S. 3648 — Immediate Access for the Terminally Ill Act

This section establishes, under new subsection (k) of Section 223 of the Social Security Act, an irrevocable option—elected at the time of application—for individuals diagnosed with a terminal illness on a list published by the Social Security Administration (SSA) Commissioner to receive disability insurance benefits (DIB) without the five-month waiting period otherwise required under subsection (c)(2), with monthly benefits reduced to 93% (from 100%) of the amount otherwise payable under subsection (a)(2). The Commissioner must publish the list, through formal rulemaking, within six months of enactment and every five years thereafter; qualifying conditions must appear on SSA's most recent Compassionate Allowance Conditions list (i.e., conditions presumptively qualifying for expedited processing due to severity), have an average life expectancy of no more than five years from diagnosis, and lack a known cure. (As background, DIB provides monthly cash benefits to insured workers under full retirement age who are unable to engage in substantial gainful activity due to a severe medically determinable impairment expected to last at least 12 months or result in death.) This section also limits the existing no-waiting-period exception for amyotrophic lateral sclerosis to applications filed between December 22, 2020, and one year after enactment (previously unconditional); makes conforming changes to DIB amount calculations under subsection (a)(2); and applies these amendments to applications filed on or after six months after enactment.

This section requires congressional approval for additions to the Social Security Administration's Compassionate Allowance Conditions list (i.e., severe diseases and medical conditions qualifying for expedited processing of disability insurance benefit claims under the Social Security Act). Beginning on the date of enactment, the SSA may not add any disease or medical condition to the list unless approved by an enacted bill or joint resolution.

This section establishes a prohibition on Social Security Disability Insurance (SSDI) benefits under SSA section 223 and related family benefits under SSA section 202(b)-(h)—such as for spouses and children—paid to individuals receiving unemployment compensation (UC) prior to attaining retirement age (as defined in SSA section 216(l)(1)). (Thus, for any such month, the total of an individual's SSDI benefits and those family benefits based on the individual's earnings record is reduced to zero.) It further requires federal agencies to share relevant information with the Social Security Administration (SSA), authorizes SSA agreements with states and others administering UC for such data, and subjects SSA determinations to notice and hearing requirements.

This section modifies the procedure for recovering overpayments of old-age, survivors, and disability insurance (OASDI) benefits by authorizing the Commissioner of Social Security to decrease an overpaid individual's monthly benefit by less than 100%—but not less than 10%—if a 100% decrease would defeat the purpose of Title II of the Social Security Act. (Thus, this provides flexibility to preserve at least 10% of a beneficiary's monthly payment in hardship cases.)