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Clinton Presidential Records
Digital Records Marker
This is not a presidential record. This is used as an administrative
marker by the William J. Clinton Presidential Library Staff.
This marker identifies the place of a publication.
Publications have not been scanned in their entirety for the purpose
of digitization. To see the full publication please search online or
visit the Clinton Presidential Library's Research Room.
Final Childhood Rules
Thursday
September 9, 1993
Part II
Department of
Health and Human
Services
Social Security Administration
20 CFR Part 416
Supplemental Security Income;
Determining Disability for a Child Under
Age 18; Final Rule
Printed on recycled paper
Corrections to Final Rules of 9/9/93
Federal Register 1 Vol. 58, No. 183 1 Thursday, September 23, 1993 / Rules and Regulations 49431
DEPARTMENT OF HEALTH AND
EFFECTIVE DATE above. In addition, we
to impairment(s) that disable adults).
HUMAN SERVICES
are making several editorial corrections.
These rules also use as many familiar
principles of disability evaluation as
Correction of Publication
Social Security Administration
feasible; however, they are of necessity
Accordingly, the publication on
different from the adult rules in some
20 CFR Part 416
September 9, 1993, of the final rule.
respects and employ evaluation criteria
which was the subject of FR Doc. 93-
that have not been used before in
[Reguistions No. 16]
21600, is corrected as follows:
adjudicating childhood disability
1. On page 47534, in the first column,
claims.
RIN 0960-AD58
the following material is inserted before
We are beginning to receive anecdotal
Supplemental Security Income;
the entry "Section 416.902-General
evidence and concerns from Members of
Determining Disability for a Child
Definitions and Terms for this Subpart":
Congress and other individuals who
Under Age 18; Correction
Sunset Date
believe that the rules-and even the
entire program-should be changed.
AGENCY: Social Security Administration.
For several reasons, we are providing
Some people question whether all
HHS.
a sunset date for final 416.924-
children who are receiving SSI benefits
ACTION: Correction to final rule.
416.924e, 416.926a, and 416.994a of 4
under these rules do, in fact. have
years from the date of publication. On
impairments of comparable severity to
SUMMARY: This document contains
that date, those rules will no longer be
disabling impairments in adults. Some
corrections to the final rule published
effective unless extended by the
question the propriety of paying SSI
Thursday. September 9, 1993 (58 FR
Secretary. or revised and promulgated
benefits to children with certain kinds
47532). This rule revised the disability
again. We received one comment asking
of impairments. Many of these
evaluation and determination process
us to provide a 3-year sunset date. The
allegations, opinions. and concerns
for Supplemental Security Income (SSI)
commenter wanted us to include a
come from individuals in the
claims of children based on disability.
sunset date to show our commitment to
educational community who have the
EFFECTIVE DATE: September 9, 1993. The
update the regulations to reflect
opportunity to see the children who file
rules in §§ 416.924-416.924e, 416.926a,
advances in medicine and early
for and receive SSI benefits. but we have
intervention. The commenter's reason
and 416.994a will no longer be effective
also heard the same concerns from other
for the need for a sunset date is one
September 9, 1997, unless extended by
people.
the Secretary, or revised and
reason for setting a date: however, we
We are committed to ensuring that the
promulgated again.
are adopting the comment for other
SSI benefits we pay do go to children
compelling reasons.
who are disabled and that the benefits
FOR FURTHER INFORMATION CONTACT:
The use of sunset dates is not new in
are used for the benefit of the children.
Cassandra Bond, Legal Assistant, Office
our regulations. We have used sunset
For this reason, we will do whatever we
of Regulations, Social Security
dates for other rules, including our
determine is necessary and within our
Administration. 6401 Security
listings in the Listing of Impairments in
Boulevard. Baltimore, Maryland 21235,
authority to improve our process. The
appendix 1 to subpart P of part 404.
sunset date for these rules is one aspect
telephone (410) 965-1794.
Sunset dates are a means of alerting the
of our commitment. If we find that it is
SUPPLEMENTARY INFORMATION:
public that changes in the rules may be
necessary to revise the rules to further
necessary, and. if they are, that we plan
Background
minimize the risk of incorrect payments.
diligently to pursue those changes in the
we will take appropriate action to revise
The final rule that is the subject of
foreseeable future. Sunset dates do not
them.
these corrections amended the rules we
require us to make changes in the rules,
2. On page 47542, in the first column,
published on February 11, 1991 (56 FR
but they do require us to reexamine the
last paragraph. first line. "one-and-one-
5534). subsequent to the February 20,
rules, and if changes are not necessary.
half" is corrected to read "two-and-one-"
1990, U.S. Supreme Court ruling in
to publish a final rule in the Federal
half."
Sullivan V. Zebley, 493 U.S. 521, 110
Register extending the effective date.
3. On page 47543, in the third
S.Ct. 885 (1990). In Zebley, the Court
The most important reason for
column. last paragraph. line four, "one-
invalidated the use of 8 medical
including a sunset date for SS 416.924-
and-one-half" is corrected to read "two-
"listings-only" approach to the denial of
416.924e, 416.926a, and 416.994a is that
and-one-half."
children's claims for SSI benefits based
these rules represent a significant
4. On page 47544, in the second
on disability, and required the use of an
change in the way we evaluate disability
column. second paragraph under the
individualized functional assessment of
in children from the way we evaluated
first "Response," line sixteen, "a year-
children whose impairments did not
disability in children prior to the
and-a-half' is corrected to read "two-
meet or equal the severity of listed
Supreme Court's decision in Zebley.
and-a-half years."
medical impairments. As did our prior
Even though we have had these rules in
5. On page 47545, in the third
final rules, the changes made in the
place for over two-and-one-half years
column, the paragraph titled
rules incorporate into the disability
and believe that they are functioning
"Response" is corrected to read as
determination process for these children
well and serving the children they are
follows:
concepts and criteria reflecting current
intended to serve, the rules we
Response: We have not adopted these
knowledge in the field of childhood
promulgated on February 11, 1991 and
comments. We are in the process of
disability and functioning
this final rule still establish some
revising the listings for both children
different disability evaluation criteria
and adults; however, these revisions go
Need for Correction
for children. The rules for which we are
far beyond the ambit of the present rules
The final rule, as published. did not
providing a sunset date do implement
and will be proposed through normal
contain the complete explanation we
the statutory standard for evaluating
Administrative Procedure Act (APA)
intended to provide concerning the
disability in children (ie., a child is
rulemaking procedures. We have
reasons that we decided to establish a
disabled if be or she has an
published final revisions of both the
"sunset date" for the rules cited in
impairment(s) of "comparable severity"
multiple body system listings. which
49432 Federal Register / Vol. 58, No. 183 / Thursday, September 23, 1993 / Rules and Regulations
includes Down syndrome. FAS, and
the commenter because it is more
due March 8, 1993. Four comments
other such disorders, and the childhood
reasonable and practicable.
were received.
mental listings (55 FR 51204 and 51208,
8. On page 47576, in the second
The PTO proposed moving the
December 12, 1990). We have published
column, in the paragraph titled "Cost
presumption of correctness of an
further final revisions to the multiple
Considerations," line 18, "saved" is
interlocutory order, which is presently
body system listings and revisions to the
corrected to read "prevented."
in 37 CFR 1.655(a), to a proposed new
endocrine system listings. and added
9. On page 47576, in the third
subsection 1.601(q). The PTO also
rules for the evaluation of immune
column. in the first paragraph titled
proposed to make explicit in 37 CFR
-system disorders. including human
"Cost Considerations," line 10, "saved"
1.637(a) that a party filing a motion has
immunodeficiency virus (HIV) infection
is corrected to read "prevented."
the burden of proving why it is entitled
(58 FR 36008, July 2, 1993). We have
10. On page 47577, in the second
to the relief sought in the motion.
also published NPRMs proposing to
column, in the Words of Issuance, add
The PTO proposed to amend 37 CFR
update the listings for adult mental
the following sentence: "The rules in
1.639 to incorporate guidance provided
disorders, which may be applicable to
416.924-416.924e, 416.926a, and
in Hanagan V. Kimura, 16 USPQ2d
children in certain circumstances (56 FR
416.994a will no longer be effective on
1791, 1794 (Comm'r Pat. 1990).
September 9, 1997 unless extended by
Subsection (c) of § 1.639 was proposed
33130, July 18, 1991), the respiratory
to be amended to refer to "additional
listings, including the childhood asthma
the Secretary or revised and
listing (56 FR 52231, October 18, 1991),
promulgated again."
evidence in the form of testimony" so as
and the cardiovascular listings,
Fred Wirth,
to distinguish the evidence needed
under subsection (c) from evidence
including the childhood listings (56 FR
Acting Deputy Assistant Secretary for
submitted under subsections (a) and (b).
31266, July 9, 1991).
Information Resources Management.
Subsection (d) to 37 CFR 1.639 was
6. On page 47570, in the first column,
[FR Doc. 93-23267 Filed 9-22-93; 8:45 am)
proposed to be added to specify the
first full paragraph. line three, "one-
BILLING CODE 4190-29-P
nature of evidence that must be
and-one-half" is corrected to read "two-
submitted when an opinion of an expert
and-one-half."
is needed. Subsection (e) was proposed
7. On page 47570, in the second
DEPARTMENT OF COMMERCE
to be added to specify the nature of
column, both paragraphs under
"Response" are corrected to read as
Patent and Trademark Office
evidence that must be submitted when
a statement of a fact witness is to be
follows:
37 CFR Part 1
relied upon. Subsection (f) was
Response: We adopted the comment,
proposed to be added to specify the
but for different reasons than the
[Docket No. 921118-3184]
nature of a showing that should be made
commenter gave. The commenter's
RIN 0651-AA63
when a statement of an opponent is
reasons are the same reasons we provide
needed or evidence in possession of an
sunset dates for our medical listings.
Patent Interference Practice Burden of
opponent is needed Subsection (g) was
The medical listings in the Listing of
Proof
proposed to be added to specify the
Impairments contain specific medical
nature of evidence that must be
criteria; as such, they do require
AGENCY: Patent and Trademark Office,
supplied if inter partes tests are to be
updating from time to time.
Commerce.
conducted.
However, these childhood rules are
ACTION: Final rule.
Present 37 CFR 1.655(a) was proposed
not analogous to the Listing of
SUMMARY: The Patent and Trademark
to be amended by deleting the last
Impairments. They are grounded on a
Office (PTO) is amending its rules of
sentence, which would be moved to and
requirement for an individualized
assessment of each child's ability to
practice in patent interference cases.
be included in the proposed definition
The amended rules specify that a party
of interlocutory order in proposed
function, an assessment that we believe
will always be relevant regardless of any
filing a motion has the burden of proof
subsection 1.601(q).
The PTO received one comment that
for that motion. The amended rules also
future advances in screening, diagnosis,
more clearly state the nature of expert-
endorsed the proposed rulemaking, but
and early intervention. Thus, the fact
was otherwise directed to an earlier
witness and fact-witness evidence that
that there may be such changes should
must accompany a preliminary motion.
rulemaking.
have little or no impact on these rules
The PTO received two comments
because our ultimate concern will still
Moreover, a definition of "interlocutory
regarding proposed subsection 1.601(q).
be to determine how a given child is
order," as contrasted with a final
One comment suggested that procedural
able to function and how that ability
decision, is added to clarify the meaning
rules should not be placed in 8
comports with our definition of
of "interlocutory order."
definition. The comment suggested that
disability. The kinds of advances
EFFECTIVE DATE: October 25, 1993. These
the last two sentences of proposed
described by the commenter will surely
rules will apply to all papers filed with
subsection 1.601(q), which deal with the
assist us in making this determination
the PTO on or after the effective date.
presumed correctness of interlocutory
(in an evidentiary way and perhaps by
FOR FURTHER INFORMATION CONTACT:
orders, be in a new subsection of section
providing greater insight into the effects
Fred E. McKelvey by telephone at (703)
1.655. This suggestion is adopted in
of children's impairments), but we do
305-9035 or by mail marked to his
part. The last two sentences of
not think that they will affect the rules
attention and addressed to Box 8,
subsection 1.601(q) will be moved to the
themselves.
Commissioner of Patents and
end of subsection 1.655(a).
However, for reasons we have already
Trademarks, Washington, DC 20231.
A second comment challenged the
given earlier in this preamble, the rules
SUPPLEMENTARY INFORMATION: A Notice
sufficiency of the notice in the proposed
may need updating in the future.
of Próposed Rulemaking was published
rulemaking The comment noted that
Therefore, we are providing a 4-year
in the Federal Register (58 FR 528) on
the word "manifest" was omitted from
sunset date for § 416.924-416.924e,
January 6, 1993, and in the Official
the portion of existing subsection
416.926a, and 416.994a. We chose 4
Gazette of the PTO (1147 Off. Gaz. 11)
1.655(a) that was moved to new
years instead of the 3 recommended by
on February 2, 1993. Comments were
subsection 1.601(q) and that the word
Chart 1. Sequential Disability Determination Process
Adults
Children: Pre-Zebley
Children: Post-Zebley
1. Are you working?
1. Are you working?
1. Are you working?
(Y = Deny)
(Y = Deny)
(Y = Deny)
2. Do you have a severe impairment?
2. Do you have a severe
2. Do you have a severe impairment?
impairment?
(N = Deny)
(N = Deny)
(N = Deny)
Compare impairment to medical listings
Compare impairment to
Compare impairment to medical listings
medical listings
Mental
Other
Mental **
Other
3a. Meet both diagnostic
3a. Meet criteria in
3a. Meet criteria in
3a. Meet both
3a. Meet medical
(A) and functional (B)
medical listings?
medical listings?
diagnostic (A) and
criteria in the listings?
criteria?
functional (B) criteria?
(Y = Allow)
(Y = Allow)
(Y = Allow)
(Y - Allow)
(Y = Allow)
3b. Equal? Meet (B)
3b. Medically equal
3b. Medically equal
3b. Equal? Meet (B) and
3b. Medically equal
and some of (A)
medical listings?
medical listings *
some of (A)?
medical listings?
(Y = Allow)
(Y = Allow)
(Y = Allow; N = Deny)
(Y - Allow)
(Y = Allow)
Assess residual functional capacity (RFC)
3c. Functionally equal medical listings?
(Y - Allow)
4. Can you do past work?
Do individualized functional assessment
(Y - Deny)
Consider age, education and work experience
4. Given IFA, is impairment(s) of comparable
severity to that which would disabled an adult?
5. Can you do any other work?
(N - Allow; Y = Deny)
(Y = Allow; N - Deny)
*
Before 1990, SSA policy in SS Ruling 83-19 explicitly prohibited using an overall functional assessment to find that a claimant's impairment equalled the
medical listings. A claimant with multiple impairments could meet or equal the listings only if at least one impairment, alone, met or medically equalled a
specified listing.
The childhood mental disorders listings were modified in 1990 to include functional criteria similar to those put in the adult listings in 1985.
March 6, 1995
Disability Policy Panel
1
National Academy of Social Insurance
C
National Commission on
Childhood Disability
Chair:
The Honorable Jim Slattery
February 13, 1995
MEMORANDUM
Members:
TO:
Members of the Commission on Childhood
Polly Arango
Disability
Family Voices
Adrianne Asch, Ph.D.
FROM:
Elaine Fultz
EF
Wellesley College
Staff Director
Dolores Berkovsky, M.S.N.,
REGARDING:
Materials Requested at February 3rd
L.M.S.W.
St. Teresa's Home, Catholic Charities
Meeting
Wade F. Horn, Ph.D.
National Fatherhood Initiative
This packet contains the remaining materials that were
Jennifer Howse, Ph.D.
requested at the Commission's February 3rd meeting.
March of Direct Birth Defects Foundation
These include:
Sharman Davis Jamison
*
Baltimore Sun article, "America's Most Wanted
Parent Advocacy Coalition Educational
Welfare Plan"
Rights Center
Dan Johnson
*
Questions Concerning a Voucher Program for
Wisconsin Department of Health & Social
Disabled Children
Services
Paul Marchand
*
Disability Digest articles
The Are
*
Questions and Answers from Childhood Disability
James M. Perrin, M.D.
Massachusetts General Hospital
Hotline
M. Carmen S. Ramirez
*
Excerpts from Inspector General's Reviews of
Schools Are For Everyone
the Participation of Children with Mental
Carol Rank
Disabilities in the Supplemental Security
Kansas Disability Determination &
Income Program
Referral Service
*
H. Rutherford Turnbull III
State-by-state data on SSI award rates
Beach Center on Families & Disabilities,
University of Kansas
*
State-by-state description of optional Medicaid
services
Barbara Wolfe, Ph.D.
University of Wisconsin
Staff Director:
Enclosures (7)
Elaine Fultz, Ph.D.
Clinton Presidential Records
Digital Records Marker
This is not a presidential record. This is used as an administrative
marker by the William J. Clinton Presidential Library Staff.
This marker identifies the place of an oversized document(s).
Given our digitization capabilities, we are sometimes unable to
adequately scan such large documents. The title from the original
document is indicated below.
Oversized documents have not been scanned in their entirety for
the purpose of digitization. To see the documents please contact or
visit the Clinton Presidential Library's Research Room.
SPECIAL REPORT
LIGHT.FOR.ALL
THE BALTIMORE SUN
Reprint of a four-part series that appeared in
The Baltimore Sun January 22-25, 1995
America's
most wanted
welfare plan