[Title 20 CFR ] [Code of Federal Regulations (annual edition) - April 1, 1996 Edition] [Title 20 - EMPLOYEES' BENEFITS] [Chapter III - SOCIAL SECURITY ADMINISTRATION] [Part 404 - FEDERAL OLD-AGE, SURVIVORS AND DISABILITY INSURANCE (1950- )] [Toc - Table Of Contents] [From the U.S. Government Publishing Office]20 EMPLOYEES' BENEFITS 2 1996-04-01 1996-04-01 false Table Of Contents EMPLOYEES' BENEFITS SOCIAL SECURITY ADMINISTRATION FEDERAL OLD-AGE, SURVIVORS AND DISABILITY INSURANCE (1950- ) Subpart A--Introduction, General Provisions and Definitions Sec. 404.1 Introduction. 404.2 General definitions and use of terms. [[Page 15]] 404.3 General provisions. Subpart B--Insured Status and Quarters of Coverage General 404.101 Introduction. 404.102 Definitions. Fully Insured Status 404.110 How we determine fully insured status. 404.111 When we consider a person fully insured based on World War II active military or naval service. 404.112 When we consider certain employees of private nonprofit organizations to be fully insured. 404.115 Table for determining the quarters of coverage you need to be fully insured. Currently Insured Status 404.120 How we determine currently insured status. Disability Insured Status 404.130 How we determine disability insured status. 404.131 When you must have disability insured status. 404.132 How we determine fully insured status for a period of disability or disability insurance benefits. 404.133 When we give you quarters of coverage based on military service to establish a period of disability. Quarters of Coverage 404.140 What is a quarter of coverage. 404.141 How we credit quarters of coverage for calendar years before 1978. 404.142 How we credit self-employment income to calendar quarters for taxable years beginning before 1978. 404.143 How we credit quarters of coverage for calendar years after 1977. 404.144 How we credit self-employment income to calendar years for taxable years beginning after 1977. 404.145 When you acquire a quarter of coverage. 404.146 When a calendar quarter cannot be a quarter of coverage. Appendix to Subpart B--Quarter of Coverage Amounts for Calendar Years After 1978 Subpart C--Computing Primary Insurance Amounts General 404.201 Introduction. 404.202 Other regulations related to this subpart. 404.203 Definitions. 404.204 Methods of computing primary insurance amounts--general. Average-Indexed-Monthly Earnings Method of Computing Primary Insurance Amounts 404.210 Average-indexed-monthly-earnings method. 404.211 Computing your average indexed monthly earnings. 404.212 Computing your primary insurance amount from your average indexed monthly earnings. 404.213 Computation where you are eligible for a pension based on your noncovered employment. Average-Monthly-Wage Method of Computing Primary Insurance Amounts 404.220 Average-monthly-wage method. 404.221 Computing your average monthly wage. 404.222 Use of benefit table in finding your primary insurance amount from your average monthly wage. Guaranteed Alternative for People Reaching Age 62 After 1978 but Before 1984 404.230 Guaranteed alternative. 404.231 Steps in computing your primary insurance amount under the guaranteed alternative--general. 404.232 Computing your average monthly wage under the guaranteed alternative. 404.233 Adjustment of your guaranteed alternative when you become entitled after age 62. Old-Start Method of Computing Primary Insurance Amounts 404.240 Old-start method--general. 404.241 1977 simplified old-start method. 404.242 Use of old-start primary insurance amount as guaranteed alternative. 404.243 Computation where you are eligible for a pension based on noncovered employment. Special Computation Rules for People Who Had a Period of Disability 404.250 Special computation rules for people who had a period of disability. 404.251 Subsequent entitlement to benefits less than 12 months after entitlement to disability benefits ended. 404.252 Subsequent entitlement to benefits 12 months or more after entitlement to disability benefits ended. Special Minimum Primary Insurance Amounts 404.260 Special minimum primary insurance amounts. 404.261 Computing your special minimum primary insurance amount. [[Page 16]] Cost-of-Living Increases 404.270 Cost-of-living increases. 404.271 When automatic cost-of-living increases apply. 404.272 Indexes we use to measure the rise in the cost-of-living. 404.273 When automatic cost-of-living increases are to be made. 404.274 Measuring the increase in the indexes. 404.275 Amount of automatic cost-of-living increases. 404.276 Publication of notice of increase. 404.277 Automatic increases of ``frozen'' minimum primary insurance amount. 404.278 Additional cost-of-living increase. Recomputing Your Primary Insurance Amount 404.280 Recomputations. 404.281 Why your primary insurance amount may be recomputed. 404.282 Effective date of recomputations. 404.283 Recomputation under method other than that used to find your primary insurance amount. 404.284 Recomputations for people who reach age 62, or become disabled, or die before age 62 after 1978. 404.285 Recomputations performed automatically. 404.286 How to request an immediate recomputation. 404.287 Waiver of recomputation. 404.288 Recomputing when you are entitled to a monthly pension based on noncovered employment. Recalculations of Primary Insurance Amounts 404.290 Recalculations. Appendices to Subpart C Appendix I--Average of the Total Wages for Years After 1950 Appendix II--Benefit Formulas Used with Average Indexed Monthly Earnings Appendix III--Benefit Table Appendix IV--Earnings Needed for a Year of Coverage after 1950 Appendix V--Computing the Special Minimum Primary Insurance Amount and Related Maximum Family Benefits Appendix VI--Percentage of Automatic Increases in Primary Insurance Amounts since 1978 Appendix VII--``Old-Law'' Contribution and Benefit Base Subpart D--Old-Age, Disability, Dependents' and Survivors' Insurance Benefits; Period of Disability General 404.301 Introduction. 404.302 Other regulations related to this subpart. 404.303 Definitions. 404.304 General rules on benefit amounts. 404.305 When you may not be entitled to benefits. Old-Age and Disability Benefits 404.310 Who is entitled to old-age benefits. 404.311 When entitlement to old-age benefits begins and ends. 404.312 Old-age benefit amounts. 404.313 Using delayed retirement credit to increase old-age benefit amount. 404.315 Who is entitled to disability benefits. 404.316 When entitlement to disability benefits begins and ends. 404.317 Disability benefit amounts. 404.320 Who is entitled to a period of disability. 404.321 When a period of disability begins and ends. 404.322 When you may apply for a period of disability after a delay due to a physical or mental condition. 404.325 The termination month. Benefits for Spouses and Divorced Spouses 404.330 Who is entitled to wife's or husband's benefits. 404.331 Who is entitled to wife's or husband's benefits as a divorced spouse. 404.332 When wife's and husband's benefits begin and end. 404.333 Wife's and husband's benefit amounts. 404.335 Who is entitled to widow's or widower's benefits. 404.336 Who is entitled to widow's or widower's benefits as a surviving divorced spouse. 404.337 When widow's and widower's benefits begin and end. 404.338 Widow's and widower's benefit amounts. 404.339 Who is entitled to mother's or father's benefits. 404.340 Who is entitled to mother's or father's benefits as a surviving divorced spouse. 404.341 When mother's and father's benefits begin and end. 404.342 Mother's and father's benefit amounts. 404.344 Your relationship by marriage to the insured. 404.345 Your relationship as wife, husband, widow, or widower under State law. [[Page 17]] 404.346 Your relationship as wife, husband, widow, or widower based upon a deemed valid marriage. 404.347 ``Living in the same household'' defined. 404.348 When a child living with you is ``in your care.'' 404.349 When a child living apart from you is ``in your care.'' Child's Benefits 404.350 Who is entitled to child's benefits. 404.351 Who may be reentitled to child's benefits. 404.352 When child's benefits begin and end. 404.353 Child's benefit amounts. 404.354 Your relationship to the insured. 404.355 Who is the insured's natural child. 404.356 Who is the insured's legally adopted child. 404.357 Who is the insured's stepchild. 404.358 Who is the insured's grandchild or stepgrandchild. 404.359 Who is the insured's equitably adopted child. 404.360 When a child is dependent upon the insured person. 404.361 When a natural child is dependent. 404.362 When a legally adopted child is dependent. 404.363 When a stepchild is dependent. 404.364 When a grandchild or stepgrandchild is dependent. 404.365 When an equitably adopted child is dependent. 404.366 ``Contributions for support,'' ``one-half support,'' and ``living with'' the insured defined--determining first month of entitlement. 404.367 When you are a ``full-time elementary or secondary school student''. 404.368 When you are considered a full-time student during a period of non-attendance. 404.369 Special rules for entitlement to child's benefits if you are a full-time student for months before August 1982. Parent's Benefits 404.370 Who is entitled to parent's benefits. 404.371 When parent's benefits begin and end. 404.373 Parent's benefit amounts. 404.374 Parent's relationship to the insured. Special Payments at Age 72 404.380 General. 404.381 Who is entitled to special age 72 payments. 404.382 When special age 72 payments begin and end. 404.383 Special age 72 payment amounts. 404.384 Reductions, suspensions, and nonpayments of special age 72 payments. Lump-Sum Death Payment 404.390 General. 404.391 Who is entitled to the lump-sum death payment as a widow or widower who was living in the same household. 404.392 Who is entitled to the lump-sum death payment when there is no widow or widower who was living in the same household--death occurs after August 1981. 404.393 Who is entitled to the lump-sum death payment when there is no widow or widower who was living in the same household--death occurs before September 1, 1981. 404.394 Who is entitled to the lump-sum death payment when burial expenses are paid from the deceased's funds. 404.395 Who is not entitled to the lump-sum death payment. Subpart E--Deductions; Reductions; and Nonpayments of Benefits 404.401 Deduction, reduction, and nonpayment of monthly benefits or lump-sum death payments. 404.401a When we do not pay benefits because of a disability beneficiary's work activity. 404.402 Interrelationship of deductions, reductions, adjustments and nonpayment of benefits. 404.403 Reduction where total monthly benefits exceed maximum family benefits payable. 404.404 How reduction for maximum affects insured individual and other persons entitled on his earnings record. 404.405 Situations where total benefits can exceed maximum because of ``savings clause.'' 404.406 Reduction for maximum because of retroactive effect of application for monthly benefits. 404.407 Reduction because of entitlement to other benefits. 404.408 Reduction of benefits based on disability on account of receipt of certain other disability benefits provided under Federal, State, or local laws or plans. 404.408a Reduction where spouse is receiving a Government pension. 404.408b Reduction of retroactive monthly social security benefits where supplemental security income (SSI) payments were received for the same period. 404.409 [Reserved] 404.410 Reduction in benefits for age--general. 404.411 Special reduction in benefits for age involving entitlement to two or more benefits. 404.412 Adjustments in benefit reductions for age. [[Page 18]] 404.413 Reduction in benefits for age following an increase in primary insurance amounts. 404.415 Deductions because of excess earnings; annual earnings test. 404.416 Amount of deduction because of excess earnings. 404.417 Deductions because of noncovered remunerative activity outside the United States; 45 hour and 7-day work test. 404.418 ``Noncovered remunerative activity outside the United States,'' defined. 404.420 Persons deemed entitled to benefits based on an individual's earnings record. 404.421 Deductions because beneficiary failed to have a child in his or her care. 404.422 Deductions because of refusal to accept rehabilitation services. 404.423 Manner of making deductions. 404.424 Total amount of deductions where more than one deduction event occurs in a month. 404.425 Total amount of deductions where deduction events occur in more than 1 month. 404.428 Earnings in a taxable year. 404.429 Earnings; defined. 404.430 Excess earnings defined for taxable years ending after December 1972; monthly exempt amount defined. 404.434 Excess earnings; method of charging. 404.435 Excess earnings; months to which excess earnings cannot be charged. 404.436 Excess earnings; months to which excess earnings cannot be charged because individual is deemed not entitled to benefits. 404.437 Excess earnings; benefit rate subject to deductions because of excess earnings. 404.439 Partial monthly benefits; excess earnings of the individual charged against his benefits and the benefits of persons entitled (or deemed entitled) to benefits on his earnings record. 404.440 Partial monthly benefits; prorated share of partial payment exceeds the benefit before deduction for excess earnings. 404.441 Partial monthly benefits; insured individual and another person entitled (or deemed entitled) on the same earnings record both have excess earnings. 404.446 Definition of ``substantial services'' and ``services''. 404.447 Evaluation of factors involved in substantial services test. 404.450 Required reports of work outside the United States or failure to have care of a child. 404.451 Penalty deductions for failure to report within prescribed time limit noncovered remunerative activity outside the United States or not having care of a child. 404.452 Reports to Social Security Administration of earnings; wages; net earnings from self-employment. 404.453 Penalty deductions for failure to report earnings timely. 404.454 Good cause for failure to make required reports. 404.455 Request by Social Security Administration for reports of earnings and estimated earnings; effect of failure to comply with request. 404.456 Current suspension of benefits because an individual works or engages in self-employment. 404.457 Deductions where taxes neither deducted from wages of certain maritime employees nor paid. 404.458 Limiting deductions where total family benefits payable would not be affected or would be only partly affected. 404.460 Nonpayment of monthly benefits of aliens outside the United States. 404.461 Nonpayment of lump sum after death of alien outside United States for more than 6 months. 404.462 Nonpayment of hospital and medical insurance benefits of alien outside United States for more than 6 months. 404.463 Nonpayment of benefits of aliens outside the United States; ``foreign social insurance system,'' and ``treaty obligation'' exceptions defined. 404.464 Nonpayment of benefits where individual is deported; prohibition against payment of lump sum based on deported individual's earnings records. 404.465 Conviction for subversive activities; effect on monthly benefits and entitlement to hospital insurance benefits. 404.466 Conviction for subversive activities; effect on enrollment for supplementary medical insurance benefits. 404.467 Nonpayment of benefits; individual entitled to disability insurance benefits or childhood disability benefits based on statutory blindness is engaging in substantial gainful activity. 404.468 Nonpayment of benefits to prisoners. 404.469 Nonpayment of benefits where individual has not furnished or applied for a Social Security number. 404.470 Nonpayment of disability benefits due to noncompliance with rules regarding treatment for drug addiction or alcoholism. 404.480 Paying benefits in installments: Drug addiction or alcoholism. Subpart F--Overpayments, Underpayments, Waiver of Adjustment or Recovery of Overpayments, and Liability of a Certifying Officer 404.501 General applicability of section 204 of the Act. 404.502 Overpayments. 404.502a Notice of right to waiver consideration. 404.503 Underpayments. [[Page 19]] 404.504 Relation to provisions for reductions and increases. 404.505 Relationship to provisions requiring deductions. 404.506 When waiver of adjustment or recovery may be applied. 404.507 Fault. 404.508 Defeat the purpose of Title II. 404.509 Against equity and good conscience; defined. 404.510 When an individual is ``without fault'' in a deduction overpayment. 404.510a When an individual is ``without fault'' in an entitlement overpayment. 404.511 When an individual is at ``fault'' in a deduction overpayment. 404.512 When adjustment or recovery of an overpayment will be waived. 404.513 Liability of a certifying officer. 404.515 Collection and compromise of claims for overpayment. 404.520 Referral of overpayments to the Internal Revenue Service for tax refund offset--General. 404.521 Notice to overpaid individual. 404.522 Review within SSA that an overpayment is past due and legally enforceable. 404.523 Findings by SSA. 404.524 Review of our records related to the overpayment. 404.525 Suspension of offset. 404.526 Tax refund insufficient to cover amount of overpayment. Subpart G--Filing of Applications and Other Forms General Provisions 404.601 Introduction. 404.602 Definitions. 404.603 You must file an application to receive benefits. Applications 404.610 What makes an application a claim for benefits. 404.611 Filing of application with Social Security Administration. 404.612 Who may sign an application. 404.613 Evidence of authority to sign an application for another. 404.614 When an application or other form is considered filed. 404.615 Claimant must be alive when an application is filed. Effective Filing Period of Application 404.620 Filing before the first month you meet the requirements for benefits. 404.621 Filing after the first month you meet the requirements for benefits. 404.622 Limiting an application. 404.623 Filing by persons eligible for old-age and husband's or wife's benefits. Filing Date Based on Written Statement 404.630 Use of date of written statement as filing date. 404.631 Statements filed with the Railroad Retirement Board. 404.632 Statements filed with a hospital. Deemed Filing Date Based on Misinformation 404.633 Deemed filing date in a case of misinformation. Withdrawal of Application 404.640 Withdrawal of an application. 404.641 Cancellation of a request to withdraw. Subpart H--Evidence General 404.701 Introduction. 404.702 Definitions. 404.703 When evidence is needed. 404.704 Your responsibility for giving evidence. 404.705 Failure to give requested evidence. 404.706 Where to give evidence. 404.707 Original records or copies as evidence. 404.708 How we decide what is enough evidence. 404.709 Preferred evidence and other evidence. Evidence of Age, Marriage, and Death 404.715 When evidence of age is needed. 404.716 Type of evidence of age to be given. 404.720 Evidence of a person's death. 404.721 Evidence to presume a person is dead. 404.722 Rebuttal of a presumption of death. 404.723 When evidence of marriage is required. 404.725 Evidence of a valid ceremonial marriage. 404.726 Evidence of common-law marriage. 404.727 Evidence of a deemed valid marriage. 404.728 Evidence a marriage has ended. Evidence for Child's and Parent's Benefits 404.730 When evidence of a parent or child relationship is needed. 404.731 Evidence you are a natural parent or child. 404.732 Evidence you are a stepparent or stepchild. 404.733 Evidence you are the legally adopting parent or legally adopted child. 404.734 Evidence you are an equitably adopted child. 404.735 Evidence you are the grandchild or stepgrandchild. 404.736 Evidence of a child's dependency. [[Page 20]] 404.745 Evidence of school attendance for child age 18 or older. 404.750 Evidence of a parent's support. Other Evidence Requirements 404.760 Evidence of living in the same household with insured person. 404.762 Evidence of having a child in your care. 404.765 Evidence of responsibility for or payment of burial expenses. 404.770 Evidence of where the insured person had a permanent home. 404.780 Evidence of ``good cause'' for exceeding time limits on accepting proof of support or application for a lump-sum death payment. Subpart I--Records of Earnings General Provisions 404.801 Introduction. 404.802 Definitions. 404.803 Conclusiveness of the record of your earnings. Obtaining Earnings Information 404.810 How to obtain a statement of earnings and a benefit estimate statement. 404.811 The statement of earnings and benefit estimate. Correcting the Earnings Record 404.820 Filing a request for correction of the record of your earnings. 404.821 Correction of the record of your earnings before the time limit ends. 404.822 Correction of the record of your earnings after the time limit ends. 404.823 Correction of the record of your earnings for work in the employ of the United States. Notice of Removal or Reduction of an Entry of Earnings 404.830 Notice of removal or reduction of your wages. 404.831 Notice of removal or reduction of your self-employment income. Subpart J--Determinations, Administrative Review Process, and Reopening of Determinations and Decisions Introduction, Definitions, and Initial Determinations 404.900 Introduction. 404.901 Definitions. 404.902 Administrative actions that are initial determinations. 404.903 Administrative actions that are not initial determinations. 404.904 Notice of the initial determination. 404.905 Effect of an initial determination. 404.906 Testing modifications to the disability determination procedures. Reconsideration 404.907 Reconsideration--general. 404.908 Parties to a reconsideration. 404.909 How to request reconsideration. 404.911 Good cause for missing the deadline to request review. 404.913 Reconsideration procedures. 404.914 Disability hearing--general. 404.915 Disability hearing--disability hearing officers. 404.916 Disability hearing--procedures. 404.917 Disability hearing--disability hearing officer's reconsidered determination. 404.918 Disability hearing--review of the disability hearing officer's reconsidered determination before it is issued. 404.919 Notice of another person's request for reconsideration. 404.920 Reconsidered determination. 404.921 Effect of a reconsidered determination. 404.922 Notice of a reconsidered determination. Expedited Appeals Process 404.923 Expedited appeals process--general. 404.924 When the expedited appeals process may be used. 404.925 How to request expedited appeals process. 404.926 Agreement in expedited appeals process. 404.927 Effect of expedited appeals process agreement. 404.928 Expedited appeals process request that does not result in agreement. Hearing Before an Administrative Law Judge 404.929 Hearing before an administrative law judge--general. 404.930 Availability of a hearing before an administrative law judge. 404.932 Parties to a hearing before an administrative law judge. 404.933 How to request a hearing before an administrative law judge. 404.935 Submitting evidence prior to a hearing before an administrative law judge. 404.936 Time and place for a hearing before an administrative law judge. 404.938 Notice of a hearing before an administrative law judge. 404.939 Objections to the issues. 404.940 Disqualification of the administrative law judge. 404.941 Prehearing case review. 404.942 Prehearing proceedings and decisions by attorney advisors. 404.943 Responsibilities of the adjudication officer. [[Page 21]] Administrative Law Judge Hearing Procedures 404.944 Administrative law judge hearing procedures--general. 404.946 Issues before an administrative law judge. 404.948 Deciding a case without an oral hearing before an administrative law judge. 404.949 Presenting written statements and oral arguments. 404.950 Presenting evidence at a hearing before an administrative law judge. 404.951 When a record of a hearing before an administrative law judge is made. 404.952 Consolidated hearings before an administrative law judge. 404.953 The decision of an administrative law judge. 404.955 The effect of an administrative law judge's decision. 404.956 Removal of a hearing request from an administrative law judge to the Appeals Council. 404.957 Dismissal of a request for a hearing before an administrative law judge. 404.958 Notice of dismissal of a request for a hearing before an administrative law judge. 404.959 Effect of dismissal of a request for a hearing before an administrative law judge. 404.960 Vacating a dismissal of a request for a hearing before an administrative law judge. 404.961 Prehearing and posthearing conferences. 404.965 [Reserved] Appeals Council Review 404.967 Appeals Council review--general. 404.968 How to request Appeals Council review. 404.969 Appeals Council initiates review. 404.970 Cases the Appeals Council will review. 404.971 Dismissal by Appeals Council. 404.972 Effect of dismissal of request for Appeals Council review. 404.973 Notice of Appeals Council review. 404.974 Obtaining evidence from Appeals Council. 404.975 Filing briefs with the Appeals Council. 404.976 Procedures before Appeals Council on review. 404.977 Case remanded by Appeals Council. 404.979 Decision of Appeals Council. 404.981 Effect of Appeals Council's decision or denial of review. 404.982 Extension of time to file action in Federal district court. Court Remand Cases 404.983 Case remanded by a Federal court. 404.984 Appeals Council review of administrative law judge decision in a case remanded by a Federal court. 404.985 Application of circuit court law. Reopening and Revising Determinations and Decisions 404.987 Reopening and revising determinations and decisions. 404.988 Conditions for reopening. 404.989 Good cause for reopening. 404.990 Finality of determinations and decisions on revision of an earnings record. 404.991 Finality of determinations and decisions to suspend benefit payments for entire taxable year because of earnings. 404.991a Late completion of timely investigation. 404.992 Notice of revised determination or decision. 404.993 Effect of revised determination or decision. 404.994 Time and place to request a hearing on revised determination or decision. 404.995 Finality of findings when later claim is filed on same earnings record. 404.996 Increase in future benefits where time period for reopening expires. Payment of Certain Travel Expenses 404.999a Payment of certain travel expenses--general. 404.999b Who may be reimbursed. 404.999c What travel expenses are reimbursable. 404.999d When and how to claim reimbursement. Subpart K--Employment, Wages, Self-Employment, and Self-Employment Income 404.1001 Introduction. 404.1002 Definitions. Employment 404.1003 Employment. 404.1004 What work is covered as employment. 404.1005 Who is an employee. 404.1006 Corporation officer. 404.1007 Common-law employee. 404.1008 Agent-driver or commission-driver, full-time life insurance saleman, home worker, or traveling or city salesman. 404.1009 Who is an employer. 404.1010 Farm crew leader as employer. Work Excluded From Employment 404.1012 Work excluded from employment. 404.1013 Included--excluded rule. 404.1014 Domestic service by a student for a local college club, fraternity or sorority. [[Page 22]] 404.1015 Family services. 404.1016 Foreign agricultural workers. 404.1017 Sharefarmers. 404.1018 Work by civilians for the United States Government or its instrumentalities--wages paid after 1983. 404.1018a Work by civilians for the United States Government or its instrumentalities--remuneration paid prior to 1984. 404.1018b Medicare qualified government employment. 404.1019 Work as a member of a uniformed service of the United States. 404.1020 Work for States and their political subdivisions and instrumentalities. 404.1021 Work for the District of Columbia. 404.1022 American Samoa or Guam. 404.1023 Ministers of churches and members of religious orders. 404.1024 Election of coverage by religious orders. 404.1025 Work for religious, charitable, educational, or certain other organizations exempt from income tax. 404.1026 Work for a church or qualified church-controlled organization. 404.1027 Railroad work. 404.1028 Student working for a school, college, or university. 404.1029 Student nurses. 404.1030 Delivery and distribution or sale of newspapers, shopping news, and magazines. 404.1031 Fishing. 404.1032 Work for a foreign government. 404.1033 Work for a wholly owned instrumentality of a foreign government. 404.1034 Work for an international organization. 404.1035 Work for a communist organization. 404.1036 Certain nonresident aliens. 404.1037 Work on or in connection with a non-American vessel or aircraft. Exemption From Social Security By Reason of Religous Belief 404.1039 Employers (including partnerships) and employees who are both members of certain religious groups opposed to insurance. Wages 404.1041 Wages. 404.1042 Wages when paid and received. 404.1043 Facilities or privileges--meals and lodging. 404.1044 Vacation pay. 404.1045 Employee expenses. 404.1046 Pay for work by certain members of religious orders. 404.1047 Annual wage limitation. 404.1048 Contribution and benefit base after 1992. 404.1049 Payments under an employer plan or system. 404.1050 Retirement payments. 404.1051 Payments on account of sickness or accident disability, or related medical or hospitalization expenses. 404.1052 Payments from or to certain tax-exempt trusts or payments under or into certain annuity plans. 404.1053 ``Qualified benefits'' under a cafeteria plan. 404.1054 Payments by an employer of employee's tax or employee's contribution under State law. 404.1055 Payments for agricultural labor. 404.1056 Explanation of agricultural labor. 404.1057 Domestic service in the employer's home. 404.1058 Special situations. 404.1059 Deemed wages for certain individuals interned during World War II. 404.1060 [Reserved] Self-Employment 404.1065 Self-employment coverage. 404.1066 Trade or business in general. 404.1068 Employees who are considered self-employed. 404.1069 Real estate agents and direct sellers. 404.1070 Christian Science practitioners. 404.1071 Ministers and members of religious orders. 404.1073 Public office. 404.1074 Farm crew leader who is self-employed. 404.1075 Members of certain religious groups opposed to insurance. 404.1077 Individuals under railroad retirement system. Self-Employment Income 404.1080 Net earnings from self-employment. 404.1081 General rules for figuring net earnings from self-employment. 404.1082 Rentals from real estate; material participation. 404.1083 Dividends and interest. 404.1084 Gain or loss from disposition of property; capital assets; timber, coal, and iron ore; involuntary conversion. 404.1085 Net operating loss deduction. 404.1086 Community income. 404.1087 Figuring partner's net earnings from self-employment for taxable year which ends as a result of death. 404.1088 Retirement payment to retired partners. 404.1089 Figuring net earnings for residents and nonresidents of Puerto Rico. 404.1090 Personal exemption deduction. 404.1091 Figuring net earnings for ministers and members of religious orders. 404.1092 Figuring net earnings for U.S. citizens or residents living outside the United States. 404.1093 Possession of the United States. [[Page 23]] 404.1094 Options available for figuring net earnings from self- employment. 404.1095 Agricultural trade or business. 404.1096 Self-employment income. Subpart L--[Reserved] Subpart M--Coverage of Employees of State and Local Governments General 404.1200 General. 404.1201 Scope of this subpart regarding coverage and wage reports and adjustments. 404.1202 Definitions. 404.1203 Evidence--for wages paid prior to 1987. 404.1204 Designating officials to act on behalf of the State. What Groups of Employees May Be Covered 404.1205 Absolute coverage groups. 404.1206 Retirement system coverage groups. 404.1207 Divided retirement system coverage groups. 404.1208 Ineligible employees. 404.1209 Mandatorily excluded services. 404.1210 Optionally excluded services. 404.1211 Interstate instrumentalities. 404.1212 Policemen and firemen. How Coverage Under Agreements Is Obtained and Continues 404.1214 Agreement for coverage. 404.1215 Modification of agreement. 404.1216 Modification of agreement to correct an error. 404.1217 Continuation of coverage. 404.1218 Resumption of coverage. 404.1219 Dissolution of political subdivision. How to Identify Covered Employees 404.1220 Identification numbers. What Records of Coverage Must Be Kept 404.1225 Records--for wages paid prior to 1987. Review of Compliance By State With Its Agreement 404.1230 Onsite review program. 404.1231 Scope of review. 404.1232 Conduct of review. 404.1234 Reports of review's findings. How to Report Wages and Contributions--for Wages Paid Prior to 1987 404.1237 Wage reports and contribution returns--general--for wages paid prior to 1987. 404.1239 Wage reports for employees performing services in more than one coverage group--for wages paid prior to 1987. 404.1242 Back pay. 404.1243 Use of reporting forms--for wages paid prior to 1987. 404.1247 When to report wages--for wages paid prior to 1987. 404.1249 When and where to make deposits of contributions and to file contribution returns and wage reports--for wages paid prior to 1987. 404.1251 Final reports--for wages paid prior to 1987. What Is a State's Liability for Contributions--for Wages Paid Prior to 1987 404.1255 State's liability for contributions--for wages paid prior to 1987. 404.1256 Limitation on State's liability for contributions for multiple employment situations--for wages paid prior to 1987. Figuring the Amount of the State's Contributions--for Wages Paid Prior to 1987 404.1260 Amount of contributions--for wages paid prior to 1987. 404.1262 Manner of payment of contributions by State--for wages paid prior to 1987. 404.1263 When fractional part of a cent may be disregarded--for wages paid prior to 1987. If a State Fails to Make Timely Payments--for Wages Paid Prior to 1987 404.1265 Addition of interest to contributions--for wages paid prior to 1987. 404.1267 Failure to make timely payments--for wages paid prior to 1987. How Errors in Reports and Contributions Are Adjusted--for Wages Paid Prior to 1987 404.1270 Adjustments in general--for wages paid prior to 1987. 404.1271 Adjustment of overpayment of contributions--for wages paid prior to 1987. 404.1272 Refund or recomputation of overpayments which are not adjustable--for wages paid prior to 1987. 404.1275 Adjustment of employee contributions--for wages paid prior to 1987. 404.1276 Reports and payments erroneously made to Internal Revenue Service-transfer of funds--for wages paid prior to 1987. How Overpayments of Contributions Are Credited or Refunded--for Wages Paid Prior to 1987 404.1280 Allowance of credits or refunds--for wages paid prior to 1987. 404.1281 Credits or refunds for periods of time during which no liability exists--for wages paid prior to 1987. 404.1282 Time limitations on credits or refunds--for wages paid prior to 1987. [[Page 24]] 404.1283 Exceptions to the time limitations on credits or refunds--for wages paid prior to 1987. 404.1284 Offsetting underpayments against overpayments--for wages paid prior to 1987. How Assessments for Underpayments of Contributions Are Made--for Wages Paid Prior to 1987 404.1285 Assessments of amounts due--for wages paid prior to 1987. 404.1286 Time limitations on assessments--for wages paid prior to 1987. 404.1287 Exceptions to the time limitations on assessments--for wages paid prior to 1987. 404.1289 Payment after expiration of time limitation for assessment-- for wages paid prior to 1987. Secretary's Review of Decisions on Credits, Refunds, or Assessments--for Wages Paid Prior to 1987 404.1290 Review of decisions by the Secretary--for wages paid prior to 1987. 404.1291 Reconsideration--for wages paid prior to 1987. 404.1292 How to request review--for wages paid prior to 1987. 404.1293 Time for filing request for review--for wages paid prior to 1987. 404.1294 Notification to State after reconsideration--for wages paid prior to 1987. 404.1295 Commissioner's review--for wages paid prior to 1987. 404.1296 Commissioner's notification to the State--for wages paid prior to 1987. How a State May Seek Court Review of Secretary's Decision--for Wages Paid Prior to 1987 404.1297 Review by court--for wages paid prior to 1987. 404.1298 Time for filing civil action--for wages paid prior to 1987. 404.1299 Final judgments--for wages paid prior to 1987. Subpart N--Wage Credits for Veterans and Members of the Uniformed Services General 404.1301 Introduction. 404.1302 Definitions. World War II Veterans 404.1310 Who is a World War II veteran. 404.1311 Ninety-day active service requirement for World War II veterans. 404.1312 World War II service included. 404.1313 World War II service excluded. Post-World War II Veterans 404.1320 Who is a post-World War II veteran. 404.1321 Ninety-day active service requirement for post-World War II veterans. 404.1322 Post-World War II service included. 404.1323 Post-World War II service excluded. Separation From Active Service 404.1325 Separation from active service under conditions other than dishonorable. Members of the Uniformed Services 404.1330 Who is a member of a uniformed service. Amounts of Wage Credits and Limits on Their Use 404.1340 Wage credits for World War II and post-World War II veterans. 404.1341 Wage credits for a member of a uniformed service. 404.1342 Limits on granting World War II and post-World War II wage credits. 404.1343 When the limits on granting World War II and post-World War II wage credits do not apply. Deemed Insured Status for World War II Veterans 404.1350 Deemed insured status. 404.1351 When deemed insured status does not apply. 404.1352 Benefits and payments based on deemed insured status. Effect of Other Benefits on Payment of Social Security Benefits and Payments 404.1360 Veterans Administration pension or compensation payable. 404.1361 Federal benefit payable other than by Veterans Administration. 404.1362 Treatment of social security benefits or payments where Veterans Administration pension or compensation payable. 404.1363 Treatment of social security benefits or payments where Federal benefit payable other than by Veterans Administration. Evidence of Active Service and Membership in Uniformed Service 404.1370 Evidence of active service and separation from active service. 404.1371 Evidence of membership in a uniformed service during the years 1957 through 1967. [[Page 25]] Subpart O--Interrelationship of Old-Age, Survivors and Disability Insurance Program With the Railroad Retirement Program 404.1401 General relationship of Railroad Retirement Act with the old- age, survivors and disability insurance program of the Social Security Act. 404.1402 When services in the railroad industry are covered. 404.1403 Definition of ``years of service''. 404.1404 Effective date of coverage of railroad services under the act. 404.1405 When the provisions of Sec. 404.1402 do not apply. 404.1406 Eligibility to railroad retirement benefits as a bar to payment of social security benefits. 404.1407 When railroad retirement benefits do not bar payment of social security benefits. 404.1408 Compensation to be treated as wages. 404.1409 Purposes of using compensation. 404.1410 Presumption on basis of certified compensation record. 404.1412 Compensation quarters of coverage. 404.1413 Certification of payment to Railroad Retirement Board. Subpart P--Determining Disability and Blindness General 404.1501 Scope of subpart. 404.1502 General definitions and terms for this subpart. Determinations 404.1503 Who makes disability and blindness determinations. 404.1503a Program integrity. 404.1504 Determinations by other organizations and agencies. Definition of Disability 404.1505 Basic definition of disability. 404.1506 When we will not consider your impairment. 404.1508 What is needed to show an impairment. 404.1509 How long the impairment must last. 404.1510 Meaning of substantial gainful activity. 404.1511 Definition of disabling impairment. Evidence 404.1512 Evidence of your impairment. 404.1513 Medical evidence of your impairment. 404.1514 When we will purchase existing evidence. 404.1515 Where and how to submit evidence. 404.1516 If you fail to submit medical and other evidence. 404.1517 Consultative examination at our expense. 404.1518 If you do not appear at a consultative examination. Standards To Be Used in Determining When a Consultative Examination Will Be Obtained in Connection With Disability Determinations 404.1519 The consultative examination. 404.1519a When we will purchase a consultative examination and how we will use it. 404.1519b When we will not purchase a consultative examination. Standards for the Type of Referral and for Report Content 404.1519f Type of purchased examinations. 404.1519g Who we will select to perform a consultative examination. 404.1519h Your treating physician or psychologist. 404.1519i Other sources for consultative examinations. 404.1519j Objections to the designated physician or psychologist. 404.1519k Purchase of medical examinations, laboratory tests, and other services. 404.1519m Diagnostic tests or procedures. 404.1519n Informing the examining physician or psychologist of examination scheduling, report content, and signature requirements. 404.1519o When a properly signed consultative examination report has not been received. 404.1519p Reviewing reports of consultative examinations. 404.1519q Conflict of interest. Authorizing and Monitoring the Referral Process 404.1519s Authorizing and monitoring the consultative examination. Procedures to Monitor the Consultative Examination 404.1519t Consultative examination oversight. Evaluation of Disability 404.1520 Evaluation of disability in general. 404.1520a Evaluation of mental impairments. 404.1521 What we mean by an impairment(s) that is not severe. 404.1522 When you have two or more unrelated impairments--initial claims. 404.1523 Multiple impairments. [[Page 26]] Medical Considerations 404.1525 Listing of Impairments in Appendix 1. 404.1526 Medical equivalence. 404.1527 Evaluating medical opinions about your impairment(s) or disability. 404.1528 Symptoms, signs and laboratory findings. 404.1529 How we evaluate symptoms including pain. 404.1530 Need to follow prescribed treatment. 404.1535 How we will determine whether your drug addiction or alcoholism is a contributing factor material to the determination of disability. 404.1536 Treatment required for individuals whose drug addiction or alcoholism is a contributing factor material to the determination of disability. 404.1537 What we mean by appropriate treatment. 404.1538 What we mean by approved institutions or facilities. 404.1539 How we consider whether treatment is available. 404.1540 Evaluating compliance with the treatment requirements. 404.1541 Establishment and use of referral and monitoring agencies. Residual Functional Capacity 404.1545 Your residual functional capacity. 404.1546 Responsibility for assessing and determining residual functional capacity. Vocational Considerations 404.1560 When your vocational background will be considered. 404.1561 Your ability to do work depends upon your residual functional capacity. 404.1562 If you have done only arduous unskilled physical labor. 404.1563 Your age as a vocational factor. 404.1564 Your education as a vocational factor. 404.1565 Your work experience as a vocational factor. 404.1566 Work which exists in the national economy. 404.1567 Physical exertion requirements. 404.1568 Skill requirements. 404.1569 Listing of Medical--Vocational Guidelines in Appendix 2. 404.1569a Exertional and nonexertional limitations. Substantial Gainful Activity 404.1571 General. 404.1572 What we mean by substantial gainful activity. 404.1573 General information about work activity. 404.1574 Evaluation guides if you are an employee. 404.1575 Evaluation guides if you are self-employed. 404.1576 Impairment-related work expenses. Widows, Widowers, and Surviving Divorced Spouses 404.1577 Disability defined for widows, widowers, and surviving divorced spouses for monthly benefits payable for months prior to January 1991. 404.1578 How we determine disability for widows, widowers, and surviving divorced spouses for monthly benefits payable for months prior to January 1991. 404.1579 How we will determine whether your disability continues or ends. Blindness 404.1581 Meaning of blindness as defined in the law. 404.1582 A period of disability based on blindness. 404.1583 How we determine disability for blind persons who are age 55 or older. 404.1584 Evaluation of work activity of blind people. 404.1585 Trial work period for persons age 55 or older who are blind. 404.1586 Why and when we will stop your cash benefits. 404.1587 Circumstances under which we may suspend your benefits before we make a determination. Continuing or Stopping Disability 404.1588 Your responsibility to tell us of events that may change your disability status. 404.1589 We may conduct a review to find out whether you continue to be disabled. 404.1590 When and how often we will conduct a continuing disability review. 404.1591 If your medical recovery was expected and you returned to work. 404.1592 The trial work period. 404.1592a The reentitlement period. 404.1593 Medical evidence in continuing disability review cases. 404.1594 How we will determine whether your disability continues or ends. 404.1595 When we determine that you are not now disabled. 404.1596 Circumstances under which we may suspend your benefits before we make a determination. 404.1597 After we make a determination that you are not now disabled. 404.1597a Continued benefits pending appeal of a medical cessation determination. 404.1598 If you become disabled by another impairment(s). 404.1599 Work incentive experiments and rehabilitation demonstration projects in the disability program. Appendix 1 to Subpart P--Listing of Impairments [[Page 27]] Appendix 2 to Subpart P--Medical-Vocational Guidelines Subpart Q--Determinations of Disability General Provisions 404.1601 Purpose and scope. 404.1602 Definitions. 404.1603 Basic responsibilities for us and the State. Responsibilities for Performing the Disability Determination Function 404.1610 How a State notifies us that it wishes to perform the disability determination function. 404.1611 How we notify a State whether it may perform the disability determination function. 404.1613 Disability determinations the State makes. 404.1614 Responsibilities for obtaining evidence to make disability determinations. 404.1615 Making disability determinations. 404.1616 Medical or psychological consultant. 404.1617 Reasonable efforts to obtain review by a qualified psychiatrist or psychologist. 404.1618 Notifying claimants of the disability determination. Administrative Responsibilities and Requirements 404.1620 General administrative requirements. 404.1621 Personnel. 404.1622 Training. 404.1623 Facilities. 404.1624 Medical and other purchased services. 404.1625 Records and reports. 404.1626 Fiscal. 404.1627 Audits. 404.1628 Property. 404.1629 Participation in research and demonstration projects. 404.1630 Coordination with other agencies. 404.1631 Confidentiality of information and records. 404.1632 Other Federal laws and regulations. 404.1633 Policies and operating instructions. Performance Standards 404.1640 General. 404.1641 Standards of performance. 404.1642 Processing time standards. 404.1643 Performance accuracy standards. 404.1644 How and when we determine whether the processing time standards are met. 404.1645 How and when we determine whether the performance accuracy standard is met. 404.1650 Action we will take if a State agency does not meet the standards. Performance Monitoring and Support 404.1660 How we will monitor. 404.1661 When we will provide performance support. 404.1662 What support we will provide. Substantial Failure 404.1670 General. 404.1671 Good cause for not following the Act, our regulations, or other written guidelines. 404.1675 Finding of substantial failure. Hearings and Appeals 404.1680 Notice of right to hearing on proposed finding of substantial failure. 404.1681 Disputes on matters other than substantial failure. 404.1682 Who conducts the hearings. 404.1683 Hearings and appeals process. Assumption of Disability Determination Function 404.1690 Assumption when we make a finding of substantial failure. 404.1691 Assumption when State no longer wishes to perform the disability determination function. 404.1692 Protection of State employees. 404.1693 Limitation on State expenditures after notice. 404.1694 Final accounting by the State. Subpart R--Representation of Parties 404.1700 Introduction. 404.1703 Definitions. 404.1705 Who may be your representative. 404.1706 Notification of options for obtaining attorney representation. 404.1707 Appointing a representative. 404.1710 Authority of a representative. 404.1715 Notice or request to a representative. 404.1720 Fee for a representative's services. 404.1725 Request for approval of a fee. 404.1728 Proceedings before a State or Federal court. 404.1730 Payment of fees. 404.1735 Services in a proceeding under Title II of the Act. 404.1740 Rules governing representatives. 404.1745 What happens to a representative who breaks the rules. 404.1750 Notice of charges against a representative. 404.1755 Withdrawing charges against a representative. 404.1765 Hearing on charges. 404.1770 Decision by hearing officer. 404.1775 Requesting review of the hearing officer's decision. 404.1776 Assignment of request for review of the hearing officer's decision. 404.1780 Appeals Council's review of hearing officer's decision. [[Page 28]] 404.1785 Evidence permitted on review. 404.1790 Appeals Council's decision. 404.1795 When the Appeals Council will dismiss a request for review. 404.1797 Reinstatement after suspension--period of suspension expired. 404.1799 Reinstatement after suspension or disqualification--period of suspension not expired. Subpart S--Payment Procedures 404.1800 Introduction. 404.1805 Paying benefits. 404.1810 Expediting benefit payments. 404.1815 Withholding certification or payments. 404.1820 Transfer or assignment of payments. 404.1825 Joint payments to a family. Subpart T--Totalization Agreements General Provisions 404.1901 Introduction. 404.1902 Definitions. 404.1903 Negotiating totalization agreements. 404.1904 Effective date of a totalization agreement. 404.1905 Termination of agreements. Benefit Provisions 404.1908 Crediting foreign periods of coverage. 404.1910 Person qualifies under more than one totalization agreement. 404.1911 Effects of a totalization agreement on entitlement to hospital insurance benefits. Coverage Provisions 404.1913 Precluding dual coverage. 404.1914 Certificate of coverage. 404.1915 Payment of contributions. Computation Provisions 404.1918 How benefits are computed. 404.1919 How benefits are recomputed. 404.1920 Supplementing the U.S. benefit if the total amount of the combined benefits is less than the U.S. minimum benefit. 404.1921 Benefits of less than $1 due. Other Provisions 404.1925 Applications. 404.1926 Evidence. 404.1927 Appeals. 404.1928 Effect of the alien non-payment provision. 404.1929 Overpayments. 404.1930 Disclosure of information. Subpart U--Representative Payment 404.2001 Introduction. 404.2010 When payment will be made to a representative payee. 404.2015 Information considered in determining whether to make representative payment. 404.2020 Information considered in selecting a representative payee. 404.2021 Order of preference in selecting a representative payee. 404.2025 Information to be submitted by a representative payee. 404.2030 Advance notice of the determination to make representative payment. 404.2035 Responsibilities of a representative payee. 404.2040 Use of benefit payments. 404.2040a Compensation for qualified organizations serving as representative payees. 404.2041 Liability for misuse of benefit payments. 404.2045 Conservation and investment of benefit payments. 404.2050 When new representative payee will be selected. 404.2055 When representative payment will be stopped. 404.2060 Transfer of accumulated benefit payments. 404.2065 Accounting for benefit payments. Subpart V--Payments for Vocational Rehabilitation Services General Provisions 404.2101 General. 404.2102 Purpose and scope. 404.2103 Definitions. 404.2104 Participation by State VR agencies or alternate participants. 404.2106 Basic qualifications for alternate participants. Payment Provisions 404.2108 Requirements for payment. 404.2109 Responsibility for making payment decisions. 404.2110 What we mean by ``SGA'' and by ``a continuous period of 9 months''. 404.2111 Criteria for determining when VR will be considered to have contributed to a continuous period of 9 months. 404.2112 Payment for VR services in a case where an individual continues to receive disability payments based on participation in an approved VR program. 404.2113 Payment for VR services in a case of VR refusal. 404.2114 Services for which payment may be made. 404.2115 When services must have been provided. [[Page 29]] 404.2116 When claims for payment for VR services must be made (filing deadlines). 404.2117 What costs will be paid. Administrative Provisions 404.2118 Applicability of these provisions to alternate participants. 404.2119 Method of payment. 404.2120 Audits. 404.2121 Validation reviews. 404.2122 Confidentiality of information and records. 404.2123 Other Federal laws and regulations. 404.2127 Resolution of disputes.