Expedited Reinstatement of Benefits

Getting Your Disability Benefits Back Without Reapplying: Expedited Reinstatement of Benefits

If you lost your disability benefits after trying to go back to work, Social Security will replace your benefits if you again find yourself unable to work. If your Social Security SSDI or SSI disability benefits were terminated because you started to work and earned too much money, you may be eligible for “expedited reinstatement” if you stop making too much money. Expedited reinstatement (EXR) allows you to get your benefits restarted without having to reapply for benefits. If you qualify for EXR, you can get your benefits back much sooner than if you had to reapply.

Here is a brief description of the EXR process and how it works:
Expedited Reinstatement of benefits affords eligible individuals a quick way to re-establish entitlement for SSA benefits after the agency terminated those benefits due to earned income and work activity.

 The former beneficiary must:

• Have the same or a related disability as the earlier entitlement.
• And again, be unable to perform Substantial Gainful Activity (SGA) earnings.

EXR permits individuals to receive provisional payments while Social Security is processing the reinstatement request.

EXR Basics:

• EXR is available to former Social Security beneficiaries including those who received.
  • SSDI
  • CBD
  • DWB
  • SSI – based on disability or blindness.
• Social Security must have terminated the individual’s prior entitlement due to work activity, NOT medical recovery or any other reason. For Title II (SSDI) beneficiaries, this means SSA determined the individual to have engaged in Substantial Gainful Activity (SGA). For SSI it means that countable income was sufficient to cause the loss of cash benefits as well as 1619(b) extended Medicaid coverage.
• The individual must be unable to perform SGA due to the same disability (or related disability) that entitled them to payments previously.
• Again, The EXR provision allows an individual to receive up to six months of provisional cash benefits while Social Security conducts a medical review to determine whether the agency can reinstate the individuals benefits. They also may be eligible for Medicare or Medicaid coverage during the provisional period.
• SSA will pay provisional benefits and reinstate Medicare, beginning with the month they file the request for reinstatement if they do not perform SGA in that month.
• There is an important deadline for EXR. To receive EXR benefits under any of the Social Security disability programs, they must request the benefits within 60 months of when SSA terminated the prior benefit, unless SSA can substantiate good cause (If the person’s disability cause the reduction or cessation of work more than five years after SSA terminates the record. EXR will not be available, and the beneficiary must file a new application for benefits.
• EXR applies when the beneficiary has used all of their Trial Work Period (TWP), engaged in SGA and used the Grace Period, completed the 3-year Extended Period of Eligibility (EPE), and have a terminated Social Security record. Beneficiaries in EPE do not need to request EXR since they remain in eligibility status in EPE even if their cash benefit stop due to earnings.

Waiting for a Decision on Expedited Reinstatement
When you apply for expedited reinstatement of your benefits, your application has to go to Disability Determination Services (DDS), which can take a while. Fortunately, Social Security will pay you benefits for up to six months while you are waiting for an answer on your EXR. Even if your application for expedited reinstatement is denied, you get to keep the benefits Social Security paid you while your application was pending. In addition, while you wait for a decision, you’ll be covered by Medicare (for SSDI recipients) or Medicaid (for SSI recipients). If your request is denied, your Medicare or Medicaid will stop.

Appealing an Expedited Reinstatement Denial
If your request for expedited reinstatement is denied, you have 60 days from the date you receive your denial letter to file a Request for Reconsideration. DDS will reconsider your application to see if it made a mistake.

If your Request for Reconsideration is denied, you have sixty days to request for a hearing in front of an administrative law judge (ALJ). This appeal process is very similar to the appeal process for initial disability applications.

Mission Possible has a disability representative ready to assist you with appeals of denied disability claims. Call us with questions or for more information Patty 866-686-7556 or Tina 888-359-2366.

~Tina
tina@mpes.net

Resource – for more information about Expedited Reinstatement, refer to DI 28057.000 – Expedited Reinstatement Sub Chapter Table of Contents (https://secure.ssa.gov/apps10/poms.nsf/lnx/0428057000).