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Federal Register / Vol. 71, No.

102 / Friday, May 26, 2006 / Notices 30467

for appeals and hearings and in issuing Security Income (SSI) benefits, cessation Type of Request: Revision of an OMB-
a decision. Respondents are individuals of benefits, or who are requesting a approved information collection.
who appeal denial of Social Security hearing.
disability income and Supplemental

Average bur-
Number of Frequency of den per Estimated an-
Collection method respondents response response: nual burden

SSA–3441 (Paper Form) ................................................................................. 404,506 1 45 303,380

Electronic Disability Collection System (EDCS) .............................................. 635,873 1 45 476,905
I3441 (Internet Form) ....................................................................................... 72,341 1 120 144,682

Totals ........................................................................................................ 1,112,720 ........................ ........................ 924,967

Estimated Annual Burden: 924,967 such agreements are also applications Estimated Annual Burden: 6,128
hours. and redeterminations of Medicaid hours.
4. Third Party Liability Information eligibility. Under these agreements, SSA 5. Claimant Statement About Loan of
Statement—42 CFR 433.136–433.139— obtains third party liability information Food or Shelter; Statement About Food
0960–0323. Identification of sources of using form SSA–8019 and provides that or Shelter Provided to Another—20 CFR
third party insurance liable for medical information to the State agencies which 416.1130–416.1148—0960–0529. Forms
care or services for Medicaid provide Medicaid under the terms of an SSA–5062 and SSA–L5063 are used to
beneficiaries, which could be used to approved plan in Title XIX of the Social obtain statements about food and/or
reduce Medicaid costs, is required Security Act. The Medicaid State shelter provided to an SSI claimant or
under 42 U.S.C. 1396a(a)(25). Medicaid agencies then use the information recipient. SSA uses this information to
State agencies are mandated under 42 provided to attempt to bill any third determine whether food and/or shelter
CFR 433.136–.139 to obtain this parties liable for medical care, support are bona fide loans or should be counted
information on Medicaid applications or services for a beneficiary to guarantee as income for SSI purposes. This
and redeterminations as a condition of that Medicaid remains the payer of last determination can affect eligibility for
Medicaid eligibility. States are resort. The respondents are SSI SSI and the amount of SSI benefits
permitted to enter into agreements with applicants and beneficiaries. payable. The respondents are claimants/
the Commissioner of Social Security to Type of Request: Extension of an recipients for SSI benefits and
make Medicaid eligibility OMB-approved information collection. individuals that provide loans of food
determinations for aged, blind and Number of Respondents: 73,540. and/or shelter to SSI claimants/
disabled beneficiaries in those States. Frequency of Response: 1. recipients.
Applications for and redeterminations Average Burden per Response: 5 Type of Request: Extension of an
of SSI eligibility in jurisdictions with minutes. OMB-approved information collection.

Average bur-
Number of Frequency of den per Estimated an-
Form number respondents response response: nual burden

SSA–5062 ........................................................................................................ 65,540 1 10 10,923

SSA–L5063 ...................................................................................................... 65,540 1 10 10,923

Totals ........................................................................................................ 131,080 ........................ ........................ 21,846

Estimated Annual Burden: 21,846 ACTION: Notice of Social Security ruling. 1–800–966–5609, for information about
hours. this notice.
Dated: May 18, 2006. SUMMARY: In accordance with 20 CFR
Elizabeth A. Davidson, 402.35(b)(1), the Commissioner of Social
we are not required to do so pursuant
Social Security Administration, Reports Security gives notice of Social Security
to 5 U.S.C. 552(a)(1) and (a)(2), we are
Clearance Officer. Ruling, SSR 06–01p. This Ruling
publishing this Social Security Ruling
[FR Doc. E6–7995 Filed 5–25–06; 8:45 am] provides guidance on the types of
in accordance with 20 CFR 402.35(b)(1).
impairments that may result from
tremolite asbestos and how to evaluate Social Security Rulings make
disability claims under titles II and XVI available to the public precedential
SOCIAL SECURITY ADMINISTRATION of the Social Security Act based on decisions relating to this Federal old-
these impairments. age, survivors, disability, supplemental
security income, and special veterans
[Social Security Ruling, SSR 06–01p] DATES: Effective Date: May 25, 2006. benefits programs. Social Security
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Titles II and XVI: Evaluating Cases FOR FURTHER INFORMATION CONTACT: Rulings may be based on determinations
Involving Tremolite Asbestos-Related Michelle Hungerman, Office of Medical or decisions made at all administrative
Impairments Policy, Social Security Administration, levels of adjudication, Federal court
6401 Security Boulevard, Baltimore, MD decisions, Commissioner’s decisions,
AGENCY: Social Security Administration. 21235–6401, 1–410–965–2289 or TTY opinions of the Office of the General

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30468 Federal Register / Vol. 71, No. 102 / Friday, May 26, 2006 / Notices

Counsel, and policy interpretations of and in work-related activities involving Inhalation of tremolite asbestos can
the law and regulations. the production of horticultural items, also cause several types of cancers,
Although Social Security Rulings do construction and insulation materials, primarily malignant mesothelioma of
not have the same force and effect as the brake pads, and other items. People may the pleura and bronchogenic carcinoma
statute or regulations, they are binding also be exposed to tremolite from living of the lung.
on all components of the Social Security in an area where such mining or Some factors that increase the chances
Administration, in accordance with 20 activities occur or from products made of developing these impairments
CFR 402.35(b)(1), and are binding as from vermiculite. exposure to tremolite include increased length of exposure to
precedents in adjudicating cases. asbestos has occurred in the Libby, tremolite asbestos, multiple routes of
If this Social Security Ruling is later Montana area and may have occurred in exposure to tremolite asbestos (for
superseded, modified, or rescinded, we other areas as well. example occupational contact and
will publish a notice in the Federal This ruling explains how we household contact), and smoking.5
Register to that effect. determine if impairments that may be 2. How Do We Consider Impairments
caused by exposure to tremolite asbestos Related to Tremolite Asbestos Exposure
(Catalog of Federal Domestic Assistance
meet our definition of disability.2 in the Sequential Evaluation Process?
Programs 96.001 Social Security Disability
Insurance; 96.006 Supplemental Security Sections 216(i) and 1614(a)(3) of the Act As with all impairments, we follow the
Income) define ‘‘disability’’ 3 as the inability to five-step sequential evaluation process
engage in any substantial gainful in 20 CFR 404.1520 and 416.920 when
Dated: May 19, 2006. we determine whether an individual is
activity by reason of any medically
Martin Gerry, disabled.
determinable physical or mental
Deputy Commissioner, Disability and Income impairment (or combination of Step 1. We first determine whether
Security Programs. the individual is working and whether
impairments) which can be expected to
Policy Interpretation Ruling result in death or which has lasted or the work is substantial gainful activity
can be expected to last for a continuous (SGA). If the individual is working and
Titles II and XVI: Evaluating Cases period of not less than 12 months.4 the work is SGA, we will find that the
Involving Tremolite Asbestos-Related individual is not disabled, regardless of
Impairments Policy Interpretation the individual’s medical condition, age,
Purpose: To provide guidance on the 1. What Types of Impairments May education, and work experience. If the
types of impairments that may result Result from Exposure to Tremolite individual is not engaging in SGA, we
from tremolite asbestos exposure and Asbestos? When tremolite asbestos is go on to the next step.
how to evaluate disability claims under inhaled, it penetrates the lung tissue by Step 2. If the individual is not
titles II and XVI of the Social Security piercing the walls of the alveolar sacs working or the work is not SGA, we
Act (the Act) based on these and permanently lodges in the pleural then establish whether the individual
impairments.1 lining. The tremolite accumulates in the has a medically determinable
Citations (Authority): Sections 216(i), pleural lining, and the affected lung and impairment that is ‘‘severe.’’
pleural areas become inflamed and The presence of chronic pulmonary
223(d), 223(f), 1614(a)(3), and 1614(a)(4)
scarred. This process may eventually insufficiency is established based on the
of the Social Security Act, as amended;
result in chronic pulmonary individual’s medical history, findings
Regulations No. 4, subpart P, sections
insufficiency, such as asbestosis, from a physical examination(s), and
404.1502, 404.1505, 404.1508–404.1513,
disorders of pulmonary circulation, spirometric pulmonary function tests.
404.1519–1523, 404.1525–404.1529,
pleural plaques, pleural thickening, or Chest x-rays or other appropriate
404.1545, 404.1560–404/1569a,
pleural effusions. These impairments radiographic imaging techniques (for
404.1593–404.1594, and appendix; 1;
can interfere with the lungs’ ability to example, a computerized axial
and Regulations No. 16, subpart I,
exchange oxygen and carbon dioxide tomography (CAT) scan) are often
sections 416.902, 416.905, 416.906,
and can cause difficulty breathing by performed to support the presence of
416.908–416.913, 416.919, 416.920,
interfering with the lungs’ ability to the impairment. Measurement of
416.921–416.929, 416.945, 416.960–
expand and contract normally. Decrease diffusing capacity of the lungs for
416.969a, 416.993–416.994a.
in blood flow to the lungs can result in carbon monoxide (DLCO), pulse
Pertinent History prolonged right pulmonary artery oximetry, or resting or exercise arterial
Tremolite is a type of asbestos hypertension, enlargement of the heart, blood gas studies (ABGS) may be
sometimes found in the mineral and failure of the right ventricle (cor performed to determine if the
vermiculite. People may be exposed to pulmonale). impairment has resulted in gas
tremolite from vermiculite in mining exchange abnormalities. In disorders of
2 The term ‘‘we’’ in this Social Security Ruling pulmonary circulation, a direct
1 For simplicity, we refer in this Ruling only to has the same meaning as in 20 CFR 404.1502 and measurement of pulmonary artery
initial adult claims for disability benefits under 416.902. ‘‘We’’ refers to either the Social Security pressure may have been obtained with
titles II and XVI of the Act, and the steps of the Administration or the State agency making the right heart catheterization.
sequential evaluation process we use to determine disability determination; that is, our adjudicators at
all levels of the administrative review process and Malignant mesothelioma and
disability in those claims, 20 CFR 401.1520 and
416.920. We use a different sequential evaluation our quality reviewers. bronchogenic carcinoma are
process for children who apply for benefits based 3 Except for statutory blindness. demonstrated by tissue biopsy. When a
on disability under title XVI of the Act. We describe 4 For individuals under age 18 claiming benefits
biopsy is performed, we generally need
that sequential evaluation process in 20 CFR under title XVI, disability will be established if the a copy of both the operative note and
416.924. We also use separate sequential evaluation individual has a medically determinable physical or
processes to determine whether an individual’s mental impairment (or combination of pathology report. If we cannot get these
disability has ended when we conduct continuing impairments) that results in ‘‘marked and severe
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disability reviews and when we determine that an functional limitations.’’ See section 1614(a)(3)(C) of 5 With continuing scientific research, new

individual was disabled only for a specific period. the Act and 20 CFR 416.906. However, for medical information may emerge to further clarify
These rules are set out in 20 CFR 401.1594, 416.994, simplicity, the following discussions refer only to the causes and nature of impairments related to
and 416.994a. The guidance in this Ruling applies claims of individuals claiming disability benefits tremolite asbestos exposure and to provide greater
to all of the appropriate steps in those regulations under title II and individuals age 18 or older specificity for clinical and laboratory diagnostic
as well. claiming disability benefits under title XVI. techniques to document them.

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Federal Register / Vol. 71, No. 102 / Friday, May 26, 2006 / Notices 30469

documents, we will accept the summary 13.14A if it is inoperable, unresectable, individual’s ability to adjust to other
of hospitalization(s) or other medical recurrent, or has metastasized to or work (step 5). The usual vocational
reports. This evidence should include beyond the hilar nodes. considerations must be applied in
details of the findings at surgery and, If the individual has an impairment(s) determining the individual’s ability to
whenever appropriate, the pathological that meets or medically equals the adjust to other work.12
findings. criteria of one of the foregoing listings Effective Date: This Ruling is effective
Once we determine that an or any other listing and meets the on the date of its publication in the
impairment(s) exists, we evaluate its duration requirement, we will find that Federal Register.
severity. As with any other medical the individual is disabled. If not, we Cross-References: SSR 85–28, ‘‘Titles
condition, we will find that an will continue with the sequential II and XVI: Medical Impairments That
impairment(s) caused by exposure to evaluation process. Are Not Severe,’’ SSR 96–2p, ‘‘Titles II
tremolite is a ‘‘severe’’ impairment(s) Residual Functional Capacity. If we and XVI: Giving Controlling Weight To
when, alone or in combination with find that the impairment(s) does not Treating Source Medical Opinions,’’
another medically determinable meet or medically equal a listing, or if SSR 96–3p, ‘‘Titles II and XVI:
physical or mental impairment(s), it we do not have enough information for Considering Allegations of Pain and
significantly limits an individual’s a determination or decision at Step 3, Other Symptoms in Determining
physical or mental ability to do basic we will assess the individual’s residual Whether a Medically Determinable
work activities. When making a functional capacity (RFC).7 We must Impairment is Severe,’’ SSR 96–7p,
determination about whether an consider all symptoms that result from ‘‘Titles II and XVI: Evaluation of
impairment(s) is severe, we will the individual’s impairments, including Symptoms in Disability Claims:
consider the effects of any symptoms those symptoms that result from Assessing the Credibility of an
(such as chest pain or complaints of impairments that are not severe, when Individual’s Statements,’’ and SSR
shortness of breath on exertion) that we evaluate how these symptoms affect 96–8p, ‘‘Titles II and XVI: Assessing
could limit functioning.6 We also the individual’s functional capacity.8 Residual Functional Capacity in Initial
recognize that limitations from In addition, if the individual’s treating Claims.’’
impairments caused by exposure to source 9 has provided an opinion about
tremolite may be more significant than [FR Doc. 06–4855 Filed 5–25–06; 8:45 am]
what the individual can still do despite
would be expected based on objective his or her impairment, we will give this BILLING CODE 4191–02–M
findings alone. We will find that an opinion controlling weight in
impairment(s) is ‘‘not severe’’ only if it determining the individual’s RFC when
is a slight abnormality (or a combination the opinion is well-supported by DEPARTMENT OF STATE
of slight abnormalities) that has no more objective medical evidence and is not [Public Notice 5420]
than a minimal effect on the inconsistent with the other substantial
individual’s ability to do basic work evidence in the case record.10 Even if United States Climate Change Science
activities. the treating source’s opinion is not Program
If the individual does not have a given ‘‘controlling weight’’ (for example
medically determinable impairment that it is not well-supported by objective The United States Climate Change
is ‘‘severe,’’ we will find that the medical evidence), the opinion is still Science Program requests expert review
individual is not disabled. If the entitled to deference and must be of the Working Group II contribution
individual does have a ‘‘severe’’ weighed using all of the factors in 20 (‘‘Climate Change 2007: Impacts,
impairment, we will go on to the next CFR 404.1527 and 416.927. In many Adaptation, and Vulnerability’’) to the
step. cases, a treating source’s medical Intergovernmental Panel on Climate
Step 3. If an individual has a severe Change Fourth Assessment Report.
opinion will be entitled to the greatest
impairment(s), we next consider The Intergovernmental Panel on
weight and should be adopted even if it
whether the impairment meets or Climate Change (IPCC) was established
does not meet the test for ‘‘controlling
medically equals a listing in the Listing by the United Nations Environment
of Impairments contained in appendix Programme (UNEP) and the World
Steps 4 and 5. After we determine the
1, subpart P of 20 CFR part 404. Meteorological Organization (WMO) in
Chronic Pulmonary Insufficiency: We individual’s RFC, we then proceed to
the fourth and, if necessary, the fifth 1988. In accordance with its mandate
evaluate chronic pulmonary and as reaffirmed in various decisions
insufficiency under listing 3.02. The step of the sequential evaluation
process.11 If the individual can do past by the Panel, the major activity of the
listing contains criteria based on IPCC is to prepare comprehensive and
spirometry, single breath DLCO, or relevant work, we will determine that
the individual is not disabled (step 4). up-to-date assessments of policy-
ABGS. Chronic pulmonary insufficiency relevant scientific, technical, and socio-
caused by exposure to tremolite asbestos If we determine that the individual’s
impairment(s) precludes the economic information relevant for
may not have findings at rest that satisfy understanding the scientific basis of
these criteria. If exercise ABGS cannot performance of past relevant work or if
there was no past relevant work, a climate change, potential impacts, and
be obtained in these situations, we options for mitigation and adaptation.
evaluate the impairment(s) at step 4, finding must be made about the
The First Assessment Report was
and if necessary, step 5 of the sequential completed in 1990, the Second
7 See 20 CFR 404.1520(e) and 416.920(e).
evaluation process. 8 See Assessment Report in 1995, and the
SSR 96–7p, ‘‘Titles II and XVI: Evaluation
Cancer: Malignant mesothelioma of of Symptoms in Disability Claims: Assessing the Third Assessment Report in 2001. Three
the pleura meets listing 13.15A. Credibility of an Individual’s Statements’’ and SSR working group volumes and a synthesis
Bronchogenic carcinoma meets listing 96–8p, ‘‘Titles II and XVI: Assessing Residual
report comprise the Fourth Assessment
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Functional Capacity in Initial Claims.’’

6 See SSR 85–28, ‘‘Titles II and XVI: Medical 9 See 20 CFR 404.1502 and 416.902. Report, with all to be finalized in 2007.
Impairments That Are Not Severe’’ and SSR 96–3p, 10 See 20 CFR 404.1527 and 416.927; SSR 96–2p, Working Group I assesses the scientific
‘‘Titles II and XVI: Considering Allegations of Pain ‘‘Titles II and XVI: Giving Controlling Weight To
and Other Symptoms In Determining Whether a Treating Source Medical Opinions.’’ 12 See 20 CFR 404.1560–404.1569a and 416.960–

Medically Determinable Impairment Is Severe.’’ 11 See 404.1545 and 416.945. 416.969a.

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