Sec. 211. DEFINITION AND ELIGIBILITY RULES
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## SEC. 211 DEFINITION AND ELIGIBILITY RULES ###
(a)Definition of Childhood Disability Section 1614(a)(3) (42 U.S.C. 1382c(a)(3)), as amended by section 105(b)(1) of the Contract with America Advancement Act of 1996, is amended— ####
(1)in subparagraph (A), by striking “An individual” and inserting “Except as provided in subparagraph (C), an indi-vidual”; ####
(2)in subparagraph (A), by striking “(or, in the case of an individual under the age of 18, if he suffers from any medically determinable physical or mental impairment of comparable severity)”; ####
(3)by redesignating subparagraphs
(C)through
(I)as subparagraphs
(D)through (J), respectively; ####
(4)by inserting after subparagraph
(B)the following new subparagraph: > > ##### “(C) > > > ######
(i)> > An individual under the age of 18 shall be considered disabled for the purposes of this title if that individual has a medically determinable physical or mental impairment, which results in marked and severe functional limitations, and which can be expected to result in death or which has lasted or can be expected to last for a continuous period of not less than 12 months. > > > ###### “(ii) > > Notwithstanding clause (i), no individual under the age of 18 who engages in substantial gainful activity (determined in accordance with regulations prescribed pursuant to subparagraph (E)) may be considered to be disabled.” > ; and ####
(5)in subparagraph (F), as redesignated by paragraph (3), by striking “(D)” and inserting “(E)”. ###
(b)Changes to Childhood SSI Regulations ####
(1)Modification to medical criteria for evaluation of mental and emotional disorders The Commissioner of Social Security shall modify sections 112.00C.2. and 112.02B.2.c.(2) of appendix 1 to subpart P of part 404 of title 20, Code of Federal Regulations, to eliminate references to maladaptive behavior in the domain of personal/behavorial function. ####
(2)Discontinuance of individualized functional assessment **[**[42 U.S.C. 1382 note](/us/usc/t42/s1382)**]** The Commissioner of Social Security shall discontinue the individualized functional assessment for children set forth in sections 416.924d and 416.924e of title 20, Code of Federal Regulations. ###
(c)Medical Improvement Review Standard as it Applies to Individuals Under the Age of 18 Section 1614(a)(4) (42 U.S.C. 1382c(a)(4)) is amended— ####
(1)by redesignating subclauses
(I)and
(II)of clauses
(i)and
(ii)of subparagraph
(B)as items
(aa)and (bb), respectively; ####
(2)by redesignating clauses
(i)and
(ii)of subparagraphs
(A)and
(B)as subclauses
(I)and (II), respectively; ####
(3)by redesignating subparagraphs
(A)through
(C)as clauses
(i)through (iii), respectively; ####
(4)by inserting before clause
(i)(as redesignated by paragraph (3)) the following new subparagraph: > > ##### “(A) > > in the case of an individual who is age 18 or older—” > ; ####
(5)by inserting after and below subparagraph (A)(iii) (as so redesignated) the following new subparagraph: > > ##### “(B) > > in the case of an individual who is under the age of 18— > > > ###### “(i) > > substantial evidence which demonstrates that there has been medical improvement in the individual's impairment or combination of impairments, and that such impairment or combination of impairments no longer results in marked and severe functional limitations; or > > > ###### “(ii) > > substantial evidence which demonstrates that, as determined on the basis of new or improved diagnostic techniques or evaluations, the individual's impairment or combination of impairments, is not as disabling as it was considered to be at the time of the most recent prior decision that the individual was under a disability or continued to be under a disability, and such impairment or combination of impairments does not result in marked and severe functional limitations; or” > ; ####
(6)by redesignating subparagraph
(D)as subparagraph
(C)and by inserting in such subparagraph “in the case of any individual,” before “substantial evidence”; and ####
(7)in the first sentence following subparagraph
(C)(as redesignated by paragraph (6)), by— #####
(A)inserting “(i)” before “to restore”; and #####
(B)inserting “, or
(ii)in the case of an individual under the age of 18, to eliminate or improve the individual's impairment or combination of impairments so that it no longer results in marked and severe functional limitations” immediately before the period. ###
(d)Effective Dates, Etc **[**[42 U.S.C. 1382c note](/us/usc/t42/s1382c)**]** ####
(1)Effective dates #####
(A)Subsections
(a)and
(b)######
(i)In general The provisions of, and amendments made by, subsections
(a)and
(b)of this section shall apply to any individual who applies for, or whose claim is finally adjudicated with respect to, benefits under title XVI of the Social Security Act on or after the date of the enactment of this Act, without regard to whether regulations have been issued to implement such provisions and amendments. ######
(ii)Determination of final adjudication For purposes of clause (i), no individual's claim with respect to such benefits may be considered to be finally adjudicated before such date of enactment if, on or after such date, there is pending a request for either administrative or judicial review with respect to such claim that has been denied in whole, or there is pending, with respect to such claim, readjudication by the Commissioner of Social Security pursuant to relief in a class action or implementation by the Commissioner of a court remand order. #####
(B)Subsection
(c)The amendments made by subsection
(c)of this section shall apply with respect to benefits under title XVI of the Social Security Act for months beginning on or after the date of the enactment of this Act, without regard to whether regulations have been issued to implement such amendments. ####
(2)Application to current recipients #####
(A)Eligibility redeterminations During the period beginning on the date of the enactment of this Act and ending on the date which is 18 months after such date of enactment, the Commissioner of Social Security shall redetermine the eligibility of any individual under age 18 who is eligible for supplemental security income benefits by reason of disability under title XVI of the Social Security Act as of the date of the enactment of this Act and whose eligibility for such benefits may terminate by reason of the provisions of, or amendments made by, subsections
(a)and
(b)of this section. Any redetermination required by the preceding sentence that is not performed before the end of the period described in the preceding sentence shall be performed as soon as is practicable thereafter. With respect to any redetermination under this subparagraph— ######
(i)section 1614(a)(4) of the Social Security Act (42 U.S.C. 1382c(a)(4)) shall not apply; ######
(ii)the Commissioner of Social Security shall apply the eligibility criteria for new applicants for benefits under title XVI of such Act; ######
(iii)the Commissioner shall give such redetermination priority over all continuing eligibility reviews and other reviews under such title; and ######
(iv)such redetermination shall be counted as a review or redetermination otherwise required to be made under section 208 of the Social Security Independence and Program Improvements Act of 1994 or any other provision of title XVI of the Social Security Act. #####
(B)Grandfather provision The provisions of, and amendments made by, subsections
(a)and
(b)of this section, and the redetermination under subparagraph (A), shall only apply with respect to the benefits of an individual described in subparagraph
(A)for months beginning on or after the later of July 1, 1997, or the date of the redetermination with respect to such individual. #####
(C)Notice Not later than January 1, 1997, the Commissioner of Social Security shall notify an individual described in subparagraph
(A)of the provisions of this paragraph. Before commencing a redetermination under the 2nd sentence of subparagraph (A), in any case in which the individual involved has not already been notified of the provisions of this paragraph, the Commissioner of Social Security shall notify the individual involved of the provisions of this paragraph. ####
(3)Report The Commissioner of Social Security shall report to the Congress regarding the progress made in implementing the provisions of, and amendments made by, this section on child disability evaluations not later than 180 days after the date of the enactment of this Act. ####
(4)Regulations Notwithstanding any other provision of law, the Commissioner of Social Security shall submit for review to the committees of jurisdiction in the Congress any final regulation pertaining to the eligibility of individuals under age 18 for benefits under title XVI of the Social Security Act at least 45 days before the effective date of such regulation. The submission under this paragraph shall include supporting documentation providing a cost analysis, workload impact, and projections as to how the regulation will effect the future number of recipients under such title. ####
(5)Cap adjustment for ssi administrative work required by welfare reform #####
(A)Authorization For the additional costs of continuing disability reviews and redeterminations under title XVI of the Social Security Act, there is hereby authorized to be appropriated to the Social Security Administration, in addition to amounts authorized under section 201(g)(1)(A) of the Social Security Act, $150,000,000 in fiscal year 1997 and $100,000,000 in fiscal year 1998. #####
(B)Cap adjustment Section 251(b)(2)(H) of the Balanced Budget and Emergency Deficit Control Act of 1985, as amended by section 103(b) of the Contract with America Advancement Act of 1996, is amended— ######
(i)in clause (i)— ######
(I)in subclause
(II)by— ######
(aa)striking “$25,000,000” and inserting “$175,000,000”; and ######
(bb)striking “$160,000,000” and inserting “$310,000,000”; and ######
(II)in subclause
(III)by— ######
(aa)striking “$145,000,000” and inserting “$245,000,000”; and ######
(bb)striking “$370,000,000” and inserting “$470,000,000”; and ######
(ii)by amending clause (ii)(I) to read as follows: > > ###### “(I) > > the term ‘**continuing disability reviews**’ means reviews or redeterminations as defined under section 201(g)(1)(A) of the Social Security Act and reviews and redeterminations authorized under section 211 of the Personal Responsibility and Work Opportunity Reconciliation Act of 1996;” > . #####
(C)Adjustments Section 606(e)(1)(B) of the Congressional Budget Act of 1974 is amended by adding at the end the following new sentences: “If the adjustments referred to in the preceding sentence are made for an appropriations measure that is not enacted into law, then the Chairman of the Committee on the Budget of the House of Representatives shall, as soon as practicable, reverse those adjustments. The Chairman of the Committee on the Budget of the House of Representatives shall submit any adjustments made under this subparagraph to the House of Representatives and have such adjustments published in the Congressional Record.”. #####
(D)Conforming amendment Section 103(d)(1) of the Contract with America Advancement Act of 1996 (42 U.S.C. 401 note) is amended by striking “medicaid programs.” and inserting “medicaid programs, except that the amounts appropriated pursuant to the authorization and discretionary spending allowance provisions in section 211(d)(2)(5) of the Personal Responsibility and Work Opportunity Reconciliation Act of 1996 shall be used only for continuing disability reviews and redeterminations under title XVI of the Social Security Act.”. ####
(6)Benefits under title xvi For purposes of this subsection, the term “**benefits under title XVI of the Social Security Act**” includes supplementary payments pursuant to an agreement for Federal administration under section 1616(a) of the Social Security Act, and payments pursuant to an agreement entered into under section 212(b) of Public Law 93–66.
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- Pub. L. 93-66
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