I 

118TH CONGRESS 

1ST SESSION H. R. 6427 

To amend title II of the Social Security Act to allow disabled individuals 

with incurable terminal illnesses listed on the Compassionate Allowance 

list to receive disability insurance benefits without a waiting period, 

to prohibit concurrent receipt of disability insurance benefits and unemployment insurance, and for other purposes. 

IN THE HOUSE OF REPRESENTATIVES 

NOVEMBER 15, 2023 

Mrs. HARSHBARGER introduced the following bill; which was referred to the 

Committee on Ways and Means 

A BILL 

To amend title II of the Social Security Act to allow disabled 

individuals with incurable terminal illnesses listed on the 

Compassionate Allowance list to receive disability insurance benefits without a waiting period, to prohibit concurrent receipt of disability insurance benefits and unemployment insurance, and for other purposes. 

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 ‘‘Immediate Access for 

5 the Terminally Ill Act’’. 


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1 SEC. 2. OPTION FOR DISABLED INDIVIDUALS WITH INCUR2 ABLE TERMINAL ILLNESSES LISTED ON THE 

3 COMPASSIONATE ALLOWANCE LIST TO RE4 CEIVE DISABILITY INSURANCE BENEFITS 

5 WITHOUT A WAITING PERIOD. 

6 (a) IN GENERAL.—Section 223 of the Social Security 

7 Act (42 U.S.C. 423) is amended— 

8 (1) in subsection (a)(1), in the matter following 

9 subparagraph (E)— 

10 (A) by inserting ‘‘and who files an applica11 tion for disability insurance benefits during the 

12 period that begins on December 22, 2020, and 

13 ends on the date that is 1 year after the date 

14 of enactment of the Immediate Access for the 

15 Terminally Ill Act’’ after ‘‘amyotrophic lateral 

16 sclerosis’’; and 

17 (B) by striking ‘‘, or (iii)’’ and inserting ‘‘, 

18 (iii) in the case of an individual who makes an 

19 election under subsection (k), for each month 

20 beginning with the first month during all of 

21 which the individual is under a disability and in 

22 which the individual becomes entitled to such 

23 insurance benefits, or (iv)’’; and 

24 (2) by adding at the end the following new sub25 section: 


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1 ‘‘(k) OPTION FOR DISABLED INDIVIDUALS WITH

2 TERMINAL ILLNESSES TO RECEIVE DISABILITY INSUR3 ANCE BENEFITS WITHOUT A WAITING PERIOD.— 

4 ‘‘(1) IN GENERAL.—An individual who is enti5 tled to a disability insurance benefit and has been 

6 diagnosed with a medical condition or disease that 

7 is included in the most recent list published by the 

8 Commissioner of Social Security under paragraph 

9 (2) may elect to receive such benefit beginning with 

10 the first month during all of which the individual is 

11 under a disability and in which the individual be12 comes entitled to such benefit. 

13 ‘‘(2) PUBLICATION OF LIST.—Not later than 6 

14 months after the date of enactment of this sub15 section, and every 5 years thereafter, the Commis16 sioner of Social Security shall, through a formal 

17 rulemaking process in accordance with sections 556 

18 and 557 of title 5, United States Code, publish a list 

19 of medical conditions and diseases— 

20 ‘‘(A) which are included in the most recent 

21 list of Compassionate Allowance Conditions 

22 published by the Social Security Administra23 tion; 

24 ‘‘(B) for which the average life expectancy 

25 for all individuals diagnosed with such condition 


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1 or disease does not exceed 5 years from the 

2 date of diagnosis; and 

3 ‘‘(C) for which there is no known cure. 

4 ‘‘(3) REDUCTION IN BENEFIT AMOUNT.—If an 

5 individual described in paragraph (1) elects to re6 ceive a disability insurance benefit beginning with 

7 the first month during all of which the individual is 

8 under a disability and in which the individual be9 comes entitled to such benefit, the amount of such 

10 benefit for any month shall be equal to 93 percent 

11 of the amount otherwise determined for the indi12 vidual under subsection (a)(2) (after the application 

13 of sections 202(q) and 215(b)(2)(A)(ii)). 

14 ‘‘(4) TIMING AND EFFECT OF ELECTION.—An 

15 individual may only make an election under this sub16 section at the time the individual files an application 

17 for a disability insurance benefit under subsection 

18 (b), and any election under this subsection shall be 

19 irrevocable.’’. 

20 (b) CONFORMING AMENDMENTS.—Section 223(a)(2) 

21 of the Social Security Act (42 U.S.C. 423(a)(2)) is amend22 ed— 

23 (1) by striking ‘‘section 202(q) and’’ and insert24 ing ‘‘subsection (k)(3), section 202(q), and’’; and 


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1 (2) in subparagraph (B), by striking ‘‘clause 

2 (ii) of paragraph (1)’’ and inserting ‘‘clause (ii), 

3 (iii), or (iv) of the matter following subparagraph 

4 (E) of paragraph (1)’’. 

5 (c) EFFECTIVE DATE.—The amendments made by 

6 this section shall apply with respect to applications for dis7 ability insurance benefits filed on or after the date that 

8 is 6 months after the date of enactment of this Act. 

9 SEC. 3. CONGRESSIONAL APPROVAL REQUIRED FOR ADDI10 TIONS TO COMPASSIONATE ALLOWANCE 

11 CONDITIONS LIST. 

12 Section 223(k) of the Social Security Act (42 U.S.C. 

13 423(k)) (as added by section 2 of this Act), is amended 

14 by adding at the end the following: 

15 ‘‘(5) CONGRESSIONAL APPROVAL REQUIRED

16 FOR ADDITIONS TO COMPASSIONATE ALLOWANCE

17 CONDITIONS LIST.—Beginning on the date of enact18 ment of this subsection, no disease or medical condi19 tion may be added to the list of Compassionate Al20 lowance Conditions published by the Social Security 

21 Administration unless there is enacted into law a bill 

22 or joint resolution approving such addition.’’. 


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1 SEC. 4. PROHIBITION ON PAYMENT OF SOCIAL SECURITY 

2 DISABILITY BENEFITS BASED ON RECEIPT OF 

3 UNEMPLOYMENT COMPENSATION. 

4 (a) IN GENERAL.—Title II of the Social Security Act 

5 (42 U.S.C. 401 et seq.) is amended by inserting after sec6 tion 224 the following new section: 

7 ‘‘PROHIBITION ON PAYMENT OF BENEFITS BASED ON

8 RECEIPT OF UNEMPLOYMENT COMPENSATION

9 ‘‘SEC. 224A. (a) If for any month prior to the month 

10 in which an individual attains retirement age (as defined 

11 in section 216(l)(1))— 

12 ‘‘(1) such individual is entitled to benefits 

13 under section 223, and 

14 ‘‘(2) such individual is entitled for such month 

15 to unemployment compensation, 

16 the total of the individual’s benefits under section 223 for 

17 such month and of any benefits under subsections (b) 

18 through (h) of section 202 for such month based on the 

19 individual’s wages and self-employment income shall be re20 duced to zero. 

21 ‘‘(b)(1) Notwithstanding any other provision of law, 

22 the head of any Federal agency shall provide such infor23 mation within its possession as the Commissioner may re24 quire for purposes of making a timely determination under 

25 this section for reduction of benefits payable under this 


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1 title, or verifying other information necessary in carrying 

2 out the provisions of this section. 

3 ‘‘(2) The Commissioner is authorized to enter into 

4 agreements with States, political subdivisions, and other 

5 organizations that administer unemployment compensa6 tion, in order to obtain such information as the Commis7 sioner may require to carry out the provisions of this sec8 tion. 

9 ‘‘(3) Any determination by the Commissioner pursu10 ant to this section shall be subject to the requirements 

11 described in section 205(b)(1), including provision of rea12 sonable notice and opportunity for a hearing. 

13 ‘‘(c) For purposes of this section, the term ‘unem14 ployment compensation’ has the meaning given that term 

15 in section 85(b) of the Internal Revenue Code of 1986.’’. 

16 SEC. 5. INCREASING THE OVERPAYMENT COLLECTION 

17 THRESHOLD FOR OLD-AGE, SURVIVORS, AND 

18 DISABILITY INSURANCE BENEFITS. 

19 (a) IN GENERAL.—Section 204(a)(1)(A) of the Social 

20 Security Act (42 U.S.C. 404(a)(1)(A)) is amended— 

21 (1) by striking ‘‘With respect to’’ and ‘inserting 

22 ‘‘(i) Subject to clause (ii), with respect to’’; and 

23 (2) by adding at the end the following new 

24 clause: 


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1 ‘‘(ii) For purposes of clause (i), if the 

2 Commissioner of Social Security deter3 mines that decreasing a payment under 

4 this title to an individual by 100 percent 

5 would defeat the purpose of this title, the 

6 Commissioner may decrease such payment 

7 by a smaller amount, provided that such 

8 smaller amount is not less than 10 percent 

9 of the amount of such payment.’’. 

Æ 


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