[Federal Register Volume 62, Number 86 (Monday, May 5, 1997)]
[Rules and Regulations]
[Pages 24328-24331]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 97-11530]


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SOCIAL SECURITY ADMINISTRATION

20 CFR Part 429

RIN 0960-AE51


Administrative Regulations; Tort Claims

AGENCY: Social Security Administration (SSA).

ACTION: Final rule.

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SUMMARY: These final rules adopt as SSA rules the same procedures and

[[Page 24329]]

practices on tort claims against the Government that were applicable to 
SSA when it was a component of HHS. The Social Security Independence 
and Program Improvements Act of 1994 established the Social Security 
Administration as an independent agency in the executive branch of the 
United States Government effective March 31, 1995 and vested general 
regulatory authority in the Commissioner of Social Security. These 
regulations establish a new part 429 in title 20 of the Code of Federal 
Regulations.

EFFECTIVE DATE: These rules are effective May 5, 1997.

FOR FURTHER INFORMATION CONTACT: Suzanne DiMarino, Division of 
Regulations and Rulings, Social Security Administration, 6401 Security 
Boulevard, Baltimore, MD 21235, (410) 965-1769 for information about 
this rule. For information on eligibility or claiming benefits, call 
our national toll-free number, 1-800-772-1213.

SUPPLEMENTARY INFORMATION: Prior to March 31, 1995, SSA was an 
operating component of the Department of Health and Human Services 
(HHS) and the general regulatory authority for SSA programs and 
administration was vested in the Secretary of Health and Human Services 
(the Secretary) based on section 1102 of the Social Security Act (the 
Act) (42 U.S.C. Sec. 1302). The SSIPIA established SSA as an 
independent agency in the Executive Branch of the Federal government 
effective March 31, 1995 and vested general regulatory authority in the 
Commissioner of Social Security (the Commissioner). SSA continues to 
administer the old-age, survivors, and disability insurance programs 
under title II and the supplemental security income program under title 
XVI.
    These final rules adopt, with only technical changes, into a new 
part 429 for SSA, the same procedures and practices set out in 45 CFR 
part 35, entitled, Tort Claims Against the Government. The rules at 45 
CFR part 35 prescribe the procedure HHS follows when claims are 
asserted under the Federal Tort Claims Act for money damages against 
the United States for damage to or loss of property or personal injury 
or death caused by the negligent or wrongful act or omission of any HHS 
employee.
    All changes are technical, that is, changes in names, addresses and 
legal citations, or paragraph redesignation. These final rules also 
amend our regulations to revise references to HHS, HEW or ``the 
Secretary'' to refer to the Social Security Administration or ``the 
Commissioner''. They also delete references to other operating 
divisions, major components, or principal operating components of HEW 
or HHS and refer solely to SSA.

Electronic Version

    The electronic file of this document is available on the Federal 
Bulletin Board (FBB) at 9:00 a.m. on the date of publication in the 
Federal Register. To download the file, modem dial (202) 512-1387. The 
FBB instructions will explain how to download the file and the fee.

Regulatory Procedures

    When required, SSA follows the Administrative Procedure Act (APA) 
rulemaking procedures specified in 5 U.S.C. 553. The APA provides 
exceptions to its prior notice and public comment procedures when an 
agency finds there is good cause for dispensing with such procedures on 
the basis that they are impracticable, unnecessary, or contrary to the 
public interest. We have determined that, since these final rules 
reflect a continuation of the procedures and practices in effect when 
SSA was an operating component of the HHS, notice of proposed 
rulemaking and public comment procedures are unnecessary. Accordingly, 
we have determined that, under 5 U.S.C. 553(b)(B), good cause exists 
for dispensing with the notice and public comment procedures in this 
case. Good cause exists because the only changes are minor and 
technical in nature. These changes make no substantive change in the 
regulations and have no impact on the public. Therefore, opportunity 
for prior comment is unnecessary, and we are issuing these changes to 
our regulations as a final rule.
    SSA is not providing a 30-day delay in the effective date of this 
final rule under 5 U.S.C. 553(d). This is not a substantive rule, and 
there is no change in policy. Accordingly, it is in the public interest 
to make these regulations effective on publication.

Executive Order 12866

    SSA has consulted with the Office of Management and Budget (OMB) 
and determined that this final rule does not meet the criteria for a 
significant regulatory action under Executive Order 12866. Thus, it was 
not subject to OMB review.

Regulatory Flexibility Act

    SSA certifies that this final rule will not have a significant 
economic impact on a substantial number of small entities since it 
makes no changes in policy. Therefore, a regulatory flexibility 
analysis as provided in Public Law 96-354, the Regulatory Flexibility 
Act, is not required.

Paperwork Reduction Act

    This final rule imposes no additional reporting or recordkeeping 
requirements subject to OMB clearance.

(Catalog of Federal Domestic Assistance Program Nos. 96.001 Social 
Security-Disability Insurance; 96.002 Social Security--Retirement 
Insurance; 96.003 Social Security--Special Benefits for Persons Aged 
72 and Over; 96.004 Social Security--Survivors Insurance; 96.005 
Special Benefits for Disabled Coal Miners; 96.006 Supplemental 
Security Income; 96.007 Social Security--Research and Demonstration)

List of Subjects in 20 CFR Part 429

    Claims.

    Dated: April 15, 1997.
John J. Callahan,
Acting Commissioner of Social Security.
    For reasons set out in the preamble, Chapter III of Title 20 of the 
Code of Federal Regulations is amended by adding the following:

PART 429--ADMINISTRATIVE REGULATIONS

Tort Claims Against the Government

Sec.
429.101  Scope of regulations.
429.102  Administrative claims; when presented; place of filing.
429.103  Administrative claims; who may file.
429.104  Administrative claims; evidence and information to be 
submitted.
429.105  Investigation, examination, and determination of claims.
429.106  Final denial of claims.
429.107  Payment of approved claims.
429.108  Release.
429.109  Penalties.
429.110  Limitation on SSA's authority.

    Authority: Sec. 702(a)(5) of the Social Security Act (42 U.S.C. 
Sec. 902(a)(5)), 28 U.S.C. Sec. 2672; 28 CFR Part 14.


Sec. 429.101  Scope of regulations.

    The regulations in this part shall apply only to claims asserted 
under the Federal Tort Claims Act, as amended, 28 U.S.C. sections 2671-
2680, for money damages against the United States for damage to or loss 
of property or personal injury or death caused by the negligent or 
wrongful act or omission of any employee of the Social Security 
Administration (SSA) while acting within the scope of his office or 
employment.


Sec. 429.102  Administrative claims; when presented; place of filing.

    (a) For purposes of the regulations in this part, a claim shall be 
deemed to have been presented when SSA

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receives, at a place designated in paragraph (c) of this section, an 
executed Standard Form 95 or other written notification of an incident 
accompanied by a claim for money damages in a sum certain for damage to 
or loss of property, for personal injury, or for death, alleged to have 
occurred by reason of the incident. A claim which should have been 
presented to SSA but which was mistakenly addressed to or filed with 
another Federal agency, shall be deemed to be presented to SSA as of 
the date that the claim is received by SSA. A claim mistakenly 
addressed to or filed with SSA shall forthwith be transferred to the 
appropriate Federal agency, if ascertainable, or returned to the 
claimant.
    (b) A claim presented in compliance with paragraph (a) of this 
section may be amended by the claimant at any time prior to final 
action by the SSA Claims Officer or prior to the exercise of the 
claimant's option to bring suit under 28 U.S.C. 2675(a). Amendments 
shall be submitted in writing and signed by the claimant. Upon the 
timely filing of an amendment to a pending claim, SSA shall have 6 
months in which to make a final disposition of the claim as amended and 
the claimant's option under 28 U.S.C. 2675(a) shall not accrue until 6 
months after the filing of an amendment.
    (c) Forms may be obtained from and claims may be filed with the SSA 
Claims Officer, Room 611, Altmeyer Building, 6401 Security Boulevard, 
Baltimore, Maryland 21235.


Sec. 429.103  Administrative claims; who may file.

    (a) A claim for injury to or loss of property may be presented by 
the owner of the property interest which is the subject of the claim, 
his duly authorized agent, or his legal representative.
    (b) A claim for personal injury may be presented by the injured 
person, his duly authorized agent, or his legal representative.
    (c) A claim based on death may be presented by the executor or 
administrator of the decedent's estate or by any other person legally 
entitled to assert such a claim under applicable state law.
    (d) A claim for loss wholly compensated by an insurer with the 
rights of a subrogee may be presented by the insurer. A claim for loss 
partially compensated by an insurer with the rights of a subrogee may 
be presented by the insurer or the insured individually, as their 
respective interests appear, or jointly. Whenever an insurer presents a 
claim asserting the rights of a subrogee, he shall present with his 
claim appropriate evidence that he has the rights of a subrogee.
    (e) A claim presented by an agent or legal representative shall be 
presented in the name of the claimant, be signed by the agent or legal 
representative, show the title or legal capacity of the person signing, 
and be accompanied by evidence of his authority to present a claim on 
behalf of the claimant as agent, executor, administrator, parent, 
guardian, or other representative.


Sec. 429.104  Administrative claims; evidence and information to be 
submitted.

    (a) Death. In support of a claim based on death, the claimant may 
be required to submit the following evidence or information:
    (1) An authenticated death certificate or other competent evidence 
showing cause of death, date of death, and age of the decedent.
    (2) Decedent's employment or occupation at time of death, including 
his monthly or yearly salary or earnings (if any), and the duration of 
his last employment or occupation.
    (3) Full names, addresses, birth dates, kinship, and marital status 
of the decedent's survivors, including identification of those 
survivors who were dependent for support upon the decedent at the time 
of his death.
    (4) Degree of support afforded by the decedent to each survivor 
dependent upon him for support at the time of his death.
    (5) Decedent's general physical and mental condition before death.
    (6) Itemized bills for medical and burial expenses incurred by 
reason of the incident causing death, or itemized receipts of payments 
for such expenses.
    (7) If damages for pain and suffering prior to death are claimed, a 
physician's detailed statement specifying the injuries suffered, 
duration of pain and suffering, any drugs administered for pain and the 
decedent's physical condition in the interval between injury and death.
    (8) Any other evidence or information which may have a bearing on 
either the responsibility of the United States for the death or the 
damages claimed.
    (b) Personal injury. In support of a claim for personal injury, 
including pain and suffering, the claimant may be required to submit 
the following evidence or information:
    (1) A written report by his attending physician or dentist setting 
forth the nature and extent of the injury, nature and extent of 
treatment, any degree of temporary or permanent disability, the 
prognosis, period of hospitalization, and any diminished earning 
capacity. In addition, the claimant may be required to submit to a 
physical or mental examination by a physician employed or designated by 
SSA. A copy of the report of the examining physician shall be made 
available to the claimant upon the claimant's written request provided 
that claimant has, upon request, furnished the report referred to in 
the first sentence of this paragraph (b)(1) and has made or agrees to 
make available to SSA any other physician's reports previously or 
thereafter made of the physical or mental condition which is the 
subject matter of his claim.
    (2) Itemized bills for medical, dental, and hospital expenses 
incurred, or itemized receipts of payment for such expenses.
    (3) If the prognosis reveals the necessity for future treatment, a 
statement of expected duration of and expenses for such treatment.
    (4) If a claim is made for loss of time from employment, a written 
statement from his employer showing actual time lost from employment, 
whether he is a full or part-time employee, and wages or salary 
actually lost.
    (5) If a claim is made for loss of income and the claimant is self-
employed, documentary evidence showing the amount of earnings actually 
lost.
    (6) Any other evidence or information which may have a bearing on 
either the responsibility of the United States for the personal injury 
or the damages claimed.
    (c) Property damage. In support of a claim for damage to or loss of 
property, real or personal, the claimant may be required to submit the 
following evidence or information:
    (1) Proof of ownership.
    (2) A detailed statement of the amount claimed with respect to each 
item of property.
    (3) An itemized receipt of payment for necessary repairs or 
itemized written estimates of the cost of such repairs.
    (4) A statement listing date of purchase, purchase price, market 
value of the property as of date of damage, and salvage value, where 
repair is not economical.
    (5) Any other evidence or information which may have a bearing 
either on the responsibility of the United States for the injury to or 
loss of property or the damages claimed.
    (d) Time limit. All evidence required to be submitted by this 
section shall be furnished by the claimant within a reasonable time. 
Failure of a claimant to furnish evidence necessary to a determination 
of his claim within three months after a request therefor has been 
mailed to his last known address may be deemed an abandonment of the 
claim.

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The claim may be thereupon disallowed.


Sec. 429.105  Investigation, examination, and determination of claims.

    When a claim is received, SSA shall make such investigation as may 
be necessary or appropriate for a determination of the validity of the 
claim and thereafter shall forward the claim, together with all 
pertinent material, and a recommendation based on the merits of the 
case, with regard to allowance or disallowance of the claim, to the SSA 
Claims Officer to whom authority has been delegated to adjust, 
determine, compromise and settle all claims hereunder.


Sec. 429.106  Final denial of claims.

    (a) Final denial of an administrative claim shall be in writing and 
sent to the claimant, his attorney, or legal representative by 
certified or registered mail. The notification of final denial may 
include a statement of the reasons for the denial and shall include a 
statement that, if the claimant is dissatisfied with SSA's action, he 
may file suit in an appropriate U.S. District Court not later than 6 
months after the date of mailing of the notification.
    (b) Prior to the commencement of suit and prior to the expiration 
of the 6-month period after the date of mailing, by certified or 
registered mail of notice of final denial of the claim as provided in 
28 U.S.C. 2401(b), a claimant, his duly authorized agent, or legal 
representative, may file a written request with SSA for reconsideration 
of a final denial of a claim under paragraph (a) of this section. Upon 
the timely filing of a request for reconsideration SSA shall have 6 
months from the date of filing in which to make a final disposition of 
the claim and the claimant's option under 28 U.S.C. 2675(a) to bring 
suit shall not accrue until 6 months after the filing of a request for 
reconsideration. Final SSA action on a request for reconsideration 
shall be effected in accordance with the provisions of paragraph (a) of 
this section.


Sec. 429.107  Payment of approved claims.

    (a) Upon allowance of his claim, claimant or his duly authorized 
agent shall sign the voucher for payment, Standard Form 1145, before 
payment is made.
    (b) When the claimant is represented by an attorney, the voucher 
for payment (SF 1145) shall designate both the claimant and his 
attorney as ``payees.'' The check shall be delivered to the attorney 
whose address shall appear on the voucher.


Sec. 429.108  Release.

    Acceptance by the claimant, his agent or legal representative, of 
any award, compromise or settlement made hereunder, shall be final and 
conclusive on the claimant, his agent or legal representative and any 
other person on whose behalf or for whose benefit the claim has been 
presented, and shall constitute a complete release of any claim against 
the United States and against any employee of the Government whose act 
or omission gave rise to the claim, by reason of the same subject 
matter.


Sec. 429.109  Penalties.

    A person who files a false claim or makes a false or fraudulent 
statement in a claim against the United States may be liable to a fine 
of not more than $10,000 or to imprisonment of not more than 5 years, 
or both (18 U.S.C. Secs. 287; 1001), and, in addition, to a forfeiture 
of $2,000 and a penalty of double the loss or damage sustained by the 
United States (31 U.S.C. Sec. 231).


Sec. 429.110  Limitation on SSA's authority.

    (a) An award, compromise or settlement of a claim hereunder in 
excess of $25,000 shall be effected only with the prior written 
approval of the Attorney General or his designee. For the purposes of 
this paragraph, a principal claim and any derivative or subrogated 
claim shall be treated as a single claim.
    (b) An administrative claim may be adjusted, determined, 
compromised or settled hereunder only after consultation with the 
Department of Justice when, in the opinion of SSA:
    (1) A new precedent or a new point of law is involved; or
    (2) A question of policy is or may be involved; or
    (3) The United States is or may be entitled to indemnity or 
contribution from a third party and SSA is unable to adjust the third 
party claim; or
    (4) The compromise of a particular claim, as a practical matter, 
will or may control the disposition of a related claim in which the 
amount to be paid may exceed $25,000.
    (c) An administrative claim may be adjusted, determined, 
compromised or settled only after consultation with the Department of 
Justice when it is learned that the United States or an employee, agent 
or cost plus contractor of the United States is involved in litigation 
based on a claim arising out of the same incident or transaction.

[FR Doc. 97-11530 Filed 5-2-97; 8:45 am]
BILLING CODE 4190-29-P