News & Information

CCH® UNEMPLOYMENT INSURANCE — 10/27/14

SSA issues final regulations revising medical criteria for evaluating genitourinary disorders

The SSA has finalized its rules revising the criteria in the Listing of Impairments that the agency uses to evaluate cases involving genitourinary disorders in adults and children under Titles II and XVI of the Social Security Act. The revisions reflect the SSA’s program experience and address adjudicator questions it has received since the agency last comprehensively revised the body system in 2005. The final rules are effective December 9, 2014.

Comments received in response to proposed rules

In the Notice of Proposed Rulemaking (78 Fed. Reg. 7695, Fedruary 4, 2013), the SSA provided the public with a 60-day comment period. The agency received six comments from members of the public, disability adjudicators, and a national association representing disability examiners in the state agencies that make disability determinations. Most of the comments were not adopted.

In response to one comment, however, the SSA provided clarification regarding CKD complications in final listings 6.00C8 and 106.00C5. And, in response to another comment that there were undefined and poorly defined terms in the genitourinary listings (including the terms “frequent,” “intractable,” “interferes,” “anasarca,” “anorexia,” and “severe bone pain”), the regulations now provide brief definitions for several medical terms when they are first used in the introductory text of the final listings. The SSA defines “anasarca” in 6.00C6 and 106.00C3; “anorexia” in 6.00C7; and “severe bone pain” and “intractable” in 6.00C3. It does not provided definitions for the terms “frequent” and “interferes” because it uses those two terms in its definition of “severe bone pain” in their common English usage.

The SSA also disagreed with one comment, which stated that the agency provided no quantitative data to show the validity of any of its genitourinary proposed listings and noted that many people engage in substantial gainful activity even though they meet the requirements of a listing. The commenter believed that this challenged the validity of using the listings to determine whether a person is disabled.

Two commenters also pointed out stylistic and technical editorial issues in the preamble and the proposed rules and the agency made appropriate corrections in the final rules. In addition to the changes made in response to public comments, the SSA revised 6.00C1 and 106.00C1 to clarify the documentation requirement for hemodialysis or peritoneal dialysis.

For further information

For further information, contact Cheryl A. Williams, Office of Medical Policy, SSA, 6401 Security Blvd., Baltimore, Maryland 21235-6401, (410) 965-1020 (See 79 Fed. Reg. 61221, October 10, 2014).