mation as to provisions being considered for inclusion in the proposed agreement or modifications;

(4) Information reported by a State as to whether or not there is in effect in such State or in a political subdivision thereof a retirement system providing benefits to employees thereof; and any other information reported by the State as to such retirement system if service performed by individuals in positions covered by that system has been included in an agreement under section 218 or a modification thereof;

(5) Statistical information, classified by State and county, with respect to public employment and remuneration therefor (other than information relating to any identified or identifiable employee);

(6) Information reported by a State, after a referendum has been conducted on whether services in positions covered by a retirement system should be excluded from or included under such an agreement, of the number of employees eligible to vote in such referendum, the number who actually voted therein, and the number who voted in favor of inclusion of such service.

(p) Pursuant to the provisions of section 290 (c) of the Immigration and Nationality Act, to any officer or employee of the Department of Justice of the United States lawfully charged with the administration of title II of such act available information required to be furnished by such section, for the purpose of such administration only, upon written request of the Attorney General of the United States or of an official of the Department of Justice duly authorized by him to make such request.

(q) Information obtained by carriers and intermediaries in the administration of title XVIII of the Act indicating unethical practices or a course of unprofessional conduct by a physician or other practitioner in furnishing services to beneficiaries may, after securing proper professional advice, be disclosed to an official of a medical or other applicable professional society or to an official of a State licensing board: Provided, That disclosure under this paragraph shall be made only upon obtaining authorization of the beneficiary where he is the source of the information, unless medical or other considerations would make it inappropriate to obtain such consent.

(r) Information obtained in the administration of title XVIII of the Act

with regard to services furnished a beneficiary by providers of services, physicians, and other persons furnishing services may, where the beneficiary has no legal representative, upon written request, be disclosed to the spouse, an immediate relative or member of the household of the beneficiary, or, for good cause shown, to any other person who has evidenced a demonstrable concern in protecting the interests of the beneficiary: Provided, That disclosure under this paragraph shall be made only upon authorization by the beneficiary, unless medical or other considerations would make it inappropriate to obtain such consent. The term "legal representative" as used in this paragraph has the same meaning as in § 401.4(d).

(s) Upon request in writing by a court having jurisdiction to issue orders or entertain petitions against individuals for the support and maintenance of their children, to such court, the most recent address of an individual or the address of the individual's most recent employer, or both, for the court's exclusive use (and for no other purpose) —

(1) In issuing or determining whether to issue such an order against such individual, or

(2) In determining (in the event such individual is not within the jurisdiction of the court) the court to which a petition for support and maintenance against such individual should be forwarded under any reciprocal arrangements with other States to obtain or modify court orders for support,

upon certification by the court that the information is requested for the use specified in this paragraph. Such certification must bear the signature of the judge or clerk of the court.

(t) Information relating to payments to, and utilization data concerning, providers and other organizations and facilities furnishing services under title XVIII of the Act, obtained in the administration of this title, may be disclosed when efficient administration permits: Provided, That no information identifying any particular beneficiaries shall be disclosed under this paragraph.

(u) To any officer or employee of an agency of the Federal or a State government lawfully charged with the administration of a program receiving grantsin-aid under titles V and XIX of the Social Security Act for the purpose of administration of such titles, except that the release of such information shall not

be authorized by a fiscal intermediary or carrier,

(1) Information, including the identification number, concerning charges made by physicians, other practitioners, or suppliers, and amounts paid under title XVIII of the Act for services furnished to beneficiaries by such physicians, other practitioners, or suppliers, to enable the agency to determine the proper amount of benefits payable for medical services performed in accordance with such titles; or

(2) Information as to physicians or other practitioners that has been disclosed under paragraph (i) (1) or (q);

(3) Information relating to the qualifications and certification status of hospitals and other health care facilities obtained in the process of determining whether, and certifying as to whether, institutions or agencies meet or continue to meet the conditions of participation of providers of services or whether other entities meet or continue to meet the conditions for coverage of services they furnish; or

(4) Information concerning costs of operation and other pertinent information from the financial reports and other records of providers furnishing services pursuant to title XVIII of the Act.

(Sec. 102(a), sec. 5, 79 Stat. 331, 67 Stat. 18, 631; 42 U.S.C. 1395 hh) [20 F.R. 5159, July 20, 1955, as amended at 20 F.R. 9504, Dec. 20, 1955; 21 F.R. 9765, Dec. 11, 1956; 32 F.R. 14894, Oct. 27, 1967; 32 F.R. 15544, Nov. 8, 1967; 33 F.R. 20037, Dec. 31, 1968; 34 F.R. 197, Jan. 7, 1969; 34 F.R. 19465, Dec. 9, 1969; 35 F.R. 762, Jan. 20, 1970]

As used in this part the term:

(a) "Claimant" includes a person who files an application or is deemed to have filed an application, on his own behalf, or as guardian of an infant, or as legal representative of an incompetent, or on whose behalf some other person files an application for monthly benefits, a lumpsum death payment, or health insurance benefits for the aged.

(b) "Prospective claimant" includes a living wage earner or self-employed individual, the legal representative of an incompetent wage earner or self-employed individual, the guardian of an infant, the next of kin of a deceased wage earner or self-employed individual, any other person who is equitably entitled by reason of having paid, in whole or part, the burial expenses of the deceased wage earner or self-employed individual, or the

legal representative of such next of kin or equitably entitled person;

(c) "Authorized representative” includes any individual authorized by the claimant or prospective claimant to request or receive information or to act on behalf of the claimant or prospective claimant;

(d) "Legal representative" includes any individual appointed by a court or otherwise authorized by law to act on behalf of a claimant or a prospective claimant:

(e) "Cost of disclosing information" means the actual cost of preparing for disclosure and disclosing such information to a person or agency requesting a disclosure thereof authorized by §§ 401.1 and 401.3;

(f) "Person" includes an individual, a firm, an association, a corporation, a State, a "political subdivision” of a State (as defined in section 218 of the act), or an instrumentality of two or more States.

(g) "Self-Employment Contributions Acts" means the Self-Employment Contributions Act and the Self-Employment Contributions Act of 1954.

(h) "Agency of a State government" includes an intermediary or carrier authorized by such agency to perform duties in the administration of programs under the Social Security Act.

[20 F.R. 5160, July 20, 1955, as amended at 21 F.R. 9766, Dec. 11, 1956; 32 F.R. 14894, Oct. 27, 1967]

§ 401.5 Payment for information in general.

Except as provided in § 401.6, no information, authorized to be disclosed by § 401.1 or § 401.3, shall be prepared for disclosure or disclosed to the person or agency requesting such disclosure until the cost incurred by the Department of disclosing such information shall have paid in full to the Department. [32 F.R. 14894, Oct. 27, 1967]

§ 401.6 Payment for information in specific cases.

In any case falling within any of the paragraphs of this section the payment required as a prerequisite to preparation for disclosure or disclosure of information shall be as specified in such paragraph in lieu of the cost of disclosing such information. In any case in which the receipt of payment in advance, pursuant to this section or § 401.5, would interfere with efficient administration, the Department may permit such pay

ment to be made at such time or times as it deems consistent with efficient administration.

(a) When the request is for information from the records of wages and selfemployment income of an individual, and the request is made by the individual, his survivor, or the legal representative of the individual or his estate, the information shall be furnished without charge; however, details of information in such records shall be furnished only upon payment of the cost of disclosing such details when the information is furnished for a purpose other than the establishment of eligibility for or entitlement to a benefit or lump-sum death payment or the crediting of earnings under title II.

(b) When the request is made by (1) the Department of Justice of the United States for any purpose specified in § 401.3 (d) or (i), or (2) the Treasury Department of the United States for any purpose specified in § 401.3 (d) or (1), other than for the purpose of administration of, or the purpose of an investigation or prosecution involving an inquiry to determine whether there has been a violation of, a Federal income tax law or any regulation or procedure in effect thereunder, the information shall be furnished without charge.

(c) When the request is made by an agency of a State Government lawfully charged with the administration of a State unemployment compensation law or contribution or tax levied in connection therewith, information relating to individual employees or employers which is necessary for the purpose of such administration may be furnished without charge, except where the request for any such information involves a special statistical study or a special compilation of data (except a comparison study made cooperatively with the State) in which case payment shall be required.

(d) In any case in which determination of the actual cost of disclosing information would interfere with efficient administration, such cost may be fixed at an amount estimated not to exceed actual cost, and the information may be prepared for disclosure and disclosed after payment of such amount. In any case in which the expense of obtaining reimbursement of such cost would be out of proportion to the amount thereof, or in which collection of such amount would

interfere with efficient administration, payment thereof may be waived.

(e) When the request is for medical information obtained under Title II of the Social Security Act relating to an individual, or as to the existence or duration of a disability of an individual, pursuant to § 401.3 (a), (f), or (g), by a person or agency thereby authorized to receive such information, the information shall be furnished without charge. [20 F.R. 5160, July 20, 1955, as amended at 22 F.R. 6572, Aug. 15, 1957; 24 F.R. 5181, June 25, 1959; 32 F.R. 14894, Oct. 27, 1967]

Subpart C-Basic Computation of Benefits and Lump Sums

BASIC COMPUTATION OF BENEFITS AND LUMP SUMS

Sec.

404.201 Primary insurance amount defined. 404.202 Method of determining primary insurance amount.

404.203 Use of conversion table to determine primary insurance amount. 404.204 Determination of primary insurance benefit for conversion table. 404.2048 Special cases not requiring use of conversion table appearing in 404.203 (b).

404.204b When the provisions of 404.2048 become inoperative.

404.205 Method of determining average monthly wage.

404.206 Wages and self-employment income used in determining average monthly wage.

404.207 Rounding average monthly wage. Starting date.

404.208 404.209

Closing date. For purposes of § 404.205.

404.210 Average monthly wage for conversion table.

404.211 Average monthly wage of veteran of World War II.

BASIC COMPUTATION ARISING FROM SOCIAL SECURITY AMENDMENTS OF 1954

404.230 Effect of Social Security Amendments of 1954.

404.231 Scope. 404.232 Method of determining primary insurance amount.

404.238 Applicability of § 404.232. 404.234 Use of conversion table to determine primary insurance amount. 404.235 Determination of primary insurance benefit for conversion table (column I).

404.236 Determination of primary insurance amount for conversion table (column II).

404.237 Method of determining average

monthly wage.

404.238 Wages and self-employment income used in determining average monthly wage.

Starting date.

404.239 Rounding average monthly wage. 404.240

404.241 Closing date.

404.242 Exclusion from computation of

average monthly wage.

404.243 Average monthly wage for conver

sion table.

Sec.

404.262 Recomputation based on 6 quarters of coverage after June 30, 1953. Recomputation after earnings of $1,200 in a calendar year. Recomputation based on deduc

404.263 404.264

tions from benefits or attainment of age 75.

404.265 Recomputation based on services covered by a retroactive agreement under section 218.

404.266 Recomputation to include wages immediately preceding entitlement.

404.267 Recomputation to include self-employment income.

404.268 Recomputation to include selfemployment income excluded in previous computation. 404.269 Recomputation at the request of a survivor of an individual to include wages and self-employment income in the year of entitlement or death.

404.270 Recomputation where individual has 6 quarters of coverage after June 30, 1953, at time of death. 404.271 Recomputation for a survivor after individual has earnings of $1,200 in a calendar year or to include his railroad compensation. 404.272 Recomputation for a deduction from benefits, attainment of age 75 and based on railroad compensation.

404.273 Recomputation at request of survivor based on services of deceased individual covered by a retroactive agreement under section 218.

404.274 Recomputation in death cases to include wages immediately preceding death or entitlement of decedent.

404.275 Recomputations to include selfemployment income of deceased individual who died in 1952 or in a taxable year beginning in 1952. 404.276 Recomputation for veteran of World War II.

50-040-71- -2

Sec.

404.305 Old-age insurance benefits; rate of

benefit.

404.306 Disability insurance benefits; conditions of entitlement.

404.307 Disability insurance benefits; duration of entitlement.

404.308 Disability insurance benefits; waiting period.

404.309 Disability insurance benefits; computation of benefit rate.

404.310 Period of disability; conditions of entitlement.

404.311 Period of disability; beginning date. 404.311a Period of disability; ending date. 404.312 Period of disability; when disregarded.

404.312a Applicability of section 303 of the Social Security Amendments of 1965 (Pub. Law 89-97). 404.313 Wife's insurance benefits; conditions of entitlement.

404.314 Wife's insurance benefits; duration of entitlement.

404.315 Wife's insurance benefits; rate of benefit.

404.316 Husband's insurance benefits; conditions of entitlement.

404.817 Husband's insurance benefits; duration of entitlement.

404.318 Husband's insurance benefits; rate of benefit.

404.319 Husband's insurance benefits; time at which support requirement must be met; period within which evidence must be filled. 404.320 Child's insurance benefits; conditions of entitlement.

404.321

Child's insurance benefits; duration of entitlement.

404.322 Child's insurance benefits; rate of

benefit.

404.323 Child's insurance benefits; time at which child must be dependent upon parent.

404.324 Child's insurance benefits; determining dependency upon parent; in general.

404.325 Child's insurance benefits; dependency upon father or adopting father.

404.326 Child's insurance benefits; dependency upon stepfather or stepmother.

404.327 Child's insurance benefits; dependency upon mother or adopting mother.

404.328 Widow's insurance benefits; conditions of entitlement.

404.329 Widow's insurance benefits; duration of entitlement.

404.330 Widow's insurance benefits; rate of benefit.

404.331 Widower's insurance benefits; conditions of entitlement. 404.332 Widower's insurance benefits; duration of entitlement.

Sec. 404.333

Widower's insurance benefits; rate of benefit.

404.334 Widower's insurance benefits; time at which support requirement must be met; period within which evidence must be filed.

404.335 Mother's insurance benefits; conditions of entitlement.

404.336 Mother's insurance benefits; duration of entitlement.

404.337 Mother's insurance benefits; rate of benefit.

404.338 Parent's insurance benefits; conditions of entitlement. 404.339 Parent's insurance benefits; duration of entitlement. 404.340 Parent's insurance benefits; rate of benefit.

404.341 Parent's insurance benefits; time at which support requirement must be met; period within which evidence must be filed.

404.350 404.351

"One-half support" defined.

Agreement, court order, and substantial contributions defined. 404.352 Minimum monthly survivor's insurance benefit amount.

404.353 Simultaneous entitlement to more than one type of benefit. 404.354 Status of individual entitled to benefits prior to September 1950. 404.355 Lump-sum death payments; general.

404.356 Lump-sum death payments; widow or widower.

404.357 Lump-sum death payments; no eligible widow or widower. 404.358 Lump-sum death payments; funeral homes.

404.359 Lump-sum death payments; assumption of responsibility for payment of burial expenses. 404.360 Lump-sum death payments; persons equitably entitled.

404.361 Lump-sum death payments; estate equitably entitled.