Employment Opportunities for Disabled Americans Act
PL 99-643 (H.R.5595), enacted 11/10/1986

100 STAT. 3574 
PUBLIC LAW 99-643—NOV. 10, 1986 
Public Law 99-643 
99th Congress 
An Act 
^-^.. 
Nov. 10, 1986 
[H.R. 5595] 
Employment 
Opportunities 
for Disabled 
Americans Act. 
42 use 1305 
note. 
Post, p. 3575. 
To make permanent and improve the provisions of section 1619 of the Social 
Security Act, and for other purposes. 
Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled. 
SECTION 1. SHORT TITLE. 
This Act may be cited as the "Employment Opportunities for 
Disabled Americans Act". 
SEC. 2. PERMANENT AUTHORIZATION OF PROGRAM OF BENEFITS UNDER 
SECTION 1619. 
Section 201(d) of the Social Security Disability Amendments of 
1980 (42 U.S.C. 1382h note) is amended by striking out ", but shall 
remain in effect only through June 30,1987". 
SEC. 3. ELIGIBILITY OF CERTAIN DISABLED OR BLIND INDIVIDUALS FOR 
BENEFITS DURING INITIAL TWO MONTHS IN CERTAIN INSTITU-
TIONS. 
(a) IN GENERAL.—Section 1611(e)(1) of the Social Security Act (42 
U.S.C. 1382(eXl)) is amended— 
(1) in subparagraph (A) by striking out "and (D)" and insert-
ing in lieu thereof "(D), and (E)"; 
(2) in subparagraph (B) by inserting "(subject to subparagraph 
(E))" after "shall be payable"; and 
(3) by adding at the end thereof the following new subpara-
graphs: 
"(E) Notwithstanding subparagraphs (A) and (B), any individual 
who— 
"(i)(I) is an inmate of a public institution, the primary purpose 
of which is the provision of medical or psychiatric care, through-
out any month as described in subparagraph (A), or 
"(II) is in a hospital, extended care fecility, nursing home, or 
intermediate care facility throughout any month as described in 
subparagraph (B), 
"(ii) was eligible under section 1619 (a) or (b) for the month 
preceding such month, and 
"(iii) under an agreement of the public institution or the 
hospital, extended care facility, nursing home, or intermediate 
care facility is permitted to retain any benefit payable by reason 
of this subparagraph, 
may be an eligible individual or eligible spouse for purposes of this 
title (and entitled to a benefit determined on the basis of the rate 
applicable under subsection (b)) for the month referred to in 
subclause (I) or (II) of clause (i) and, if such subclause still applies, 
for the succeeding month. 
"(F) An individual who is an eligible individual or an eligible 
spouse for a month by reason of subparagraph (E) shall not be 
PUBLIC LAW 99-643—NOV. 10, 1986 
100 STAT. 3575 
treated as being eligible under section 1619 (a) or (b) for such month 
42 use l382h. 
for purposes of clause (ii) of such subparagraph.". 
(b) MEDICAID STATE PLAN REQUIREMENT.—Section 1902 of the 
Social Security Act (42 U.S.C. 1396a) is amended by adding at the 
end the following new subsection: 
"(1) Notwithstanding any provision of subsection (a) to the con-
trary, a State plan under this title shall provide that any supple-
mental security income benefits paid by reason of section 
1611(e)(1)(E) to an individual who— 
Ante, p. 3574. 
"(1) is eligible for medical assistance under the plan, and 
"(2) is in a hospital, skilled nursing facility, or intermediate 
care facility at the time such benefits are paid, 
will be disregarded for purposes of determining the amount of any 
post-eligibility contribution by the individual to the cost of the care 
and services provided by the hospital, skilled nursing facility, or 
intermediate care facility.". 
SEC. 4. IMPROVEMENTS TO SECTION 1619 PROGRAM. 
(a) CASH BENEFITS.—Section 1619(a) of the Social Security Act (42 
U.S.C. 1382h(a)) is amended to read as follows: 
"(a)(1) Any individual who was determined to be an eligible 
state and local 
individual (or eligible spouse) by reason of being under a disability 
governments. 
and was eligible to receive benefits under section 1611 (or a federally 
administered State supplementary payment) for a month and whose 
earnings in a subsequent month exceed the amount designated by 
the Secretary ordinarily to represent substantial gainful activity 
shall qu£ilify for a monthly benefit under this subsection for such 
subsequent month (which shall be in lieu of any benefit under 
section 1611) equal to an amount determined under section 
1611(b)(1) (or, in the case of an individual who has an eligible spouse, 
under section 1611(b)(2)), and for purposes of title XIX shall be 42 use 1396. 
considered to be receiving supplemental security income benefits 
under this title, for so long as— 
"(A) such individual continues to have the disabling physical 
or mental impairment on the basis of which such individual was 
found to be under a disability; and 
"(B) the income of such individual, other than 
income 
excluded pursuant to section 1612(b), is not equal to or in excess 
42 use I382a. 
of the amount which would cause him to be ineligible for 
payments under section 1611 and such individual meets all 
other non-disability-related requirements for eligibility for 
benefits under this title. 
"(2) The Secretary shall make a determination under paragraph 
(1)(A) with respect to an individual not later than 12 months after 
the first month for which the individual qualifies for a benefit under 
this subsection.". 
(b) CONTINUING BENEFITS UNDER TITLE XIX.—Section 16190?) of 
such Act is amended— 
(1) in pars^aph (1) by striking out "continues to meet" and 
inserting in lieu thereof "meets", 
(2) in paragraph (4) by striking out "benefits under this title 
state and local 
and title XIX" and inserting in lieu thereof "benefits under this 
governments. 
title (including any federally administered State supplementary 
pajrments), benefits under title XIX, and publicly funded attend-
ant care services (including personal care assistance),", 
(3) by redesignating paragraphs (1) through (4) as subpara-
graphs (A) through (D), respectively. 
100 STAT. 3576 
PUBLIC LAW 99-643—NOV. 10, 1986 
Blind persons. 
State and local 
governments. 
42 use 1396. 
Post, p. 3577. 
42 use 1382a. 
(4) by striking out the matter preceding subparagraph (A) (as 
redesignated by paragraph (3)) and inserting in lieu thereof the 
following: 
"(bXD For purposes of title XIX, any individual under age 65 who 
was determined to be a blind or disabled individual eligible to 
receive a benefit under section 1611 or any federally administered 
State supplementary payment for a month and who in a subsequent 
montii is ineligible for benefits under this title (and for any federally 
administered State supplementary payments) because of his or her 
income shall, nevertheless, be considered to be receiving supple-
mental security income benefits for such subsequent month pro-
vided that the Secretary determines under regulations that—", and 
(5) by adding at the end thereof (after and below subpara-
graph (D), as so redesignated) the following new paragraphs: 
"(2XA) Determinations made under paragraph (1)(D) shall be 
based on information and data updated no less frequently than 
annually. 
"(B) In determining an individual's earnings for purposes of para-
graph (1)(D), there shall be excluded from such earnings an amount 
equal to the sum of any amounts which are or would be excluded 
under clauses (ii) and (iv) of section 1612(b)(4XB) (or under clauses (ii) 
and (iii) of section 1612(bX4XA)) in determining his or her income.". 
(c) REVIEW PROCESS FOR OERTAIN INDIVIDUALS.— 
(1) Section 1631 of such Act (42 U.S.C. 1383) is amended— 
(A) in subsection (eXlXA) by striking out "subparagraph 
(B)" and inserting in lieu thereof "subparagraph (B) and 
J 
subsection (j)", and 
(B) by adding at the end thereof the following new 
subsection: 
"Application and Review Requirements for (Dertain Individuals 
42 use I382h. 
"(jXD Notwithstanding any provision of section 1611 or 1619, any 
individual who— 
"(A) was an eligible individual (or eligible spouse) under 
section 1611 or was eligible for benefits under or pursuant to 
. ^
: ^ 
-n 2
1
= 
section 1619, and 
"(B) who, after such eligibility, is ineligible for benefits under 
or pursuant to both such sections for a period of 12 consecutive 
months, 
may not thereafter become eligible for benefits under or pursuant to 
either such section until the individual has reapplied for benefits 
under section 1611 and been determined to be eligible for benefits 
under such section. 
"(2XA) Notwithstanding any provision of section 1611 or section 
1619, any individual who was eligible for benefits pursuant to 
section 1619(b), and who— 
"(i)(l) on the basis of the same impairment on which his or her 
eligibility under such section 1619(b) was based becomes eligible 
/i 
for benefits under section 1611 or 1619(a) for a month that 
follows a period durii^ which the individual was ineligible for 
benefits imder sections 1611 and 1619(a), and 
"(II) has earned income (other than income excluded pursuant 
to section 1612(b)) for any month in the 12-month period preced-
ing such month that is equal to or in excess of the amount that 
would cause him or her to be ineligible for payments under 
PUBLIC LAW 99-643—NOV. 10, 1986 
100 STAT. 3577 
section 1611(b) for that month (if he or she were otherwise 
42 USC 1382. 
eligible for such payments); or 
i, 
"(iiXD on the basis of the same impairment on which his or 
her eligibility under such section 1619(b) was based becomes 
42 use I382h. 
eligible under section 1619(b) for a month that follows a period 
during which the individual was ineligible under section 1611 
and section 1619, and 
"(II) has earned income (other than income excluded pursuant 
to section 1612(b)) for such month or for any month in the 12- 42 USC I382a. 
month period preceding such month that is equal to or in excess 
of the amount that would cause him or her to be ineligible for 
pajmients under section 1611(b) for that month (if he or she 
were otherwise eligible for such pajnnents); 
shall, upon becoming eligible (as described in clause (iXD or (ii)(I)), be 
subject to a prompt review of the type described in section 1614(a)(5). 
42 USC I382c. 
"(B) If the Secretary determines pursuant to a review required by 
subparagraph (A) that the impairment upon which the eligibility of 
an individual is based has ceased, does not exist, or is not disabling, 
i 
such individual may not thereafter become eligible for a benefit 
under or pursuant to section 1611 or section 1619 until the individ-
ual has reapplied for benefits under section 1611 and been deter-
mined to be eligible for benefits under such section.". 
(2) Section 1619 of such Act (as amended by subsections (a) 
and (b) of this section) is further amended— 
(A) in subsection (a) by striking out "Any individual" and 
inserting in lieu thereof "Except as provided in section 
1631(j), any individual", and 
•' 
(B) in subsection (b) by striking out "For purposes o f and 
inserting in lieu thereof "Except as provided in section 
1631(j), for purposes of'. 
Ante, p. 3576. 
(3) Section 1611 of such Act (42 U.S.C. 1382) is amended by 
adding at the end thereof the following new subsection: 
•' 
"Application and Review Requirements for Certain Individuals 
"(i) For application and review requirements affecting the eligi-
bility of certain individuals, see section 1631(j).", 
(d) CONFORMING AMENDMENTS.— 
' 
(1) Section 1611(e) of such Act (42 U.S.C. 1382(e)) is amended 
t 
by striking out paragraph (4). 
(2) Section 1614(a)(3) of such Act (42 U.S.C. 1382c(aX3)) is 
amended— 
— . 
(A) in subparagraph (D) by striking out ", except for 
. ^ 
, ^ 
purposes of subparagraph (F) or paragraph (4),", and 
(B) by striking out subparagraph (F), and by redesignat-
ing subparagraphs (G) and (H) as subparagraphs (F) and (G), 
respectively. 
(3XA) Section 1614(a) of such Act (as amended by paragraph 
(2)) is further amended by striking out paragraph (4) and by 
redesignating paragraph (5) as paragraph (4). 
(B) Section 1631(jX2XA) of such Act (as added by subsection (c)) 
is amended by striking out "section 1614(aX5)" and inserting in 
lieu thereof "section 1614(aX4)". 
100 STAT. 3578 
PUBLIC LAW 99-643—NOV. 10, 1986 
Blind persons. 
Ante, p. 3577. 
42 use 1382h. 
42 use 1382a. 
Blind persons. 
42 use 402. 
42 use 1396. 
42 use 1383e 
note. 
42 use 1383c. 
42 use 1381. 
SEC. 5. NOTIFICATIONS TO APPLICANTS AND RECIPIENTS. 
Section 1631 of the Social Security Act (42 U.S.C. 1383) (as 
amended by section 4) is further amended by adding at the end 
thereof the following new subsection: 
"Notifications to Applicants and Recipients 
' 
"(k) The Secretary shall notify an individual receiving benefits 
under section 1611 on the basis of disability or blindness of his or 
her potential eligibility for benefits under or pursuant to section 
1619— 
"(1) at the time of the initial award of benefits to the individ-
ual under section 1611 (if the individual has attained the age of 
i' 18 at the time of such initial award), and 
"(2) at the earliest time after an initial award of benefits to an 
individual under section 1611 that the individual's earned 
income for a month (other than income excluded pursuant to 
section 1612(b)) is $200 or more, and periodically thereafter so 
long as such individual has earned income (other than income 
so excluded) of $200 or more per month.". 
SEC. 6. LOSS OF SSI BENEFITS UPON ENTITLEMENT TO CHILD'S INSUR-
ANCE BENEFITS BASED ON DISABILITY. 
(a) IN GENERAL.—Section 1634 of the Social Security Act (42 U.S.C. 
1383c) is amended by adding at the end thereof the following new 
subsection: 
"(c) If any individual who has attained the age of 18 and is 
receiving benefits under this title on the basis of blindness or a 
disability which began before he or she attained the age of 22— 
"(1) becomes entitled, on or after the effective date of this 
-f| subsection, to child's insurance benefits which are payable 
under section 202(d) on the basis of such disability or to an 
increase in the amount of the child's insurance benefits which 
are so payable, and 
"(2) ceases to be eligible for benefits under this title because of 
such child's insurance benefits or because of the increase in 
such child's insurance benefits, 
such individual shall be treated for purposes of title XIX as receiv-
ing benefits under this title so long as he or she would be eligible for 
benefits under this title in the absence of such child's insurance 
benefits or such increase.". 
(b) STATE DETERMINATIONS.—Any determination required under 
section 1634(c) of the Social Security Act with respect to whether an 
individual would be eligible for benefits under title XVI of such Act 
in the absence of children's benefits (or an increase thereof) shall be 
made by the appropriate State agency. 
(c) CONFORMING CHANGE.—Section 1920(a)(2) of such Act (42 
U.S.C. 1396s(a)(2)) is amended— 
(1) by inserting "(A)" before "Section", and 
(2) by adding after and below subparagraph (A) the following 
new subparagraph: 
"(B) Section 1634 of this Act (relating to individuals who lose 
eligibility for SSI benefits due to entitlement to child's insurance 
benefits under section 202(d) of this Act).". 
PUBLIC LAW 99-643—NOV. 10, 1986 
100 STAT. 3579 
SEC. 7. MEDICAID ELIGIBILITY FOR CERTAIN RECIPIENTS OF CASH 
BENEFITS UNDER SECTION 1619. 
(a) IN GENERAL.—Section 1619(b) of the Social Security Act (42 
U.S.C. 1382h(b)) (as amended by section 4) is further amended by 
adding at the end thereof the following new paragraph: 
"(3) In the case of a State that exercises the option under section 
1902(f), any individual who— 
"(AXi) qualifies for a benefit under subsection (a), or 
"(ii) meets the requirements of paragraph (1); and 
"(B) was eligible for medical assistance under the State plan 
approved under title XIX in the month immediately preceding 
the first month in which the individual qualified for a benefit 
under such subsection or met such requirements, 
shall remain eligible for medical assistance under such plan for so 
long as the individual qualifies for a benefit under such subsection 
or meets such requirements.". 
(b) CONFORMING AMENDMENT.—Section 1902(f) of such Act (42 
U.S.C. 1396a(f)) is amended by striking out "subsection (e)" and 
inserting in lieu thereof "subsection (e) and section 1619(bX3)". 
SEC 8. PAYMENT OF BENEFITS DUE DECEASED RECIPIENTS. 
(a) IN GENERAL.—Section 1631(bXl) of the Social Security Act is 
amended— 
(1) by insertmg "(A)" afl^r "(1)"; 
(2) by striking out "by recovery from" where it first appears 
V 
in the first sentence and all that follows down through "The 
Secretary (A) shaU make" and inserting in lieu thereof the 
following: 
"by recovery from such individual or his eligible spouse (or from the 
estate of either) or by payment to such individual or his eligible 
spouse, or, if such individual is deceased, by payment— 
"(i) to any survivii^ spouse of such individual, whether or not 
the individual's eUg^le spouse, if (within the meaning of the 
first sentence of section 202(i)) such surviving husband or wife 
was living in the same household with the individual at the 
time of his death or within the 6 months immediately preceding 
the month of such death, or 
"(ii) if such individual was a disabled or blind child who was 
living with his parent or parents at the time of his death or 
within the 6 months immediately preceding the month of such 
death, to such i)arent or parents. 
"(B) The Secretary (i) shall make"; 
(3) by striking out "and (B) shall in any event" and inserting 
in lieu thereof and (ii) shall in any event , 
(4) by striking out "(i) the amount" and "(ii) an amount" and 
inserting in lieu thereof "(I) the amount" and "(II) an amount", 
respectively; and 
(5) by striking out "clause (B)" and "clause (A)" in the last 
sentence and inserting in lieu thereof "clause (ii)" and "clause (i)", 
respectively. 
(b) EFFECTIVE DATE.—^The amendments made by subsection (a) 
shall apply with respect to benefits payable for months after May 
1986. 
SEC. 9. TREATMENT OF CERTAIN COUPLES IN MEDICAL INSTITUTIONS. 
(a) IN GENERAL.—Section 1611(e) of the Social Security Act is 
amended by adding at the end thereof the following new subsection: 
State and local 
governments. 
42 use 1396a. 
42 use 1396. 
42 use 1382h. 
42 use 1383. 
42 use 402. 
Children and 
youth. 
42 use 1383 
note. 
42 use 1382. 
100 STAT. 3580 
PUBLIC LAW 99-643—NOV. 10, 1986 
State and local 
governments. 
42 u s e 1382 
note. 
42 u s e 1382h 
note. 
42 u s e 1396a 
note. 
State and local 
governments. 
42 u s e 1396. 
.';0I» 3tX» '2i-
"(5) Notwithstanding anything to the contrary in the criteria 
being used by the Secretary in determining when a husband and 
wife are to be considered two eligible individuals for purposes of this 
title and when they are to be considered an eligible individual with 
an eligible spouse, the State agency administering or supervising 
the administration of a State plan under any other program under 
this Act may (in the administration of such plan) treat a husband 
and wife sharing a room or comparable accommodation in a hos-
pital, home, or facility described in paragraph (1)(B) as though they 
were an eligible individual with his or her eligible spouse for 
purposes of this title (rather than two eligible individuals), after 
they have continuously shared such a room or accommodation for 6 
months, if treating such husband and wife as two eligible individ-
uals would prevent either of them from receiving benefits or assist-
ance under such plan or reduce the amount thereof". 
(b) EFFECTIVE DATE.—The amendment made by subsection (a) 
shall take effect on the date of the enactment of this Act. 
SEC. 10. EFFECTIVE DATES. 
' 
>vv. 
(a) PERMANENT AUTHORIZATION.—The amendment made by sec-
tion 2 shall become effective on the date of the enactment of this 
Act. 
. 
. . . . . . 
(b) PROGRAM MODIFICATIONS.— * -'f t
« * >
• 
-^ 
(1) Except as provided in paragraph (2), the amendments 
made by sections 3, 4, 5, 6, and 7 shall become effective on July 
1,1987. 
(2) In the case of a State plan for medical assistance under 
title XIX of the Social Security Act which the Secretary of 
Health and Human Services determines requires State legisla-
tion in order for the plan to meet the requirements imposed by 
the amendments made by section 3(b) and section 7 of this Act, 
the State plan shall not be regarded as failing to comply with 
the requirements of such title solely on the basis of its failure to 
meet such additional requirements until 60 days after the close 
S 
of the first regular session of the State legislature that begins 
after the date of the enactment of this Act. 
Approved November 10, 1986. 
i&iat 
«f>^r^ \} 
iff'iOfi't. „i.*-
LEGISLATIVE HISTORY-H.R. 5595 (S. 2209): 
HOUSE REPORTS: No. 99-893 (Comm. on Ways and Means). 
SENATE REPORTS: No. 99-466 accompanying S. 2209 (Comm. on Finance). 
CONGRESSIONAL RECORD, Vol. 32 (1986): 
Sept. 30, considered and passed House. 
Oct. 8, considered and passed Senate, amended, in lieu of S. 2209. 
, ., Oct. 15, House concurred in Senate amendments with an amendment. 
'''• 
Oct. 16, House agreed to certain Senate amendment, to another with amend-
ments. 
Oct. 18, Senate concurred in House amendments.