[Federal Register Volume 78, Number 169 (Friday, August 30, 2013)]
[Proposed Rules]
[Pages 53700-53702]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: 2013-21143]


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SOCIAL SECURITY ADMINISTRATION

20 CFR Part 404

[Docket No. SSA-2012-0075]
RIN 0960-AH54


Revised Medical Criteria for Evaluating Hearing Loss and 
Disturbances of Labyrinthine-Vestibular Function

AGENCY: Social Security Administration.

ACTION: Advance notice of proposed rulemaking (ANPRM).

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SUMMARY: We are requesting your comments on whether and how we should 
revise the criteria in our Listing of Impairments (listings) for 
evaluating hearing loss and disturbances of labyrinthine-vestibular 
function in adults and children. We are requesting your comments as 
part of our ongoing effort to ensure that our listings reflect current 
medical knowledge. If we propose specific revisions, we will publish a 
notice of proposed rulemaking in the Federal Register.

DATES: To ensure that we consider your comments, we must receive them 
by no later than October 29, 2013.

ADDRESSES: You may submit comments by any one of three methods--
Internet, fax, or mail. Do not submit the same comments multiple times 
or by more than one method. Regardless of which method you choose, 
please state that your comments refer to Docket No. SSA-2012-0075 so 
that we may associate your comments with this ANPRM.
    Caution: You should be careful to include in your comments only 
information that you wish to make publicly available. We strongly urge 
you not to include in your comments any personal information, such as 
Social Security numbers or medical information.
    1. Internet: We strongly recommend that you submit your comments 
via the

[[Page 53701]]

Internet. Visit the Federal eRulemaking portal at http://www.regulations.gov. Use the Search function to find docket number SSA-
2012-0075. The system will issue you a tracking number to confirm your 
submission. You will not be able to view your comment immediately 
because we must post each comment manually. It may take up to a week 
for your comment to be viewable.
    2. Fax: Fax comments to (410) 966-2830.
    3. Mail: Address your comments to the Office of Regulations and 
Reports Clearance, Social Security Administration, 107 Altmeyer 
Building, 6401 Security Boulevard, Baltimore, Maryland 21235-6401.
    Comments are available for public viewing on the Federal 
eRulemaking portal at http://www.regulations.gov or in person, during 
regular business hours, by arranging with the contact person identified 
below.

FOR FURTHER INFORMATION CONTACT: Cheryl A. Williams, Office of Medical 
Listings Improvement, Social Security Administration, 6401 Security 
Boulevard, Baltimore, Maryland 21235-6401, (410) 965-1020. 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:

What is the purpose of this ANPRM?

    We are publishing this ANPRM as part of our ongoing effort to 
ensure that our listing criteria reflect current medical knowledge. 
This ANPRM gives you an opportunity to send us your comments and 
suggestions on revisions to the introductory text sections 2.00B and 
102.00B and the listings and other criteria in sections 2.00 and 102.00 
for evaluating hearing loss and disturbances of labyrinthine-vestibular 
function. We last published final rules revising the criteria that we 
use to evaluate hearing disorders on June 2, 2010.\1\ We last published 
final rules with the criteria we use to evaluate disturbances in 
labyrinthine-vestibular function on December 6, 1985.\2\
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    \1\ 75 FR 30693.
    \2\ 50 FR 50068.
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On which rules are we inviting comments and suggestions?

    We are inviting comments and suggestions on our current rules which 
you can find in sections 2.00 and 102.00 in the listings in appendix 1 
to subpart P of part 404 of our regulations, on the Internet at http://www.ssa.gov/OP_Home/cfr20/404/404-app-p01.htm.

Who should send us comments and suggestions?

    We invite comments and suggestions from people who apply for or 
receive benefits from us, advocates and organizations that represent 
people who have hearing disorders or disturbances of labyrinthine-
vestibular function, State agencies that make disability determinations 
for us, experts in the evaluation of hearing disorders, researchers, 
and other members of the general public.

What should you comment about?

    We are interested in any comments and suggestions on how we might 
revise introductory text sections 2.00B and 102.00B, listing 2.07 for 
evaluating disturbances of labyrinthine-vestibular function, and 
listings 2.10, 2.11, 102.10, and 102.11 for evaluating hearing loss. 
For example:
     Do the rules for evaluating hearing loss or disturbances 
of labyrinthine-vestibular function contain technical language or 
jargon that is not clearly explained? If not clearly explained, what 
technical language or jargon needs further explanation?
     Are the requirements for otological examinations and 
audiometric testing provided in sections 2.00B and 102.00B clearly 
stated? If not clearly stated, what requirements need further 
clarification?
     What types of testing should we consider when evaluating 
hearing loss in adults or children who cannot cooperate in behavioral 
testing?
     Would it be helpful to add a sample audiogram that 
contains all the requirements necessary for evaluation of hearing loss 
in adults or children?
     What word recognition tests other than the Hearing in 
Noise Test (HINT) or the Hearing in Noise Test--Children (HINT-C) 
should we consider when we evaluate hearing loss treated with cochlear 
implantation?
     Should we provide examples of medical reasons for a 
discrepancy between the speech reception threshold and the pure tone 
average?
     Could we improve clarity by replacing the phrase 
``disturbances in labyrinthine-vestibular function'' with the phrase 
``disturbances of inner ear function''?
     Rather than evaluating disturbances in labyrinthine-
vestibular function in adults under the listings, would evaluating 
disturbances in labyrinthine-vestibular function using residual 
functional capacity \3\ improve the determination process?
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    \3\ Residual functional capacity describes what a person can 
still do despite his or her impairment(s). 20 CFR 404.1545 and 
416.945.
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     Should we continue to evaluate disturbances of 
labyrinthine-vestibular function under the Special Senses and Speech 
body system?
     What else could we do to make the rules for evaluating 
hearing or disturbances in labyrinthine-vestibular function easier to 
understand?
     Would a different format make the rules easier to 
understand (for example, changing the grouping or ordering of sections; 
use of headings; paragraphing; use of diagrams; use of tables)?
     Experts who study disability believe that many personal, 
environmental, educational, and social factors contribute in 
significant ways to the relationship between a person's hearing ability 
and the ability to work. Rather than providing criteria for evaluating 
hearing loss in adults under the listings, should we evaluate all 
hearing loss using residual functional capacity?

Will we respond to your comments from this notice?

    We will consider all comments and suggestions we receive. However, 
we will not respond directly to the comments you send in response to 
this ANPRM.

What will we consider when we decide whether to propose revisions?

    When we decide whether to propose revisions to our rules for 
evaluating hearing loss or disturbances in labyrinthine-vestibular 
function, we will consider:
     All comments and suggestions we receive in response to 
this notice;
     Information about advances in medical knowledge, 
treatment, and methods of evaluating hearing loss or disturbances in 
labyrinthine-vestibular function; and
     Our disability program experience.
    In addition, we will consider the following when we decide whether 
to propose revisions to our rules for evaluating labyrinthine-
vestibular function:
     The comments and suggestions that we received in response 
to an ANPRM that we published on April 13, 2005.\4\
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    \4\ Revised Medical Criteria for Evaluating Hearing Impairments 
and Disturbance of Labyrinthine-Vestibular Function, 70 FR 19353. 
The comments we received in response to this ANPRM are available at: 
www.regulations.gov, by searching for docket ``SSA-2006-0178''.
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     Information we received at a Policy Conference on Hearing 
Impairments and

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Disturbance of Labyrinthine-Vestibular Function, held November 7-8, 
2005.\5\
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    \5\ The full transcript for the Policy Conference presentations 
on labyrinthine-vestibular function is available at: http://www.regulations.gov/#!documentDetail;D=SSA-2006-0178-0003.
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    If we decide to propose specific revisions, we will publish a 
notice of proposed rulemaking in the Federal Register and you will have 
a chance to comment on the revisions we propose.

List of Subjects in 20 CFR Part 404

    Administrative practice and procedure, Blind, Disability benefits, 
Old-age, Survivors and disability insurance, Reporting and 
recordkeeping requirements, Social security.

    Dated: August 22, 2013.
Carolyn W. Colvin,
Acting Commissioner of Social Security.
[FR Doc. 2013-21143 Filed 8-29-13; 8:45 am]
BILLING CODE 4191-02-P