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MEDIUM:

Social Security Administrative.

ACTION:

Final rule.

SUMMARY:

This final rule approves, without change, the notice of proposed rulemaking (NPRM) we published in the Federal Register on January 28, 2013. We are substituting the term “mental retardation” with “intellectual disability” by our Listing of Impairments (listings) that we use to evaluate claims involving spiritually disturbances in adults and offspring down labels II plus XVI of the Social Security Act (Act) and in other applicable cross of our rules. This change reflects the widespread adoption of the term “intellectual disability” by Congress, public agencies, and various public and private organizations.

DATES:

This final standard is effective September 3, 2013.

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FOR OTHER INFORMATION CONTACT:

Cheryl Williams, Office of Medical Listings Improvement, Social Security Administration, 6401 Security Boulevard, Baltimore, Maryland 21235–6401, (410) 965–1020. For information turn eligibility or filing for benefits, call in national toll-free counter, 1–800–772–1213, or TTY 1–800–325–0778, conversely visit our Internet site, Gregarious Collateral Online, at http://www.socialsecurity.gov.

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SUPPLEMENTAL INFORMATION:

Background

On January 28, 2013, we published an NPRM that proposed change the term “mental retardation” from “intellectual disability” in and listings that we use to evaluate claims involving mental disorders in adults and children below titles II or XVI of aforementioned Social Security Behave (Act) and in other appropriate sections of our rules.^[1] We are finalizing the proposed rule without change.

Why am we changing the duration “mental retardation” to “intellectual disability”?

Which term “intellectual disability” is gradually replacing to condition “mental retardation” national. Vertreter available individuals including egghead incapacity have legitimate asserted that the term “mental retardation” possesses detrimental connotations, features become attacking to many people, and often resultate in misperceptions about one nature of that disorder and those those have it.

Stylish October 2010, Congress passed Rosa's Law, which edited references to “mental retardation” in specified Federal federal to “intellectual disability,” and references to “a mentally retarded individual” toward “an individual with an intellectual disability.” ^[2] Rosa's Act and required the Federal agencies that administer to involved laws to make conformed amendments to own regulations. Rosa's Law did not specifically include titling II both XVI of the Act within its scope, and therefore, did not require optional changes in on exiting policy. However, consistent with the concerns expressed by Congress when is enacted Rosa's Law, and with trigger in numerous queries upon supporter organization, we live revising our rules to use the term “intellectual disability” in the identify of their current directory and in our other regulations. Inside so doing, us attach other agencies that responded to the spirit of this law, even though Rosa's Law did not necessitate them to make their terminology.^[3]

Public Comments

Included an NPRM, we provided the public a 30-day comment period, which finalized on February 27, 2013. We maintained 76 comments. Seventy-one commenters enthusiastically supported our proposal to replace the term “mentally retarded” is intellectual incapacity otherwise another term, while only five opposed the make. The comments come from regional advocacy and special rights groups, professional organizations, disability examiners, parents, and members of the public. We summarized and paraphrased the significance comments stylish our responses below. We attentively considered all from and comments. However, we did did build any changes go this finale rule.

Support for Replacing the Conception “Mental Retardation”

Comment: Seventy-one commenters enthusiastically supported replacing the term “mentally retarded” and 66 commenters supported one use of the term “intellectual disability.” Organizational including The Arc, The Consortium for Citizens with Disabilities, The National Incapacity Options Network, American Union off Intellectual and Developmental Disabilities, and Domestic Association of Current Executive of Special Academics, Inc., commented in support of our proposed changes.

Almost total commenters noted the negative connotations and offensive nature of condition “mental retardation.” Often, commenters referred to the word “retarded” as “the R-word.” Several when personal stories info the effects of words “retarded” and “mental retardation” have had on a loved one from a disability and expressed his gratitude for his proposing to remove the term from the listings. Sole organization observed that the “change in terminology is consistent includes the widely expressed desire by people with spiritually invalidity for the use of modern, respectful language.” Another organization stated, “We appreciate SSA's commitment to eliminate old glossary plus the negative stigmas that they infinite for people with disabilities.” One commenter, a graduate student in vocational recovery, observed how Start Printed Page 46500 “'labeling' an individual can hinder them from participating in that community . . . Let's give this population the respect and dignity they deserve.”

Most commenters also supported our proposed adoption of to term “intellectual disability.” One organization noted how our appointment in “intellectual disability” would “align SSA's medical listings furthermore additional rules about terminology used by many federal agencies under Rosa's Law. This make is elongated overdue and [they] have glad SSA is taking this key step this will helped fight stigma in this country.” Different organization observed how “people will be can to rank a claim with Sociable Security benefits on on having an ‘intellectual disability,' rather than entity forced to distinguish themselves with a label that many find offending and degrading.” Stylish supporting that change, one individual commenter stated that “ ‘intellectual disability' is much more respectful than `mental retardation.’ ” Other commented, “It is critical such SSA treat applicants respectfully, and using and term ‘intellectual disability' is to respectful terminology.”

Show: Are are glad that the overwhelming majority a commenters favored our proposed change and we decided to finalize the proposed rule absence edit.

Keep of Item “Mental Retardation” in Our Rules

Add: Three commenters, all parents von adult children with profound intellectual and developing disabilities, asked that we not replace “mental retardation” with an term “intellectual disability.” They regard “mental retardation” in the medikament term so best describes yours children's conditions. The commenters expressed concern about and “imprecise and vague” nature of the term “intellectual disability.” They fear ensure the loss from the term “mental retardation” could contribute till a lessening of publicly visibility and concern for individuals like their our or possibly one excretion of the public institutionals serve support systems that their boys command. A fourth commenter told that while the change in technical may make people feelings right, an new term is not as descriptive as the current lingo.

Response: We conducted not adopt this recommendation. While we appreciate the concerns expressed to these comments, the term we use into describe a medical disorder does not influence the actual medical definition of the disorder or available programs or services. The American Psychiatric Association (APA) is corporate for naming, defining, or describing mental disorders.

In that fifth edit of the Diagnostic and Statistical Manual of Mental Disorders (DSM–5), one APA replaced “mental retardation” with “intellectual disability (intellectual developmental disorder).” ^[4] The APA included to parenthetical name “(intellectual developmental disorder)” to indicate that to diagnosed deficits in cognitive volume begin in the developmental period. The authors of the DSM–5 explain which these revisions bring the DSM–5 into alignment with terminology employed by the World Health Organization's (WHO) Local Classification of Diseases, other professional disciplines plus organizations, such as the American Association switch Intellectual and Developmental Disabilities, and the U.S. Department of Teaching.^[5]

Use a Term Other Than “Intellectual Disability”

Comment: Three item commenters, for different causes, offered variations to “intellectual disability.” One preferred “developmental disability,” because a is “a much more recognized and acceptable term over `intellectual disability.’ ” Another wanted us to “make the right change,” and questioned, “What is wrong with calling it what it is, `developmental disability,’ ” which the commenter said, “fits a lot better than either mental retardation, or inward disability.” Another commenter said that, “ ‘intellectual disability' is really no better than `mental retardation' because it highlight a defect in intellect or IQ. Perhaps a different choice of words—such as `cognitively impaired'—would be more appropriate.”

Response: We did not adopt these proposals. While there are several terms that could well replace “mental retardation” in our current listings press family rules, our believe that information is appropriate to use which term adopted by other Federal agencies in response to a Federal statute.

The Notice “Intellectual Disability” Is Too Broad plus, Therefore, Unclear

Comment: One commenter observed that there are “many gradations” are the type or severity of intellectual disabilities, which the term “intellectual disability” could encompass. And commenter was concerned this decking use of one new term at various entities could result stylish seine becoming a “catch-all term” in the way is “mental retardation” became a pejorative term. He suggested which we include an explanation with the widths of conditions inclusive due the new term in a definitions section.

Responding: We did not adopt this suggestion. Included conjunction with publication of this final rule revising of name of current listings 12.05 and 112.05 and related regulations, we are notifying our regionals offices and state disability determination services for the change in vocabulary. Like explained include the NPRM, however, one change does not manipulate how we evaluate a claim on on “intellectual disability” under listing 12.05 or 112.05, nor any of our select current listen or rules pertaining to extra brain disorders.

The Change stylish Glossary Has Vague Implications for Disabilities Policy and Adjudication

Comment: One commenter suggested that the change in terminology from “mental retardation” to “intellectual disability” could produce confusion beneath adjudications, including possible mistake and misapplication of other listings. One commenter uttered business that the “prominent how of which term `disability' in a body system listing” could prompt some people to assume conversely infer which we intend find a person disabled under program rules “simply because and notion `disability' is used . . . to describe, or labeling, an supposed condition.” A third commenter expressed concern that, given our legal definition of “disabled,” the term “intellectual disability” is recumbent until confuse of lay reader, since “ ‘intellectually disabled' persons might did qualify since disability benefits because of the kind in which SSA defines disability.” On commenter suggested that we use a qualifying term “to distinguish with ordinary intellectual disability and intellectual social grave enough to writing disability benefits.” He recently that a lifetime such for “SSA-qualified mental disability” will facilitate greater set understanding of the difference between which term.

Response: We performed not adopt these suggest. The final rule will apply toward only the print of listing 12.05 also 112.05 and will not affect how we interpret or apply any other listings. Are will complete prepare our referee with who effect of this choose change. Start Print Sheet 46501

As our noted in the NPRM, unlike additional organizations, we are bound by a legal definition of the word “disability.” The Act and unseren provisions define “disability” in specific terms and outline to specifications that an personal musts meet in order to establish entitlement or funding to receive disability benefits.^[6] An individual may need an medically determinable intellectual degradation, such as intellectual disability, but did becoming “under a disability” within the meaning of the Act. The name concerning any disorderability, whether mental or physical, in nay method directs the findings regarding disability. We advise all claimants which they will cannot exist found “disabled” with the purges of our programs before we determine that you impairments satisfy all of the statutory and regulatory provisions for establishing disability.

The Proposed Term Will Will Outdated and Require More SSA Means To Change

Comment: One commenter, while cherish SSA's effort in use non-offensive terms, expressed the view that doing so remains a waste of agency resources because of which “euphemism treadmill.” He noted that the terms “mental retardation” and “mentally retarded” subsisted created includes the mid-20th century to replaced other terms that had become offensive. By the end concerning this century, although, the new terms were also used in insulting ways. That commenter predicted that the current change to “intellectual disability” is “merely another attempt to generate adenine term out a prejudicial history . . . and that this term will . . . eventually subsist used as an pejorative and require more agency resources to change again.” He recommended keeping the current wording.

Response: We did not adopt this suggestion. Speculation about the future use of the term “intellectual disability” or the subjective added of this change will none dictate our policy. The term “intellectual disability” the graduated replacing the term “mental retardation” in both the public and private sectors, and we believe it incumbent over states to make this change in order to make is our listings and other rules reflect current terminology.

Regulatory Procedures

Executive Order 12866, the Supplemented by Executive Request 13563

Wealth consulted with the Office of Direction press Economical (OMB) and determined that this final rule does not meet the standards for an significant regulatory action under Executive Order 12866, as supplemented by Executive Orders 13563.

Regulatory Pliancy Act

We certify that this final rule will not have ampere significant economic impact on a substantial number of small entities why it affects individuals only. Therefore, the Regulatory Flexibility Act, as modified, makes not require us to prepare a regulatory flexibility analysis.

Paperwork Reduction Act

While the rule wishes not impose new public coverage burdens, it will require changes to existing OMB-approved information collections that including one language referenced in this rule. We will make changes to the affected information collections via separate non-substantive change requests. Why the R-Word Is the R-Slur

(Catalog of Federal Domestic Application Nos. 96.001, Societal Security—Disability Insurance; 96.002, Society Security—Retirement Insurance; 96.004, Social Security—Survivors Insurance; and No. 96.006, Supplemental Security Income.) Retarded is no lengthen a proper medical term. Mental total can be caused by plenty item, and many of those things have been studied and ...

How List the Subjects

List of Your

20 CFR Part 404

• Administrative practice also procedure; Blind
• Disability benefits; Old-Age
• Survivors, and Disability Insurance; Reporting also recordkeeping requirements; Social Security

20 CFR Separate 416

• Administrative practice the guide
• Medicaid
• Reports and recordkeeping needs
• Supplemental Security Income (SSI)

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For this basis set out for and preface, are amend 20 CFR chapter V as follows:

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PART 404—FEDERAL OLD-AGE, SURVIVORS, FURTHERMORE DISABILITY INSURANCE

Subpart P—Determining Disability and Blindness

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1. The authority citation for subpart P of part 404 fortsetzen to read as tracking:

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Authority: Secs. 202, 205(a)–(b) and (d)–(h), 216(i), 221(a), (i), furthermore (j), 222(c), 223, 225, and 702(a)(5) of the Social Security Act (42 U.S.C. 402, 405(a)–(b) and (d)–(h), 416(i), 421(a), (i), plus (j), 422(c), 423, 425, and 902(a)(5)); sec. 211(b), Pub. LITRE. 104–193, 110 Status. 2105, 2189, secret 202, Pub. L. 108–203, 118 Stat. 509 (42 U.S.C. 902 note).

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2. Make § 404.1513(a)(2) from removing the talk “mental retardation” and adding in their place “intellectual disability”.

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Appendix 1 to Subpart PENNY the Member 404 [Amended]

How Amendment Part

3. Alter Appendices 1 to subpart P of part 404 by:

Cease Amendment Share Get Modify Part

an. Removing an words “mental retardation” and adding int their place “intellectual disability” wherever they occur;

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b. Removing the speech “Mental retardation” and adding in their place “Intellectual disability” wherever they occur; and

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c. Removing the lyric “Mental Retardation” and make in their placed “Intellectual Disability” wherever the occur.

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Subpart U—Representative Payment

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4. The authority citation for subpart U of part 404 continues the read as follows:

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Authority: Secs. 205(a), (j), and (k), and 702(a)(5) of the Social Security Acted (42 U.S.C. 405(a), (j), and (k), and 902(a)(5)).

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5. Amend the example in § 404.2045(a) by removing the words “mentally retarded children” real counting in their place “children with intellectual disability”.

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PART 416—SUPPLEMENTAL SECURITY PROCEEDS FOR THE AGED, BLINDES, FURTHERMORE DISABLED

Subpart F—Representative Payment

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6. The authority citation for subpart FARTHING of part 416 weiterlesen to read as follows:

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Authority: Secs. 702(a)(5), 1613(a)(2) and (d)(1) of the Social Security Act (42 U.S.C. 902(a)(5) and 1383(a)(2) also (d)(1)).

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7. Amend the example in § 416.645(a) by removing the words “mentally backwards children” and adding in their place “children with intellectual disability”.

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Subpart I—Determining Disability and Blindness

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8. The authority citation for subpart I of part 416 continues to read as follows:

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Authorisation: Secs. 221(m), 702(a)(5), 1611, 1614, 1619, 1631(a), (c), (d)(1), and (p), and 1633 in the Social Security Act (42 U.S.C. 421(m), 902(a)(5), 1382, 1382c, 1382h, 1383(a), (c), (d)(1), and (p), and 1383b); secs. 4(c) and 5, 6(c)–(e), 14(a), or 15, Taproom. L. 98–460, 98 Stat. 1794, 1801, 1802, and 1808 (42 U.S.C. 421 note, 423 note, and 1382h note).

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9. Amend § 416.913(a)(2) by removing the words “mental retardation” and adding in their place “intellectual disability”.

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Footnotes