I 

114TH CONGRESS 

2D SESSION H. R. 5347 

To provide for phased-in payment of Social Security Disability Insurance 

payments during the waiting period for individuals with a terminal illness. 

IN THE HOUSE OF REPRESENTATIVES 

MAY 26, 2016 

Mr. RODNEY DAVIS of Illinois (for himself and Mr. KIND) introduced the 

following bill; which was referred to the Committee on Ways and Means 

A BILL 

To provide for phased-in payment of Social Security Disability Insurance payments during the waiting period 

for individuals with a terminal illness. 

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 Dis5 ability Fairness Act of 2016’’. 

6 SEC. 2. PHASED-IN PAYMENT OF SSDI BENEFITS DURING 

7 THE WAITING PERIOD FOR THE TERMINALLY 

8 ILL. 

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

10 Act (42 U.S.C. 423) is amended— 


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1 (1) in subsection (a)— 

2 (A) in paragraph (1), in the matter fol3 lowing subparagraph (E), by striking ‘‘or (ii)’’ 

4 and inserting ‘‘(ii) subject to paragraph (2)(B), 

5 for each month beginning with the first month 

6 during all of which the individual is determined 

7 under subparagraph (D) of subsection (d)(2) to 

8 be under a disability and in which he becomes 

9 so entitled to such insurance benefits, or (iii)’’; 

10 (B) in paragraph (2)— 

11 (i) in subparagraph (A), by striking 

12 ‘‘or’’ at the end; 

13 (ii) by redesignating subparagraph 

14 (B) as subparagraph (C); 

15 (iii) in subparagraph (C), as so redes16 ignated, by striking ‘‘(ii)’’ and inserting 

17 ‘‘(iii)’’; and 

18 (iv) by inserting after subparagraph 

19 (A) the following new subparagraph: 

20 ‘‘(B) in any case in which clause (ii) of para21 graph (1) of this subsection is applicable, the first 

22 month for which the individual becomes entitled to 

23 such disability insurance benefits, subject to the 

24 phase-in percentage period described in paragraph 

25 (3)(A), or’’; and 


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1 (C) by adding at the end the following new 

2 paragraph: 

3 ‘‘(3)(A) For purposes of paragraph (2)(B), in any 

4 case in which clause (ii) of paragraph (1) of this sub5 section is applicable, an individual’s disability insurance 

6 benefit for the earliest period of consecutive calendar 

7 months throughout which the individual has been entitled 

8 to such insurance benefits shall be equal to the product 

9 of the benefit amount determined under paragraph (2)(B) 

10 (as determined before application of this paragraph) 

11 and— 

12 ‘‘(i) for the first calendar month, 50 percent; 

13 ‘‘(ii) for the second calendar month, 75 percent; 

14 and 

15 ‘‘(iii) for each subsequent calendar month 

16 through the twelfth calendar month, 100 percent. 

17 ‘‘(B) If an individual who has been determined under 

18 subparagraph (D) of subsection (d)(2) to be under a dis19 ability has been entitled to a disability insurance benefit 

20 on such basis for 12 consecutive calendar months, the in21 dividual’s disability insurance benefit for any month dur22 ing the subsequent period of 12 consecutive calendar 

23 months shall be equal to— 


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1 ‘‘(i) the benefit amount determined under para2 graph (2)(B) (as determined before application of 

3 subparagraph (A)); minus 

4 ‘‘(ii) the quotient obtained by dividing the total 

5 amount of disability insurance benefits provided to 

6 the individual during the earliest period of five con7 secutive calendar months for which the individual 

8 was entitled to such benefits on such basis by 12. 

9 ‘‘(C) If an individual who has been determined under 

10 subparagraph (D) of subsection (d)(2) to be under a dis11 ability has been entitled to a disability insurance benefit 

12 on such basis for 24 consecutive calendar months, the in13 dividual’s disability insurance benefit for any subsequent 

14 month shall be equal to 95 percent of the benefit amount 

15 determined under paragraph (2)(B) (as determined before 

16 application of subparagraphs (A) and (B)).’’; and 

17 (2) in subsection (d)(2), by adding at the end 

18 the following: 

19 ‘‘(D) For purposes of clause (ii) of paragraph 

20 (1) of subsection (a), an individual shall be deter21 mined to be under a disability upon submission of a 

22 diagnosis of a terminal illness (as defined in section 

23 1861(dd)(3)(A)) that has been certified by not less 

24 than 2 physicians (as defined in section 1861(r)(1)) 

25 who are not related (as defined in section 267(c)(4) 


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1 of the Internal Revenue Code) and are not in the 

2 same physician group practice.’’. 

3 (b) REPORTS TO CONGRESS.— 

4 (1) REPORT BY SOCIAL SECURITY ADMINISTRA5 TION.—Not later than 12 months after the date of 

6 the enactment of this Act, and each year thereafter, 

7 the Commissioner of Social Security, in coordination 

8 with the Inspector General of the Social Security 

9 Administration, shall submit to the relevant commit10 tees of Congress a report that evaluates the provi11 sion of disability insurance benefits to terminally ill 

12 individuals, including— 

13 (A) the total number of individuals who— 

14 (i) filed applications for disability in15 surance benefits (as determined under sec16 tion 223(a)(3) of the Social Security Act) 

17 based on a diagnosis of a terminal illness; 

18 (ii) receive such benefits; 

19 (iii) die within 6 months of first re20 ceiving such benefits; 

21 (iv) die within 12 months of first re22 ceiving such benefits; 

23 (v) receive such benefits during the 

24 period described in section 223(a)(3)(B) of 

25 the Social Security Act; and 


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1 (vi) receive such benefits during the 

2 period described in section 223(a)(3)(C) of 

3 the Social Security Act; 

4 (B) the total amount expended, including 

5 related administrative expenses, for the provi6 sion of disability insurance benefits under sec7 tion 223(a)(3) of the Social Security Act to in8 dividuals diagnosed with a terminal illness; and 

9 (C) recommendations for such legislation 

10 and administrative actions as are determined 

11 appropriate for preventing fraud, waste, and 

12 abuse related to such benefits. 

13 (2) REPORT BY GOVERNMENT ACCOUNTABILITY

14 OFFICE.—Not later than 4 years after the date of 

15 the enactment of this Act, the Comptroller General 

16 of the United States shall submit a report to the rel17 evant committees of Congress that evaluates the pro18 vision of disability insurance benefits to terminally ill 

19 individuals and provides recommendations for such 

20 legislation and administrative actions as are deter21 mined appropriate to improve the provision of such 

22 benefits to such individuals. 

23 (c) EFFECTIVE DATE; SUNSET.— 

24 (1) IN GENERAL.—Subject to paragraph (2), 

25 the amendments made by this section shall apply to 


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1 benefits payable for months beginning after Decem2 ber 31, 2016. 

3 (2) SUNSET.—The amendments made by sub4 section (a) shall cease to have effect on January 1, 

5 2022, and upon such date, section 223 of the Social 

6 Security Act shall read as if such amendments had 

7 not been enacted. 

Æ 


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