Expedited Reinstatement of SSDI Benefits

Overview

If a person cannot sustain SGA-level work after their SSDI is terminated, then the Expedited Reinstatement of benefits can get them back on SSDI quickly. They don’t have to file a new SSDI application.

Expedited Reinstatement of Benefits (EXR) Requirements

The Expedited Reinstatement of benefits (EXR) rules allow an individual to once again receive monthly SSDI payments without a new application if all the following are true:

• Their SSDI benefits were terminated due to earnings over the SGA level.
• They is no longer have countable earnings over the SGA monthly level (in 2023, $1,470/$2,460 if blind).
• They file an EXR request within 60 months of their SSDI termination.
• They have the same (or a related) disability.
• That disability must prevent the individual from performing SGA based on the “medical improvement” review standard used by the medical Continuing Disability Review (CDR) process. (For more about CDRs, see SSI Benefits at Work, Tool 2.)

SSDI dependent or “auxiliary” benefits may also be reinstated. The dependent/auxiliary must file a new “initial application” and satisfy all requirements for entitlement to the benefits.

Six Months of Provisional SSDI Payments

After filing an EXR application, payment of provisional SSDI benefits can begin quickly. These provisional payments are a special EXR feature. Up to 6 months of provisional payments are available. Dependent/auxiliary beneficiaries, including those receiving Childhood Disability Benefits, may also be eligible for provisional payments. SSA will not reduceprovisional payments to collect an existing overpayment unless the beneficiary agrees to this in writing.

Provisional payments can end earlier than 6 months if the Social Security Administration (SSA) notifies the beneficiary about its EXR decision or if the beneficiary has countable monthly earnings above the SGA level.

If an EXR application is later denied, provisional payments are not considered an overpayment unless the beneficiary knew or should have known they did not meet the EXR criteria.

Meeting the EXR Disability Criteria

A successful EXR application establishes two key things:

• The individual must have the same disability (or a related disability) as they had in their original claim.
• That disability must prevent the individual from performing SGA based on the “medical improvement” review standard used in medical CDRs.

When SSA reviews an EXR application, it uses the medical CDR standard to determine if there is medical improvement in the disability that the original claim was based on. By contrast, with an initial application for benefits, the applicant must meet all disability elements. Generally, the medical CDR standard is easier to meet than the standard for new applications.

The EXR 24-Month Initial Reinstatement Period (IRP)

After an EXR approval, the SSDI beneficiary begins the Initial Reinstatement Period (IRP). For each month the beneficiary has countable earnings over the SGA level, SSDI is not paid for that month and an IRP month is not used. For each month the beneficiary has countable earnings that are at or below the SGA level, they receive an SSDI payment, called an IRP payment, starting with the initial month of provisional payments. The IRP continues until 24 IRP payments have been made.

IRP could last indefinitely. Countable earnings beginning with the EXR approval month are treated the same as earnings during the EPE, with the beneficiary potentially moving in and out of SSDI payment status until 24 IRP months are used.

After the beneficiary gets 24 IRP payments (these could be in consecutive months or in non-consecutive months), they are eligible for a new Trial Work Period (TWP) and Extended Period of Eligibility (EPE). If benefits are terminated after the new EPE due to SGA-level earnings, the beneficiary will have the right to apply for another EXR.

Requesting EXR

To request EXR, call or visit your local SSA office to schedule your EXR interview. During the interview, the SSA representative should explain the option to submit a new SSDI application or request EXR. SSA must provide all the information that you need to make an informed choice.

Because you must establish that you no longer have countable earnings above the SGA level, you should be ready to submit:

• Pay statements or other proof of wages for the month of EXR application
• Proof of any basis for reducing countable earnings during the months in question, through Paid Time Off, Impairment-Related Work Expenses, and Subsidy or Special Condition. (See Tool 4.)

Although these documents can be submitted through the mail, our advice is to provide them in person.

Retroactive Payments May Be Possible

If an EXR application is approved, it is possible for a beneficiary to obtain up to 12 months of retroactive SSDI payments. This can be helpful if they would have qualified for EXR but did not apply for it when they were first eligible. The retroactive period potentially covers the 12 months that preceded the EXR application. The retroactive period can go back to the first month the individual’s countable earnings were at or below the SGA level for the year in question.