Sec.

404.1290 Secretary defined.

Subpart N Benefits in Case of Veterans

WORLD WAR II VETERANS

404.1301 General effect of section 217 of the Act. 404.1302 "World War II" period defined. 404.1303 "Post-World War II" period deAned.

404.1304 "World War II veterans" defined. 404.1305 "Veteran of post-World War I service" defined. 404.1306 "Active service of 90 days" defined 404.1307 "Separation under conditions other than dishonorable" deûned.

404.1308 Effect of section 217(a) of the Act 404.1309 Effect of section 217(e) of the Act. 04.1310 Limitation on granting of World War II and post-World War II service wage credits.

404.1311 404.1812

404.1813

404.1314

404.1315

"Federa: beneft” deûned.

Determination and certification of payments based on World War II or post-World War II service wage credits.

Effect of notice of determination that a "Federal beneft" is payable.

Erroneous payment resulting from a determination that a "Federal beneft" has been determined payable.

Effect of section 217(b) of the Act; deemed insured status and deemed wages provided.

404.1816 Conditions barring application of deemed insured status. Computation of benefits based on deemed insured status.

404.1317

404.1520

404.1521

Determinations of disability.

Initial determinations as to entitlement or termination entitlement.

404.1522 Reconsideration, hearing and re

404.1523 404.1524 404.1525

view.

Evidence of disability.

Medical evidence.

Determination of disability by nongovernmental organization or other governmental agency.

404.1526 Conclusion by physician regarding individual's disability. Consultative examinations. Evidence of continuation of disability.

Place and manner of submitting evidence.

Failure to submit evidence.

Responsibility to give notice of

event which may effect a change in disability status.

404.1321

When payment of benefits under deemed insured status is or is not deemed erroneous.

404.1527

404.1528

404.1322 Evidence of veteran's period of military service and separation from service.

404.1529

404.1530

404.1323 Filing evidence of support.

404.1531

Subpart 0 Interrelationship of Old-Age, Survivors and Disability Insurance Program With the Railroad Retirement Program

Evaluation of work activities.

Time spent in work.

Evaluation of earnings from work. Period of trial work.

404.1609 404.1610

dependent

spouse, child, or parent. Claims of creditors.

Accountability.

Transfer of accumulated benefit payments.

NOTE: Nomenclature changes affecting this Part 404 appear at 38 FR 3597, Feb. 8, 1973, and 41 FR 51588, Nov. 23, 1976. Subpart A-Introduction, General Definitions and General Provisions

AUTHORITY: Secs. 203, 205, 227, and 1102, 53 Stat. 1367, as amended, 53 Stat. 1368, as amended, 79 Stat. 379, 49 Stat. 647, as amended; section 5 of the Reorganization Plan No. 1 of 1953, 67 Stat. 18, 631; 42 U.S.C. 403, 405, 427, and 1302, unless otherwise noted.

The regulations in this Part 404 (Regulations No. 4 of the Social Security Administration) relate to the provisions of Title II of the Social Security Act as amended on August 28. 1950. and as further amended thereafter The regu lations in this part are divided into seventeen subparts:

(a) Subpart A contains provisions relating to general definitions and use of terms.

(b) Subpart B relates to quarters of coverage and insured status require. ments.

(c) Subpart C relates to basic com. putation, recomputation, and recalculation of benefits and lump sums.

(d) Subpart D relates to the requirements for entitlement to monthly benefits and to the lump-sum death payment duration of entitlement and benefit rates.

(e) Subpart E contains provisions relating to the reduction and increase of insurance benefits and to deductions

from benefits and lump-sum death payments.

(f) Subpart F relates to overpayments, underpayments, waiver of adjustment or recovery of overpayments and liability of certifying officers.

(g) Subpart G relates to filing of applications and other forms.

(h) Subpart H relates to evidentiary requirements for establishing an initial and continuing right to monthly benefits and for establishing a right to lump-sum death payment. (Evidentiary requirements relating to disability are contained in Subpart P.)

(1) Subpart I relates to maintenance and revision of records of wages and self-employment income.

(j) Subpart J relates to procedurcs for determining and reviewing entitlement to and payment of benefits and lump sums, determining and reviewing rights with respect to the establishment and continuance of a period of disability, the revision of earnings records, and the representation of parties.

(k) Subpart K relates to employment, wages, self-employment and selfemployment income.

(1) Subpart L relates to determinations of relationship of a claimant to the individual on whose earnings the application is based.

(m) Subpart M relates to coverage of employees of State and local Governments.

(n) Subpart N relates to benefits in cases involving veterans.

(0) Subpart O relates to the interrelationship of the old-age, survivors and disability insurance program with the railroad retirement program.

(p) Subpart P relates to rights and benefits based on disability.

(q) Subpart Q of this part relates to the selection of a representative payee to receive benefits on behalf of a beneficiary and to the duties and responsibilities of a representative payee.

[26 FR. 7054, Aug. 5, 1961; 26 FR. 7760. Aug 19, 1961, as amended at 27 FR 4513, May 11. 1962; 28 F.R. 14492, Dec. 31, 1963] § 404.2

General definitions and use of

terms.

(a) Terms relating to the acts and regulations. (1) "The Act" means the Social Security Act, as amended.

(2) "Social Security Act" means the act approved August 14, 1935 (49 Stat. 620).

(3) "Social Security Act Amendments of 1950" means the act approved August 28, 1950 (64 Stat. 477).

(4) "Social Security Act Amendments of 1952" means the act approved July 18, 1952 (66 Stat. 767).

(5) "Social Security Amendments of 1954" means the act approved September 1, 1954 (68 Stat. 1052).

(6) "Social Security Amendments of 1956" means the act approved August 1. 1956 (70 Stat. 807).

(7) "Social Security Amendments of 1958" means the act approved August 28, 1958 (72 Stat. 1013).

(8) "Social Security Amendments of 1960" means the act approved September 13, 1960 (74 Stat. 924).

(9) "Social Security Amendments of 1961" means the act approved June 30, 1961 (75 Stat. 131).

(10) "Social Security Amendments of 1965" means the act approved July 30, 1965 (79 Stat. 286).

(11) "Social Security Amendments of 1967" means the act approved January 2, 1968 (81 Stat. 821).

(12) "Social Security Amendments of 1969" means the act approved December 30, 1969 (83 Stat. 487).

(13) "Social Security Amendments of 1972" means the act approved October 30, 1972 (86 Stat. 1329).

(14) "Regulations 2" (20 CFR, 1938 ed., Part 402) means the regulations approved July 20, 1937, as amended from time to time, relating to Federal old-age benefits under title II of the Social Security Act and amendments to such title effective prior to January 1, 1940.

(15) "Regulations 3" (20 CFR, 1961 ed., Part 403) means the regulations approved May 21, 1940, as amended and supplemented from time to time, relating to Federal old-age and survivors benefits under title II of the Social Security Act and amendments to such title effective prior to January 1, 1951

(16) "Internal Revenue Code of 1939" means the act approved February 10, 1939 (53 Stat. Part 1), as amended.

(17) "Internal Revenue Code of 1954" means the act approved August 16, 1954 (68A Stat. 1), as amended.

(b) Secretary; Commissioner; Administration; Appeals Council; Administrative Law Judge defined. (1) "Secretary" means the Secretary of Health, Education, and Welfare.

(2) "Commissioner" means the Commissioner of Social Security.

(3) "Administration," except where the context clearly indicates otherwise, means the Social Security Administration in the Department of Health, Education, and Welfare.

(4) "Appeals Council" means the Appeals Council of the Bureau of Hearings and Appeals in the Social Security Administration or such member or members thereof as may be designated by the Chairman.

(5) "Administrative Law Judge" (formerly designated "hearing examiner"), means an Administrative Law Judge in the Bureau of Hearings and Appeals of the Social Security Administration.

(c) Miscellaneous. (1) "Certify," when used in connection with the duty imposed on the Secretary by section 205 (1) of the act, means that action taken by the Administration in the form of a written statement addressed to the Managing Trustee, setting forth the name and address of the person to whom payment of a benefit or lump sum, or any part thereof, is to be made, the amount to be paid, and the time at which payment should be made.

(2) "Benefit" means an old-age insurance benefit, disability insurance benefit, wife's insurance benefit, husband's insurance benefit, child's insurance benefit, widow's insurance benefit, widower's insurance benefit, mother's insurance benefit, father's insurance benefit, parent's insurance benefit, or special payment at age 72 under title II of the Act. (Lump sums, which are death payments under title II of the Act, are excluded from the term "benefit" as defined in this part to permit greater clarity in the regulations.)

(3) "Lump sum" means a lump-sum death payment under title II of the act or any person's share of such a payment.

(4) "Attainment of age." An individual attains a given age on the first moment of the day preceding the anniversary of his birth corresponding to such age.

(5) "State," unless otherwise indicated, includes (1) the District of Columbia, (ii) the Virgin Islands, (iii) the Commonwealth of Puerto Rico effective

January 1, 1951, (iv) Guam and American Samoa, effective September 13, 1960, generally, and for purposes of sections 210(a) and 211 of the act effective after 1960 with respect to service performed after 1960, and effective for taxable years beginning after 1960 with respect to crediting net earnings from self-employment and self-employment income, and (v) the Territories of Alaska and Hawaii prior to January 3, 1959, and August 21, 1959, respectively when those territories acquired statehood.

(6) "United States," when used in a geographical sense, includes, unless otherwise indicated, (1) the States, (11) the Territories of Alaska and Hawaii prior to January 3, 1959, and August 21, 1959, respectively, when they acquired statehood, (iii) the District of Columbia, (iv) the Virgin Islands, (v) the Commonwealth of Puerto Rico effective January 1, 1951, and (vi) Guam and American Samoa, effective September 13, 1960, generally, and for purposes of sections 210(a) and 211 of the act, effective after 1960 with respect to service performed after 1960, and effective for taxable years beginning after 1960 with respect to crediting net earnings from self-employment and self-employment

income.

(7) Masculine gender includes the feminine, unless otherwise indicated.

(8) The terms defined in sections 209. 210, and 211 of the act shall have the meanings therein assigned to them.

(Sec. 210, 74 Stat. 936, 937 to 942; 42 U.S.O. 410) [26 F.R. 7055, Aug. 5, 1961; 26 F.R. 7760, Aug. 19, 1961, as amended at 28 FR. 1037. Feb. 2. 1963; 28 FR. 14492. Dec 31, 1963; 29 F.R. 15509, Nov. 19, 1964; 41 FR 32886, Aug. 6, 1976]

§ 404.3 General provisions.

(a) Extent to which Regulations No. 3 (20 CFR, 1961 ed., Part 403) remain in effect. Regulations No. 3 of the Social Security Administration (20 CFR. 1961 ed.. Part 403) continue in effect with respect to old-age and survivors insurance benefits under title II of the Act for months prior to September 1950 (except with respect to additional deductions from such benefits under section 203(g) of the Act in effect prior to the Social Security Act Amendments of 1950); with respect to lump-sum death payments under title II of the Act where death occurred after 1939 and before September 1950; and with respect to determinations

as to whether, under title II of the Act. services performed before 1951 constitute employment and remuneration paid before 1951 constitutes wages. Except as provided in this paragraph or as specifically incorporated into this Part 404 by reference, Regulations No. 3 of the Social Security Administration (20 CFR. 1961 ed., Part 403) are superseded by the regulations in this Part 404.

(b) Effect of cross references. The cross references in the regulations in this Part 404 to other portions of the regulations, when the word "see" is used, are made only for convenience and shall be given no legal effect.

(c) Periods of limitation ending on nonwork days. Pursuant to the provisions of section 216(j) of the act, effective September 13, 1960, where any provision of title II. or any provision of another law of the United States (other than the Internal Revenue Code of 1954) relating to or changing the effect of title II, or any regulation of the Secretary issued under title II, provides for a period within which an act is required to be done which affects eligibility for or the amount of any benefit or payment under this title or is necessary to establish or protect any rights under this title, and such period ends on a Saturday, Sunday or Federal legal holiday or on any other day all or part of which is declared to be a nonwork day for Federal employees by statute or Executive Order, then such act shall be considered as done within such period if it is done on the first day thereafter which is not a Saturday, Sun-day, or legal holiday or any other day all or part of which is declared to be a nonwork day for Federal employees either by statute or Executive Order. For purposes of this paragraph, the day on which a period ends shall include the final day of any extended period where such extension is authorized by law or by the Secretary pursuant to law. Such extension of any period of limitation does not apply to periods during which benefits may be paid for months prior to the month an application for such benefits is filed pursuant to § 404.607, or to periods during which an application for benefits may be accepted as such pur<suant to § 404.606.

(Sec. 216, 74 Stat. 994; 42 U.S.C. 416) [26 P.R. 7055. Aug. 5. 1961, as amended at 29 FR. 15509, Nov. 19, 1964]

Subpart B-Quarters of Coverage

and Insured Status

AUTHORITY: The provisions of this Subpart B issued under secs. 205, 216, 217, 223, 227 and 1102, 53 Stat. 1868, as amended, 68 Stat. 1081, as amended, 70 Stat. 815, as mended, 79 Stat. 379, as amended, 49 Stat. 647, as amended; sec. 5 of Reorganization Plan No. 1 of 1953, 67 Stat. 18, 631; 42 U.8.0. 105, 416, 417, 423, 427, and 1802. Sections 404.102 to 404.106 also issued under sec. 218, 64 Stat. 504, as amended; 42 U.S.C. 413; #11404.108 to 404.114 aiso issued under sec. 214, 64 Stat. 505, as amended: 42 U.S.C. 414. 404.120(a) also issued under sec. 5(k), 68 Stat. 1081, as amended; 45 U.S.C. 2280. Additional authority is cited in parentheses following the sections affected.

SOURCE: The provisions of this Subpart B appear at 28 F.R. 3378, Apr. 6. 1963; 28 F.R. 8695. Apr. 16, 1963 unless otherwise noted. § 404.101 Insured status; general.

The insured status of an individual is a basic factor in determining entitlement on his earnings record to monthly bene¿fits, special age 72 payments, the lumpsum death payment, and the establishment of a period of disability. For example, an individual must be "fully insured" (see §§ 404.108-404.113) to qualify for old-age insurance benefits, and either "fully" or "currently" insured (see 404.114) for mother's insurance benefits or the lump-sum death payment to be payable on his earnings account. An individual is "fully" or "currently” I insured when he has acquired sufficient "quarters of coverage" (see 404.103) to give him such status. If an individual is |_ neither fully" nor “currently” insured, no monthly insurance benefit or lumpsum death payment is payable on the basis of his earnings record. Subpart D of this part explains which benefits are based on a fully insured status. which are based on a currently insured status. and which are based on both a "fully" and "currently" insured status.

(Sec. 228. 80 Stat. 67: 42 U.S.O. 428) [34 FR. 18933, Nov. 27. 1969]

at least a specified minimum amount of wages are paid (or earned, under certain conditions—see paragraph (e) of this section) in such quarter, or if at least a specified amount of self-employment income is credited to such quarter, or if such quarter occurs in a year in which an individual has a specified amount of wages or self-employment income or a combination of both. However, certain calendar quarters may not be credited as quarters of coverage even though the wage or self-employment income requirements may be met in such quarters. Calendar quarters are credited as quarters of coverage in accordance with the rules in the following paragraphs of this section but subject to the limitations described in § 404.104. (See Subpart K for a definition of "wages” and “selfemployment income." See section 229 of the Act for wages deemed to have been paid 8 member of the uniformed services.)

(b) Quarters of coverage based on wages paid in, or self-employment income credited to, a calendar quarter. Subject to the limitations in § 404.104, quarter of coverage is a calendar quarter in which an individual:

(1) Has been paid $50 or more wages (however, see paragraph (c) of this section where wages are paid for agricultural labor performed after 1954; and § 404.106 in case of wages paid in 1937);

or

(2) Has been credited (in accordance with § 404.107) with $100 or more of selfemployment income.

(c) Quarters of coverage based on wages paid for agricultural labor performed after 1954. An individual is credited with quarters of coverage baser on wages paid in a year for agricultura labor performed after 1954 in accord ance with the following rules. If suc wages paid in a year total·

(1) $400 or more, then all quarters of that year which are not otherwise quarters of coverage, are quarters of coverage:

(2) $300 or more but less than $400, then the last three quarters of that year which can be, but which are not otherwise, quarters of coverage, are quarters of coverage;

(3) $200 or more but less than $300, then the last two quarters of that year which can be, but which are not otherwise, quarters of coverage, are quarters of coverage;