Preserving and Reforming SSDI (PAR-SSDI) Act of 2016

To amend title II of the Social Security Act to improve the process by which the Social Security Administration makes disability determinations and awards disability benefits, and for other purposes. 1. Short title This Act may be cited as the Preserving and Reforming SSDI (PAR–SSDI) Act of 2016 2. Consideration of vocational factors in disability determinations (a) Language proficiency Section 223(d)(2) of the Social Security Act ( 42 U.S.C. 423(d)(2) (D) In determining whether an individual is under a disability, the Commissioner shall make such determination without regard to the individual’s ability to communicate in English. . (b) Quarters of coverage requirement Section 223(d)(2) of the Social Security Act ( 42 U.S.C. 423(d)(2) (E) In determining whether an individual is under a disability for a month, the Commissioner may not consider the individual’s vocational background unless the individual had not less than 16 quarters of coverage during the 24-quarter period ending with the quarter in which such month occurs. . (c) Periodic update of vocational and educational factors Not later than 5 years after the date of the enactment of this Act and not later than the end of every subsequent 5-year period, the Commissioner of Social Security shall prepare and implement a complete update of the vocational and educational factors considered in making disability determinations under title II of the Social Security Act. (d) Effective date The amendments made by this section shall apply with respect to applications for disability insurance benefits filed on or after the date of the enactment of this Act. 3. Disqualification on receipt of disability insurance benefits in a month for which unemployment compensation is received (a) In general Section 223(d)(4) of the Social Security Act ( 42 U.S.C. 423(d)(4) (C) (i) If for any week in whole or in part within a month an individual is paid or determined to be eligible for unemployment compensation, such individual shall be deemed to have engaged in substantial gainful activity for such month. (ii) For purposes of clause (i), the term unemployment compensation (I) regular compensation extended compensation additional compensation 26 U.S.C. 3304 (II) trade adjustment assistance under title II of the Trade Act of 1974 ( 19 U.S.C. 2251 et seq. . (b) Trial work period Section 222(c) of the Social Security Act ( 42 U.S.C. 422(c) (6) (A) For purposes of this subsection, an individual shall be deemed to have rendered services in a month if the individual is entitled to unemployment compensation for such month. (B) For purposes of subparagraph (A), the term unemployment compensation (i) regular compensation extended compensation additional compensation 26 U.S.C. 3304 (ii) trade adjustment assistance under title II of the Trade Act of 1974 ( 19 U.S.C. 2251 et seq. . (c) Data matching The Commissioner of Social Security shall implement the amendments made by this section using appropriate electronic data. (d) Effective date The amendments made by this subsection shall apply with respect to individuals who initially apply for disability insurance benefits on or after January 1, 2017. 4. Eligibility for Medicare (a) In general Section 226(b)(2) of the Social Security Act ( 42 U.S.C. 426(b) (1) in subparagraph (A), by striking 24 calendar months 60 calendar months (2) in subparagraph (B), by striking 24 months 60 months (3) in subparagraph (C)(ii), by striking 24 months 60 months (4) in the matter following subparagraph (C)(ii)(II)— (A) by striking twenty-fifth month of his entitlement or status sixty-first month (B) by striking twenty-fifth month of his entitlement sixty-first month of his entitlement (b) Conforming amendments Section 226 of such Act ( 42 U.S.C. 426 (1) in subsection (e)(1)(B), by striking 24 months 60 months (2) in subsection (f), by striking 24 months 60 months (c) Effective date The amendments made by this section shall apply with respect to applications for disability insurance benefits filed on or after the date of the enactment of this Act. 5. Inclusion of unearned income in determination of substantial gainful activity (a) In general Section 223(d)(4) of the Social Security Act ( 42 U.S.C. 423(d)(4) (D) (i) If the amount of unearned income (as defined in section 1612) of an individual for a month is equal to or greater than the monthly income limit for such month, the individual shall be deemed to have engaged in substantial gainful activity for such month. (ii) For purposes of this subparagraph, the monthly income limit is the amount of earnings derived from services, prescribed by the Commissioner under regulations issued pursuant to subparagraph (A), sufficient to demonstrate an individual’s ability to engage in substantial gainful activity for a month. . (b) Effective date The amendment made by subsection (a) shall apply with respect to monthly insurance benefits paid for months beginning after the date that is 1 year after the date of the enactment of this Act. 6. Medical evidence in disability determinations (a) Exclusion of medical evidence that is not submitted in its entirety or furnished by a licensed practitioner Section 223(d)(5) of the Social Security Act ( 42 U.S.C. 423(d)(5) (1) in subparagraph (B), by striking In Subject to subparagraphs (C) and (D), in (2) by adding at the end the following new subparagraphs: (C) (i) An individual and, if applicable, such individual’s representative shall submit, in its entirety and without redaction, all relevant medical evidence known to the individual or the representative to the Commissioner of Social Security. (ii) In the case of a hearing before an administrative law judge to determine if an individual is under a disability (as defined in paragraph (1)), the Commissioner of Social Security shall not consider any piece of medical evidence furnished by an individual or such individual’s representative unless such individual and, if applicable, such individual’s representative, certifies at the hearing that all relevant medical evidence has been submitted in its entirety and without redaction. (iii) For purposes of this subparagraph, the term relevant medical evidence (iv) Any individual or representative who knowingly violates this subparagraph shall be guilty of making a false statement or representation of material fact, shall be subject to civil and criminal penalties under sections 208 and 1129, and, in the case of a representative, shall be suspended or disqualified from appearing before the Social Security Administration. (D) The Commissioner of Social Security shall not consider any evidence furnished by a physician or health care practitioner who is not licensed or has been sanctioned. . (b) Health care providers supplying consultative exams (1) In general Beginning 1 year after the date of enactment of this Act, in determining whether an individual applying for disability insurance benefits under title II of the Social Security Act is disabled, the Commissioner of Social Security shall not consider medical evidence resulting from a consultative exam with a health care provider conducted for the purpose of supporting the individual’s application unless the evidence is accompanied by a Medical Consultant Acknowledgment Form signed by the health care provider who conducted the exam. (2) Medical consultant acknowledgment form (A) Definition As used in this subsection, the term Medical Consultant Acknowledgment Form (B) Requirements The Commissioner of Social Security shall develop the Medical Consultant Acknowledgment Form and make it available to the public not later than 6 months after the date of enactment of this Act. The contents of the Medical Consultant Acknowledgment Form shall include— (i) information on how medical evidence is used in disability determinations; (ii) instructions on completing a residual functional capacity form; (iii) information on the legal and ethical obligations of a health care provider who supplies medical evidence for use in a disability determination, including any civil or criminal penalties that may be imposed on a health care provider who supplies medical evidence for use in a disability determination; and (iv) a statement that the signatory has read and understands the contents of the form. (3) Penalties for fraud In addition to any other penalties that may be prescribed by law, any individual who forges a signature on a Medical Consultant Acknowledgment Form submitted to the Commissioner of Social Security shall be guilty of making a false statement or representation of material fact, and upon conviction shall be subject to civil and criminal penalties under sections 208 and 1129 of the Social Security Act and, in the case of a representative, shall be suspended or disqualified from appearing before the Social Security Administration. (c) Effective date The amendments made by subsection (a) shall apply with respect to applications for disability insurance benefits filed on or after the date of the enactment of this Act. 7. Change in index used to calculate social security cost-of-living adjustments (a) In general Section 215(i)(1) of the Social Security Act ( 42 U.S.C. 415(i)(1) (1) in subparagraph (G), by striking the period at the end and inserting ; and (2) by adding at the end the following new subparagraph: (H) the term Consumer Price Index . (b) Application to pre-1979 law (1) In general Section 215(i)(1) of the Social Security Act as in effect in December 1978, and as applied in certain cases under the provisions of such Act as in effect after December 1978, is amended— (A) in subparagraph (C), by striking the period at the end and inserting ; and (B) by adding at the end the following new subparagraph: (D) the term Consumer Price Index . (2) Conforming change Section 215(i)(4) of the Social Security Act ( 42 U.S.C. 415(i)(4) and by section 231 of the Preserving and Reforming SSDI (PAR–SSDI) Act of 2016 1986 (c) Effective date The amendments made by this section shall apply with respect to adjustments effective with or after the first December that begins at least 3 years after the date of the enactment of this Act. 8. Third-party income verification (a) In general Section 223(i) of the Social Security Act ( 42 U.S.C. 423(i) (1) by redesignating paragraph (5) as paragraph (6); and (2) by inserting after paragraph (4) the following: (5) (A) In any case in which the Commissioner of Social Security initiates a review under this subsection of the case of an individual who has been determined to be under a disability, such review shall include an independent estimate by a qualified social security income verification contractor of such individual’s monthly income at the time of such review. (B) Upon initiating a review of an individual under this subsection, the Commissioner of Social Security shall provide such individual’s name, address, and social security account number to a qualified social security income verification contractor for purposes of obtaining the independent estimate described in subparagraph (A). (C) (i) Not later than 60 days after the date of the enactment of this paragraph, the Commissioner of Social Security shall enter into one or more qualified income verification contracts. (ii) For purposes of this paragraph, the term qualified social security income verification contract (I) to provide an estimate (based on the best information available to such person) of the income of any individual specified by the Commissioner as described in subparagraph (A); (II) to provide such information regarding the basis for such estimate as the Commissioner may specify; and (III) that prohibits each person providing such services from contacting the individual, employers of the individual, members of the individual’s family, and such other persons as the Commissioner may specify. (iii) For purposes of this section, the term qualified social security income verification contractor (D) (i) Nothing in any provision of law shall be construed to prevent the Secretary from— (I) entering into a qualified social security income verification contract, or (II) providing identifying information to a qualified social security income verification contractor as provided in this paragraph. (ii) The United States shall not be liable for any act or omission of any person performing services under a qualified social security income verification contract. (E) In any case in which an independent estimate conducted pursuant to this paragraph with respect to an individual entitled to disability insurance benefits demonstrates that such individual failed to accurately report any monthly income, the Commissioner of Social Security shall conduct an investigation of such individual to determine whether such individual’s monthly income demonstrates the individual's ability to engage in substantial gainful activity. .

Summary: Preserving and Reforming SSDI (PAR-SSDI) Act of 2016 This bill amends title II (Old Age, Survivors and Disability Insurance) (OASDI) of the Social Security Act (SSAct) to: direct the Social Security Administration (SSA), in determining whether an individual is under a disability, to make such a determination without regard to the individual's ability to communicate in English; prohibit the SSA, in determining whether an individual is under a disability for a month, from considering the individual's vocational background in computing the quarters of coverage requirement unless the individual had not less than 16 quarters of coverage during the 24-quarter period ending with the quarter in which such month occurs; and direct the SSA to prepare and implement a complete update of the vocational and educational factors considered in making disability determinations. The bill declares that for any week in whole or in part within a month that an individual is paid or determined to be eligible for unemployment compensation he or she shall be deemed to have engaged in substantial gainful activity and so be disqualified from receiving Social Security disability benefits after a certain period has elapsed. The bill also states that, for purposes of determining services rendered by an individual during a period of trial work which will not disqualify the individual for disability benefits, the individual shall be deemed to have rendered services in a month if he or she is entitled to unemployment compensation or trade adjustment assistance for that month. The bill revises prerequisites for the entitlement of certain individuals under age 65 to SSAct title XVIII (Medicare) part A hospital insurance benefits. The length of time such an individual must be entitled to disability insurance, child's insurance, or widow's insurance benefits, in order to qualify for entitlement to Medicare part A hospital benefits, shall increase from the current 24 months to 60 months. If the amount of an individual's unearned income for a month is equal to or greater than the monthly income limit for that month, the individual shall be deemed to have engaged in substantial gainful activity for the month for purposes of determining disability insurance benefit payments. The SSA must receive from an individual and/or the individual's representative, in its entirety and without redaction, all known relevant medical evidence related to a disability claim. Any medical evidence not submitted in its entirety or not furnished by a licensed practitioner shall be excluded in disability determinations. In determining whether a disability benefits applicant is disabled, the SSA shall not consider medical evidence resulting from a consultative exam with a health care provider unless the application is accompanied by a Medical Consultant Acknowledgment Form signed by the health care provider who conducted the exam. The bill changes the index used to calculate OASDI cost-of-living adjustments to the Chained Price Index for All Urban Consumers. In any case in which SSA initiates a review of disability benefits for an individual, the review shall include an independent estimate by a qualified Social Security income verification contractor of the individual's monthly income.