide for timely

review of disability claims and to provide for presumed

disability in cases of delayed disposition of such claims.

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled,

3 SECTION 1. SHORT TITLE.

4 This Act may be cited as the ‘‘Social Security Disabil5 ity Review Standards Act of 1993’’.

6 SEC. 2. REQUIREMENT OF FACE-TO-FACE MEETING IN DIS7 ABILITY DETERMINATIONS.

8 Section 221(h) of the Social Security Act (42 U.S.C.

9 421(h)) is amended—
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1 (1) by redesignating such subsection as sub2 section (h)(2); and

3 (2) by adding at the beginning of such sub4 section the following new paragraph:

5 ‘‘(h)(1) Any initial determination under subsection

6 (a) or (g) that an individual applying for benefits under

7 this title is not under a disability shall be made only after

8 such individual has been provided a reasonable oppor9 tunity for a face-to-face meeting with a disability examiner

10 who is authorized under this section to make disability de11 terminations pursuant to such individual’s application.’’.

12 SEC. 3. STANDARDS FOR TIMELY REVIEW OF DISABILITY

13 CLAIMS.

14 Section 221(k) of the Social Security Act (42 U.S.C.

15 421(k)) is amended by adding at the end the following

16 new paragraph:

17 ‘‘(3) The Secretary shall take such actions as are nec18 essary to ensure that, to the maximum extent prac19 ticable—

20 ‘‘(A) an initial determination of whether an in21 dividual who has applied for disability insurance

22 benefits under section 223 or benefits under section

23 202 based on such individual’s disability is under a

24 disability shall be made not later than 30 days after

25 the date on which such application is filed,
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1 ‘‘(B) in any case in which, pursuant to the ap2 plication, an initial determination is made that the

3 individual is not under a disability and the individual

4 does not fail to timely request reconsideration of

5 such determination, a determination on reconsider6 ation of whether the individual is under a disability

7 shall be made not later than 90 days after the date

8 on which such application is filed, and

9 ‘‘(C) in any case in which, on reconsideration,

10 a determination is made that the individual is not

11 under a disability and the individual does not fail to

12 timely request a hearing under subsection (d) on

13 such determination, a determination of whether the

14 individual is under a disability shall be made pursu15 ant to such a hearing not later than 150 days after

16 the date on which such application is filed.’’.

17 SEC. 4. PRESUMED DISABILITY IN ABSENCE OF TIMELY

18 DISABILITY DETERMINATIONS.

19 (a) PRESUMED DISABILITY UNDER TITLE II OF THE

20 SOCIAL SECURITY ACT.—Section 221 of the Social Secu21 rity Act (42 U.S.C. 421) is amended by adding at the end

22 the following new subsection:

23 ‘‘Presumptive Disability

24 ‘‘(m)(1) In any case in which—
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1 ‘‘(A) an individual applying for benefits under

2 section 223 or benefits based on such individual’s

3 disability under section 202 meets the requirements

4 for entitlement to such benefits other than the re5 quirement that the individual be under a disability,

6 ‘‘(B) as of 150 days after the date on which the

7 individual filed the application for such benefits, a

8 final determination of whether the individual is

9 under a disability has not been made, and

10 ‘‘(C) the individual has in a timely manner

11 taken such actions as are necessary to preserve such

12 individual’s rights to administrative review under

13 this title,

14 such individual shall be presumed to be under a disability

15 for each month during the period of months beginning

16 with the first month after the expiration of such 150-day

17 period and ending with the month in which action is taken

18 to implement a final determination of whether the individ19 ual is under a disability.

20 ‘‘(2) Any benefits paid to an individual under this

21 title on the basis of presumed disability under this sub22 section for months during the period of months described

23 in paragraph (1), and benefits paid to another person

24 under this title for such months on the basis of such pre25 sumed disability, shall in no event be considered overpay-
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1 ments for purposes of section 204 solely because such indi2 vidual is determined not to be under a disability.’’.

3 (b) PRESUMED BLINDNESS OR DISABILITY UNDER

4 TITLE XVI OF THE SOCIAL SECURITY ACT.—Section

5 1631(a) of such Act (42 U.S.C. 1383(a)) is amended by

6 adding at the end the following new paragraph:

7 ‘‘(10)(A) In any case in which—

8 ‘‘(i) an individual applying for benefits under

9 this title meets the requirements for entitlement to

10 such benefits other than the requirement that the in11 dividual be blind or disabled,

12 ‘‘(ii) as of 150 days after the date on which the

13 individual filed the application for such benefits, a

14 final determination of whether the individual is blind

15 or disabled has not been made, and

16 ‘‘(iii) the individual has taken such actions as

17 are necessary to preserve such individual’s rights to

18 administrative review under this section,

19 such individual shall be presumed to be blind or disabled

20 for each month during the period of months beginning

21 with the first month after the expiration of such 150-day

22 period and ending with the month in which action is taken

23 to implement a final determination of whether the individ24 ual is blind or disabled.’’.
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1 SEC. 5. EFFECTIVE DATE; STUDY OF STAFF NEEDS.

2 (a) EFFECTIVE DATE.—The amendments made by

3 this Act shall apply with respect to applications for bene4 fits under title II or XVI of the Social Security Act filed

5 after 180 days after the date of the enactment of this Act.

6 (b) STUDY OF STAFF NEEDS.—

7 (1) IN GENERAL.—As soon as practicable after

8 the date of the enactment of this Act, the Secretary

9 of Health and Human Services shall conduct a study

10 of any additional staff needs required to implement

11 the amendments made by this Act.

12 (2) REPORT.—Not later than 30 days after the

13 date of the enactment of this Act, the Secretary of

14 Health and Human Services shall submit to the

15 Committee on Ways and Means of the House of

16 Representatives and the Committee on Finance of

17 the Senate the results of the study conducted under

18 paragraph (1), together with any recommendations

19 which the Secretary finds appropriate.

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