I 

111TH CONGRESS 

2D SESSION H. R. 6066 

To amend title II of the Social Security Act to provide appropriate safeguards 

for applicants for disability insurance benefits and other benefits based 

on disability under such title against inappropriate offsets of such benefits against benefits otherwise provided under private disability insurance 

coverage. 

IN THE HOUSE OF REPRESENTATIVES 

JULY 30, 2010 

Ms. LINDA T. SA ́NCHEZ of California 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 provide 

appropriate safeguards for applicants for disability insurance benefits and other benefits based on disability under 

such title against inappropriate offsets of such benefits 

against benefits otherwise provided under private disability insurance coverage. 

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 ‘‘Preventing Social Se5 curity Fraud Act of 2010’’. 


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1 SEC. 2. PROTECTIONS FOR APPLICANTS FOR DISABILITY 

2 INSURANCE BENEFITS OR OTHER BENEFITS 

3 BASED ON DISABILITY AGAINST INAPPRO4 PRIATE OFFSETS AGAINST BENEFITS UNDER 

5 PRIVATE DISABILITY INSURANCE COVERAGE. 

6 (a) IN GENERAL.—Section 221 of the Social Security 

7 Act (42 U.S.C. 421) is amended by adding at the end the 

8 following new subsection: 

9 ‘‘(n)(1) At the time at which an insurance issuer 

10 takes any action in connection with private disability in11 surance coverage provided by the issuer which constitutes 

12 a presumed entitlement benefit reduction, the issuer shall 

13 certify to the Commissioner, in such form and manner as 

14 may be prescribed by the Commissioner, that the issuer 

15 has determined that there is reasonable cause to assume 

16 that the individual is under a disability (as defined in sec17 tion 223(d)) and is, or upon application would be, entitled 

18 to disability insurance benefits under section 223, or 

19 child’s, widow’s, or widower’s insurance benefits under 

20 section 202 based on disability. Such certification shall in21 clude a statement (meeting such requirements as the Com22 missioner may prescribe) in support of the issuer’s deter23 mination. 

24 ‘‘(2) For purposes of this subsection, an action taken 

25 in connection with private disability insurance coverage 

26 constitutes a presumed entitlement benefit reduction to 


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1 the extent that such action has the effect of reducing the 

2 benefits under such coverage of any individual covered 

3 under such coverage by reason of a failure by such indi4 vidual— 

5 ‘‘(A) to apply for disability insurance benefits 

6 under section 223, or child’s, widow’s, or widower’s 

7 insurance benefits under section 202 based on dis8 ability, or 

9 ‘‘(B) to timely request a hearing under sub10 section (d) (or an administrative review prior to such 

11 a hearing) with respect to such benefits. 

12 ‘‘(3) The Commissioner shall include in any applica13 tion form for applying for benefits under section 223, or 

14 child’s, widow’s, or widower’s insurance benefits under 

15 section 202 based on disability, and any application form 

16 for applying for a hearing under subsection (d) (or admin17 istrative review prior to such a hearing) relating to such 

18 benefits, a question regarding whether the applicant has 

19 been requested by an insurance issuer offering private dis20 ability insurance coverage, or any other person on behalf 

21 of such issuer, to file the application. 

22 ‘‘(4) For purposes of this subsection— 

23 ‘‘(A) The term ‘private disability insurance cov24 erage’ means disability insurance coverage offered in 

25 the private sector by an insurance issuer. 


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1 ‘‘(B) The term ‘disability insurance coverage’ 

2 means cash benefits provided to individuals in the 

3 event of disability or physical or mental impairment 

4 (as defined in the terms of the policy under which 

5 such coverage is provided) under a policy, certificate, 

6 or contract offered by an insurance issuer. 

7 ‘‘(C) The term ‘insurance issuer’ means an in8 surance company, insurance service, or insurance or9 ganization which is licensed to engage in the busi10 ness of insurance in a State and which is subject to 

11 State law which regulates insurance.’’. 

12 (b) PENALTIES.—Section 208(a) of such Act (42 

13 U.S.C. 408(a)) is amended by inserting ‘‘or’’ at the end 

14 of paragraph (8), and by inserting after paragraph (8) the 

15 following new paragraph: 

16 ‘‘(9) willfully, knowingly, and with intent to de17 ceive the Commissioner of Social Security— 

18 ‘‘(A) furnishes or causes to be furnished 

19 false information in a certification required 

20 under section 221(n)(1); or 

21 ‘‘(B) fails to timely provide such certifi22 cation;’’. 

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

24 this section shall apply with respect to private disability 


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1 insurance coverage for periods beginning on or after Janu2 ary 1, 2011. 

Æ 


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