[Federal Register: December 18, 2008 (Volume 73, Number 244)]
[Rules and Regulations]
[Page 76940-76945]
From the Federal Register Online via GPO Access [wais.access.gpo.gov]
[DOCID:fr18de08-11]
=======================================================================
-----------------------------------------------------------------------
SOCIAL SECURITY ADMINISTRATION
20 CFR Parts 404, 408, 416, and 422
[Docket No. SSA-2008-0005]
RIN 0960-AG75
Clarification of Evidentiary Standard for Determinations and
Decisions
AGENCY: Social Security Administration.
ACTION: Final Rules.
-----------------------------------------------------------------------
SUMMARY: We are amending our rules to clarify that we apply the
preponderance of the evidence standard when we make determinations and
decisions at all levels of our administrative review
[[Page 76941]]
process. These rules do not change our policy that the Appeals Council
applies the substantial evidence standard when it reviews a decision by
an administrative law judge (ALJ) to determine whether to grant a
request for review. We are also adding definitions of the terms
``substantial evidence'' and ``preponderance of the evidence'' for use
in applying these rules.
DATES: These final rules are effective on January 20, 2009.
FOR FURTHER INFORMATION CONTACT: Joshua Silverman, Office of
Regulations, Social Security Administration, 6401 Security Boulevard,
Baltimore, MD 21235-6401, (410) 594-2128, for information about these
rules. 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:
Electronic Version
The electronic file of this document is available on the date of
publication in the Federal Register at http://www.gpoaccess.gov/fr/
index.html.
Explanation of Changes
Our Administrative Review Process
We currently decide claims for benefits using an administrative
review process that consists of four levels: Initial determination,
reconsideration, hearing before an ALJ, and Appeals Council review. See
20 CFR 404.900, 408.1000, and 416.1400. We make an initial
determination at the first level. If a person is dissatisfied with the
initial determination, he may request reconsideration.\1\ If a person
is dissatisfied with the reconsidered determination, he may request a
hearing before an ALJ.\2\ Finally, if a person is dissatisfied with the
ALJ's decision,\3\ he may request that the Appeals Council review that
decision. Once a person has completed these administrative steps and
received our final decision, the person may request judicial review of
the final decision in Federal district court.
---------------------------------------------------------------------------
\1\ For disability claims, there are ten States that are
participating in a ``prototype'' test under 20 CFR 404.906 and
416.1406. In these States, the second step for people who are
dissatisfied with their initial determinations in disability cases
is a hearing before an ALJ. The ten States are: Alabama, Alaska,
California (Los Angeles North and West Branches), Colorado,
Louisiana, Michigan, Missouri, New Hampshire, New York, and
Pennsylvania.
\2\ In some cases, attorney advisors in our Office of Disability
Adjudication and Review make wholly favorable decisions before an
ALJ hearing is conducted. 20 CFR 404.942 and 416.1442.
\3\ The words ``determination'' and ``decision'' are defined in
20 CFR 404.900 and 416.1400. At the initial and reconsideration
levels of the administrative review process, we issue
``determinations.'' At the ALJ hearing and Appeals Council levels,
we issue ``decisions.''
---------------------------------------------------------------------------
Each adjudicator reviewing a claim in the administrative process
makes an independent (or de novo) determination or decision based on
the evidence in the record.\4\ For example, an ALJ would not simply
review a State agency's initial and reconsideration disability
determinations to determine whether they were correct. Rather, the ALJ
would review the evidence in the record and make an independent
decision.
---------------------------------------------------------------------------
\4\ In some States, adjudicators must consider, and sometimes
adopt, certain findings made in prior disability adjudications under
acquiescence rulings (ARs) that we have issued to address circuit
court holdings. See AR 97-4(9), 62 FR 64038, available at: http://
www.socialsecurity.gov/OP_Home/rulings/ar/09/AR97-04-ar-09.html; AR
98-3(6), 63 FR 29770, available at: http://www.socialsecurity.gov/
OP_Home/rulings/ar/06/AR98-03-ar-06.html; AR 98-4(6), 63 FR 29771,
corrected at 63 FR 31266, available at: http://
www.socialsecurity.gov/OP_Home/rulings/ar/06/AR98-04-ar-06.html;
and AR 00-1(4), 65 FR 1936, available at: http://
www.socialsecurity.gov/OP_Home/rulings/ar/04/AR2000-01-ar-04.html.
---------------------------------------------------------------------------
In contrast, in deciding whether to grant a person's request for
Appeals Council review of an ALJ's decision, the Appeals Council first
considers the ALJ's decision and the evidence before the ALJ using the
substantial evidence standard of review, which we discuss below. If the
Appeals Council does not grant a request for review, the ALJ's decision
becomes our final decision.\5\ If the Appeals Council grants the
request for review, it will usually either remand the case to an ALJ
for additional proceedings and a new decision or issue its own
decision.
---------------------------------------------------------------------------
\5\ The Appeals Council may also dismiss the request for review
either with or without first granting the request. Additionally, the
Appeals Council may review a case on its own motion without an
individual asking it to do so. See 20 CFR 404.967, 404.969, 404.984,
416.1467, 416.1469, and 416.1484. See also 20 CFR 408.1050, which
incorporates the relevant provisions of 20 CFR 416.1467-416.1482 by
reference.
---------------------------------------------------------------------------
Our Standard of Proof
A claimant has the burden of proving his claim with us.
Adjudicators at each level of the administrative review process,
including the Appeals Council, consider whether a claimant has proven
his claim using an evidentiary standard called the ``preponderance of
the evidence'' when they make a determination or decision. We define
preponderance of the evidence as ``such relevant evidence that as a
whole shows that the existence of the fact to be proven is more likely
than not.'' 20 CFR 405.5.
The Social Security Act does not specify the standard of proof to
use when we make a determination or decision. Courts and scholars have
long recognized that the preponderance of the evidence standard is the
traditional standard of proof in a civil or an administrative
adjudicatory proceeding.\6\ Our longstanding policy has been that the
preponderance of the evidence standard applies to determinations or
decisions on claims under parts 404, 408, and 416.\7\ Prior to these
final rules, we did not have regulations in parts 404, 408, and 416
that clearly stated that we use the preponderance of the evidence
standard when we make a determination or decision. The absence of
explicit language in these parts explaining the standards we use at
each level of the administrative process caused some confusion about
the applicable standard. By issuing these final rules, we intend to
resolve any confusion about the applicable standard.
---------------------------------------------------------------------------
\6\ Federal courts apply a substantial evidence standard when
they review our final decisions. 42 U.S.C. 405(g), 1009(b), and
1383(c)(3).
\7\ A claimant must give us ``convincing'' evidence to prove
that he meets certain requirements for eligibility, as described in
subpart H of parts 404 and 416. Because these final rules address
the appropriate standard of proof to be applied in making
determinations or decisions rather than the burden of proving
eligibility for benefits, these final rules are not applicable to
subpart H of parts 404 and 416.
---------------------------------------------------------------------------
Our Standard of Review at the Appeals Council
When the Appeals Council considers whether to grant a request for
review of an ALJ's decision, it does not use a preponderance of the
evidence standard. Instead, it considers, among other things, whether
the action, findings, or conclusions of the ALJ are supported by
substantial evidence.\8\ 20 CFR 404.970(a) and 416.1470(a). The
definition of substantial evidence in these final rules is ``such
relevant evidence as a reasonable mind might accept as adequate to
support a conclusion.'' The substantial evidence standard of review
gives deference to the findings of the ALJ rather than requiring a
decision based on a new evaluation of the evidence.\9\
---------------------------------------------------------------------------
\8\ The Appeals Council also reviews any new and material
evidence under 20 CFR 404.970(b) and 416.1470(b).
\9\ Our regulations also provide that the Associate Commissioner
for Disability Determinations or his delegate may use the
substantial evidence standard of review when reviewing a sample of
disability hearing officers' reconsideration determinations. 20 CFR
404.918 and 416.1418. In general, disability hearing officers make
reconsideration determinations in cases of beneficiaries who we have
determined are no longer disabled. See 20 CFR 404.914-404.918 and
416.1414-416.1418.
---------------------------------------------------------------------------
[[Page 76942]]
As stated earlier, the Appeals Council uses the substantial
evidence standard to decide whether to review an ALJ's decision. If it
grants review and then issues its own decision, the Appeals Council
uses the preponderance of the evidence standard when it issues its
decision.
Explanation of Changes
We are revising several regulation sections in parts 404, 408, 416,
and 422 to clarify that we use the preponderance of the evidence
standard of proof to adjudicate claims at all levels of the
administrative review process. We also are adding a definition of the
term ``preponderance of the evidence'' in 20 CFR 404.901, 408.1001, and
416.1401, and a definition of the term ``substantial evidence'' in 20
CFR 404.901 and 416.1401. These are the same definitions we currently
use in 20 CFR 405.5.
We are also making additional changes from the language proposed in
the NPRM. None of these changes alter the meaning of these sections.
First, we are revising several of the affected regulatory sections in
these final rules to put them in active voice and to use consistent
language. Second, we are making two changes to 20 CFR 422.203(c). We
are adding a reference to attorney advisor decisions under 20 CFR
404.942 and 416.1142 and deleting the phrase ``under applicable
provisions of the law and regulations and appropriate precedents.''
These changes make the language in section 20 CFR 422.203(c) consistent
with the language in final 20 CFR 404.953(a) and 416.1453(a), and they
acknowledge that, under certain circumstances, attorney advisors can
make decisions instead of an ALJ under 20 CFR 404.942 and 416.1442.
We believe these clarifications will improve the accuracy and
consistency of the decision-making process.
We have the authority to make these changes under 42 U.S.C. 405(a),
902(a)(5), 1010(a), and 1383(d)(1).
Public Comments
In the notice of proposed rulemaking published at 73 FR 33745 (June
13, 2008), we provided the public with a 60-day period in which to
comment on the proposed changes. That comment period ended on August
12, 2008. We received comments from four people. We carefully
considered each comment. Because some of the comments were long and
quite detailed, we have condensed, summarized, and paraphrased them in
the following discussions. However, we have tried to present all views
adequately and to address carefully all of the significant issues
raised by the commenters that are within the scope of the proposed
rules. We generally have not addressed comments that are outside the
scope of the rulemaking proceeding.
Comment: One commenter generally supported the proposed rules and
said that there should be only one evidentiary standard used by our
adjudicators at all levels of the adjudication process.
Response: We agree with the commenter that adjudicators at each
level of the administrative review process, including the Appeals
Council, should use the same evidentiary standard. These rules provide
that they will all use the preponderance of the evidence standard of
proof when they make determinations or decisions. As stated above, the
Appeals Council only uses the substantial evidence standard of review
when it considers whether to grant a request for review of an ALJ's
decision. Although it is unclear from the commenter's letter, to the
extent that the commenter suggested that the Appeals Council should
apply the preponderance of the evidence standard of proof when it
reviews an ALJ's decision, we are not adopting the comment. Our rules
governing the Appeals Council's use of the substantial evidence
standard to review ALJ decisions have worked well, and we do not
believe that there is any reason to change them.
Comment: Two commenters were concerned that the proposed changes
could create an ambiguity about who has the burden of proof. One of
these commenters also said that our determinations and decisions should
be made based on substantial evidence and that the burden of a party is
to provide proof by a preponderance of the evidence. Both commenters
expressed concern that the proposed changes could appear to shift the
burden of proof in disability cases to us by requiring that we base our
determinations and decisions on a preponderance of the evidence. One of
these commenters suggested that we add regulatory text to explain who
has the burden of proof at each of the five steps of the sequential
evaluation process that we use to decide whether a person is disabled.
See 20 CFR 404.1520 and 416.920.
Response: We are not adopting this comment. These final rules
concern the appropriate standard of proof, not who has the burden of
proof at any stage of our sequential evaluation process. Our current
regulations explain the burden of proof in disability claims.\10\ We
previously explained the concept of how the burden of proof, a term
traditionally associated with adversarial litigation, applies in the
context of our nonadversarial system. 68 FR 51153, 51154-51155 (Aug.
26, 2003). We do not believe that it is appropriate to make the changes
suggested by the commenters because these final rules do not change the
allocation of the burden of proof in our adjudications.
---------------------------------------------------------------------------
\10\ See 20 CFR 404.1512, 404.1560(c)(2), 404.1566(c), 416.912,
416.960(c)(2), and 416.966(c). A claimant has the burden of
providing proof of his disability under each of the first four steps
in the sequential evaluation process. In the fifth and final step of
the sequential evaluation process, we become responsible for
providing evidence that demonstrates that other work exists in
significant numbers in the national economy that the claimant can
perform after considering the claimant's residual functional
capacity, age, education, and work experience. However, a claimant
must persuade us that he is disabled at each step of the sequential
evaluation process. See Bowen v. Yuckert, 482 U.S. 137, 146 (1987).
---------------------------------------------------------------------------
Comment: One commenter said that our use of the word ``review'' in
several of the proposed sections was ambiguous. The commenter thought
that it was unclear whether we meant a review of the evidence or a
review of the determination or decision. The commenter suggested that
we use a phrase such as ``again look'' instead of ``review'' when we
refer to reviewing evidence.
Response: We are not adopting this comment. In many sections of our
rules, we use the word ``review'' to refer generally to a consideration
of evidence. With regard to the Appeals Council's review of a decision
or a dismissal, we use the word ``review'' as a term of art.\11\ We
believe that the plain meaning of the word is readily apparent in the
context of the sections of the regulations in which we use it, and we
are not aware that these longstanding usages have confused either
adjudicators or the public.
---------------------------------------------------------------------------
\11\ See, e.g., 20 CFR 404.967 and 416.1467.
---------------------------------------------------------------------------
Comment: One commenter suggested changes to our proposed language
for 20 CFR 404.979, 404.984, 416.1479, and 416.1484. Specifically, the
commenter suggested amending those sections to state that the Appeals
Council uses the substantial evidence standard when it remands a case
to an ALJ, and that the Appeals Council will remand a case it reviewed
to an ALJ for further proceedings unless the decision being appealed is
supported by substantial evidence.
Response: We are not adopting this comment because it is
inconsistent with our existing regulations, which provide that the
Appeals Council may grant a request for review and remand a case for
reasons other than a lack of substantial evidence to support a
decision. See 20
[[Page 76943]]
CFR 404.970 and 416.1470. The Appeals Council may also remand a case to
an ALJ pursuant to a Federal court's instructions without conducting
its own review. See 20 CFR 404.983 and 416.1483.
Comment: One commenter suggested that we change both of our
proposed definitions. He also suggested that we adopt a new term--
``substantial evidence standard of review''-- that would address when a
reviewing body may remand a decision based on an adjudicator's failure
to discuss evidence and that we amend 20 CFR 404.902 and 416.1492
accordingly.
Response: We are not adopting this comment. As we noted above, our
definitions of the terms ``preponderance of the evidence'' and
``substantial evidence'' are taken directly from our existing rule in
20 CFR 405.5. The definitions in that rule are based on accepted
definitions and are consistent with our longstanding usage. The
commenter's proposed additions to these definitions would not
appreciably clarify our rules, and some of the language the commenter
proposed could raise questions among the public and our adjudicators.
We also believe that our adjudicators and the public are familiar with
the concept of substantial evidence because our subregulatory
instructions have included a definition of ``substantial evidence'' for
approximately 37 years. See SSR 71-53c.
The commenter's other proposals are beyond the scope of this
rulemaking because they focus on how the Appeals Council or a Federal
court can determine whether a decision is supported by substantial
evidence. If we decide that it would be appropriate to adopt rules
along the lines proposed by the commenter, we would first follow the
Administrative Procedure Act's rulemaking procedures.
Regulatory Procedures
Executive Order 12866, as Amended
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, as amended.
Thus, they were not subject to OMB review.
Regulatory Flexibility Act
We certify that these rules will not have a significant economic
impact on a substantial number of small entities as they affect
individuals only. Therefore, a regulatory flexibility analysis as
provided in the Regulatory Flexibility Act, as amended, is not
required.
Paperwork Reduction Act
These rules will impose no additional reporting or recordkeeping
requirements requiring OMB clearance.
(Catalog of Federal Domestic Assistance Program Nos. 96.001, Social
Security--Disability Insurance; 96.002, Social Security--Retirement
Insurance; 96.004, Social Security--Survivors 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 408
Administrative practice and procedure, Aged, Reporting and
recordkeeping requirements, Social Security, Supplemental Security
Income (SSI), Veterans.
20 CFR Part 416
Administrative practice and procedure, Aged, Blind, Disability
benefits, Public assistance programs, Reporting and recordkeeping
requirements, Supplemental Security Income (SSI).
20 CFR Part 422
Administrative practice and procedure, Organization and functions
(Government agencies), Reporting and recordkeeping requirements, Social
Security.
Dated: December 12, 2008.
Michael J. Astrue,
Commissioner of Social Security.
0
For the reasons set forth in the preamble, we are amending subpart J of
part 404, subpart J of part 408, subpart N of part 416, and subparts B
and C of part 422 of chapter III of title 20 of the Code of Federal
Regulations as set forth below:
PART 404--FEDERAL OLD-AGE, SURVIVORS AND DISABILITY INSURANCE
(1950-)
Subpart J--[Amended]
0
1. The authority citation for subpart J of part 404 continues to read
as follows:
Authority: Secs. 201(j), 204(f), 205(a), (b), (d)-(h), and (j),
221, 223(i), 225, and 702(a)(5) of the Social Security Act (42
U.S.C. 401(j), 404(f), 405(a), (b), (d)-(h), and (j), 421, 423(i),
425, and 902(a)(5)); sec. 5, Pub. L. 97-455, 96 Stat. 2500 (42
U.S.C. 405 note); secs. 5, 6(c)-(e), and 15, Pub. L. 98-460, 98
Stat. 1802 (42 U.S.C. 421 note); sec. 202, Pub. L. 108-203, 118
Stat. 509 (42 U.S.C. 902 note).
0
2. Amend Sec. 404.901 by adding the definitions for ``Preponderance of
the evidence'' and ``Substantial evidence'' in alphabetical order to
read as follows:
Sec. 404.901 Definitions.
* * * * *
Preponderance of the evidence means such relevant evidence that as
a whole shows that the existence of the fact to be proven is more
likely than not.
* * * * *
Substantial evidence means such relevant evidence as a reasonable
mind might accept as adequate to support a conclusion.
* * * * *
0
3. Amend Sec. 404.902 by revising the second sentence and adding a new
sentence before the existing third sentence in the introductory text to
read as follows:
Sec. 404.902 Administrative actions that are initial determinations.
* * * We will base our initial determination on the preponderance
of the evidence. We will state the important facts and give the reasons
for our conclusions in the initial determination. * * *
* * * * *
0
4. Amend Sec. 404.917 by revising the second sentence of paragraph (b)
to read as follows:
Sec. 404.917 Disability hearing-disability hearing officer's
reconsidered determination.
* * * * *
(b) * * * The disability hearing officer must base the reconsidered
determination on the preponderance of the evidence offered at the
disability hearing or otherwise included in your case file.
* * * * *
0
5. Revise Sec. 404.920 to read as follows:
Sec. 404.920 Reconsidered determination.
After you or another person requests a reconsideration, we will
review the evidence we considered in making the initial determination
and any other evidence we receive. We will make our determination based
on the preponderance of the evidence.
0
6. Amend Sec. 404.941 by revising the second sentence of paragraph (a)
to read as follows:
Sec. 404.941 Prehearing case review.
(a) * * * That component will decide whether it should revise the
determination based on the preponderance of the evidence. * * *
* * * * *
[[Page 76944]]
0
7. Amend Sec. 404.942 by revising the second sentence of paragraph (a)
to read as follows:
Sec. 404.942 Prehearing proceedings and decisions by attorney
advisors.
(a) * * * If after the completion of these proceedings we can make
a decision that is wholly favorable to you and all other parties based
on the preponderance of the evidence, an attorney advisor, instead of
an administrative law judge, may issue the decision. * * *
* * * * *
0
8. Amend Sec. 404.948 by revising the first sentence of paragraph (a)
to read as follows:
Sec. 404.948 Deciding a case without an oral hearing before an
administrative law judge.
(a) * * * If the evidence in the hearing record supports a finding
in favor of you and all the parties on every issue, the administrative
law judge may issue a hearing decision based on a preponderance of the
evidence without holding an oral hearing. * * *
* * * * *
0
9. Amend Sec. 404.953 by revising the second sentence of paragraph
(a), the first sentence of paragraph (b), and the first sentence of
paragraph (c) to read as follows:
Sec. 404.953 The decision of an administrative law judge.
(a) * * * The administrative law judge must base the decision on
the preponderance of the evidence offered at the hearing or otherwise
included in the record. * * *
(b) * * * The administrative law judge may enter a wholly favorable
oral decision based on the preponderance of the evidence into the
record of the hearing proceedings. * * *
(c) * * * Although an administrative law judge will usually make a
decision, the administrative law judge may send the case to the Appeals
Council with a recommended decision based on a preponderance of the
evidence when appropriate. * * *
0
10. Amend Sec. 404.979 by adding a new third sentence to read as
follows:
Sec. 404.979 Decision of Appeals Council.
* * * If the Appeals Council issues its own decision, it will base
its decision on the preponderance of the evidence. * * *
0
11. Amend Sec. 404.984 by revising the last sentence of paragraph (a),
the second sentence of paragraph (b)(3), and the last sentence of
paragraph (c) to read as follows:
Sec. 404.984 Appeals Council review of administrative law judge
decision in a case remanded by a Federal court.
(a) * * * The Appeals Council will either make a new, independent
decision based on the preponderance of the evidence in the record that
will be the final decision of the Commissioner after remand, or it will
remand the case to an administrative law judge for further proceedings.
(b) * * *
(3) * * * If the Appeals Council assumes jurisdiction, it will make
a new, independent decision based on the preponderance of the evidence
in the entire record affirming, modifying, or reversing the decision of
the administrative law judge, or it will remand the case to an
administrative law judge for further proceedings, including a new
decision. * * *
(c) * * * After the Appeals Council receives the briefs or other
written statements, or the time allowed (usually 30 days) for
submitting them has expired, the Appeals Council will either issue a
final decision of the Commissioner based on the preponderance of the
evidence affirming, modifying, or reversing the decision of the
administrative law judge, or remand the case to an administrative law
judge for further proceedings, including a new decision.
* * * * *
PART 408--SPECIAL BENEFITS FOR CERTAIN WORLD WAR II VETERANS
Subpart J--[Amended]
0
12. The authority citation for subpart J of part 408 continues to read
as follows:
Authority: Secs. 702(a)(5) and 809 of the Social Security Act
(42 U.S.C. 902(a)(5) and 1009).
0
13. Amend Sec. 408.1001 by adding the definition for ``Preponderance
of the evidence'' in alphabetical order to read as follows:
Sec. 408.1001 Definitions.
* * * * *
Preponderance of the evidence means such relevant evidence that as
a whole shows that the existence of the fact to be proven is more
likely than not.
* * * * *
0
14. Amend Sec. 408.1002 by adding a new third sentence to read as
follows:
Sec. 408.1002 What is an initial determination?
* * * We will base our initial determination on the preponderance
of the evidence.
0
15. Amend Sec. 408.1020 by revising the second sentence to read as
follows:
Sec. 408.1020 How do we make our reconsidered determination?
* * * We will make our determination based on the preponderance of
the evidence in the record. * * *
PART 416--SUPPLEMENTAL SECURITY INCOME FOR THE AGED, BLIND, AND
DISABLED
Subpart N--[Amended]
0
16. The authority citation for subpart N of part 416 continues to read
as follows:
Authority: Secs. 702(a)(5), 1631, and 1633 of the Social
Security Act (42 U.S.C. 902(a)(5), 1383, and 1383b); sec. 202, Pub.
L. 108-203, 118 Stat. 509 (42 U.S.C. 902 note).
0
17. Amend Sec. 416.1401 by adding the definitions for ``Preponderance
of the evidence'' and ``Substantial evidence'' in alphabetical order to
read as follows:
Sec. 416.1401 Definitions.
* * * * *
Preponderance of the evidence means such relevant evidence that as
a whole shows that the existence of the fact to be proven is more
likely than not.
* * * * *
Substantial evidence means such relevant evidence as a reasonable
mind might accept as adequate to support a conclusion.
* * * * *
0
18. Amend Sec. 416.1402 by revising the second sentence and adding a
new sentence before the existing third sentence in the introductory
text to read as follows:
Sec. 416.1402 Administrative actions that are initial determinations.
* * * We will base our initial determination on the preponderance
of the evidence. We will state the important facts and give the reasons
for our conclusions in the initial determination. * * *
* * * * *
0
19. Amend Sec. 416.1417 by revising the second sentence of paragraph
(b) to read as follows:
Sec. 416.1417 Disability hearing--disability hearing officer's
reconsidered determination.
* * * * *
(b) * * * The disability hearing officer must base the reconsidered
determination on the preponderance of the evidence offered at the
disability
[[Page 76945]]
hearing or otherwise included in your case file.
* * * * *
0
20. Revise Sec. 416.1420 to read as follows:
Sec. 416.1420 Reconsidered determination.
After you or another person requests a reconsideration, we will
review the evidence we considered in making the initial determination
and any other evidence we receive. We will make our determination based
on the preponderance of the evidence. The person who makes the
reconsidered determination will have had no prior involvement with the
initial determination.r
0
21. Amend Sec. 416.1441 by revising the second sentence of paragraph
(a) to read as follows:
Sec. 416.1441 Prehearing case review.
(a) * * * That component will decide whether it should revise the
determination based on the preponderance of the evidence. * * *
* * * * *
0
22. Amend Sec. 416.1442 by revising the second sentence of paragraph
(a) to read as follows:
Sec. 416.1442 Prehearing proceedings and decisions by attorney
advisors.
(a) * * * If after the completion of these proceedings we can make
a decision that is wholly favorable to you and all other parties based
on the preponderance of the evidence, an attorney advisor, instead of
an administrative law judge, may issue the decision. * * *
* * * * *
0
23. Amend Sec. 416.1448 by revising the first sentence of paragraph
(a) to read as follows:
Sec. 416.1448 Deciding a case without an oral hearing before an
administrative law judge.
(a) * * * If the evidence in the hearing record supports a finding
in favor of you and all the parties on every issue, the administrative
law judge may issue a hearing decision based on a preponderance of the
evidence without holding an oral hearing. * * *
* * * * *
0
24. Amend Sec. 416.1453 by revising the second sentence of paragraph
(a), the first sentence of paragraph (b), and the first sentence of
paragraph (d) to read as follows:
Sec. 416.1453 The decision of an administrative law judge.
(a) * * * The administrative law judge must base the decision on
the preponderance of the evidence offered at the hearing or otherwise
included in the record. * * *
(b) * * * The administrative law judge may enter a wholly favorable
oral decision based on the preponderance of the evidence into the
record of the hearing proceedings. * * *
* * * * *
(d) * * * Although an administrative law judge will usually make a
decision, the administrative law judge may send the case to the Appeals
Council with a recommended decision based on a preponderance of the
evidence when appropriate. * * *
0
25. Amend Sec. 416.1479 by adding a new third sentence to read as
follows:
Sec. 416.1479 Decision of Appeals Council.
* * * If the Appeals Council issues its own decision, it will base
its decision on the preponderance of the evidence. * * *
0
26. Amend Sec. 416.1484 by revising the last sentence of paragraph
(a), the second sentence of paragraph (b)(3), and the last sentence of
paragraph (c) to read as follows:
Sec. 416.1484 Appeals Council review of administrative law judge
decision in a case remanded by a Federal court.
(a) * * * The Appeals Council will either make a new, independent
decision based on the preponderance of the evidence in the record that
will be the final decision of the Commissioner after remand, or it will
remand the case to an administrative law judge for further proceedings.
(b) * * *
(3) * * * If the Appeals Council assumes jurisdiction, it will make
a new, independent decision based on the preponderance of the evidence
in the entire record affirming, modifying, or reversing the decision of
the administrative law judge, or it will remand the case to an
administrative law judge for further proceedings, including a new
decision. * * *
(c) * * * After the Appeals Council receives the briefs or other
written statements, or the time allowed (usually 30 days) for
submitting them has expired, the Appeals Council will either issue a
final decision of the Commissioner based on the preponderance of the
evidence affirming, modifying, or reversing the decision of the
administrative law judge, or remand the case to an administrative law
judge for further proceedings, including a new decision.
* * * * *
PART 422--ORGANIZATION AND PROCEDURES
Subpart B--[Amended]
0
27. The authority citation for subpart B of part 422 continues to read
as follows:
Authority: Secs. 205, 232, 702(a)(5), 1131, and 1143 of the
Social Security Act (42 U.S.C. 405, 432, 902(a)(5), 1320b-1, and
1320b-13), and sec. 7213(a)(1)(A) of Pub. L. 108-458.
0
28. Amend Sec. 422.130 by revising the first sentence of paragraph (c)
to read as follows:
Sec. 422.130 Claim procedure.
* * * * *
(c) * * * In the case of an application for benefits, the
establishment of a period of disability, a lump-sum death payment, a
recomputation of a primary insurance amount, or entitlement to hospital
insurance benefits or supplementary medical insurance benefits, after
obtaining the necessary evidence, we will determine, based on the
preponderance of the evidence (see Sec. Sec. 404.901 and 416.1401 of
this chapter) as to the entitlement of the individual claiming or for
whom is claimed such benefits, and will notify the applicant of the
determination and of his right to appeal. * * *
Subpart C--[Amended]
0
29. The authority citation for subpart C of part 422 continues to read
as follows:
Authority: Secs. 205, 221, and 702(a)(5) of the Social Security
Act (42 U.S.C. 405, 421, and 902(a)(5)); 30 U.S.C. 923(b).
0
30. Revise the last sentence of Sec. 422.203(c) to read as follows:
Sec. 422.203 Hearings.
* * * * *
(c) * * * The administrative law judge, or an attorney advisor
under Sec. Sec. 404.942 or 416.1442 of this chapter, must base the
hearing decision on the preponderance of the evidence offered at the
hearing or otherwise included in the record.
[FR Doc. E8-30056 Filed 12-17-08; 8:45 am]
BILLING CODE 4191-02-P