I 

111TH CONGRESS 

1ST SESSION H. R. 723 

To amend the Social Security Act to eliminate the 5-month waiting period 

for Social Security disability and the 24-month waiting period for Medicare benefits in the cases of individuals with disabling burn injuries. 

IN THE HOUSE OF REPRESENTATIVES 

JANUARY 27, 2009 

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

to the Committee on Ways and Means 

A BILL 

To amend the Social Security Act to eliminate the 5-month 

waiting period for Social Security disability and the 24- 

month waiting period for Medicare benefits in the cases 

of individuals with disabling burn injuries. 

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 and 

5 Medicare Improved Burn Injury Treatment Access Act of 

6 2009’’. 

7 SEC. 2. FINDINGS. 

8 Congress makes the following findings: 


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1 (1) Terrorist acts, such as the September 11, 

2 2001, attacks in New York and Washington, DC 

3 and attacks in countries throughout the world, 

4 major accidental events, chemical plant explosions, 

5 airplane crashes, and major industrial accidents, re6 sult in a substantial number of burn-injured pa7 tients. 

8 (2) In most major traumatic events, 25 percent 

9 to 30 percent of the injured will require burn care 

10 treatment. About one-third of those hospitalized in 

11 New York on September 11th had severe burn inju12 ries. 

13 (3) According to the American Burn Associa14 tion (ABA), which is the national professional soci15 ety representing hospitals with burn centers, as well 

16 as burn surgeons, nurses, therapists, and other 

17 members of the burn care team, there are only 128 

18 burn centers in the United States. The total burn19 bed capacity at all burn centers in the United States 

20 is 1,835 beds. Burn centers in four States have 

21 closed, with a loss of several beds, which further di22 minishes the Nation’s ability to handle the mass 

23 burn casualties that could result from a major ter24 rorist attack. 


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1 (4) Burn centers are a national resource that 

2 must be preserved and strengthened as part of the 

3 Nation’s preparedness activities to deal with ter4 rorist attacks or other disasters that would likely 

5 lead to mass burn casualties. 

6 (5) Based on a study of over 54,000 burn cases 

7 over a 20-year period of time, the ABA in its 2002 

8 National Burn Repository Report indicates that 38 

9 percent of burn-injured patients treated in burn cen10 ters were uninsured. This high level of uncompen11 sated care threatens the survival of burn centers, the 

12 continued existence of which is essential to the emer13 gency preparedness efforts of the United States. 

14 (6) Burn injuries are among the most costly to 

15 treat and require immediate medical attention. 

16 (7) Because of the necessity of providing imme17 diate care in the case of burn injuries, the waiting 

18 periods established for Medicare coverage for dis19 abled burn patients should be waived and it is essen20 tial for Medicare to reimburse the costs of such burn 

21 treatment to ensure the financial survival of burn 

22 centers. 


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1 SEC. 3. ELIMINATION OF 5-MONTH SOCIAL SECURITY DIS2 ABILITY WAITING PERIOD IN CASES OF INDI3 VIDUALS WITH DISABLING BURN INJURIES. 

4 (a) DISABILITY INSURANCE BENEFITS.—Section 

5 223(a) of the Social Security Act (42 U.S.C. 423(a)) is 

6 amended by adding at the end the following new para7 graph: 

8 ‘‘(3)(A) In the case of any individual who has a dis9 abling burn injury and is not entitled to disability insur10 ance benefits under this section for any month solely by 

11 reason of the waiting period under clause (i) in the first 

12 sentence of paragraph (1), the Commissioner of Social Se13 curity shall waive the application of the waiting period, 

14 and, notwithstanding clauses (i) and (ii) of the first sen15 tence of paragraph (1), such individual shall be entitled 

16 to disability insurance benefits for each month, beginning 

17 with the first month during all of which such individual 

18 is under a disability and in which such individual would 

19 become so entitled to such insurance benefits under such 

20 sentence but for such waiting period, and ending as pro21 vided in paragraph (1). 

22 ‘‘(B) For purposes of subparagraph (A), the process 

23 for determining under paragraph (1) the month in which 

24 the disability ceases shall require that the status of the 

25 individual’s disability be determined at least once every 3 

26 years. 


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1 ‘‘(C) For purposes of subparagraph (A) and sections 

2 202(e)(5)(C), 202(f)(6)(C), and 216(i)(2)(A)(ii), an indi3 vidual is considered to have a ‘disabling burn injury’ if 

4 the individual has a burn injury that satisfies a finding 

5 of disability in accordance with the Social Security Admin6 istration’s publication, ‘Disability Evaluation under Social 

7 Security’ (Blue Book, January 2005) for purposes of es8 tablishing eligibility for benefits under this title.’’. 

9 (b) WIDOW’S INSURANCE BENEFITS BASED ON DIS10 ABILITY.—Section 202(e)(5) of such Act (42 U.S.C. 

11 402(e)(5)) is amended by adding at the end the following 

12 new subparagraph: 

13 ‘‘(C) In the case of any individual who has a disabling 

14 burn injury (as described in section 223(a)(3)(B)) and is 

15 not entitled to widow’s insurance benefits under this sec16 tion for any month solely by reason of the waiting period 

17 under paragraph (1)(F)(i), the Commissioner of Social Se18 curity shall waive the application of the waiting period, 

19 and, notwithstanding clauses (i) and (ii) of paragraph 

20 (1)(F), such individual shall be entitled to widow’s insur21 ance benefits for each month, beginning with the first 

22 month during all of which she is under a disability and 

23 in which she would become so entitled to such insurance 

24 benefits under paragraph (1) but for such waiting period, 

25 and ending as provided in paragraph (1). For purposes 


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1 of the previous sentence, in determining under paragraph 

2 (1) the month in which the disability ceases the status of 

3 the individual’s disability shall be reviewed at least once 

4 every 3 years.’’. 

5 (c) WIDOWER’S INSURANCE BENEFITS BASED ON

6 DISABILITY.—Section 202(f)(5) of such Act (42 U.S.C. 

7 402(f)(5)) is amended by adding at the end the following 

8 new subparagraph: 

9 ‘‘(C) In the case of any individual who has a disabling 

10 burn injury (as described in section 223(a)(3)(B)) and is 

11 not entitled to widower’s insurance benefits under this sec12 tion for any month solely by reason of the waiting period 

13 under paragraph (1)(F)(i), the Commissioner of Social Se14 curity shall waive the application of the waiting period, 

15 and, notwithstanding clauses (i) and (ii) of paragraph 

16 (1)(F), such individual shall be entitled to widower’s in17 surance benefits for each month, beginning with the first 

18 month during all of which he is under a disability and 

19 in which he would become so entitled to such insurance 

20 benefits under paragraph (1) but for such waiting period, 

21 and ending as provided in paragraph (1). For purposes 

22 of the previous sentence, in determining under paragraph 

23 (1) the month in which the disability ceases the status of 

24 the individual’s disability shall be reviewed at least once 

25 every 3 years.’’. 


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1 (d) COMMENCEMENT OF PERIOD OF DISABILITY.— 

2 Section 216(i)(2)(A) of such Act (42 U.S.C. 416(i)(2)(A)) 

3 is amended— 

4 (1) by inserting ‘‘(i)’’ after ‘‘(2)(A)’’; 

5 (2) by inserting ‘‘(I)’’ after ‘‘but only if’’; 

6 (3) by inserting ‘‘(II)’’ after ‘‘duration or’’; and 

7 (4) by adding at the end the following new 

8 clause: 

9 ‘‘(ii) In any case in which an individual has a dis10 abling burn injury (as described in section 223(a)(3)(B)) 

11 and a month is not included within a period of disability 

12 of such individual solely by reason of the 5-month duration 

13 requirement under clause (i)(I), the Commissioner of So14 cial Security shall waive the application of such require15 ment, and, notwithstanding clause (i)(I), such month shall 

16 be included in a period of disability.’’. 

17 (e) EFFECTIVE DATES.—The amendments made by 

18 subsection (a) shall apply only with respect to benefits 

19 under section 223 of the Social Security Act, or under sec20 tion 202 of such Act on the basis of the wages and self21 employment income of an individual entitled to benefits 

22 under such section 223, for months beginning after the 

23 date of the enactment of this Act. The amendments made 

24 by subsections (b) and (c) shall apply only with respect 

25 to benefits based on disability under subsection (e) or (f) 


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1 of section 202 of the Social Security Act for months after 

2 the date of the enactment of this Act. The amendments 

3 made by subsection (d) shall apply only with respect to 

4 applications for disability determinations filed under title 

5 II of the Social Security Act after the date of the enact6 ment of this Act. 

7 SEC. 4. ELIMINATION OF 24-MONTH MEDICARE DISABILITY 

8 WAITING PERIOD IN CASES OF INDIVIDUALS 

9 WITH DISABLING BURN INJURIES. 

10 (a) IN GENERAL.—Section 226(h) of the Social Secu11 rity Act (42 U.S.C. 426(h)) is amended— 

12 (1) in the matter preceding paragraph (1), by 

13 inserting ‘‘or a disabling burn injury (as described 

14 in section 223(a)(3)(B))’’ after ‘‘amyotrophic lateral 

15 sclerosis (ALS)’’; 

16 (2) by redesignating paragraphs (1), (2), and 

17 (3) as subparagraphs (A), (B), and (C), respectively, 

18 with appropriate indentation and striking ‘‘For pur19 poses of’’ and inserting ‘‘(1) For purposes of’’; and 

20 (3) by adding at the end the following new 

21 paragraphs: 

22 ‘‘(2) Paragraph (1) shall not apply to an individual 

23 medically determined to have a disabling burn injury (as 

24 so described) if— 


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1 ‘‘(A) on the date such injury occurred such in2 dividual was covered under a group health plan (as 

3 defined in section 2791 of the Public Health Service 

4 Act) or had health insurance coverage (as defined in 

5 such section), regardless of the extent to which such 

6 plan or coverage provides benefits with respect to 

7 such injury; or 

8 ‘‘(B) after the date of the enactment of the So9 cial Security and Medicare Improved Burn Injury 

10 Treatment Access Act of 2009, the terms and condi11 tions of coverage, with respect to such injury, under 

12 the State plan under title XIX of the State in which 

13 the individual resides are more restrictive than such 

14 terms and conditions as of the day before such date 

15 of enactment. 

16 ‘‘(3) For purposes of applying paragraph (1) in the 

17 case of an individual medically determined to have a dis18 abling burn injury (as so described), in determining when 

19 an individual’s entitlement or status terminates, the status 

20 of the individual’s disability shall be reviewed at least once 

21 every 3 years.’’. 

22 (b) EFFECTIVE DATE.—The amendment made by 

23 subsection (a) shall apply to benefits under title XVIII of 

24 the Social Security Act with respect to items and services 


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1 furnished in months beginning after the date of the enact2 ment of this Act. 

Æ 


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