TN 2 (02-06)

A. Policy - Favorable Medical Decision

The DDS makes a determination regarding eligibility and prepares an SSA-832 to document the determination on a title XVI request for EXR. The DDS faxes (or uses another locally agreed upon procedure to expedite the decision) the SSA-832 allowance to the FO (see DI 11010.340).

B. Procedure - Field Office Actions - Title XVI

1. Determine an EXR approval by reviewing the SSA-832:

   • Item 9 has block A indicated;

   • Item 10 shows “other”;

   • Item 20 shows WRM code 31 (for EXR); and

   • Remarks show “Expedited Reinstatement MOE MM/DD/YY”.

2. Stop the provisional payments and terminate the current record. Follow the instructions in SM 01701.080D.

3. Start-date the EXR record per SM 01701.080D.

4. Send an expedited reinstatement award notice.

5. Clear the EXR event in the DCF as a continuance per DI 13010.620.

6. After all actions are complete, return the title XVI folder to the National Records Center (SSANRC), 6016 East GeoSpace Dr., 601 South 291 HWY, Independence, MO 64056.

C. Policy – Payment of Representative’s Fee

GN 03910.010 asserts a beneficiary’s right to representation, including expedited reinstatement. Individuals have the right to representation while applying for EXR and any related appeals. A representative who wants to charge or collect a fee for services provided in these administrative proceedings must first obtain SSA’s authorization, except when the conditions described in GN 03920.010 are present.

If SSA makes a favorable medical determination on the EXR request, and the claimant’s title XVI benefits are reinstated, and the claimant’s representative requests a fee for the administrative services he/she provided the claimant, SSA does not include these provisional payments in authorizing a fee under the fee agreement process. In addition, SSA does not use these provisional payments to calculate the amount of the title XVI past-due benefits to withhold for direct payment of a representative’s fee under the fee agreement or fee petition process, or to pay a fee authorized by a court. Refer to GN 03920.017, Payment of Representative’s Fee, and GN 03920.031, Representative’s Fee – Title XVI Past-Due Benefits.