(1) Terrorist acts, such as the September 11, 
2001, attacks in New York and Washington, DC 
and attacks in countries throughout the world, 
major accidental events, chemical plant explosions, 
airplane crashes, and major industrial accidents, re-
sult in a substantial number of burn-injured pa-
tients. 
(2) In most major traumatic events, 25 percent 
to 30 percent of the injured will require burn care 
treatment. About one-third of those hospitalized in 
New York on September 11th had severe burn inju-
ries. 
(3) According to the American Burn Associa-
tion (ABA), which is the national professional soci-
ety representing hospitals with burn centers, as well 
as burn surgeons, nurses, therapists, and other 
members of the burn care team, there are only 128 
burn centers in the United States. The total burn- 
bed capacity at all burn centers in the United States 
is 1,835 beds. Burn centers in four States have 
closed, with a loss of several beds, which further di-
minishes the Nation’s ability to handle the mass 
burn casualties that could result from a major ter-
rorist attack. 
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(4) Burn centers are a national resource that 
must be preserved and strengthened as part of the 
Nation’s preparedness activities to deal with ter-
rorist attacks or other disasters that would likely 
lead to mass burn casualties. 
(5) Based on a study of over 54,000 burn cases 
over a 20-year period of time, the ABA in its 2002 
National Burn Repository Report indicates that 38 
percent of burn-injured patients treated in burn cen-
ters were uninsured. This high level of uncompen-
sated care threatens the survival of burn centers, the 
continued existence of which is essential to the emer-
gency preparedness efforts of the United States. 
(6) Burn injuries are among the most costly to 
treat and require immediate medical attention. 
(7) Because of the necessity of providing imme-
diate care in the case of burn injuries, the waiting 
periods established for Medicare coverage for dis-
abled burn patients should be waived and it is essen-
tial for Medicare to reimburse the costs of such burn 
treatment to ensure the financial survival of burn 
centers. 
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SEC. 3. ELIMINATION OF 5-MONTH SOCIAL SECURITY DIS-
ABILITY WAITING PERIOD IN CASES OF INDI-
VIDUALS WITH DISABLING BURN INJURIES. 
(a) DISABILITY
INSURANCE
BENEFITS.—Section 
223(a) of the Social Security Act (42 U.S.C. 423(a)) is 
amended by adding at the end the following new para-
graph: 
‘‘(3)(A) In the case of any individual who has a dis-
abling burn injury and is not entitled to disability insur-
ance benefits under this section for any month solely by 
reason of the waiting period under clause (i) in the first 
sentence of paragraph (1), the Commissioner of Social Se-
curity shall waive the application of the waiting period, 
and, notwithstanding clauses (i) and (ii) of the first sen-
tence of paragraph (1), such individual shall be entitled 
to disability insurance benefits for each month, beginning 
with the first month during all of which such individual 
is under a disability and in which such individual would 
become so entitled to such insurance benefits under such 
sentence but for such waiting period, and ending as pro-
vided in paragraph (1). 
‘‘(B) For purposes of subparagraph (A), the process 
for determining under paragraph (1) the month in which 
the disability ceases shall require that the status of the 
individual’s disability be determined at least once every 3 
years. 
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‘‘(C) For purposes of subparagraph (A) and sections 
202(e)(5)(C), 202(f)(6)(C), and 216(i)(2)(A)(ii), an indi-
vidual is considered to have a ‘disabling burn injury’ if 
the individual has a burn injury that satisfies a finding 
of disability in accordance with the Social Security Admin-
istration’s publication, ‘Disability Evaluation under Social 
Security’ (Blue Book, January 2005) for purposes of es-
tablishing eligibility for benefits under this title.’’. 
(b) WIDOW’S INSURANCE BENEFITS BASED ON DIS-
ABILITY.—Section 202(e)(5) of such Act (42 U.S.C. 
402(e)(5)) is amended by adding at the end the following 
new subparagraph: 
‘‘(C) In the case of any individual who has a disabling 
burn injury (as described in section 223(a)(3)(B)) and is 
not entitled to widow’s insurance benefits under this sec-
tion for any month solely by reason of the waiting period 
under paragraph (1)(F)(i), the Commissioner of Social Se-
curity shall waive the application of the waiting period, 
and, notwithstanding clauses (i) and (ii) of paragraph 
(1)(F), such individual shall be entitled to widow’s insur-
ance benefits for each month, beginning with the first 
month during all of which she is under a disability and 
in which she would become so entitled to such insurance 
benefits under paragraph (1) but for such waiting period, 
and ending as provided in paragraph (1). For purposes 
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of the previous sentence, in determining under paragraph 
(1) the month in which the disability ceases the status of 
the individual’s disability shall be reviewed at least once 
every 3 years.’’. 
(c) WIDOWER’S INSURANCE BENEFITS BASED ON 
DISABILITY.—Section 202(f)(5) of such Act (42 U.S.C. 
402(f)(5)) is amended by adding at the end the following 
new subparagraph: 
‘‘(C) In the case of any individual who has a disabling 
burn injury (as described in section 223(a)(3)(B)) and is 
not entitled to widower’s insurance benefits under this sec-
tion for any month solely by reason of the waiting period 
under paragraph (1)(F)(i), the Commissioner of Social Se-
curity shall waive the application of the waiting period, 
and, notwithstanding clauses (i) and (ii) of paragraph 
(1)(F), such individual shall be entitled to widower’s in-
surance benefits for each month, beginning with the first 
month during all of which he is under a disability and 
in which he would become so entitled to such insurance 
benefits under paragraph (1) but for such waiting period, 
and ending as provided in paragraph (1). For purposes 
of the previous sentence, in determining under paragraph 
(1) the month in which the disability ceases the status of 
the individual’s disability shall be reviewed at least once 
every 3 years.’’. 
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(d) COMMENCEMENT OF PERIOD OF DISABILITY.— 
Section 216(i)(2)(A) of such Act (42 U.S.C. 416(i)(2)(A)) 
is amended— 
(1) by inserting ‘‘(i)’’ after ‘‘(2)(A)’’; 
(2) by inserting ‘‘(I)’’ after ‘‘but only if’’; 
(3) by inserting ‘‘(II)’’ after ‘‘duration or’’; and 
(4) by adding at the end the following new 
clause: 
‘‘(ii) In any case in which an individual has a dis-
abling burn injury (as described in section 223(a)(3)(B)) 
and a month is not included within a period of disability 
of such individual solely by reason of the 5-month duration 
requirement under clause (i)(I), the Commissioner of So-
cial Security shall waive the application of such require-
ment, and, notwithstanding clause (i)(I), such month shall 
be included in a period of disability.’’. 
(e) EFFECTIVE DATES.—The amendments made by 
subsection (a) shall apply only with respect to benefits 
under section 223 of the Social Security Act, or under sec-
tion 202 of such Act on the basis of the wages and self- 
employment income of an individual entitled to benefits 
under such section 223, for months beginning after the 
date of the enactment of this Act. The amendments made 
by subsections (b) and (c) shall apply only with respect 
to benefits based on disability under subsection (e) or (f) 
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of section 202 of the Social Security Act for months after 
the date of the enactment of this Act. The amendments 
made by subsection (d) shall apply only with respect to 
applications for disability determinations filed under title 
II of the Social Security Act after the date of the enact-
ment of this Act. 
SEC. 4. ELIMINATION OF 24-MONTH MEDICARE DISABILITY 
WAITING PERIOD IN CASES OF INDIVIDUALS 
WITH DISABLING BURN INJURIES. 
(a) IN GENERAL.—Section 226(h) of the Social Secu-
rity Act (42 U.S.C. 426(h)) is amended— 
(1) in the matter preceding paragraph (1), by 
inserting ‘‘or a disabling burn injury (as described 
in section 223(a)(3)(B))’’ after ‘‘amyotrophic lateral 
sclerosis (ALS)’’; 
(2) by redesignating paragraphs (1), (2), and 
(3) as subparagraphs (A), (B), and (C), respectively, 
with appropriate indentation and striking ‘‘For pur-
poses of’’ and inserting ‘‘(1) For purposes of’’; and 
(3) by adding at the end the following new 
paragraphs: 
‘‘(2) Paragraph (1) shall not apply to an individual 
medically determined to have a disabling burn injury (as 
so described) if— 
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‘‘(A) on the date such injury occurred such in-
dividual was covered under a group health plan (as 
defined in section 2791 of the Public Health Service 
Act) or had health insurance coverage (as defined in 
such section), regardless of the extent to which such 
plan or coverage provides benefits with respect to 
such injury; or 
‘‘(B) after the date of the enactment of the So-
cial Security and Medicare Improved Burn Injury 
Treatment Access Act of 2009, the terms and condi-
tions of coverage, with respect to such injury, under 
the State plan under title XIX of the State in which 
the individual resides are more restrictive than such 
terms and conditions as of the day before such date 
of enactment. 
‘‘(3) For purposes of applying paragraph (1) in the 
case of an individual medically determined to have a dis-
abling burn injury (as so described), in determining when 
an individual’s entitlement or status terminates, the status 
of the individual’s disability shall be reviewed at least once 
every 3 years.’’. 
(b) EFFECTIVE DATE.—The amendment made by 
subsection (a) shall apply to benefits under title XVIII of 
the Social Security Act with respect to items and services 
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furnished in months beginning after the date of the enact-
ment of this Act. 
Æ 
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