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CHAPTER III-SOCIAL SECURITY ADMINISTRATION, DEPARTMENT OF HEALTH,

EDUCATION, AND WELFARE

Part

401

404

405

422

Disclosure of official records and information.

Federal old-age, survivors and disability insurance (1950– ).
Federal health insurance for the aged (1965 ------).
Organization and Procedures.

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§ 401.1

Prohibition against disclosure.

No disclosure of (a) any return or portion of a return (including information returns or other written statements) filed with the Commissioner of Internal Revenue under Title VIII of the Social Security Act, the Federal Insurance Contributions Act or the Self-Employment Contributions Acts, or under regulations made under authority thereof, which has been transmitted to the Department of Health, Education, and Welfare by the Commissioner of Internal Revenue, or (b) any file, record, report, or other paper or any information obtained at any time by or from the Department or any officer or employee of the Department, or any person, agency, or organization with whom the Social Security Administration

has entered into an agreement to perform certain functions in the administration of Title II or Title XVIII of the Social Security Act, which in any way relates to, or is necessary to, or is used in or in connection with, the administration of the old-age, survivors, disability, or health insurance programs conducted pursuant to Titles II and XVIII of the Social Security Act, shall be made directly or indirectly except as hereinafter authorized by this part or as otherwise expressly authorized by the Commissioner of Social Security.

[32 F.R. 14892, Oct. 27, 1967] § 401.2

Authority for refusal to disclose. Any request or demand for any such file, record, report, or other paper, or information, disclosure of which is forbidden by this part, shall be declined upon authority of the provisions of section 1106 of the Social Security Act, and this part prescribed thereunder. If any officer or employee of the Department is sought to be required, by subpena or other compulsory process, to produce such file, record, report, or other paper, or give such information, he shall respectfully decline to present such file, record, report, or other paper, or divulge such information, basing his refusal upon the provisions of law, and this part prescribed thereunder.

[20 F.R. 5159, July 20, 1955]

§ 401.3 Information which may be disclosed and to whom.

Disclosure of any such file, record, report, or other paper, or information, is hereby authorized in the following cases and for the following purposes:

(a) (1) As to information (except medical information) directly concerning any claimant or prospective claimant for benefits or payments under Title II or Title XVIII of the Social Security Act;

(i) To such claimant or prospective claimant or his duly authorized representative; or

(ii) To others or to the public but only if such claimant or prospective claimant or his duly authorized representative authorizes disclosure of such information and such disclosure is consistent with the proper and efficient administration of the act; or

(2) As to medical information directly concerning any claimant or prospective claimant for benefits or payments under Title II of the Social Security Act;

(i) To such claimant or prospective claimant or his duly authorized representative, but only if disclosure of such medical information is reasonably necessary for a Title II purpose; or

(ii) To such claimant's or prospective claimant's physician or to a medical institution at or of which such claimant or prospective claimant is a patient, but only if (a) such claimant or prospective claimant or his duly authorized representative consents to the disclosure of such information, (b) the source of such information, or if such source is not available, a physician in the employ of the Department, consents to such disclosure, and (c) such disclosure is solely for the purpose of the care or treatment of such claimant or prospective claimant; or

(3) As to medical information concerning an individual obtained in the administration of Title XVIII;

(1) To such individual or his duly authorized representative, but only if disclosure of such medical information is reasonably necessary for a Title XVIII purpose; or

(ii) To such individual's physician or to a medical institution at or of which such individual is a patient, but only if (a) such individual or his duly authorized representative consents to the disclosure of such information, (b) the source of such information, or if such source is not available, a physician in

the employ of the Department, consents to such disclosure, and (c) such disclosure is solely for the purpose of the care or treatment of such individual; or

(iii) To such individual or his duly authorized representative or to others for other than a Title XVIII purpose, a statement limited to the nature of the illness or injury and the services rendered, when such information is necessary for a determination as to what supplementary benefits or services such individual may be eligible to receive under a public or private hospital or medical insurance or benefit program which is consistent with the purposes and objectives of Title XVIII, if the source of such information does not object to the disclosure, and in the case of a disclosure to others than the individual or his duly authorized representative, only if the individual or his duly authorized representative consents to such disclosure; or

(4) Statements of earnings and medical information authorized to be furnished under this paragraph may be furnished in summary form or in such detail as is determined by the Department to be consistent with the proper and efficient administration of the old-age, survivors, disability, and health insurance programs under Titles II and XVIII.

(b) After the death of an individual; (1) As to information concerning the fact, date, or circumstances of death of the individual, to any person; or

(2) As to other information relating to the individual (except medical information), to a surviving relative or the legal representative of the estate of the individual, or to others when necessary for a determination as to what supplementary benefits or services such deceased individual was eligible to receive under a public or private hospital or medical insurance or benefit plan, where the individual had consented to such disclosure prior to his death or the surviving relative or legal representative consents to such disclosure; or

(3) As to medical information relating to the individual and obtained in the administration of title II, to a surviving relative or legal representative of the estate of the individual, but only if disclosure of such medical information is reasonably necessary for a title II purpose; or

(4) As to medical information relating to the individual and obtained in the administration of title XVIII,

(i) To a surviving relative or legal representative of the estate of the individual when reasonably necessary for a title XVIII purpose; or

(ii) To a surviving relative or legal representative of the estate of the individual or to others for other than a title XVIII purpose, when such information is necessary for a determination as specified in paragraph (a) (3) (iii) of this section, a statement limited to the nature of the illness or injury and the services rendered, if the source of such information does not object to the disclosure, and in the case of disclosure to others than a surviving relative or legal representative, only if the individual had consented to such disclosure prior to his death or the surviving relative or legal representative consents to such disclosure.

(5) Statements of earnings and medical information authorized to be furnished under this paragraph may be furnished in summary form or in such detail as is determined by the Department to be consistent with the proper and efficient administration of the old-age, survivors, disability, and health insurance programs under titles II and XVIII. None of the foregoing information under this paragraph (except information furnished for the purpose of determining what benefits or services the deceased individual was eligible to receive under a public or private hospital or medical insurance or benefit program), shall be disclosed except upon written request stating the purpose thereof, and where such disclosure is considered not detrimental to the individual or to his estate.

(c) To the employer or former employer of an individual, the social security account number of the individual, and a copy of a coverage or wage determination relating to the individual, or a summary thereof setting forth the conclusions reached and the reasons therefor, if services for or wages paid by such employer or former employer are the subject of the determination. Any other information originally supplied by an employer may be furnished to him, upon written request stating the purpose thereof, when efficient administration permits.

(d) To any officer or employee of the Treasury Department, or of the Department of Justice, of the United States, lawfully charged with the administration of Titles II, VIII, or IX of the Social Security Act, the Federal Insurance Con

tributions Act, the Self-Employment Contributions Acts, or the Federal Unemployment Tax Act, or any Federal income tax law, for the purpose of such administration only.

(e) Except in the case of medical information relating to an individual, to any officer or employee of an agency of the Federal Government or a State Government lawfully charged with the administration of a Federal or State unemployment compensation law or contribution or tax levied in connection therewith, for the purpose of such administration only.

(f) To any officer or employee of an agency of the Federal Government lawfully charged with the administration of a law providing for public assistance, or work relief, or pension, or retirement, or other benefit payments, only for the purpose of the proper administration of such law, or of the Social Security Act. Medical information relating to an individual and obtained in the administration of Title II, may be furnished for such a purpose to such an officer or employee only upon consent of such individual or his duly authorized representative, and of the source of such information or, if such source is not available, of a physician in the employ of the Department. Medical information relating to an individual and obtained in the administration of Title XVIII may be furnished if the source of such information does not object to the disclosure and the individual or his duly authorized representative consents to such disclosure.

(g) (1) To any officer or employee of an agency of a State government lawfully charged with the administration of a program receiving grants-in-aid under Titles I, V, X, XIV, XVI, or XIX of the Social Security Act, information regarding benefits paid to an individual or his entitlement to benefits under Title II of the Social Security Act, or information with respect to entitlement of an individual or benefits provided him under Title XVIII of such act, and, if it has been determined, the date of birth of a recipient or applicant, and also whether a period of disability has been established for such recipient or applicant, the beginning and ending date of such period, and the date determined to be the date of onset of such disability, where such information is necessary to enable the agency to determine the eligibility of or the amount of benefits or services due such recipient or applicant. Medical in

formation relating to an individual and obtained in the administration of Title II, may be furnished for such a purpose to such an officer or employee only upon consent of such individual or his duly authorized representative and of the source of such information or, if such source is not available, of a physician in the employ of the Department. Medical information relating to an individual and obtained in the administration of Title XVIII may be furnished if the source of such information does not object to the disclosure and the individual or his duly authorized representative consents to such disclosure.

(2) To any officer or employee of an agency of a State Government lawfully charged with the administration of a program receiving aid under the Vocational Rehabilitation Act, for the proper administration of such program only, the information specified in the first sentence of subparagraph (1) of this paragraph and in addition:

(i) The name, address, social security account number, and such other information as may be obtained with respect to the alleged disability, of an applicant for benefits on account of disability or for a determination of disability; and

(ii) The name, address, social security account number, and such other information as may be obtained with respect to the alleged disability, of any individual making inquiry concerning benefits on account of disability or concerning a determination of disability, if no objection is made by such individual to the release of such information.

(3) To any officer or employee of an agency of a State government lawfully charged with the administration of a program receiving grants-in-aid under part A of title IV of the Social Security Act, the information specified in subparagraph (1) of this paragraph and in addition, in accordance with requirements and procedures issued from time to time by the Social and Rehabilitation Service, information concerning the whereabouts of an absent parent of a child of a family eligible for, an applicant for, or a recipient of, aid under a program receiving grants-in-aid under part A of title IV of the Social Security Act.

(4) Upon request in writing, to any officer or employee of a State or local agency participating in the administration of a State plan approved under titles I, X, XIV, XVI, or XIX of the Social Security Act, or any other State or local

public assistance program, the most recent address of an individual, and/or the address of his most recent employer, inIcluded in the files of the Department maintained pursuant to section 205 of the Act, if:

(i) Such agency certifies that (a) an order has been issued by a court of competent jurisdiction against such individual for the support and maintenance of his child or children who are under the age of 16 in destitute or necessitous circumstances, (b) such child or children are applicants for or recipients of assistance available under such a plan or program, (c) such agency has attempted without success to secure such information from all other sources reasonably available to it, and (d) such information is requested (either for the agency's own use, or on the request and for the use of the court which issued the order) for the purpose of obtaining such support and maintenance; and

(ii) Such request referred to in this subparagraph (4) is accompanied by a certified copy of the order referred to in subdivisions (i) (a) and (d) of this subparagraph.

(h) To a Federal, State, municipal, or hospital official upon written request stating that he has the name or social security account number of a deceased or insane person or a person suffering from amnesia or who is unconscious or in a state equivalent thereto, but cannot establish such person's identity, such identifying data as is available relative to such person which may be determined by the proper officer of the Department to be necessary to assist the requesting officer or agency to make the required identification. Information as to the existence of a legally reportable medical condition of an individual discovered in connection with an application for benefits on account of disability or for a determination of disability may also be furnished to a State or municipal agency required by local law to be furnished such information.

(i) To any officer, agency, establishment, or department of the Federal Government, charged with the duty of conducting an investigation or prosecution, for the purpose of such an investigation or prosecution involving:

(1) An inquiry to determine whether there has been a violation of any provision of the Social Security Act, the Federal Insurance Contributions Act, the Self-Employment Contributions Acts,

the Federal Unemployment Tax Act, or any Federal income tax law, or of any regulation or procedure in effect thereunder, provided such violation is punishable as a crime under any of such laws or under any other Federal statute imposing criminal penalties; or

(2) An inquiry to determine whether any action of an officer or employee of the Department relating to the administration of the Social Security Act was attempted or effected with intent to defraud the United States; or

(3) An inquiry with respect to an alleged theft, forgery, alteration, unlawful negotiation, or destruction of a check issued for a benefit under Title II or Title XVIII of the Social Security Act; or (4) An inquiry relating to the commission or threatened commission of an act of espionage or sabotage or other similar act inimical to the national security: Provided, That such information shall be disclosed only to the Federal Bureau of Investigation or the U.S. Secret Service and only upon written certification by a central official of the requesting agency that the information requested is required in an investigation of major importance to enable it to discharge its statutory responsibility for protecting the national security.

(j) Any return, file, record, report, or other paper or any information may be disclosed when it is to be used in connection with any claim or other proceeding under the Social Security Act and such disclosure is necessary for the proper performance of the duties of any officer or employee of the Department, or of any officer or employee of a State agency to carry out an agreement entered into under section 221 of the Social Security Act, or of any officer or employee of a public or private agency or organization to carry out the health insurance provisions of Title XVIII of said act.

(k) Statistical data or other similar information not relating to any particular person which may be compiled from records regularly maintained by the Department may be disclosed when efficient administration permits. Information contained in or compiled from reports submitted by employers only (other than information relating to any identified or identifiable person except such employers, and other than information relating to any identified or identifiable self-employed individual) may be disclosed, when efficient administration permits, to any other agency of

the Federal Government for use in its statistical and planning work only.

(1) The Commissioner may from time to time prescribe instructions as to the manner of disclosure of the foregoing information.

(m) Disclosure of any return, file, record, report, or other paper or information obtained in the Administration of Title II or Title XVIII of the act not relating or necessary to, or used in or in connection with, the administration of the old-age, survivors, disability, or health insurance programs conducted pursuant to such titles of the act, shall not be subject to the limitation on disclosure in section 1106 of the act and shall be made only as may be otherwise required by law and in accordance with policies prescribed by the Commissioner.

(n) To any officer or employee of an agency of a State government lawfully charged with the supervision of, or financial responsibility for, the care of a person who is mentally incompetent and who is confined in a State mental institution, information regarding his entitlement to benefits under Titles II and XVIII of the Social Security Act, and if entitled, the amount of such benefits and the name and address of the person to whom such benefits have been or are being paid. Disclosure under this paragraph shall be made only upon written certification by the State agency or institution that such informtaion is to be used in connection with the performance of its duties under State law and that there is no other source from which it can obtain such information.

(o) In connection with agreements and modifications of agreements for the coverage of State and local employees entered into pursuant to section 218 of the Social Security Act, the following may be disclosed when efficient administration permits:

(1) The name of a State (or instrumentality of two or more States) with whom an agreement or modification has been entered into, the name or title of the official charged with carrying out the State's responsibilities with respect to an agreement, and the date of an agreement or modification;

(2) The contents of an executed agreement or modification;

(3) Information as to whether or not a State (or instrumentality of two or more States) has indicated an intention or desire to enter into such an agreement or modification, but not including infor

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