[Federal Register Volume 62, Number 184 (Tuesday, September 23, 1997)]
[Rules and Regulations]
[Pages 49598-49603]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 97-25124]


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SOCIAL SECURITY ADMINISTRATION

20 CFR Parts 404 and 416

RIN 0960-AE58


Administrative Review Process, Testing Elimination of the Fourth 
Step of Administrative Review in the Disability Claim Process (Request 
for Review by the Appeals Council)

ACTION: Final rules.

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SUMMARY: We are amending our rules to establish authority to test 
elimination of the final step in the administrative review process used 
in determining claims for Social Security and Supplemental Security 
Income (SSI) benefits based on disability. Under the final rules, the 
right of appeal for a claimant who is included in the test procedures 
and who is dissatisfied with the decision of an administrative law 
judge (ALJ) will be to file a civil action in Federal district court, 
rather than to request the Appeals Council to review the decision. We 
are testing procedures that eliminate the request for Appeals Council 
review in furtherance of the Plan for a New Disability Claim Process 
that former Commissioner of Social Security Shirley S. Chater approved 
in September 1994. Unless specified, all other regulations relating to 
the disability determination process and the administrative review 
process remain unchanged.

EFFECTIVE DATE: September 23, 1997.

FOR FURTHER INFORMATION CONTACT: Harry J. Short, Legal Assistant, 
Division of Regulations and Rulings, Social Security Administration, 
6401 Security Boulevard, Baltimore, MD 21235, (410) 965-6243. For 
information on eligibility or claiming benefits, call our national 
toll-free number, 1-800-772-1213.

SUPPLEMENTARY INFORMATION:

Background

    The Social Security Administration (SSA) currently uses a four-step 
process in deciding claims for Social Security benefits under title II 
of the Social Security Act (the Act) and for SSI benefits under title 
XVI of the Act. Claimants who are not satisfied with the initial 
determination on their claims may request reconsideration. Claimants 
who are not satisfied with the reconsidered determination may request a 
hearing before an ALJ, and claimants who are dissatisfied with an ALJ's 
decision may request review by the Appeals Council. Claimants who have 
completed these four steps, and who are dissatisfied with the final 
decision, may request judicial review of the decision by filing a civil 
action in Federal district court. 20 CFR 404.900 and 416.1400.
    SSA's Plan for a New Disability Claim Process (59 FR 47887, 
September 19, 1994) anticipates establishment of a redesigned, two-step 
process for deciding Social Security and SSI claims based on 
disability. The redesign plan anticipates that the process for 
determining disability can be significantly improved by strengthening 
the steps of the process in which we make initial determinations and 
provide dissatisfied claimants an opportunity for a hearing before an 
ALJ, and by eliminating the reconsideration step and the step in which 
claimants request the Appeals Council to review the decisions of ALJs.
    In 20 CFR 404.906 and 416.1406 (60 FR 20023, April 24, 1995), we 
have established authority to test, singly and in combination, several 
model procedures for modifying the disability claims process. Under 
that authority, we are testing, in isolation from other possible 
changes, a modification of the initial determination step in which a 
single decisionmaker, rather than a team composed of a disability 
examiner and a medical consultant, makes the initial determination of 
disability. In addition, under authority established in 20 CFR 404.943 
and 416.1443 (60 FR 47469, September 13, 1995), we are also testing, in 
another model for evaluating a possible change in isolation from other 
changes, use of an adjudication officer as the focal point for all 
prehearing activities in disability cases in which a claimant requests 
a hearing before an ALJ.
    To assess how the above changes and other elements of the 
disability redesign plan would work together in different combinations, 
we initiated an integrated test on April 7, 1997, that combines model 
procedures for major elements of the redesign plan. As structured under 
testing authority established in Secs. 404.906, 404.943, 416.1406, and 
416.1443 in combination, this integrated model includes, in addition to 
models for the single decisionmaker and the adjudication officer, a 
model for procedures to provide a predecision interview conducted by 
the single decisionmaker (at which a claimant for benefits based on 
disability will have an opportunity to submit further evidence and have 
an interview with the initial decisionmaker if the evidence is 
insufficient to support a fully favorable initial disability 
determination or would require an initial determination denying the 
claim), and a model to test eliminating the reconsideration step in 
disability claims.
    In order to increase our ability to assess the effects of possible 
modifications of the disability claim process in combination, we are, 
through publication of these final rules, adding new Secs. 404.966 and 
416.1466 to our regulations to authorize testing of an additional 
modification in our integrated model. These final rules authorize us to 
incorporate in the integrated model additional procedures to test 
elimination of the step in the disability claim process in which a 
claimant requests the Appeals Council to review the hearing decision of 
an ALJ.
    Our specific goal in testing elimination of the request for Appeals 
Council review will be to assess the effects of this change, as it 
functions in

[[Page 49599]]

conjunction with other modifications in the disability claim process 
included in the integrated model, on: (1) judicial workloads, and (2) 
the legal sufficiency of decisions subjected to judicial review. We 
consider the effects of the change in those respects to represent the 
principal, practical issues bearing on the advisability of eliminating 
the request for review step in connection with the planned, overall 
redesign of the disability claim process.

Regulatory Provisions

    Under new Secs. 404.966 and 416.1466, we will randomly select 
approximately one half of the requests for an ALJ hearing in the 
integrated model for potential inclusion in the test procedures for 
eliminating the request for Appeals Council review. The remaining 
requests for hearing in the integrated model will be processed under 
our regulations concerning the request for Appeals Council review step 
and subsequent judicial review. This will enable us to assess other 
modifications tested in the integrated model in association with both 
the test procedures for eliminating the request for Appeals Council 
review and our existing request for review procedures.
    The provisions of Secs. 404.966 and 416.1466 apply only to those 
ALJ decisions that have been identified for inclusion in that part of 
our integrated model in which the request for review by the Appeals 
Council is eliminated. Under these provisions, we will eliminate the 
request for review step (which has been established by agency 
regulations and is not mandated by the Act) in a case in the integrated 
model if: (1) the case has been randomly selected for inclusion in this 
aspect of the model, and (2) an ALJ issues a decision in the case that 
is less than wholly favorable to the claimant (i.e., unfavorable or 
only partially favorable to the claimant). Cases in the integrated 
model in which an ALJ issues a wholly favorable decision, dismisses a 
request for hearing, or issues a recommended decision will not be 
included in this part of the model. These cases will be processed under 
our existing procedures for requesting Appeals Council review and 
judicial review.
    In a case to which the new rules apply, the appeal available to a 
claimant who is dissatisfied with the ALJ's decision will be, as the 
notice of the decision will advise, filing a civil action in Federal 
district court. Requesting review by the Appeals Council will be 
eliminated as an appeal and as a prerequisite to seeking judicial 
review.
    Under Secs. 404.966 and 416.1466, the ALJ's decision will be 
binding unless a party to the decision files a civil action, the 
Appeals Council decides within a specified time to review the decision 
on its own motion under the authority provided in 20 CFR 404.969 and 
416.1469, or the decision is revised by the ALJ or the Appeals Council 
under the rules on reopening final decisions in 20 CFR 404.987 and 
416.1487. A party to the decision will have the right to request the 
Appeals Council to grant an extension of time to file a civil action.

Evaluation Procedures

    We will evaluate the effect of eliminating the request for review 
step on judicial workloads by comparing the rate at which civil actions 
are filed by individuals whose claims are processed under the current 
administrative review steps in the disability claims process--i.e., the 
four step process--to the rate at which civil actions are filed in 
cases selected for processing under the test procedures for eliminating 
the request for Appeals Council review. We will also consider the rate 
at which civil actions are filed in cases in the integrated model in 
which we retain the request for Appeals Council review. In addition, we 
will collect and evaluate information on the reasons individuals 
included in the elimination of the request for review decide either to 
pursue or to forgo appeals to district courts.
    We will assess the effect of eliminating the request for review on 
the legal sufficiency of final decisions by comparing the rates at 
which, following the filing of civil actions in cases included in the 
integrated model and in a control sample of cases processed under the 
current administrative review steps in the disability claims process, 
we request court-remand of a case within the period during which the 
Commissioner of Social Security may file his answer to a civil action 
under section 205(g) of the Act. The Appeals Council, working with 
agency counsel, will evaluate the claims in the integrated model and in 
the control sample to identify instances in which a court should be 
requested (as courts may be under existing procedures) to remand a case 
for further administrative action. The information we will collect and 
evaluate will include data on the agency's ability to assess the legal 
sufficiency of cases on a timely basis without having to file court 
motions requesting extensions of the time in which the agency's answer 
may be filed.

Public Comments

    These regulatory provisions were published in the Federal Register 
as a notice of proposed rulemaking (NPRM) on May 16, 1997 (62 FR 
26997). We provided the public a 30-day comment period. We received 
statements in response to this notice from 10 individuals, including 
employees of SSA and attorney and nonattorney representatives of 
claimants. We also received comments from a legal services 
organization, the American Bar Association, and the Administrative 
Office of the United States Courts.
    Many of the commenters discussed reasons for believing that the 
request for Appeals Council review should be retained either as a 
mandatory or an optional step in the disability claim process. These 
comments can be viewed as opposing testing of the elimination of the 
request for review step on the basis that the need for the step, as it 
now exists or as it might be changed under the commenter's suggestions, 
is sufficiently clear to rule out testing its elimination. We have 
summarized these statements in a single comment to this effect that we 
address below with the other substantive comments received.
    The American Bar Association welcomed SSA's proposal to study the 
Appeals Council's role and endorsed the plan to examine the impact of 
eliminating the request for review step, without taking a position with 
respect to the specific procedures proposed for testing that impact. 
The Administrative Office of the United States Courts reported that the 
Federal judiciary continues to be seriously concerned about the impact 
of eliminating the request for review by the Appeals Council on the 
caseloads of the Federal courts. However, this office supported careful 
testing of the proposed changes and thorough analysis of the results as 
consistent with the common interests of SSA and the courts in providing 
efficient and legally sufficient decisions, and made specific 
recommendations, which we address below in our responses to the 
comments received, as to how to ensure such testing and analysis.
    Because some of the comments were detailed, we condensed, 
summarized or paraphrased them. We have, however, tried to summarize 
the commenters' views accurately and respond to all of the significant 
issues raised by the commenters that are within the scope of the 
proposed rules. As we discuss below in responding to the comments, we 
have made an addition to the proposed rules to clarify their intent. We 
have also responded to comments received by adding to our planned 
evaluation design.
    Comment: A number of the commenters implicitly or explicitly

[[Page 49600]]

opposed testing elimination of the request for review step in the 
disability claim process on the basis that the step is necessary or 
worthwhile and should not be eliminated. The wide-ranging reasons cited 
for this view included the following: that a shorter process is not 
necessarily a fairer process, that SSA should deal with the increase in 
the Appeals Council's workloads by increasing its staff and other 
support, that claimants may drop out of the process prematurely because 
of the costs and other difficulties involved in filing civil actions, 
that SSA's workloads will be increased by the filing of new claims by 
individuals who leave the administrative appeals process prematurely, 
and that the change will result in large increases in caseloads in the 
Federal courts.
    Response: The reasons cited in support of this comment are 
generally similar to reasons for not eliminating the request for review 
step we received and considered in developing and publishing the Plan 
for a New Disability Claim Process. Many of these reasons have merit, 
to one degree or another. However, there are also sound reasons for 
believing that eliminating the request for review step would improve 
the disability claim process, if carried out in conjunction with other 
changes to that process. After reviewing these additional statements in 
opposition to eliminating the request for review step, we continue to 
believe that we should test eliminating this step in conjunction with 
other possible changes for the purpose of gaining additional 
information needed to make a fully informed decision.
    Comment: One individual opposed the proposed testing of the 
elimination of the request for review step on the basis that such 
testing could itself adversely affect over 30,000 claimants, lessening 
their chances of receiving a favorable ALJ decision (because ALJs will 
know in advance that less than wholly favorable decisions in certain 
cases will not be subject to a request for Appeals Council review), 
without providing the claimants involved in the testing any offsetting 
benefits stemming from process unification and changes to the front-end 
of the disability claim process.
    Response: As we stated in the NPRM, these rules will authorize 
elimination of the request for review in only a relatively small number 
of cases, which we project at approximately 1900. The test will apply 
only in those cases in the integrated model that give rise to a request 
for an ALJ hearing (projected at approximately 10,000 cases), that are 
then randomly selected for inclusion in the request for review 
elimination (contingent on an ALJ's issuance of a less than wholly 
favorable decision), and that result in a less than wholly favorable 
decision.
    We do not know that there would be, as this comment indicates, a 
reduction in the likelihood of an allowance decision because the ALJ in 
a case knows that the case will not be subject to a request by the 
claimant for review by the Appeals Council and will, instead, be 
subject to the immediate filing of a civil action to secure judicial 
review. However, we believe that we should maximize the relevant, 
advance notice that we can give individuals that their cases will be 
included in these test procedures of the integrated model (if an ALJ 
issues a decision that is less than wholly favorable) and will, 
therefore, provide notice of that circumstance in the acknowledgment 
letter issued by the adjudication officer at the start of the ALJ 
hearing process. We also believe it is important to test these changes 
at the ALJ hearing level with the advance knowledge of the participants 
in that, if the request for review step were ultimately eliminated, all 
the participants in the hearing process would know that the appeal 
available to a dissatisfied claimant would be to file a civil action in 
Federal district court.
    The test of eliminating the request for review will be accompanied 
by changes in the front-end of the disability claim process and by 
process unification changes. Individuals participating in this test 
will participate in other changes being tested in the integrated model, 
including the opportunity for a face-to-face interview with the initial 
decisionmaker and elimination of the reconsideration step. In addition, 
like all claims for benefits based on disability, the claims involved 
in the test of eliminating the request for Appeals Council review will 
be decided under the significant process unification changes we have 
already made to the disability claims process. These changes include 
the publication of a series of Social Security Rulings on some of the 
most significant issues in disability adjudication (61 FR 34466-34492, 
July 2, 1996), and the training of all of our adjudicators, at all 
adjudicative levels, in the correct application of these rulings.
    Comment: One individual expressed doubt about the methodology of 
the proposed test, questioning whether testing elimination of the 
request for Appeals Council review in only about 1900 cases will 
provide a statistically valid universe for deriving useful information 
relative to a process that involves, at the ALJ level, hundreds of 
thousands of cases and varied factors affecting case outcome.

    Response: Prior to implementing the integrated model in April 1997, 
we secured an independent analytical assessment of the completeness, 
adequacy, and statistical soundness of our plans for conducting and 
evaluating the testing to be carried out in that model, including our 
plans for testing elimination of the request for Appeals Council 
review. Performed by the Lewin Group, Inc., this assessment concluded 
that our test design was fundamentally sound and that, even if 
recommendations for improving the test were not implemented, the test 
would likely produce valid findings and provide information that 
decisionmakers and stakeholders need. Final Report, An Independent 
Assessment of the Proposed Structure, Operation, and Evaluation Plans 
of the Full Process Model Pilot (hereafter, Final Report), prepared by 
the Lewin Group, Inc., March 14, 1997, p. 2. (The ``Full Process Model 
Pilot'' is same test that we are herein referring to as the 
``integrated model.'')
    We have implemented most of the recommendations the Lewin Group 
made for improving our test and evaluation procedures. The 
recommendations implemented include the recommendation the Lewin Group 
made relative to testing elimination of the request for Appeals Council 
review (which recommendation concerned when in the process individuals 
should be notified that they will not have an opportunity to request 
Council review). Final Report, p. 21.

    Comment: The Administrative Office of the United States Courts 
requested clarification as to which judicial districts will be 
affected.

    Response: The test of eliminating the request for Appeals Council 
review will affect claims of individuals residing in the following ten 
States: Arizona, Colorado, Georgia, Kentucky, New York, Pennsylvania, 
South Carolina, Tennessee, Utah, and Wisconsin. District courts in 
these States will be affected by procedures for testing and evaluating 
the request for Appeals Council review elimination.

    Comment: The Administrative Office of the United States Courts also 
recommended that follow-up surveys be conducted with participants in 
the test of eliminating the request for Appeals Council review to 
determine what factors went into the decisions of claimants either to 
pursue or to forgo appeals to district courts.

    Response: Under our evaluation design for the integrated model, we

[[Page 49601]]

intend to conduct surveys to collect information on multiple issues we 
are assessing in this model. We believe it would be helpful to collect 
and evaluate information regarding the factors concerning court filings 
identified by this commenter, and we will do that. Collecting such 
information requires no change in the regulatory provisions as 
proposed.

    Comment: The Administrative Office of the United States Courts also 
thought that it would be advantageous to have a set period for the 
test, followed by a meaningful review of the results, particularly the 
impact upon Federal court filings, prior to a determination being made 
as to whether permanent changes would be made to the Appeals Council 
review step. This commenter also noted in this regard that the Federal 
judiciary would like to be made aware of the results of the proposed 
test.

    Response: We project that the operational aspects of the integrated 
model will be completed within two and a half to three years of our 
initiation of testing in the front-end parts of the model in April 
1997. This projection includes the estimated time we will require to 
conduct pre-answer assessments of the legal sufficiency of new court 
cases that arise in cases in the integrated model. No fixed term for 
the test can be set because completion of its operational aspects will 
depend on when the last civil action is filed in cases in the 
integrated model in which the request for review is eliminated or the 
Appeals Council denies review. We will then require an additional 
period to conclude our evaluation of the test results.
    We agree that we should not decide to propose elimination of the 
request for review step in the disability claim process until we have 
undertaken preliminary consultation with key stakeholders, including 
the Administrative Office of the United States Courts, about the 
results demonstrated in our testing of the integrated model, and about 
the multiple issues that would be involved in proposing such a change. 
If a decision were made to propose elimination of the request for 
review step after analysis of the test results, we would, of course, 
publish an NPRM soliciting public comments on the various changes in 
our regulations that would be required to implement this change.

    Comment: A private attorney representative of claimants commented 
that the proposed regulations are ``contrary to the Act in that they 
purport to use the first part of sentence six [of Sec. 205(g) of the 
Act] to reclaim ALJ decisions the agency concludes are indefensible or 
that the agency does not otherwise want to defend.'' This commenter 
believes that the first part of sentence six is properly used only in 
very narrow circumstances, such as when a hearing transcript cannot be 
prepared, and that Congress did not enact part one of sentence six to 
provide the agency with a chance to rehear or redo an inadequate ALJ 
decision for the purpose of avoiding a ruling on the merits of the 
decision under sentence four of Sec. 205(g).
    Response: The agency's procedures for assessing the legal 
defensibility of cases filed in Federal court will not be affected by 
the final rules, and any court action requested in light of such 
assessment will continue to be subject to the relevant provisions of 
Sec. 205(g) of the Act. We do not, however, agree that the first clause 
of sentence six of Sec. 205(g) must be construed in the restrictive 
manner suggested by the commenter, who believed that sentence six 
allows remands prior to the filing of the answer only in ``very narrow 
circumstances, such as when a hearing transcript cannot be prepared.'' 
The first clause of sentence six expressly allows the court to remand 
cases for further proceedings ``for good cause shown.'' It neither 
delineates nor limits the circumstances which may be sufficient for a 
demonstration of good cause. Moreover, the legislative history of this 
provision recognizes the type of procedural difficulty suggested by the 
commenter to be an example of ``good cause,'' not an exclusive 
delineation of the circumstances that may constitute good cause. H.R. 
Conf. Rep. No. 944, 96th Cong., 2d Sess. 58-59 (1980). Significantly, 
virtually every court which has addressed the issue has held that the 
defining characteristic of a sentence six, clause one remand lies in 
the timing of the remand request, not in its characterization as either 
substantive or technical, i.e., if the remand is requested by the 
Commissioner prior to the filing of his answer, it falls under sentence 
six, and if the Commissioner's request is made subsequent to the filing 
of an answer, it may fall under sentence four.
    Comment: This same individual also commented that the proposed 
rules represent an implicit assertion by the agency that it may extend 
the 60 days for taking own motion review to any time before the 
Commissioner files his answer.

    Response: It is our intent that the Appeals Council shall have 
authority to review a case on its own motion under these final rules 
only if it decides to review the case, and issues a notice establishing 
the occurrence of such a decision, within the 60-day period prescribed 
in Secs. 404.969 and 416.1469 (i.e., within 60 days of the date of the 
hearing decision). We believe this intent is clear in the rules as 
proposed, which indicate in Secs. 404.966(b)(2) and 416.1466(b)(2) that 
the own-motion authority the Appeals Council will have under these 
rules is the authority provided in Secs. 404.969 and 416.1469.
    In test cases in which the request for review by the Appeals 
Council is eliminated and the notice of the ALJ's decision advises the 
parties of the right to file a civil action, it is also our intent that 
the authority of the Appeals Council to decide to review a case on its 
own motion shall cease to exist, even if 60 days have not yet lapsed 
after the date of the ALJ's decision, as of the date, if any, upon 
which the jurisdiction of a Federal district court is established by 
the filing of a civil action as provided in the Federal Rules of Civil 
Procedure. We have clarified Secs. 404.966(b)(2) and 416.1466(b)(2) to 
make this intention clearer. The agency's assessment of a case 
following establishment of the jurisdiction of a Federal court will 
occur under the provisions of Sec. 205(g) of the Act, 42 U.S.C. 
Sec. 405(g).
    In a case in which we test elimination of the request for Appeals 
Council review, a decision by the Appeals Council to review an ALJ's 
decision under Secs. 404.969 or 416.1469 will mean that the Council has 
assumed jurisdiction of the case, thereby causing the decision not to 
be a final decision of the Commissioner of Social Security subject to 
judicial review under Sec. 205(g) of the Act. If the Appeals Council 
decides to review one of these cases on its own motion, it must issue a 
notice establishing its decision to do so before a civil action is 
filed establishing the jurisdiction of a Federal district court.
    To clarify our intent in these respects, we have revised 
Secs. 404.966(b)(2) and 416.1466(b)(2) in the final rules to include a 
provision specifying that the Appeals Council must issue a notice 
announcing its decision to review the case on its own motion before the 
filing date of any civil action establishing the jurisdiction of a 
Federal district court.
    Comment: This same individual also commented that the proposed 
regulations invite unnecessary litigation over motions for extension of 
time to file answer.
    Response: As we discussed in the NPRM, our intent is that the 
Appeals Council, working with agency counsel, will evaluate the legal 
sufficiency of cases in the integrated model and in a

[[Page 49602]]

control sample to determine, within the time in which the Commissioner 
of Social Security may file his answer, if we should request the court 
to remand the case. We do not expect that these activities will require 
the agency frequently to request extensions of time to file answers in 
these cases. However, our ability to carry out these evaluations in a 
timely fashion is an important consideration and will be one of the 
matters we assess in the testing to be conducted under these final 
rules.
    Based on our analysis of the comments, we are adopting the proposed 
rules with the above-discussed addition to Secs. 404.966(b)(2) and 
416.1466(b)(2). This addition clarifies the time during which the 
Appeals Council may decide on its own motion to review a case to which 
these final rules apply. We have also made the following minor 
editorial changes in the rules as proposed: we have inserted the words 
``in which'' in the final clause of the last sentence of 
Secs. 404.966(a) and 416.1466(a), and we have made technical 
corrections in the numbering of the subparagraphs of Secs. 404.966(b) 
and 416.1466(b). The additions we have made to our evaluation plans 
based on consideration of the comments require no changes in the 
regulatory provisions as proposed.

Regulatory Procedures

    We find good cause for dispensing in this instance with the 30-day 
delay in the effective date of a substantive rule provided for by 5 
U.S.C. 553(d). For the reasons set forth below, we find that it is 
unnecessary and contrary to the public interest to delay the effective 
date of these final rules.
    We find that delay of the effective date is unnecessary because the 
affected individuals will be notified of the possibility of elimination 
of the Appeals Council review step more than 30 days before any such 
elimination actually occurs. Under new Secs. 404.966 and 416.1466, we 
will randomly select cases in the integrated model for contingent 
inclusion in the test of eliminating the request for Appeals Council 
review after a request for an ALJ hearing is filed and before the 
adjudication officer acknowledges receipt of the request for a hearing. 
In the cases selected, as we have previously discussed, the 
acknowledgement letter the adjudication officer sends will notify the 
individual filing the request (and any appointed representative of the 
individual) that if an ALJ issues a decision that is less than wholly 
favorable, the right of appeal available to the individual will be to 
file a civil action in Federal district court.
    Elimination of the request for Appeals Council review step will not 
occur in a case, if it occurs at all, until after the adjudication 
officer sends the case to an ALJ, a hearing is scheduled and held 
(except where the parties waive an oral hearing), and the ALJ issues a 
decision that is less than wholly favorable. Therefore, even with 
elimination of the 30-day delay in the effective date of these final 
rules, the substantive change authorized by Secs. 404.966 and 416.1466, 
elimination of the request for Appeals Council review step for test 
purposes, will not actually occur until after more than 30 days have 
elapsed from the date of the publication of these final rules in the 
Federal Register.
    We also find that delay of the effective date is contrary to the 
public interest because it would compromise our ability to evaluate the 
effects of the test. By making the rules effective upon publication, we 
can immediately implement the planned selection and notice procedures 
and thereby make it possible to test elimination of the request for 
Appeals Council review in the greatest number of cases in the 
integrated model that can be used without reducing our ability also to 
test, as we believe we should, use of the other new procedures in the 
integrated model with the request for review step. We believe that 
maximizing the number of cases in the integrated model in which we can 
test elimination of the request for Appeals Council review step, while 
also testing retention of that step in conjunction with the other 
changes in the integrated model, will contribute to the soundness of 
our evaluation of the effects of eliminating this step from the 
disability claim process.

Executive Order 12866

    We have consulted with the Office of Management and Budget (OMB) 
and determined that these rules meet the criteria for a significant 
regulatory action under Executive Order 12866. Thus, they were subject 
to OMB review. These rules do not adversely affect State, local or 
tribal governments. The administrative costs of the test will be 
covered within budgeted resources. No program costs are expected to 
result from the processing of the test cases. We have not, therefore, 
prepared a cost/benefit analysis under Executive Order 12866.

Regulatory Flexibility Act

    We certify that these regulations will not have a significant 
economic impact on a substantial number of small entities because these 
rules affect only individuals. Therefore, a regulatory flexibility 
analysis as provided in the Regulatory Flexibility Act, as amended, is 
not required.

Paperwork Reduction Act

    These regulations impose no new reporting or record keeping 
requirements requiring OMB clearance.

(Catalog of Federal Domestic Assistance Program Nos. 96.001, Social 
Security-Disability Insurance; 96.006, Supplemental Security Income)

List of Subjects

20 CFR Part 404

    Administrative practice and procedure, Death benefits, Disability 
benefits, Old-Age, Survivors and Disability Insurance, Reporting and 
recordkeeping requirements, Social Security.

20 CFR Part 416

    Administrative practice and procedure, Aged, Blind, Disability 
benefits, Public assistance programs, Supplemental Security Income 
(SSI), Reporting and record keeping requirements.

    Dated: August 26, 1997.
John J. Callahan,
Acting Commissioner of Social Security.

    For the reasons set out in the preamble, subpart J of part 404 and 
subpart N of part 416 of chapter III of title 20 of the Code of Federal 
Regulations are amended as set forth below.

PART 404--FEDERAL OLD-AGE, SURVIVORS AND DISABILITY INSURANCE 
(1950-    )

    20 CFR part 404, subpart J, is amended as follows:
    1. The authority citation for subpart J of part 404 continues to 
read as follows:

    Authority: Secs. 201(j), 205(a), (b), (d)-(h), and (j), 221, 
225, and 702(a)(5) of the Social Security Act (42 U.S.C. 401(j), 
405(a), (b), (d)-(h), and (j), 421, 425, and 902(a)(5)); 31 U.S.C. 
3720A; sec. 5, Pub. L. 97-455, 96 Stat. 2500 (42 U.S.C. 405 note); 
secs. 5, 6(c)-(e), and 15, Pub. L. 98-460, 98 Stat. 1802 (42 U.S.C. 
421 note).

    2. New Sec. 404.966 is added under the undesignated center heading 
``APPEALS COUNCIL REVIEW'' to read as follows:


Sec. 404.966  Testing elimination of the request for Appeals Council 
review.

    (a) Applicability and scope. Notwithstanding any other provision in 
this part or part 422 of this chapter, we are establishing the 
procedures set out in this section to test elimination of the request 
for review by the Appeals Council. These procedures will apply in 
randomly selected cases in which we have tested a combination of model

[[Page 49603]]

procedures for modifying the disability claim process as authorized 
under Secs. 404.906 and 404.943, and in which an administrative law 
judge has issued a decision (not including a recommended decision) that 
is less than wholly favorable to you.
    (b) Effect of an administrative law judge's decision. In a case to 
which the procedures of this section apply, the decision of an 
administrative law judge will be binding on all the parties to the 
hearing unless --
    (1) You or another party file an action concerning the decision in 
Federal district court;
    (2) The Appeals Council decides to review the decision on its own 
motion under the authority provided in Sec. 404.969, and it issues a 
notice announcing its decision to review the case on its own motion no 
later than the day before the filing date of a civil action 
establishing the jurisdiction of a Federal district court; or
    (3) The decision is revised by the administrative law judge or the 
Appeals Council under the procedures explained in Sec. 404.987.
    (c) Notice of the decision of an administrative law judge. The 
notice of decision the administrative law judge issues in a case 
processed under this section will advise you and any other parties to 
the decision that you may file an action in a Federal district court 
within 60 days after the date you receive notice of the decision.
    (d) Extension of time to file action in Federal district court. Any 
party having a right to file a civil action under this section may 
request that the time for filing an action in Federal district court be 
extended. The request must be in writing and it must give the reasons 
why the action was not filed within the stated time period. The request 
must be filed with the Appeals Council. If you show that you had good 
cause for missing the deadline, the time period will be extended. To 
determine whether good cause exists, we will use the standards in 
Sec. 404.911.

PART 416--SUPPLEMENTAL SECURITY INCOME FOR THE AGED, BLIND, AND 
DISABLED

    20 CFR part 416, subpart N, is amended as follows:
    1. The authority citation for subpart N continues to read as 
follows:

    Authority: Sec. 702(a)(5), 1631, and 1633 of the Social Security 
Act (42 U.S.C. 902(a)(5), 1383, and 1383b).

    2. New Sec. 416.1466 is added under the undesignated center heading 
``APPEALS COUNCIL REVIEW'' to read as follows:


Sec. 416.1466  Testing elimination of the request for Appeals Council 
review.

    (a) Applicability and scope. Notwithstanding any other provision in 
this part or part 422 of this chapter, we are establishing the 
procedures set out in this section to test elimination of the request 
for review by the Appeals Council. These procedures will apply in 
randomly selected cases in which we have tested a combination of model 
procedures for modifying the disability claim process as authorized 
under Secs. 416.1406 and 416.1443, and in which an administrative law 
judge has issued a decision (not including a recommended decision) that 
is less than wholly favorable to you.
    (b) Effect of an administrative law judge's decision. In a case to 
which the procedures of this section apply, the decision of an 
administrative law judge will be binding on all the parties to the 
hearing unless --
    (1) You or another party file an action concerning the decision in 
Federal district court;
    (2) The Appeals Council decides to review the decision on its own 
motion under the authority provided in Sec. 416.1469, and it issues a 
notice announcing its decision to review the case on its own motion no 
later than the day before the filing date of a civil action 
establishing the jurisdiction of a Federal district court; or
    (3) The decision is revised by the administrative law judge or the 
Appeals Council under the procedures explained in Sec. 416.1487.
    (c) Notice of the decision of an administrative law judge. The 
notice of decision the administrative law judge issues in a case 
processed under this section will advise you and any other parties to 
the decision that you may file an action in a Federal district court 
within 60 days after the date you receive notice of the decision.
    (d) Extension of time to file action in Federal district court. Any 
party having a right to file a civil action under this section may 
request that the time for filing an action in Federal district court be 
extended. The request must be in writing and it must give the reasons 
why the action was not filed within the stated time period. The request 
must be filed with the Appeals Council. If you show that you had good 
cause for missing the deadline, the time period will be extended. To 
determine whether good cause exists, we will use the standards in 
Sec. 416.1411.

[FR Doc. 97-25124 Filed 9-22-97; 8:45 am]
BILLING CODE 4190-29-P