[Federal Register Volume 61, Number 119 (Wednesday, June 19, 1996)]
[Rules and Regulations]
[Pages 31022-31027]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 96-15407]



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SOCIAL SECURITY ADMINISTRATION

20 CFR Parts 404 and 416

[Regulations Nos. 4 and 16]
RIN 0960-AD39


Payment for Vocational Rehabilitation Services Furnished 
Individuals During Certain Months of Nonpayment of Supplemental 
Security Income Benefits

AGENCY: Social Security Administration (SSA).

ACTION: Final rules.

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SUMMARY: We are amending our regulations relating to payment for 
vocational rehabilitation (VR) services provided to recipients of 
supplemental security income (SSI) benefit payments based on disability 
or blindness under title XVI of the Social Security Act (the Act). 
These regulations reflect section 5037 of the Omnibus Budget 
Reconciliation Act of 1990 (OBRA 1990). Section 5037 of OBRA 1990 added 
section 1615(e) to the Act which authorizes the Commissioner of Social 
Security (the Commissioner) to pay a State VR agency for costs incurred 
in furnishing VR services to an individual during certain months for 
which the individual did not receive SSI payments based on disability 
or blindness as well as during months for which the individual did 
receive such payments. We also are amending our regulations on VR 
payments to clarify certain rules and remove some outdated rules.

EFFECTIVE DATE: These regulations are effective June 19, 1996.

FOR FURTHER INFORMATION CONTACT: Regarding this Federal Register 
document--Richard M. Bresnick, Legal Assistant, Division of Regulations 
and Rulings, Social Security Administration, 6401 Security Boulevard, 
Baltimore, MD 21235, (410) 965-1758; regarding eligibility or filing 
for benefits--our national toll-free number, 1-800-772-1213.

SUPPLEMENTARY INFORMATION: We are amending our regulations on payment 
for VR services provided to individuals receiving SSI benefits based on 
disability or blindness. These amended regulations reflect section 5037 
of OBRA 1990, Public Law (Pub. L.) 101-508, which added paragraph (e) 
to section 1615 of the Act. Our existing regulations concerning payment 
for such services carry out the provisions of section 1615(d) of the 
Act.
    In general, section 1615(d) of the Act authorizes the Commissioner 
to reimburse a State VR agency for the costs incurred in providing VR 
services

[[Page 31023]]

to individuals receiving SSI benefits under title XVI of the Act based 
on disability or blindness in three categories of cases. Specifically, 
section 1615(d) permits payment for VR services furnished to such 
individuals only in cases where: (1) The furnishing of such services 
results in the individual's performance of substantial gainful activity 
(SGA) for a continuous period of nine months; (2) the individual is 
continuing to receive benefits, despite his or her medical recovery, 
under section 1631(a)(6) of the Act because of his or her participation 
in a VR program; or (3) the individual, without good cause, refuses to 
continue to accept VR services or fails to cooperate in such a manner 
as to preclude his or her successful rehabilitation. (In such a case of 
refusal to continue or cooperate in a VR program, payments are 
authorized only for the VR services provided prior to the cessation of 
VR participation. If the individual resumes participation, then 
payments are authorized for the VR services provided after 
participation is resumed only if all requirements for payment are met.) 
These cases are described in sections 1615(d) (1), (2) and (3) of the 
Act, respectively, and in Secs. 416.2211-416.2213 of our regulations.
    Under section 1615(d) of the Act, payment may be made for VR 
services furnished by a State VR agency, i.e., an agency administering 
a State plan for VR services approved under title I of the 
Rehabilitation Act of 1973, as amended. However, in the case of a State 
which is unwilling to participate or does not have such a plan for VR 
services, our regulation at Sec. 416.2204 provides that we may arrange 
for VR services for an SSI recipient who is disabled or blind through 
an alternative VR service provider (alternate participant) and pay such 
provider for the costs of services under the same terms and conditions 
that apply to State VR agencies. This regulation is based in part on 
section 222(d)(2) of the Act, which provides for the use of alternate 
participants in the VR payment program under title II of the Act 
(relating to the rehabilitation of Social Security disability 
beneficiaries), and on the authority provided to the Commissioner under 
section 1633(a) of the Act to make such administrative and other 
arrangements as may be necessary or appropriate to carry out title XVI 
of the Act, including making arrangements under title XVI in the same 
manner as they are made under title II.
    Prior to the enactment of OBRA 1990, SSA was authorized to pay a 
State VR agency under section 1615(d) of the Act only for VR services 
that were provided to an individual during months for which the 
individual received SSI benefits based on disability or blindness, 
including benefits payable under section 1611 or 1619(a) of the Act or, 
for cases under section 1615(d)(2), discussed above, continued payment 
of such benefits under section 1631(a)(6) of the Act. This is reflected 
in our existing regulations at Secs. 416.2201, 416.2203 and 
416.2215(a)(2).
    Section 5037 of OBRA 1990 added section 1615(e) to the Act to 
provide us the authority to pay a State VR agency under section 1615(d) 
for the costs described in that section that are incurred in providing 
VR services to an individual during certain months for which the 
individual was not receiving SSI benefits based on disability or 
blindness as well as during months for which the individual was 
receiving such benefits. Under section 1615(e) of the Act, payment may 
be made for VR services in a case described in section 1615(d)(1), (2) 
or (3) of the Act which are provided to an individual in a month for 
which the individual receives, i.e., is eligible for--
    <bullet> SSI cash benefits under section 1611 or special SSI cash 
benefits under section 1619(a) of the Act (this is the same as under 
prior law);
    <bullet> A special status for Medicaid under section 1619(b) of the 
Act; or
    <bullet> A federally administered State supplementary payment under 
section 1616 of the Act or section 212(b) of Pub. L. 93-66.
    In addition, section 1615(e) of the Act permits payment for VR 
services provided in a month for which an individual was ineligible for 
the benefits or special status described above for a reason other than 
cessation of disability or blindness, if such month occurred prior to 
the 13th consecutive month of such ineligibility following a month for 
which the individual was eligible for such benefits or special status. 
This means that payment may be made for VR services furnished during a 
month for which an individual's benefit payment or special status for 
Medicaid under section 1619(b) was suspended.
    Section 1615(e) of the Act became effective November 5, 1990, the 
date of the enactment of OBRA 1990, and applies to claims for 
reimbursement pending on or after that date. This amendment to the Act, 
which allows us to reimburse a State VR agency or alternate participant 
for VR services furnished during certain months for which an individual 
was not receiving SSI benefits, responds to a recommendation in the 
March 1988 Report of the Disability Advisory Council that the Congress 
amend the Act to permit SSA to pay for VR services provided in months 
when an individual is in suspension status.

Changes to the VR Payment Regulations

    These final rules amend the existing regulations concerning the SSI 
VR payment program under title XVI of the Act to take account of the 
provisions of section 1615(e) of the Act which permit payment for VR 
services furnished during certain months for which a disabled or blind 
individual does not receive SSI benefits. These rules also make some 
other changes in the existing VR payment regulations to clarify certain 
rules and delete some obsolete rules. These changes affect the 
regulations governing the Social Security VR payment program under 
title II of the Act as well as the regulations concerning the SSI VR 
payment program under title XVI. The existing Social Security VR 
payment regulations carry out section 222(d) of the Act which contains 
provisions that are similar to the provisions of section 1615(d) of the 
Act, except that they apply to payment for VR services provided to 
individuals entitled to Social Security benefits based on disability 
under title II.

Changes to the Regulations to Implement Section 1615(e) of the Act

    We are amending Sec. 416.2201 to explain that, in general, sections 
1615(d) and (e) of the Act authorize payment for costs of VR services 
provided to certain disabled or blind individuals who are eligible for 
SSI benefits, special SSI eligibility status, or federally administered 
State supplementary payments. In the amendment to Sec. 416.2201, we 
also explain that for the purpose of the SSI VR payment regulations, we 
refer to SSI benefits, special SSI eligibility status, or federally 
administered State supplementary payments as ``disability or blindness 
benefits.'' Additionally, we are adding a corresponding definition of 
``disability or blindness benefits'' for this purpose in Sec. 416.2203, 
discussed below.
    The amendment to Sec. 416.2201 further explains that, subject to 
the other requirements and conditions for payment prescribed in the 
regulations, payment may be made for VR services which are furnished 
during a month(s) for which an individual is eligible for disability or 
blindness benefits or continues to receive such benefits under section 
1631(a)(6) of the Act, or which are furnished during a month(s) for 
which the individual's disability or blindness benefits are suspended. 
This rule also is reflected in the revised Sec. 416.2215, discussed 
below.

[[Page 31024]]

    In Sec. 416.2203, ``Definitions,'' we are deleting the paragraph 
defining ``eligible,'' which discusses eligibility for SSI benefits 
only, and adding a new paragraph to explain the meaning of ``disability 
or blindness benefits'' when used in the SSI VR payment regulations. 
These final rules provide that ``disability or blindness benefits,'' as 
defined for the SSI VR payment regulations only, refer to regular SSI 
benefits under section 1611 of the Act, special SSI cash benefits under 
section 1619(a) of the Act, special SSI eligibility status under 
section 1619(b) of the Act, and/or a federally administered State 
supplementary payment under section 1616 of the Act or section 212(b) 
of Pub. L. 93-66, for which an individual is eligible based on 
disability or blindness, as appropriate. Thus, in these final VR 
payment regulations, when we use the terms ``disability or blindness 
benefits'' with reference to the SSI program, we mean the benefits, 
status, or payments referred to in section 1615(e) of the Act. As used 
in this preamble, ``disability or blindness benefits'' has the same 
meaning as in the final rules. Further, in Sec. 416.2203, we are 
defining the phrase ``special SSI eligibility status'' to refer to the 
special status for Medicaid under section 1619(b) of the Act since this 
is the phrase we use to describe the special status in our other SSI 
regulations, e.g., Secs. 416.260 and 416.264.
    We are also amending several sections of the SSI VR payment 
regulations to replace phrases such as ``disability or blindness 
payment'' with the phrase ``disability or blindness benefits'' and to 
substitute the term ``benefits'' for ``payment'' or ``payments'' as the 
context requires. We are making these changes to Secs. 416.2201(b), 
416.2209 (b) and (c), 416.2212, 416.2213(c), 416.2215 (a) and (b), and 
416.2216(c)(2).
    Section 416.2215(a) of our existing regulations provides that in 
order for the State VR agency or alternate participant to be paid, the 
VR services must have been provided--(1) after September 30, 1981; (2) 
during months the individual is eligible for SSI disability or 
blindness payments; and (3) before completion of a continuous 9-month 
period of SGA. We are revising paragraph (a)(2) of Sec. 416.2215 to 
provide that to be payable, the VR services must have been provided 
during a month or months for which--(i) the individual is eligible for 
disability or blindness benefits or continues to receive such benefits 
under section 1631(a)(6) of the Act; or (ii) the disability or 
blindness benefits of the individual are suspended due to his or her 
ineligibility for the benefits. We are also revising paragraph (a)(3) 
of Sec. 416.2215 to provide that the VR services must have been 
provided prior to the completion of a continuous 9-month period of SGA 
or termination of disability or blindness benefits, whichever occurs 
first.
    The revisions to Sec. 416.2215 (a)(2) and (a)(3) provide cross-
references to the regulations in Subpart M of 20 CFR Part 416 which 
contain our rules on suspension and termination of benefits under the 
SSI program. In general, these regulations provide that unless a 
termination of an individual's eligibility for benefits is required, an 
individual's benefits will be suspended for any month for which the 
individual no longer meets the requirements for eligibility for 
benefits under the SSI program. Termination of eligibility is required 
when benefits have been suspended for a period of 12 consecutive 
months, i.e., the individual remains ineligible for SSI benefits, 
special status for Medicaid, and/or federally administered State 
supplementary payments for a continuous 12-month period. Eligibility 
for SSI benefits based on disability or blindness also terminates if 
the individual's disability or blindness ceases, unless the individual 
is participating in an approved VR program and the other requirements 
for the continuation of benefits under section 1631(a)(6) of the Act 
are met.
    The revisions to Secs. 416.2215 (a)(2) and (a)(3) are consistent 
with the provisions of sections 1615 (d) and (e) of the Act. They 
permit payment for VR services which are provided either during a 
month(s) for which an individual is eligible for disability or 
blindness benefits, including the continuation of such benefits under 
section 1631(a)(6) of the Act, or during a month(s) for which the 
individual is ineligible for disability or blindness benefits, for a 
reason other than cessation of disability or blindness, if such 
month(s) occurs prior to the 13th consecutive month of such 
ineligibility, i.e., a month(s) for which benefits are suspended but 
not terminated.
    We are also amending the introductory paragraph of Sec. 416.2217 to 
add a reference to section 1615(e) of the Act. In addition, we are 
changing the regulations governing the Social Security VR payment 
program under title II of the Act to reflect the expanded scope of the 
SSI VR payment program under title XVI resulting from section 1615(e) 
of the Act. We are amending Sec. 404.2115(b) of the title II 
regulations to explain that if VR services are provided to an 
individual who is entitled to title II disability benefits and who also 
is or has been receiving disability or blindness benefits under the SSI 
program, the determination as to when VR services must have been 
provided may be made under either Sec. 404.2115 or Sec. 416.2215, 
whichever is advantageous to the State VR agency or alternate 
participant that is participating in both VR programs.

Other Changes to the VR Payment Regulations

    In addition to the changes to the regulations discussed above, we 
are amending the Social Security and SSI VR payment regulations to 
clarify certain rules relating to payment for VR services provided to 
an individual in a case where the individual, without good cause, 
refuses to continue or cooperate in a VR program. Additionally, we are 
deleting some obsolete rules relating to the time periods within which 
claims for payment for VR services must be filed. Further, we are 
making a few other nonsubstantive changes to certain provisions of the 
regulations affected by the changes described above.
    We are amending Secs. 404.2113(c) and 416.2213(c) to indicate that 
if deductions are imposed against an individual's Social Security 
disability benefits because of VR refusal, or if an individual's 
disability or blindness benefits under the SSI program are suspended 
because of VR refusal, the services for which payment may be made in 
such a case are those VR services which were provided to the individual 
prior to his or her VR refusal. If the individual thereafter resumes 
participation in a VR program and again receives VR services, payment 
may be made for those services only if the criteria for payment in 
Sec. 404.2113 or Sec. 416.2213 are again met, or if the services 
qualify for payment under one of the other provisions of the 
regulations permitting payment, i.e., Secs. 404.2111, 404.2112, 
416.2211, or 416.2212.
    We are also deleting the parenthetical phrase ``(suspension of 
benefits in cases described in Sec. 404.2113)'' in existing 
Sec. 404.2115(a)(3). This change is appropriate since under section 
222(b) of the Act and Sec. 404.422 of the title II regulations, a 
determination by us that a Social Security disability beneficiary has 
refused, without good cause, to accept VR services available to the 
individual results in our imposing deductions against Social Security 
benefits, rather than suspending benefits. This is reflected in 
existing Secs. 404.2109(c) and 404.2113(c). To be consistent with these 
sections, we are amending Sec. 404.2116(c)(2) to clarify that a 
beneficiary's VR refusal results in deductions against Social Security

[[Page 31025]]

disability benefits, rather than a suspension of benefits.
    Existing Secs. 404.2116 (b)(2) and (c)(2) and 416.2216 (b)(2) and 
(c)(2) contain provisions which provide for the filing of claims for 
payment for VR services in certain cases within 12 months after the 
month of the initial publication of these sections in the Federal 
Register, 55 FR 8449 (March 8, 1990). This 12-month period ended March 
31, 1991, the close of the 12th month following the month of 
publication in the Federal Register. Since this time period for filing 
a claim is no longer in effect, we are deleting these provisions from 
the regulations.
    We are amending Secs. 404.2116(c)(2) and 416.2216(c)(2) to clarify 
that the other 12-month period described in these sections for filing a 
claim for payment in the case of an individual's VR refusal begins 
after the first month for which deductions are imposed against Social 
Security disability benefits, or after the first month for which 
disability or blindness benefits under the SSI program are suspended, 
because of such VR refusal.
    On September 11, 1995, we published these final rules as proposed 
rules in the Federal Register at 60 FR 47126 with a 60-day comment 
period. We received comments from two sources, but one commenter simply 
stated factually that the proposed regulations would amend certain 
regulatory provisions. This commenter offered no further comment or 
opinion about the nature or effect of the proposed regulations. The 
other commenter generally was supportive of the proposed rules, but did 
suggest a better description of the issues and a short explanation of 
the statutory requirements. In the absence of other comments, we 
believe the explanation of the proposed rules as published is adequate. 
Therefore, we are publishing the final rules essentially unchanged from 
the proposed rules.

Regulatory Procedures

    Pursuant to section 702(a)(5) of the Social Security Act, 42 U.S.C. 
902(a)(5), as amended by section 102 of Pub. L. 103-296, SSA follows 
the Administrative Procedure Act (APA) rulemaking procedures specified 
in 5 U.S.C. 553 in the development of its regulations. The APA provides 
in 5 U.S.C. 553(d) that a substantive rule will be published at least 
30 days before its effective date, with certain exceptions. We find 
good cause for dispensing with the 30-day delay in the effective date 
of this rule, as provided for by 5 U.S.C. 553(d)(3). As explained 
above, we are amending our regulations to reflect current provisions of 
the law. It would be contrary to the public interest to delay making 
our regulations consistent with current law. Therefore, we find that it 
is in the public interest to make this rule effective upon publication.

Executive Order 12866

    We have consulted with the Office of Management and Budget (OMB) 
and determined that these rules do not meet the criteria for a 
significant regulatory action under Executive Order 12866. Thus, they 
were not subject to OMB review.

Regulatory Flexibility Act

    We certify that these regulations will not have a significant 
economic impact on a substantial number of small entities. Therefore, a 
regulatory flexibility analysis as provided in Pub. L. 96-354, the 
Regulatory Flexibility Act, is not required.
    These final regulations carry out section 1615(e) of the Act which 
allows payment for VR services under section 1615(d) of the Act 
provided during certain months for which an individual does not receive 
SSI benefits based on disability or blindness. They apply to States and 
certain alternate providers of VR services which are willing to provide 
services to disabled or blind SSI recipients, or Social Security 
disability beneficiaries, under our VR payment programs under the 
conditions specified in the regulations.

Paperwork Reduction Act

    These final regulations impose no additional reporting or 
recordkeeping requirements subject to clearance by OMB.

(Catalog of Federal Domestic Assistance Program Nos. 96.001, Social 
Security-Disability Insurance; 96.006, Supplemental Security Income)

List of Subjects

20 CFR Part 404

    Administrative practice and procedure, Blind, Disability benefits, 
Old-Age, Survivors and Disability Insurance, Reporting and 
recordkeeping requirements, Social Security.

20 CFR Part 416

    Administrative practice and procedure, Aged, Blind, Disability 
benefits, Public assistance programs, Supplemental Security Income 
(SSI), Reporting and recordkeeping requirements.

    Dated: June 4, 1996.
Shirley S. Chater,
Commissioner of Social Security.

    For the reasons set out in the preamble, we are amending subpart V 
of part 404 and subpart V of part 416 of 20 CFR chapter III as follows:

PART 404--FEDERAL OLD-AGE, SURVIVORS AND DISABILITY INSURANCE 
(1950-    )

Subpart V--[Amended]

    1. The authority citation for subpart V of part 404 continues to 
read as follows:

    Authority: Secs. 205(a), 222, and 702(a)(5) of the Social 
Security Act (42 U.S.C. 405(a), 422, and 902(a)(5)).

    2. Section 404.2113 is amended by revising the last sentence of 
paragraph (c) to read as follows:


Sec. 404.2113  Payment for VR services in a case of VR refusal.

* * * * *
    (c) * * * A State VR agency or alternate participant may be paid, 
subject to the provisions of this subpart, for the costs of VR services 
provided to an individual prior to his or her VR refusal if deductions 
have been imposed against the individual's monthly disability benefits 
for a month(s) after October 1984 because of such VR refusal.
    3. Section 404.2115 is amended by revising paragraphs (a)(3) and 
(b) to read as follows:


Sec. 404.2115  When services must have been provided.

    (a) * * *
    (3) Before completion of a continuous 9-month period of SGA or 
termination of entitlement to disability benefits, whichever occurs 
first.
    (b) If an individual who is entitled to disability benefits under 
this part also is or has been receiving disability or blindness 
benefits under part 416 of this chapter, the determination as to when 
services must have been provided may be made under this section or 
Sec. 416.2215 of this chapter, whichever is advantageous to the State 
VR agency or alternate participant that is participating in both VR 
programs.
    4. Section 404.2116 is amended by revising paragraphs (b)(2) and 
(c)(2) to read as follows:


Sec. 404.2116  When claims for payment for VR services must be made 
(filing deadlines).

* * * * *
    (b) * * *
    (2) If no written notice was sent to the State VR agency or 
alternate participant, a claim must be filed within 12 months after the 
month in which VR services end.
    (c) * * *
    (2) If no written notice was sent to the State VR agency or 
alternate participant,

[[Page 31026]]

a claim must be filed within 12 months after the first month for which 
deductions are imposed against disability benefits because of such VR 
refusal.

PART 416--SUPPLEMENTAL SECURITY INCOME FOR THE AGED, BLIND, AND 
DISABLED

Subpart V--[Amended]

    5. The authority citation for subpart V of part 416 is revised to 
read as follows:

    Authority: Secs. 702(a)(5), 1615, 1631(d)(1) and (e), and 
1633(a) of the Social Security Act (42 U.S.C. 902(a)(5), 1382d, 
1383(d)(1) and (e), and 1683b(a)).

    6. Section 416.2201 is amended by revising the introductory text 
and paragraph (b) to read as follows:


Sec. 416.2201  General.

    In general, sections 1615 (d) and (e) of the Social Security Act 
(the Act) authorize payment from the general fund for the reasonable 
and necessary costs of vocational rehabilitation (VR) services provided 
certain disabled or blind individuals who are eligible for supplemental 
security income (SSI) benefits, special SSI eligibility status, or 
federally administered State supplementary payments. In this subpart, 
such benefits, status, or payments are referred to as disability or 
blindness benefits (see Sec. 416.2203). Subject to the provisions of 
this subpart, payment may be made for VR services provided an 
individual during a month(s) for which the individual is eligible for 
disability or blindness benefits, including the continuation of such 
benefits under section 1631(a)(6) of the Act, or for which the 
individual's disability or blindness benefits are suspended (see 
Sec. 416.2215). Paragraphs (a), (b) and (c) of this section describe 
the cases in which the State VR agencies and alternate participants can 
be paid for the VR services provided such an individual under this 
subpart. The purpose of sections 1615 (d) and (e) of the Act is to make 
VR services more readily available to disabled or blind individuals, 
help State VR agencies and alternate participants to recover some of 
their costs in VR refusal situations, as described in Sec. 416.2213, 
and ensure that savings accrue to the general fund. Payment will be 
made for VR services provided on behalf of such an individual in cases 
where--
* * * * *
    (b) The individual continues to receive disability or blindness 
benefits, even though his or her disability or blindness has ceased, 
under section 1631(a)(6) of the Act because of his or her continued 
participation in an approved VR program which we have determined will 
increase the likelihood that he or she will not return to the 
disability or blindness rolls (see Sec. 416.2212); or
* * * * *
    7. Section 416.2203 is amended by removing the definition of 
``Eligible'' and adding 2 new definitions in alphabetical order to read 
as follows:


Sec. 416.2203  Definitions.

* * * * *
    Disability or blindness benefits, as defined for this subpart only, 
refers to regular SSI benefits under section 1611 of the Act (see 
Sec. 416.202), special SSI cash benefits under section 1619(a) of the 
Act (see Sec. 416.261), special SSI eligibility status under section 
1619(b) of the Act (see Sec. 416.264), and/or a federally administered 
State supplementary payment under section 1616 of the Act or section 
212(b) of Public Law 93-66 (see Sec. 416.2001), for which an individual 
is eligible based on disability or blindness, as appropriate.
* * * * *
    Special SSI eligibility status refers to the special status 
described in Secs. 416.264 through 416.269 relating to eligibility for 
Medicaid.
* * * * *


Sec. 416.2209  [Amended]

    8. Section 416.2209 is amended in paragraph (b) by removing 
``payments'' and adding ``benefits'' in its place and in paragraph (c) 
by removing ``payment'' and adding ``benefits'' in its place.
    9. Section 416.2212 is amended by revising the section heading and 
the first and second sentences to read as follows:


Sec. 416.2212  Payment for VR services in a case where an individual 
continues to receive disability or blindness benefits based on 
participation in an approved VR program.

    Section 1631(a)(6) of the Act contains the criteria we will use in 
determining if an individual whose disability or blindness has ceased 
should continue to receive disability or blindness benefits because of 
his or her continued participation in an approved VR program. A VR 
agency or alternate participant can be paid for the cost of VR services 
provided to an individual if the individual was receiving benefits 
based on this provision in a month(s) after October 1984 or, in the 
case of a blindness recipient, in a month(s) after March 1988. * * *
    10. Section 416.2213 is amended by revising the last sentence of 
paragraph (c) to read as follows:


Sec. 416.2213  Payment for VR services in a case of VR refusal.

* * * * *
    (c) * * * A State VR agency or alternate participant may be paid, 
subject to the provisions of this subpart, for the costs of VR services 
provided to an individual prior to his or her VR refusal if the 
individual's disability or blindness benefits have been suspended for a 
month(s) after October 1984 because of such VR refusal.
    11. Section 416.2215 is revised to read as follows:


Sec. 416.2215  When services must have been provided.

    (a) In order for the VR agency or alternate participant to be paid, 
the services must have been provided--
    (1) After September 30, 1981;
    (2) During a month(s) for which--
    (i) The individual is eligible for disability or blindness benefits 
or continues to receive such benefits under section 1631(a)(6) of the 
Act (see Sec. 416.2212); or
    (ii) The disability or blindness benefits of the individual are 
suspended due to his or her ineligibility for the benefits (see subpart 
M of this part concerning suspension for ineligibility); and
    (3) Before completion of a continuous 9-month period of SGA or 
termination of disability or blindness benefits, whichever occurs first 
(see subpart M of this part concerning termination of benefits).
    (b) If an individual who is receiving disability or blindness 
benefits under this part, or whose benefits under this part are 
suspended, also is entitled to disability benefits under part 404 of 
this chapter, the determination as to when services must have been 
provided may be made under this section or Sec. 404.2115 of this 
chapter, whichever is advantageous to the State VR agency or alternate 
participant that is participating in both VR programs.
    12. Section 416.2216 is amended by revising paragraphs (b)(2) and 
(c)(2) to read as follows:


Sec. 416.2216  When claims for payment for VR services must be made 
(filing deadlines).

* * * * *
    (b) * * *
    (2) If no written notice was sent to the State VR agency or 
alternate participant, a claim must be filed within 12 months after the 
month in which VR services end.
    (c) * * *
    (2) If no written notice was sent to the State VR agency or 
alternate participant, a claim must be filed within 12 months

[[Page 31027]]

after the first month for which disability or blindness benefits are 
suspended because of such VR refusal.


Sec. 416.2217  [Amended]

    13. Section 416.2217 is amended in the introductory text of the 
section by adding ``and (e)'' after ``section 1615(d).''

[FR Doc. 96-15407 Filed 6-18-96; 8:45 am]
BILLING CODE 4190-29-P