43442 Federal Register / Vol. 82, No. 178 / Friday, September 15, 2017 / Notices 

1See Centers for Disease Control and Prevention, 

‘‘Sickle Cell Disease.’’ (https://www.cdc.gov/ 

ncbddd/sicklecell/data.html.) 

2See National Heart, Lung, and Blood Institute, 

‘‘What Are the Signs and Symptoms of Sickle Cell 

Disease?’’ (https://www.nhlbi.nih.gov/health/ 

health-topics/topics/sca). Health problems usually 

do not appear until an infant is around 5 to 6 

months of age. 

SOCIAL SECURITY ADMINISTRATION 

[Docket No. SSA–2017–0007] 

Social Security Ruling, SSR 17–3p; 

Titles II and XVI: Evaluating Cases 

Involving Sickle Cell Disease (SCD) 

AGENCY: Social Security Administration. 

ACTION: Notice of Social Security Ruling 

(SSR). 

SUMMARY: We are providing notice of 

SSR 17–3p. This SSR provides guidance 

on SCD and how we evaluate SCD in 

disability claims under titles II and XVI 

of the Social Security Act. 

DATES: This SSR is applicable on 

September 15, 2017. 

FOR FURTHER INFORMATION CONTACT: 

Cheryl A. Williams, Office of Disability 

Policy, Social Security Administration, 

6401 Security Boulevard, Baltimore, 

Maryland 21235–6401, (410) 965–1020. 

For information on eligibility or filing 

for benefits, call our national toll-free 

number, 1–800–772–1213 or TTY 1– 

800–325–0778, or visit our Internet site, 

Social Security Online, at http://

www.socialsecurity.gov. 

SUPPLEMENTARY INFORMATION: Although 

5 U.S.C. 552(a)(1) and (a)(2) do not 

require us to publish this SSR, we are 

doing so in accordance with 20 CFR 

402.35(b)(1). 

Through SSRs, we make available to 

the public precedential decisions 

relating to the Federal old-age, 

survivors, disability, supplemental 

security income, and special veterans’ 

benefits programs. We may base SSRs 

on determinations or decisions made at 

all levels of administrative adjudication, 

Federal court decisions, Commissioner’s 

decisions, opinions of the Office of the 

General Counsel, or other 

interpretations of the law and 

regulations. 

Although SSRs do not have the same 

force and effect as statutes or 

regulations, they are binding on all 

components of the Social Security 

Administration. 20 CFR 402.35(b)(1). 

This SSR will remain in effect until 

we publish a notice in the Federal 

Register that rescinds it, or until we 

publish a new SSR that replaces or 

modifies it. 

(Catalog of Federal Domestic Assistance, 

Programs Nos. 96.001, Social Security— 

Disability Insurance; 96.002, Social 

Security—Retirement Insurance; 96.004, 

Social Security—Survivors Insurance; 

96.006—Supplemental Security Income.) 

Nancy A. Berryhill, 

Acting Commissioner of Social Security. 

Policy Interpretation Ruling 

Titles II and XVI: Evaluating Cases 

Involving Sickle Cell Disease (SCD) 

Purpose: This Social Security Ruling 

(SSR) provides background information 

on SCD and how we evaluate SCD 

during our adjudication process. We 

provide this guidance to help 

adjudicators consistently apply our 

policies in disability claims involving 

SCD. 

Citations: Sections 216(i), 223(d), 

223(f), 1614(a)(3) and 1614(a)(4) of the 

Social Security Act, as amended; 

Regulations No. 4, subpart P, sections 

404.1502, 404.1505, 404.1509, 404.1512, 

404.1513, 404.1520, 404.1520a, 

404.1520b, 404.1521, 404.1522, 

404.1523, 404.1525, 404.1526, 404.1529, 

404.1545, 404.1560–404.1569a, 

404.1593, 404.1594, appendices 1 and 2; 

and Regulations No. 16, subpart I, 

sections 416.902, 416.905, 416.906, 

416.909, 416.911, 416.912, 416.913, 

416.920, 416.920a, 416.920b, 416.921, 

416.922, 416.923, 416.924, 416.924a, 

416.925, 416.926, 416.926a, 416.929, 

416.945, 416.960–416.969a, 416.987, 

416.993, 416.994, and 416.994a. 

Introduction 

SCD is the most common inherited 

blood disease in the United States, 

affecting an estimated 100,000 

Americans.1 SCD is not always easy to 

evaluate due to its varying nature and 

complications. In this SSR, we provide 

basic information about SCD and its 

variants and clarify that sickle cell trait 

is not a variant of SCD. We also provide 

guidance for assessing SCD under the 

hematological disorder listings and 

determining how this impairment may 

affect the residual functional capacity 

finding for adults and the functional 

equivalence finding for children. 

Policy Interpretation 

We consider all medical evidence 

when we evaluate a claim for disability 

benefits. The following information is in 

a question and answer format that 

provides guidance about SCD and how 

to consider evidence regarding this 

impairment. Questions 1 and 2 provide 

basic background information about 

SCD and its variants. Question 3 

clarifies that sickle cell trait is not a 

variant of SCD. Question 4 discusses the 

complications and symptoms of SCD. 

Questions 5 through 7 explain how 

adjudicators should evaluate SCD at 

various points of the adjudication 

process, including the adult and child 

hematological listings we consider. 

List of Questions 

1. What is SCD? 

2. What are the different variants of 

SCD? 

3. Is sickle cell trait a variant of SCD? 

4. What are the common 

complications and symptoms of SCD? 

5. How do we evaluate the 

complications of SCD under the 

hematological disorder listings? 

6. How do we evaluate the 

complications of SCD when assessing 

residual functional capacity (RFC) for 

adults? 

7. How do we evaluate the 

complications of SCD under functional 

equivalence for children? 

Answers 

1. What is SCD? 

SCD is a type of hemolytic anemia 

and an inherited hematological disorder 

that affects the hemoglobin within a 

person’s red blood cells (RBC). 

Hemoglobin is the protein within RBC 

that carries oxygen. The abnormal 

hemoglobin makes the RBC more prone 

to distortion (‘‘sickling’’), which results 

in blocked blood vessels and a 

shortened RBC lifespan. Hemolytic 

anemia results when the abnormal RBC 

are destroyed faster than the body can 

produce them. 

When hemoglobin is normal, a 

person’s RBC are round and easily travel 

through blood vessels, bringing oxygen 

to the body’s organs and tissues. SCD 

causes sickle-shaped RBC that are not 

flexible and can stick to vessel walls, 

causing blockages (vaso-occlusion) that 

slow or stop the flow of blood and 

oxygen. This blockage may in turn cause 

pain. Persons with SCD are predisposed 

to pain, infection, and other 

complications. Because people inherit 

SCD, the disease is present at birth, but 

the age when children display 

symptoms varies.2

2. What are the different variants of 

SCD? 

The different variants of SCD may 

indicate the severity of complications 

and the resulting functional limitations 

caused by SCD. Laboratory blood tests 

such as hemoglobin electrophoresis 

establish the existence and the variants 

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Federal Register / Vol. 82, No. 178 / Friday, September 15, 2017 / Notices 43443 

3See Centers for Disease Control and Prevention, 

‘‘Sickle Cell Disease.’’ (https://www.cdc.gov/ 

ncbddd/sicklecell/facts.html). 

4Other conditions that could be harmful for 

people with sickle cell trait include high altitudes, 

dehydration, low oxygen levels in the air, and 

increased pressure in the atmosphere. We evaluate 

impairments that result from sickle cell trait under 

the affected body system. 

5See Nelson D.A., et al. Sickle Cell Trait, 

Rhabdomyolysis, and Mortality among U.S. Army 

Soldiers. New England Journal of Medicine, Aug; 

375(17), 1695–6 (2016). 

6See National Heart, Lung, and Blood Institute, 

‘‘What Are the Signs and Symptoms of Sickle Cell 

Disease?’’ (http://www.nhlbi.nih.gov/health/healthtopics/topics/sca/signs). 

7See Okpala I, Tawil A. Management of Pain in 

Sickle-Cell Disease. Journal of the Royal Society of 

Medicine, Sep; 95(9), 456–458, 2002 (available at: 

http://www.ncbi.nlm.nih.gov/pmc/articles/ 

PMC1279994/). 

8See Gladwin MT, Miller, A. Pulmonary 

Complications of Sickle Cell Disease. American 

Journal of Respiratory and Critical Care Medicine, 

Jun; 185(11), 1154–1165, 2012 (available at: https:// 

www.ncbi.nlm.nih.gov/pmc/articles/PMC3373067/). 

9See National Institutes of Health. MedlinePlus. 

‘‘Pulmonary Hypertension.’’ (https://

medlineplus.gov/pulmonaryhypertension.html). 

10See, The Internet Stroke Center, ‘‘Stroke as a 

Complication of Sickle Cell Disease.’’ (http://

www.strokecenter.org/patients/about-stroke/ 

pediatric-stroke/stroke-as-a-complication-of-sicklecell-disease/). 

11See Booth, C., et al. Infection in Sickle Cell 

Disease: A Review. International Journal of 

Infectious Diseases, Jan; 14(1), e2–e12, 2010 

(available at: http://www.sciencedirect.com/science/ 

article/pii/S1201971209001453). 

of SCD. The following are the most 

common variants of SCD: 3

• Hemoglobin (Hb) SS (HbSS)—a 

person with this form of SCD inherits 

one sickle cell gene from each parent. 

HbSS is the most common and usually 

most severe form of SCD. 

• HbSC—a person inherits one sickle 

cell gene from one parent, and another 

gene for an abnormal hemoglobin called 

‘‘C’’ from the other parent. HbSC is 

usually a milder type of SCD. 

• Hb S-beta (Sb) thalassemia— a 

person inherits one sickle cell gene from 

one parent, and a gene for beta 

thalassemia from the other parent. There 

are two forms of beta thalassemia, sickle 

beta zero thalassemia (Hb Sb0

thalassemia) and sickle beta plus 

thalassemia (Hb Sb+ thalassemia). Sickle 

beta zero thalassemia is usually a more 

severe form of SCD. People with sickle 

beta plus thalassemia tend to have a 

milder form of SCD. 

• HbSD, HbSE, and HbSO—people 

with these variants of SCD have one 

sickle cell gene plus another abnormal 

hemoglobin gene, ‘‘D,’’ ‘‘E,’’ or ‘‘O.’’ 

These are rarer types of SCD with 

varying severity. 

3. Is sickle cell trait a variant of SCD? 

No. Sickle cell trait is not a variant of 

SCD. Sickle cell trait occurs when a 

person inherits one sickle hemoglobin 

gene from one parent and a normal gene 

from the other parent. People with 

sickle cell trait rarely have signs and 

symptoms associated with SCD and 

usually do not need treatment. 

However, in rare cases and under 

extreme conditions such as intense 

exercise, people with sickle cell trait 

have a higher risk of severe breakdown 

of muscle tissue (exertional 

rhabdomyolysis) that can lead to serious 

complications.4 In spite of this higher 

risk, recent evidence indicates that 

sickle cell trait is not associated with an 

increased probability of death.5

Sickle cell trait alone is not an 

impairment. As defined by the Social 

Security Act, an impairment must result 

from anatomical, physiological, or 

psychological abnormalities that can be 

shown by medically acceptable clinical 

and laboratory diagnostic techniques. 

To establish an impairment in this 

context, we require objective medical 

evidence (medical signs and laboratory 

findings) from an acceptable medical 

source of complications from sickle cell 

trait. In addition, a person’s 

complications from sickle cell trait must 

meet the statutory duration requirement, 

i.e., be expected to result in death or last 

or be expected to last for a continuous 

period of not less than 12 months. 

Therefore, we cannot find a person 

disabled due to sickle cell trait if there 

are no medical signs or laboratory 

findings of complications from sickle 

cell trait and the complications from 

sickle cell trait do not meet the duration 

requirement. 

4. What are the common complications 

and symptoms of SCD? 

Complications of SCD may include, 

but are not limited to pain crises, 

anemia, osteomyelitis, leg ulcers, 

pulmonary infections or infarctions, 

acute chest syndrome, pulmonary 

hypertension, chronic heart failure, 

gallbladder disease, liver failure, kidney 

failure, nephritic syndrome, aplastic 

crisis, stroke, and mental impairments 

such as depression. Examples of 

symptoms that may stem from these 

complications include pain, fatigue, 

malaise, shortness of breath, and 

difficulty feeding in infants. The 

symptoms of SCD vary from person to 

person and can change over time. 

A. Pain (vaso-occlusive) crisis is a 

common complication of SCD. Pain 

crises are either acute or chronic. Acute 

pain crises occur suddenly when 

sickled RBC stop blood flow and reduce 

oxygen delivery. This pain can be 

intense, stabbing, or throbbing. Pain can 

strike almost anywhere in the body and 

in more than one spot at a time. The 

pain often occurs in the lower back, 

legs, arms, abdomen, and chest.6

Chronic pain in SCD is more than a 

continuation of acute pain crisis. It 

usually occurs when lack of oxygen to 

the bone due to vaso-occlusion results 

in the death of bone tissue (avascular 

necrosis) at various joints such as the 

hips, shoulders and ankles.7

B. Anemia is another complication of 

SCD. It occurs when sickled RBC die 

prematurely, which reduces the amount 

of oxygen-carrying hemoglobin in the 

blood. Symptoms from anemia can 

include fatigue, weakness, shortness of 

breath, and dizziness. Chronic 

deprivation of oxygen-rich blood can 

damage nerves and organs in the body, 

including the spleen, brain, eyes, joints, 

bones, lungs, liver, heart, kidneys, and 

other organs. 

C. Pulmonary complications such as 

acute chest syndrome (ACS) and 

pulmonary hypertension are the leading 

cause of death for SCD patients.8 ACS is 

a vaso-occlusion of the pulmonary 

vessels. Symptoms of ACS include but 

are not limited to chest pain, fever, 

tachypnea (abnormally rapid breathing), 

wheezing, or coughing. Pulmonary 

hypertension can occur when sickled 

RBC cause pulmonary arteries to 

become narrow and blocked. The result 

of this damage to the pulmonary arteries 

is high blood pressure in the lungs. 

Symptoms of pulmonary hypertension 

include shortness of breath, fatigue, and 

chest pain.9

D. Strokes and silent strokes affect 

people with SCD at a higher rate 

because sickled RBC clump along the 

walls of larger arteries going to the 

brain. Strokes can result in full or 

partial paralysis on one side of the body, 

problems with balance, or difficulty 

speaking or understanding. Silent 

strokes can occur without outward 

symptoms and are only detectable by 

brain imaging. However, silent strokes 

can impair intellectual ability, attention, 

visual-spatial skills, language, and longterm memory.10

E. Bacterial infections are often severe 

complications in people with SCD. 

Anemia from SCD and vaso-occlusions 

can damage the spleen, which 

ultimately increases risk of infection 

and damages other organs. Infection 

frequently leads to hospitalization and 

is the primary cause of death in young 

children with SCD.11

F. Mental disorders in people with 

SCD are often secondary to the impact 

of treatment, pain, and other symptoms. 

For example, depression from 

reoccurring pain is especially common 

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43444 Federal Register / Vol. 82, No. 178 / Friday, September 15, 2017 / Notices 

12See Jonassaint CR, Jones VL, Leong S, Frierson 

GM. A Systematic Review of the Association 

between Depression and Health Care Utilization in 

Children and Adults with Sickle Cell Disease. 

British Journal of Hematology, Jul; 174(1), 136–47, 

2016. 

13Becker M, Axelrod DJ. Hematologic Problems 

in Psychosomatic Medicine. Psychiatric Clinics of 

North America, Dec; 30(4), 739–759, 2007 (available 

at: http://www.sciencedirect.com/science/article/ 

pii/S0193953X07000767). 

14We evaluate a child’s functioning under the 

rules for functional equivalence. See 20 CFR 

416.926a. 

15We use listing 7.18 to evaluate hematological 

disorders and complications caused by 

hematological disorders. We can only evaluate 

anemia under 7.18 if it results from an underlying 

hematological disorder. If the person’s anemia 

results from a condition that is not a hematological 

disorder, we would evaluate the anemia under the 

listing for that impairment. 

16See 20 CFR 404.1545 and 416.945, and SSR 96– 

8p. 

17Functional equivalence applies only to claims 

for children under title XVI. All claims for title II, 

even if the claimant is under age 18, are decided 

under the adult rules. 

18See 20 CFR 416.926a, SSR 09–1p, 74 FR 7527 

(2009) also available at https://www.ssa.gov/OP_

Home/rulings/ssi/02/SSR2009-01-ssi-02.html, and 

SSR 09–2p, 74 FR 7525 (2009) also available at 

https://www.ssa.gov/OP_Home/rulings/ssi/02/ 

SSR2009-02-ssi-02.html. For the complete titles of 

all SSRs cited in this footnote and those following, 

see the CROSS-REFERENCES section at the end of 

this SSR. 

19See 20 CFR 416.924a(b) and 416.926a. 

20See 20 CFR 416.926a(g) and SSR 09–3p. 

21See 20 CFR 416.926a(h) and SSR 09–4p. 

22See 20 CFR 416.926a(i) and SSR 09–5p. 

23See 20 CFR 416.926a(j) and SSR 09–6p. 

in people with SCD.12 Other mental 

disorders that may occur include, but 

are not limited to, anxiety and cognitive 

disorders from stroke.13

5. How do we evaluate the 

complications of SCD under the 

hematological disorder listings? 

We may evaluate SCD under the 

following hematological disorder 

listings: 

• Listing 7.05 and 107.05, Hemolytic 

anemias; or 

• Listing 7.17 and 107.17, 

Hematological disorders treated by bone 

marrow or stem cell transplantation; or 

• Listing 7.18, Repeated 

complications of hematological 

disorders. 

Under listing 7.05 and 107.05, we 

assess hemolytic anemias, including 

sickle cell disease, thalassemia, and 

their variants. We evaluate pain crises 

caused by SCD under listings 7.05A and 

107.05A. We assess complications of 

SCD requiring hospitalizations under 

listings 7.05B and 107.05B. Listings 

7.05C and 107.05C describes the criteria 

we use to evaluate SCD that results in 

anemia with low hemoglobin levels. 

Under listings 7.17 and 107.17, we 

consider people who receive bone 

marrow or stem cell transplantation to 

treat their SCD, to be disabled for at 

least 12 months after the date of 

transplant. 

We evaluate adults who have repeated 

complications from SCD, but do not 

have the requisite findings for listing 

7.05 or 7.17, under listing 7.18.14 To 

meet listing 7.18, SCD must cause 

repeated complications, resulting in 

significant, documented symptoms or 

signs and a ‘‘marked’’ level of limitation 

in one of the general areas of 

functioning: Activities of daily living, 

social functioning, or completing tasks 

because of deficiencies in concentration, 

persistence, or pace. We use listing 7.18 

to evaluate only hematological 

disorders.15

If a person’s SCD does not meet a 

hematological listing, we will compare 

the specific findings in each case to any 

appropriate hematological listings to 

determine whether medical equivalence 

may exist. We may also find medical 

equivalence if the person has multiple 

impairments, including SCD, none of 

which meet or medically equal the 

requirements of a listing alone, but the 

combination of impairments is 

medically equivalent in severity to a 

listed impairment. 

If the person’s SCD does not meet or 

equal the criteria in a listing, we will 

consider whether he or she has an 

impairment that satisfies the criteria in 

a listing in another body system. For 

example, we may evaluate the effects of 

intracranial bleeding or stroke under 

11.00 or 12.00. 

6. How do we evaluate the 

complications of SCD when assessing 

residual functional capacity (RFC) for 

adults? 

For adults, we assess RFC when the 

effects of a person’s SCD, either alone or 

in combination with another 

impairment(s), do not meet or medically 

equal a listing. We base the RFC 

assessment on all the relevant evidence 

in the record, including the effects of 

treatment.16 In assessing RFC, we must 

consider all of a person’s work-related 

limitations, whether due to SCD, other 

impairment(s), or a combination of 

impairments. For example, adults with 

SCD may have pain, fatigue, and 

shortness of breath that may affect their 

ability to stand and walk. In addition, a 

person experiencing repeated acute pain 

crises may have difficulty maintaining 

concentration to complete tasks and 

have frequent absences from work. 

7. How do we evaluate the 

complications of SCD under functional 

equivalence? 17

Children with SCD that does not meet 

or medically equal a listing may 

nevertheless have an impairment(s) that 

functionally equals the listings under 

our rules for evaluating disability in 

children.18 When we determine whether 

a child’s impairment(s) functionally 

equal the listings, we use the six 

domains of functioning. 

When we evaluate a child’s 

functioning in these six domains, we 

consider how the child functions 

compared to children the same age who 

do not have impairments. We must 

explain any limitation in a child’s 

ability to function appropriately for his 

or her age based on a medically 

determinable impairment(s).19 It is 

important to remember that the 

cumulative physical effects of SCD and 

its treatment can vary in kind and 

intensity, affecting each child 

differently. The six domains of 

functioning are: 

Acquiring and using information. 

Some children with SCD may have 

limitations in acquiring and using 

information due to stroke, including 

silent stroke.20 A stroke can cause brain 

injury that impairs a child’s ability to 

learn, concentrate, speak, and 

remember. 

Attending and completing tasks. 

Frequent pain crises can result in 

limitations in attending and completing 

tasks at school and at home.21 If a child 

does not feel well due to pain, it may 

be difficult for him or her to stay 

focused on activities long enough to 

complete them in an age-appropriate 

manner. A child with SCD who is 

experiencing pain may also have 

difficulty paying attention to details and 

may make mistakes on schoolwork due 

to an inability to concentrate. 

Interacting and relating with others. 

SCD can also cause limitations 

interacting and relating with others.22

The unpredictable nature of pain in SCD 

may cause anxiety and difficulty 

maintaining relationships. Children 

suffering from complications of SCD 

may become withdrawn, uncooperative, 

or unresponsive. 

Moving about and manipulating 

objects. If SCD limits a child’s ability to 

move and manipulate objects, we 

evaluate those effects in the domain of 

‘‘Moving about and manipulating 

objects.’’ 23 For example, sickling in the 

hip bones, knees, and ankles due to SCD 

may cause joint pain and problems with 

walking, running, and climbing up and 

down stairs. 

Caring for yourself. Caring for yourself 

involves a child’s basic understanding 

of his or her body’s normal functioning 

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24See 20 CFR 416.926a(k) and SSR 09–7p. 

25See 20 CFR 416.926a(l) and SSR 09–8p. 

26We will use this SSR beginning on its 

applicable date. We will apply this SSR to new 

applications filed on or after the applicable date of 

the SSR and to claims that are pending on and after 

the applicable date. This means that we will use 

this ruling on and after its applicable date in any 

case in which we make a determination or decision. 

We expect that Federal courts will review our final 

decisions using the rules that were in effect at the 

time we issued the decisions. If a court reverses our 

final decision and remands a case for further 

administrative proceedings after the applicable date 

of this SSR, we will apply this SSR to the entire 

period at issue in the decision we make after the 

court’s remand. 

and the adequate emotional health for 

carrying out self-care tasks.24 A child 

with SCD may avoid taking medication 

or ignore complications of the disease 

out of frustration with the limitations of 

SCD. 

Health and physical well-being. The 

ongoing effects of SCD and its treatment 

may affect a child’s health and physical 

well-being.25 In this domain, we 

evaluate the effects of periodic 

exacerbations of pain crises due to 

sickle cell anemia. We consider the 

frequency and duration of the 

exacerbations as well as the extent to 

which they affect a child’s ability to 

function physically. 

This SSR is applicable on September 

15, 2017. 26

Cross References: SSR 86–8: Titles II 

and XVI: The Sequential Evaluation 

Process; SSR 96–3p: Titles II and XVI: 

Considering Allegations of Pain and 

Other Symptoms in Determining 

Whether a Medically Determinable 

Impairment is Severe; SSR 96–8p: Titles 

II and XVI: Assessing Residual 

Functional Capacity in Initial Claims; 

SSR 09–1p: Title XVI: Determining 

Childhood Disability Under the 

Functional Equivalence Rule—The 

‘‘Whole Child’’ Approach; SSR 09–2p: 

Title XVI: Determining Childhood 

Disability—Documenting a Child’s 

Impairment-Related Limitations; SSR 

09–3p: Title XVI: Determining 

Childhood Disability—The Functional 

Equivalence Domain of ‘‘Acquiring and 

Using Information’’; SSR 09–4p: Title 

XVI: Determining Childhood 

Disability—The Functional Equivalence 

Domain of ‘‘Attending and Completing 

Tasks’’; SSR 09–5p: Title XVI: 

Determining Childhood Disability—The 

Functional Equivalence Domain of 

‘‘Interacting and Relating with Others’’; 

SSR 09–6p: Title XVI: Determining 

Childhood Disability—The Functional 

Equivalence Domain of ‘‘Moving About 

and Manipulating Objects’’; SSR 09–7p: 

Title XVI: Determining Childhood 

Disability—The Functional Equivalence 

Domain of ‘‘Caring for Yourself’’; SSR 

09–8p: Title XVI: Determining 

Childhood Disability—The Functional 

Equivalence Domain of ‘‘Health and 

Physical Well-Being’’; SSR 16–3p: Titles 

II and XVI: Evaluation of Symptoms in 

Disability Claims; and Program 

Operations Manual System (POMS) DI 

22001.001, DI 22505.001, DI 22505.003, 

DI 24501.021, DI 24510.005, DI 

25201.005, DI 25220.010, DI 25505.025, 

and DI 25505.030. 

[FR Doc. 2017–19551 Filed 9–14–17; 8:45 am] 

BILLING CODE 4191–02–P 

DEPARTMENT OF STATE 

[Public Notice: 10119] 

Cultural Property Advisory Committee; 

Notice of Meeting 

AGENCY: Department of State. 

ACTION: Notice of a meeting. 

SUMMARY: The Department of State is 

issuing this notice to announce the 

location, date, time and agenda for the 

next meeting of the Cultural Property 

Advisory Committee. 

DATES: October 23 through 25, 2017, 

9:00 a.m. to 5:00 p.m. (EDT). The open 

session of the Cultural Property 

Advisory Committee will be held on 

October 23, 2017 at 10:00 a.m. (EDT). It 

will last approximately one hour. 

Participants will participate 

electronically. Those who wish to 

participate in the open session should 

visit http://culturalheritage.state.gov 

where information will be provided on 

how to access the meeting no later than 

October 16, 2017. 

Written Comments: must be received 

no later than October 15, 2017, at 11:59 

p.m. (EDT). 

ADDRESSES: The meeting will be held at 

the U.S. Department of State, Annex 5, 

2200 C St. NW. and the Harry S Truman 

Building, 2201 C St. NW., Washington, 

DC. 

Comments: Methods of written 

comment submission are as follows: 

• Electronic Comments: Use http://

www.regulations.gov, enter the docket 

[DOS–2017–0036] and follow the 

prompts to submit comments. 

• Paper Comments: Only send paper 

comments if comments contain 

privileged or confidential information 

(within the meaning of 19 U.S.C. 

2605(i)(1)) to: U.S. Department of State, 

Bureau of Educational and Cultural 

Affairs—Cultural Heritage Center, SA–5 

Floor 5, 2200 C St. NW., Washington, 

DC 20522–0505. 

FOR FURTHER INFORMATION CONTACT: For 

general questions concerning the 

meeting, contact Catherine Foster, 

Bureau of Educational and Cultural 

Affairs—Cultural Heritage Center by 

phone, (202) 632–6301, or mail: 

CulProp@state.gov. 

SUPPLEMENTARY INFORMATION: Pursuant 

to section 306(e)(2) of the Convention 

on Cultural Property Implementation 

Act (5 U.S.C. 2601 et seq.) (‘‘the Act’’), 

the Department is announcing a meeting 

of the Cultural Property Advisory 

Committee (‘‘the Committee’’). The 

Committee’s responsibilities are carried 

out in accordance with provisions of the 

Act. A portion of this meeting will be 

closed to the public pursuant to 5 U.S.C. 

552b(c)(9)(B) and 19 U.S.C. 2605. 

Meeting Agenda: The Committee will 

review a proposal to extend the 

Memorandum of Understanding 

Between the Government of United 

States of America and the Government 

of the Kingdom of Cambodia 

Concerning the Imposition of Import 

Restrictions on Archaeological Material 

from Cambodia from the Bronze Age 

through the Khmer Era (‘‘the Cambodia 

MOU’’). 

Open Session Participation: An open 

session of the meeting to receive oral 

public comments on the proposed 

extension of the Cambodia MOU will be 

held Monday, October 23, 2017, from 

10:00 a.m. to 11:00 a.m. (EDT). The text 

of the Act and a copy of the Cambodia 

MOU may be found at http://

culturalheritage.state.gov. 

If you wish to make an oral 

presentation at the meeting, you must 

request to be scheduled by October 15, 

2017 via email (culprop@state.gov), and 

you must submit a written summary of 

your oral presentation, ensuring that it 

is received no later than 11:59 p.m. 

(EDT) on October 15, 2017, via the 

Regulations.gov Web site listed in the 

‘‘COMMENTS’’ section above. Oral 

comments will be limited to five (5) 

minutes to allow time for questions 

from members of the Committee. All 

oral comments must relate specifically 

to matters referred to in 19 U.S.C. 

2602(a)(1), with respect to which the 

Committee makes its findings and 

recommendations. Oral presentation to 

the Committee may be requested but, 

due to time constraints, is not 

guaranteed. 

Written Comments: If you do not wish 

to make oral comments but still wish to 

make your views known, you may 

submit written comments for the 

Committee to consider. Written 

comments from outside interested 

parties regarding the proposed 

extension of the Cambodia MOU must 

be received no later than October 15, 

2017, at 11:59 p.m. (EDT). Your written 

comments should relate specifically to 

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