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Just Like Starting Over: Expedited Reinstatement and the Initial Reinstatement Period

It might seem that once someone has worked herself off benefits it would be quite the challenge to get them back again, but, under certain circumstances, it is easier to resume eligibility than it is for those seeking benefits for the first time. This is all thanks to the provision known as Expedited Reinstatement of Benefits (EXR).

EXR can come into play if the beneficiary’s situation meets the following criteria:

·       SSDI benefits were lost because the beneficiary was deemed to be working at Substantial Gainful Activity (SGA). An SSI beneficiary could use EXR if his work activity had caused him to be ineligible for SSI and the 1619b Medicaid coverage.

·       The applicant must now not be able to work at SGA levels and is unable to do so because of the same, or a related, disability as the one that had caused her to receive benefits in the first place.

·       The application is made within 60 months of the termination of the original benefits. Social Security will allow applications to be made after that period but only if there are some good reasons as to why the request is so late in coming.

Once the application is made Social Security will complete a medical review to re-determine if the applicant still meets the disability criteria but, realizing that this takes a long time, SSA does allow up to 6 months of provisional benefits which will either carry on if it’s determined that the applicant is still disabled, or will stop if they aren’t. It may be of some consolation to those who are denied that they don’t have to pay back any of the provisional payments.

As EXR begins so does a brand new work phase, which is known as the Initial Reinstatement Period (IRP). For an SSDI recipient this functions much as it does for those in the Extended Period of Eligibility (EPE). For any months when a beneficiary works over SGA she is not eligible for a check; for all those months when her work activity is below SGA she does receive a check. This will carry on until such time as she has 24 months of work activity below SGA. Once she hits that milestone the clock essentially re-sets and she embarks on a new Trial Work Period and the work incentive cycle begins anew. For an SSI beneficiary he has to be eligible for SSI and 1619b for 24 months before he can exceed those income limits. If he exceeds the limits before 24 months are over he would lose his SSI eligibility and would have to re-apply for SSI as though it were an initial application. If the 24 months of the IRP are completed and then he exceeds the 1619b limits he could re-apply for EXR.

To apply for EXR you should contact your local Social Security field office. For any questions you can also call the SSA general number at 1-800-772-1213.