C.F.R. » Title 20 » CHAPTER III—SOCIAL SECURITY ADMINISTRATION › PART 404—FEDERAL OLD-AGE, SURVIVORS AND DISABILITY INSURANCE (1950- ) › Subpart Q—Determinations of Disability

20 C.F.R. § 404.1627

Audits

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(a) Audits performed by the State—(1) Generally. Audits of accounts and records pertaining to the administration of the disability program under the Act, will be performed by the States in accordance with the Single Audit Act of 1984 (Pub. L. 98-502) which establishes audit requirements for States receiving Federal assistance. If the audit performed by the State meets our program requirements, we will accept the findings and recommendations of the audit. The State will make every effort to act upon and resolve any items questioned in the audit.

(2) Questioned items. Items questioned as a result of an audit under the Single Audit Act of 1984 of a cross-cutting nature will be resolved by the Department of Health and Human Services, Office of Grant and Contract Financial Management. A cross-cutting issue is one that involves more than one Federal awarding agency. Questioned items affecting only the disability program will be resolved by SSA in accord with paragraph (b)(2) of this section,

(3) State appeal of audit determinations. The Office of Grant and Contract Financial Management will notify the State of its determination on questioned cross-cutting items. If the State disagrees with that determination, it may appeal in writing within 60 days of receiving the determination. State appeals of a cross-cutting issue as a result of an audit under the Single Audit Act of 1984 will be made to the Department of Health and Human Services' Departmental Appeals Board. The rules for hearings and appeals are provided in 45 CFR part 16.

(b) Audits performed by the Commissioner—(1) Generally. If the State does not perform an audit under the Single Audit Act of 1984 or the audit performed is not satisfactory for disability program purposes, the books of account and records in the State pertaining to the administrations of the disability programs under the Act will be audited by the SSA's Inspector General or audited or reviewed by SSA as appropriate. These audits or reviews will be conducted to determine whether the expenditures were made for the intended purposes and in amounts necessary for the proper and efficient administration of the disability programs. Audits or reviews will also be made to inspect the work and activities required by the regulations to ensure compliance with pertinent Federal statutes and regulations. The State will make every effort to act upon and resolve any items questioned in an audit or review.

(2) Questioned items. Expenditures of State agencies will be audited or reviewed, as appropriate, on the basis of cost principles and written guidelines in effect at the time the expenditures were made or incurred. Both the State and the State agency will be informed and given a full explanation of any items questioned. They will be given reasonable time to explain items questioned. Any explanation furnished by the State or State agency will be given full consideration before a final determination is made on the audit or review report.

(3) State appeal of audit determinations. The appropriate Social Security Administration Regional Commissioner will notify the State of his or her determination on the audit or review report. If the State disagrees with that determination, the State may request reconsideration in writing within 60 days of the date of the Regional Commissioner's notice of the determination. The written request may be made, through the Associate Commissioner, Office of Disability, to the Commissioner of Social Security, room 900, Altmeyer Building, 6401 Security Boulevard, Baltimore, Maryland 21235. The Commissioner will make a determination and notify the State of the decision in writing no later than 90 days from the date the Social Security Administration receives the State's appeal and all supporting documents. The decision by the Commissioner on other than monetary disallowances will be final and binding upon the State. The decision by the Commissioner on monetary disallowances will be final and binding upon the State unless the State appeals the decision in writing to the Department of Health and Human Services, Departmental Appeals Board within 30 days after receiving the Commissioner's decision. See § 404.1683.

[56 FR 11019, Mar. 14, 1991, as amended at 62 FR 38452, July 18, 1997]
Notes of Decisions
Cited in 12 cases (1 in the last 5 years), 1999–2022 · leading case: Monette v. Colvin
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Monette v. Colvin (2016) ca2 “1527 (c); SSR 06-03p, 2006 WL 2329939 , at *4-5, The greater weight accorded by the ALJ to the opinion of the consultative psychologist is also consistent with the record at large and the applicable regulations, See 20 C.F.R. § 404.1627 (c); see also Diaz v.”
Harrold v. Berryhill (2017) ca10 “See 20 C.F.R. § 404.1627 (e). The ALJ’s failure to evaluate and weigh Dr.”
Abdullah Amir v. Comm. of Social Security (2017) ca6 “See 20 C.F.R. § 404.1627 (d)(1) (“We are responsible for making the determination .”
Swanson v. Commissioner of Social Security Administration (2017) azd “913 (a); see also 20 C.F.R. § 404.1627 . The agency also accepts evidence from “other sources” to show the severity of the applicant’s impairment and how it affects the ability to work.”
Alejandro v. Barnhart (2003) txsd “20 C.F.R. §§ 404.1627 (0(2)®, 416.927(f)(2)(h); see also SSR 96-2p at *5; SSR 96-5p at *6.”
Quigley v. Barnhart (2002) mad “20 C.F.R. 404.1627(f)(2)(H) (2000). 6 (Emphasis supplied) Since Dr.”
Echevarria v. Apfel (1999) nysd “20 C.F.R. §§ 404.1627 (d)-©, 416.927(d)-©.”
Ottman v. Barnhart (2004) innd “The regulations, and this Circuit, clearly recognize that reviewing physicians and psychologist are experts in their field and the ALJ is entitled to rely on their expertise.”
Santos-Sanchez v. Astrue (2010) nysd “” 20 C.F.R. § 404.1627 (0(2)©; see also Riley v.”
(SS) Ballesteros v. Commissioner of Social Security (2022) caed “A finding of disability is an 11 ultimate issue that is reserved to the Commissioner (20 CFR 404.1627(d), 416.927(d)). Because the issue is reserved, and because workers' 12 compensation cases utilize standards very different from Social Security, these opinions cannot be…”
RICHMOND JR. v. SAUL (2019) insd “In that case, the Court upheld an ALJ’s decision that discussed two of the factors listed in 20 C.F.R. § 404.1627 , finding the decision minimally articulated the bases for the ALJ’s conclusions.”
MURPHY v. BERRYHILL (2019) paed “Generally, the governing regulations dictate that an ALJ must give medical opinions the weight she deems appropriate based on factors such as whether the physician examined or treated the claimant, whether the opinion is supported by medical signs and laboratory findings, and…”
— 20 C.F.R. § 404.1627(d) — 1 case
(SS) Ballesteros v. Commissioner of Social Security (2022) caed “A finding of disability is an 11 ultimate issue that is reserved to the Commissioner (20 CFR 404.1627(d), 416.927(d)). Because the issue is reserved, and because workers' 12 compensation cases utilize standards very different from Social Security, these opinions cannot be…”
— 20 C.F.R. § 404.1627(f)(2)(H) — 1 case
Quigley v. Barnhart (2002) mad “20 C.F.R. 404.1627(f)(2)(H) (2000). 6 (Emphasis supplied) Since Dr.”
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