Page images
PDF
EPUB

Secretary's final decision after such hearing as is provided in section 205 (g).

(e) Each State which has an agreement with the Secretary under this section shall be entitled to receive from the Trust Funds, in advance or by way of reimbursement, as may be mutually agreed upon, the cost to the State of carrying out the agreement under this section. The Secretary shall from time to time certify such amount as is necessary for this purpose to the Managing Trustee, reduced or increased, as the case may be, by any sum (for which adjustment hereunder has not previously been made) by which the amount certified for any prior period was greater or less than the amount which should have been paid to the State under this subsection for such period; and the Managing Trustee, prior to audit or settlement by the General Accounting Office, shall make payment from the Trust Funds at the time or times fixed by the Secretary, in accordance with such certification. Appropriate adjustments between the Federal Old-Age and Survivors Insurance Trust Fund and the Federal Disability Insurance Trust Fund with respect to the payments made under this subsection shall be made in accordance with paragraph (1) of subsection (g) of section 201 (but taking into account any refunds under subsection (f) of this section) to insure that the Federal Disability Trust Fund is charged with all expenses incurred which are attributable to the administration of section 223 and the Federal Old-Age and Survivors Insurance Trust Fund is charged with all other expenses.

(f) All money paid to a State under this section shall be used solely for the purposes for which it is paid; and any money so paid which is not used for such purposes shall be returned to the Treasury of the United States for deposit in the Trust Funds.

(g) In the case of individuals in a State which has no agreement under subsection (b), in the case of individuals outside the United States, and in the case of any class or classes of individuals not included in an agreement under subsection (b), the determinations referred to in subsection (a) shall be made by the Secretary in accordance with regulations prescribed by him.

Rehabilitation Services

Referral for Rehabilitation Services

Sec. 222. (a) It is hereby declared to be the policy of the Congress that disabled individuals applying for a determination of disability, and disabled individuals who are entitled to child's insurance benefits, shall be promptly referred to the State agency or agencies administering or supervising the administration of the State plan approved under the Vocational Rehabilitation Act for necessary vocational rehabilitation services, to the end that the maximum number of such individuals may be rehabilitated into productive activity.

Deductions on Account of Refusal to Accept Rehabilitation Services

(b) (1) Deductions, in such amounts and at such time or times as the Secretary, shall determine, shall be made from any payment or payments under this title to which an individual is entitled, until the total of such deductions equals such individual's benefit or benefits under

sections 202 and 223 for any month in which such individual, if a child who has attained the age of eighteen and is entitled to child's insurance benefits or if an individual entitled to disability insurance benefits, refuses without good cause to accept rehabilitation services available to him under a State plan approved under the Vocational Rehabilitation Act. Any individual who is a member or adherent of any recognized church or religious sect which teaches its members or adherents to rely solely, in the treatment and cure of any physical or mental impairment, upon prayer or spiritual means through the application and use of the tenets or teachings of such church or sect, and who, solely because of his adherence to the teachings or tenets of such church, or sect, refuses to accept rehabilitation services available to him under a State plan approved under the Vocational Rehabilitation Act, shall, for the purposes of the first sentence of this subsection, be deemed to have done so with good cause.

(2) Deductions shall be made from any child's insurance benefit to which a child who has attained the age of eighteen is entitled or from any mother's insurance benefit to which a person is entitled, until the total of such deductions equals such child's insurance benefit or benefits or such mother's insurance benefit or benefits under section 202 for any month in which such child or person entitled to mother's insurance benefits is married to an individual who is entitled to disability insurance benefits and in which such individual refuses to accept rehabilitation services and a deduction, on account of such refusal, is imposed under paragraph (1). If both this paragraph and paragraph (3) are applicable to a child's insurance benefit for any month, only an amount equal to such benefit shall be deducted.

(3) Deductions shall be made from any wife's, husband's, or child's insurance benefit, based on the wages and self-employment income of an individual entitled to disability insurance benefits, to which a wife, husband, or child is entitled, until the total of such deductions equal such wife's, husband's, or child's insurance benefit or benefits under section 202 for any month in which the individual, on the basis of whose wages and self-employment income such benefit was payable, refuses to accept rehabilitation services and deductions, on account of such refusal, are imposed under paragraph (1).

Period of Trial Work

(c) (1) The term "period of trial work," with respect to an individual entitled to benefits under section 223 or 202 (d), means a period of months beginning and ending as provided in paragraphs (3) and (4).

(2) For purposes of sections 216 (i) and 223, any services rendered by an individual during a period of trial work shall be deemed not to have been rendered by such individual in determining whether his disability has ceased in a month during such period. For purposes of this subsection the term "services" means activity which is performed for remuneration or gain or is determined by the Secretary to be of a type normally performed for remuneration or gain.

(3) A period of trial work for any individual shall begin with the month in which he becomes entitled to disability insurance benefits,

or, in the case of an individual entitled to benefits under section 202(d) who has attained the age of eighteen, with the month in which he becomes entitled to such benefits or the month in which he attains the age of eighteen, whichever is later. Notwithstanding the preceding sentence, no period of trial work may begin for any individual prior to the beginning of the month following the month in which this paragraph is enacted; and no such period may begin for an individual in a period of disability of such individual in which he had a previous period of trial work.

(4) A period of trial work for any individual shall end with the close of whichever of the following months is the earlier:

(A) the ninth month, beginning on or after the first day of such period, in which the individual renders services (whether or not such nine months are consecutive); or

(B) the month in which his disability (as defined in section 223 (c) (2)) ceases (as determined after application of paragraph (2) of this subsection).

(5) In the case of an individual who becomes entitled to benefits under section 223 for any month as provided in clause (ii) of subsection (a)(1) of such section, the preceding provisions of this subsection shall not apply with respect to services in any month beginning with the first month for which he is so entitled and ending with the first month thereafter for which he is not entitled to benefits under section 223.281

Disability Insurance Benefit Payments

Disability Insurance Benefits

Sec. 223. (a) (1) Every individual who

(A) is insured for disability insurance benefits (as determined under subsection (c) (1)),

(B) 282 has not attained the age of sixty-five,

(C) has filed application for disability insurance benefits, and

(D) is under a disability (as defined in subsection (c) (2)) at the time such application is filed,

shall be entitled to a disability insurance benefit (i) for each month beginning with the first month after his waiting period (as defined in subsection (c) (3)) in which he becomes so entitled to such insurance benefits, or (ii) for each month beginning with the first month during all of which he is under a disability and in which he becomes so entitled to such insurance benefits, but only if he was entitled to disability insurance benefits which terminated, or had a period of disability (as defined in section 216 (i)) which ceased, within the sixtymonth period preceding the first month in which he is under such

281 P. L. 86-778, sec. 403 (a) substituted a new subsec. (c) for former subsec. (c), effective only with respect to months beginning after September 1960. For sec. 222 (c) as it read prior to this amendment, see p. 304.

282 P. L. 86-778, sec. 401 (a), deleted "has attained the age of fifty and," applicable with respect to monthly benefits under sec. 223 for months after October 1960 which are based on the wages and self-employment income of an individual who did not attain the age of fifty in or prior to October 1960, but only where an application for such benefits is filed in or after September 1960.

disability,2 283 and ending with the month preceding whichever of the following months is the earliest: the month in which he dies, the month in which he attains the age of sixty-five, or the third month following the month in which his disability ceases.284

(2) Such individual's disability insurance benefit for any month shall be equal to his primary insurance amount for such month determined under section 215 as though he had attained retirement age in

(A) the first month of his waiting period, or

285

(B) in any case in which clause (ii) of paragraph (1) of this subsection is applicable, the first month for which he becomes entitled to such disability insurance benefits,286

and as though he had become entitled to old-age insurance benefits in the month in which he filed his application for disability insurance benefits. For the purposes of the preceding sentence, in the case of a woman who both was fully insured and had attained retirement age in or before the first month referred to in subparagraph (A) or (B) of such sentence, as the case may be, the elapsed years referred to in section 215 (b) (3) shall not include the first year in which she both was fully insured and had attained retirement age, or any year thereafter.287

Filing of Application

(b) No application for disability insurance benefits shall be accepted as a valid application for purposes of this section (1) if it is filed more than nine months before the first month for which the applicant becomes entitled to such benefits, or (2) in any case in which clause (ii) of paragraph (1) of subsection (a) is applicable, if it is filed more than six months before the first month for which the applicant becomes entitled to such benefits; and any application filed within such nine months' period or six months' period, as the case may be, shall be deemed to have been filed in such first month.288 An individual who would have been entitled to a disability insurance benefit for any month after June 1957 had he filed application therefor prior to the end of such month shall be entitled to such benefit for such month if he is continuously under a disability after such month and until he

283 P. L. 86-778, sec. 402 (a), inserted the material beginning "shall be entitled" and through "such disability" in place of the following "shall be entitled to a disability insurance benefit for each month, beginning with the first month after his waiting period (as defined in subsection (c) (3)) in which he becomes so entitled to such insurance benefits." This amendment is effective with respect to benefits under sec. 223 for September 1960 and subsequent months.

284 P. L. 86-778, sec. 403 (b), substituted the material beginning with "whichever" and through the end of the sentence in place of the following: "the first month in which any of the following occurs: his disability ceases, he dies, or he attains the age of sixty-five." This amendment is applicable with respect to benefits under sec. 223 for months after September 1960 in the case of individuals who, without regard to this amendment, would have been entitled to such benefits for September 1960 or for any succeeding month. 285 P. L. 86-778, sec. 303 (f), substituted "had attained retirement age" for "became entitled to old-age insurance benefits." The amendment made by sec. 303 (f) is effective with respect to individuals who become entitled to benefits under sec. 223 after 1960.

286 P. L. 86-778, sec. 402 (b), amneded par. (2) by inserting "(A)" before the phrase "the first month of his waiting period," by adding "or" at the end of such phrase and by adding subpar. (B) in its entirety, effective only with respect to benefits under sec. 223 for September 1960 and subsequent months.

297 P. L. 86-778, sec. 303 (f) added the material following subpar. (B) through the end of the sentence, effective as indicated in footnote 285.

See also sec. 303 (g) of P. L. 86-778, on p. 230.

288 P. L. 86-778, sec. 402 (c) substituted the present first sentence of sec. 223 (b), applicable only in the case of applications for benefits under sec. 223 filed after February 1960, in place of the following: "No application for disability insurance benefits which is filed more than nine months before the first month for which the applicant becomes entitled to such benefits shall be accepted as a valid application for purposes of this section."

65368-61--9

files application therefor, and he files such application 289 prior to the end of the twelfth month immediately succeeding such month.

Definitions

(c) For purposes of this section

(1) An individual shall be insured for disability insurance benefits in any month if

(A) he would have been a fully insured 290 individual (as defined in section 214) had he attained retirement age and filed application for benefits under section 202 (a) on the first day of such month, and

(B) he had not less than twenty quarters of coverage during the forty-quarter period ending with the quarter in which such first day occurred, not counting as part of such fortyquarter period any quarter any part of which was included in a period of disability (as defined in section 216 (i)) unless such quarter was a quarter of coverage.291

(2) The term "disability" means inability to engage in any substantial gainful activity by reason of any medically determinable physical or mental impairment which can be expected to result in death or to be of long-continued and indefinite duration. An individual shall not be considered to be under a disability unless he furnishes such proof of the existence thereof as may be required.

(3) The term "waiting period" means, in the case of any application for disability insurance benefits, the earliest period of six consecutive calendar months

(A) throughout which the individual who files such application has been under a disability which continues until such application is filed, and

(B) (i) which begins not earlier than with the first day of the eighteenth month before the month in which such application is filed if such individual is insured for disability insurance benefits in such eighteenth 189 month, or (ii) if he is not so insured in such month, which begins not earlier than with the first day of the first month after such eighteenth month in which he is so insured.

Notwithstanding the preceding provisions of this paragraph, no waiting period may begin for any individual before January 1, 1957.292

Sec. 224. [Repealed.] 293

289 P. L. 86-778, sec. 402 (d), substituted "if he is continously under a disability after such month and until he files application therefor, and he files such application," for "if he files application therefor," applicable only in the case of applications for benefits under sec. 223 filed in or after September 1960.

290 Sec. 204 (b) of P. L. 85-840 substituted "fully insured" for "fully and currently insured" effective subject to the conditions and limitations in sec. 207 (a) of P. L. 85-840, see p. 216. 291 See also sec. 404 of P. L. 86-778, p. 232, for special insured status test applicable in certain cases.

292 P. L. 86-778, sec. 401 (b), amended the last sentence of par. (3) by deleting the following material, which had appeared after "1957;": "nor may any such period begin for any individual before the first day of the sixth month before the month in which he attains the age of fifty." This amendment shall apply with respect to monthly benefits under sec. 223 for months after October 1960 which are based on the wages and self-employment income of an individual who did not attain the age of fifty in or prior to October 1960 but only where applications for benefits are filed in or after September 1960.

293 Sec. 206 of P. L. 85-840 repealed sec. 224 (which had provided for the reduction of disability benefits) effective with respect to monthly benefits for August 1958 and succeeding months. For sec. 224 as it read prior to repeal see p. 283.

« PreviousContinue »