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42 U.S.C. § 425Additional rules relating to benefits based on disability

submitted 91 years ago by ch. 531 to r/title-42-THE-PUBLIC-HEALTH-AND-WELFARE · 854 words · no verdicts yet

in plain englishAI-generated · not legal advice

The Commissioner of Social Security can suspend disability benefits if a person's disability might have ended, until it's checked. Benefits keep flowing during certain vocational rehabilitation programs instead. The Commissioner can also require payroll records to confirm earnings and eligibility.

(a) Suspension of benefits. If the Commissioner of Social Security, based on information received, believes that someone getting disability benefits under section 423 — or a child over 18 getting benefits under section 402(d), or a widow or surviving divorced wife under 60 getting benefits under section 402(e), or a widower or surviving divorced husband under 60 getting benefits under section 402(f) — might no longer be disabled, the Commissioner may suspend those benefits. Payment stays suspended until it's determined, under section 421, whether the disability has ended, or until the Commissioner believes it hasn't ended after all. If a state handles that person's disability determination under a section 421(b) agreement, the Commissioner must promptly tell that state and ask for a quick determination. "Disability" here has the same meaning as in section 423(d). If a disabled person's own benefits are suspended for a month, anyone else getting benefits that month based on that person's earnings — under section 402(b), (c), or (d) — also gets suspended. This suspension rule does not apply to a child aged 18 to 22 who is a full-time student, as section 402(d) defines that, for any month they're enrolled that way. (b) Continued payments during rehabilitation program. Even though a person's medical condition may have improved or ended, their disability benefits described in subsection (a) can't be stopped or suspended on that basis if: (1) they're taking part in the Ticket to Work and Self-Sufficiency Program, or another vocational rehabilitation, employment, or support-services program the Commissioner has approved, and (2) the Commissioner decides that finishing the program — or continuing it for a set time — makes it more likely the person will eventually leave the disability rolls for good. (c) Access to information held by payroll data providers. (1) The Commissioner may require anyone applying for, or already getting, certain monthly benefits under sections 402(d)(1)(B)(ii), 402(d)(6)(A)(ii), 402(d)(6)(B), 402(e)(1)(B)(ii), 402(f)(1)(B)(ii), or 423(a)(1) to authorize the Commissioner to get records about them from any payroll data provider (as section 1320e-3(c)(1) defines that term), whenever the Commissioner needs the record to decide whether they're eligible now or should keep being eligible. (2) This authorization stays in effect until the earliest of: a final decision denying the application or ending entitlement; the benefits actually ending; or the person canceling the authorization in a written notice to the Commissioner. (3) The Commissioner does not have to share any information obtained this way back with the payroll data provider. (4) The Commissioner must tell anyone who gives this authorization how long it lasts and what it covers. (5) If someone refuses to give, or revokes, this authorization, subsection (d) stops applying to them starting the first day of the first month they refuse or revoke it. (d) Reporting responsibilities for beneficiaries subject to information exchange with payroll data provider. Someone who authorized the Commissioner to get payroll records under subsection (c) cannot be penalized under section 1320a-8a for a mistake or omission in the wages the payroll data provider reported about them.
the actual law source: uscode.house.gov ↗public domain
(a) Suspension of benefits

If the Commissioner of Social Security, on the basis of information obtained by or submitted to the Commissioner, believes that an individual entitled to benefits under section 423 of this title, or that a child who has attained the age of eighteen and is entitled to benefits under section 402(d) of this title, or that a widow or surviving divorced wife who has not attained age 60 and is entitled to benefits under section 402(e) of this title, or that a widower or surviving divorced husband who has not attained age 60 and is entitled to benefits under section 402(f) of this title, may have ceased to be under a disability, the Commissioner of Social Security may suspend the payment of benefits under such section 402(d), 402(e), 402(f), or 423 of this title until it is determined (as provided in section 421 of this title) whether or not such individual’s disability has ceased or until the Commissioner of Social Security believes that such disability has not ceased. In the case of any individual whose disability is subject to determination under an agreement with a State under section 421(b) of this title, the Commissioner of Social Security shall promptly notify the appropriate State of the Commissioner’s action under this subsection and shall request a prompt determination of whether such individual’s disability has ceased. For purposes of this subsection, the term “disability” has the meaning assigned to such term in section 423(d) of this title. Whenever the benefits of an individual entitled to a disability insurance benefit are suspended for any month, the benefits of any individual entitled thereto under subsection (b), (c), or (d) of section 402 of this title, on the basis of the wages and self-employment income of such individual, shall be suspended for such month. The first sentence of this subsection shall not apply to any child entitled to benefits under section 402(d) of this title, if he has attained the age of 18 but has not attained the age of 22, for any month during which he is a full-time student (as defined and determined under section 402(d) of this title).

(b) Continued payments during rehabilitation program

Notwithstanding any other provision of this subchapter, payment to an individual of benefits based on disability (as described in the first sentence of subsection (a)) shall not be terminated or suspended because the physical or mental impairment, on which the individual’s entitlement to such benefits is based, has or may have ceased, if—

(1)

such individual is participating in a program consisting of the Ticket to Work and Self-Sufficiency Program under section 1320b–19 of this title or another program of vocational rehabilitation services, employment services, or other support services approved by the Commissioner of Social Security, and

(2)

the Commissioner of Social Security determines that the completion of such program, or its continuation for a specified period of time, will increase the likelihood that such individual may (following his participation in such program) be permanently removed from the disability benefit rolls.

(c) Access to information held by payroll data providers
(1)

The Commissioner of Social Security may require each individual who applies for or is entitled to monthly insurance benefits under subsections (d)(1)(B)(ii), (d)(6)(A)(ii), (d)(6)(B), (e)(1)(B)(ii), and (f)(1)(B)(ii) of section 402 of this title and subsection (a)(1) of section 423 of this title to provide authorization by the individual for the Commissioner to obtain from any payroll data provider (as defined in section 1320e–3(c)(1) of this title) any record held by the payroll data provider with respect to the individual whenever the Commissioner determines the record is needed in connection with a determination of initial or ongoing entitlement to such benefits.

(2)

An authorization provided by an individual under this subsection shall remain effective until the earliest of—

(A)

the rendering of a final adverse decision on the individual’s application or entitlement to benefits under this subchapter;

(B)

the termination of the individual’s entitlement to benefits under this subchapter; or

(C)

the express revocation by the individual of the authorization, in a written notification to the Commissioner.

(3)

The Commissioner of Social Security is not required to furnish any authorization obtained pursuant to this subsection to the payroll data provider.

(4)

The Commissioner shall inform any person who provides authorization pursuant to this clause of the duration and scope of the authorization.

(5)

If an individual who applies for or is entitled to benefits under this subchapter refuses to provide, or revokes, any authorization under this subsection, subsection (d) shall not apply to such individual beginning with the first day of the first month in which he or she refuses or revokes such authorization.

(d) Reporting responsibilities for beneficiaries subject to information exchange with payroll data provider

An individual who has authorized the Commissioner of Social Security to obtain records from a payroll data provider under subsection (c) shall not be subject to a penalty under section 1320a–8a of this title for any omission or error with respect to such individual’s wages as reported by the payroll data provider.

Source credit: (Aug. 14, 1935, ch. 531, title II, § 225, as added Aug. 1, 1956, ch. 836, title I, § 103(a), 70 Stat. 817; amended Pub. L. 85–840, title II, § 205(o), Aug. 28, 1958, 72 Stat. 1025; Pub. L. 89–97, title III, § 306(c)(15), July 30, 1965, 79 Stat. 373; Pub. L. 90–248, title I, §§ 104(d)(5), 158(c)(9), Jan. 2, 1968, 81 Stat. 833, 869; Pub. L. 92–603, title I, § 107(b)(5), Oct. 30, 1972, 86 Stat. 1343; Pub. L. 96–265, title III, § 301(a), June 9, 1980, 94 Stat. 449; Pub. L. 98–21, title III, § 309(p), Apr. 20, 1983, 97 Stat. 117; Pub. L. 101–508, title V, § 5113(a), Nov. 5, 1990, 104 Stat. 1388–273; Pub. L. 103–296, title I, § 107(a)(4), title II, § 201(a)(3)(A), Aug. 15, 1994, 108 Stat. 1478, 1494; Pub. L. 104–121, title I, § 105(a)(4), Mar. 29, 1996, 110 Stat. 853; Pub. L. 106–170, title I, § 101(b)(1)(D), Dec. 17, 1999, 113 Stat. 1873; Pub. L. 114–74, title VIII, § 824(b)(1), (c)(1), Nov. 2, 2015, 129 Stat. 608, 609.)

history & why it existsrecord from the source credit
  • 1935Enacted · Act of Aug. 14, 1935, ch. 531 · 70 Stat. 817
  • 1958Amended · Pub. L. 85-840 · 72 Stat. 1025
  • 1965Amended · Pub. L. 89-97 · 79 Stat. 373
  • 1968Amended · Pub. L. 90-248 · 81 Stat. 833, 869
  • 1972Amended · Pub. L. 92-603 · 86 Stat. 1343
  • 1980Amended · Pub. L. 96-265 · 94 Stat. 449
  • 1983Amended · Pub. L. 98-21 · 97 Stat. 117
  • 1990Amended · Pub. L. 101-508 · 104 Stat. 1388
  • 1994Amended · Pub. L. 103-296 · 108 Stat. 1478, 1494
  • 1996Amended · Pub. L. 104-121 · 110 Stat. 853
  • 1999Amended · Pub. L. 106-170 · 113 Stat. 1873
  • 2015Amended · Pub. L. 114-74 · 129 Stat. 608, 609

A history note hasn’t been published yet. The record shows enactment by ch. 531 on 1935-08-14.

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