DI 13050: Expedited Reinstatements
TN 2 (02-06)
A. Background
SSA may use the date a claimant (or proper applicant) first contacts SSA (either an oral or written contact) as the filing date of the request for expedited reinstatement (EXR). When an individual expresses intent to file a request for EXR, attempt to obtain a signed reinstatement request from him/her as quickly as possible. If it is not possible to obtain a signed request at the time the intent to file is expressed or implied, the protective filing date must be documented to ensure that the claimant's EXR filing date is protected. The 800 Number System should be used to document the protective filing date.
The protective filing policies applicable to initial claims in GN 00204.010 to GN 00204.015 and SI 00601.010 to SI 00601.040 are generally applicable to EXR requests. However all EXR protective filings are closed out with a 60-day notice (versus the normal 6-month notice for Title II initial claims).
B. Policy - Protective Filing
An oral inquiry or written statement that indicates an individual's intent to file for EXR may be used to establish an earlier filing date for the reinstatement request for Title II disability benefits (including Medicare Part B) and Title XVI disability benefits. The elements for a protective writing (see GN 00204.010) apply to an EXR request. The documents listed in GN 00204.010D. that can serve as a protective filing for an initial claim can also serve as a protective filing for an EXR request. In addition, an EXR request for one title can be used as a protective filing for the other title in the same manner as in initial claims (see GN 00204.010 and SI 00601.010 to SI 00601.035).
Protective filing does not apply to the start month for provisional payments. See DI 13050.025C. (Title II) and DI 13050.030E.1. (Title XVI) for determining when provisional payments begin.
C. Policy- Scope of Entitlement
1. General
A protective filing established for the wage earner also protects the filing date of Title II auxiliaries who are listed in the wage earner's request for reinstatement. For Title XVI cases, the date an individual contacts SSA also protects the filing date for an eligible spouse. See SI 00601.020A.2. for Title XVI policy on the scope of a written statement and SI 00601.025D. for Title XVI policy on the scope of an oral inquiry. See GN 00204.010C. for general policy regarding the scope of entitlement based upon a protective writing.
2. Special Considerations
a. Title II Request for Reinstatement
A Title II EXR request serves as an oral inquiry for SSI, or an oral inquiry for EXR on SSI, when the estimated amount of Title II benefits does not preclude Title XVI payments (see SI 00601.027).
b. Title XVI Request for Reinstatement
A Title XVI EXR request serves as an application for Title II benefits, or as a Title II request for EXR, in the same manner as it would for a Title XVI claim (See SI 00601.010D.).
c. Title XVI Redetermination
A Title XVI redetermination serves as a protective writing for Title II EXR in the same manner as it would a Title II initial claim. See GN 00204.015 and SI 00601.025B.
d. EXR Protective Filing for New Claim
An EXR protective filing date also protects the filing date of a new application if the individual decides not to pursue filing for expedited reinstatement or if the EXR request is denied.
D. Procedure - Expedited Reinstatement Contact
If a protective writing is received, see DI 13050.015A.; retain the writing in the EXR file to document the protective filing date.
When an individual inquires about EXR and wishes to file an EXR request, document the contact through the 800 Number System per MSOM APPTS 001.002.
NOTE: If it appears that the individual is not eligible for reinstatement through EXR because the prior termination date is more than 60 months before the contact month, document the contact anyway because good cause for late filing may need to be developed (see DI 13050.010A.2. for instructions on good cause). If the individual does not request EXR or requests EXR and is denied, the contact can then provide protective filing for a new initial claim, if the individual decides to file a new claim.
E. Procedure – Closeout Notices
Use the applicable EXR Cover Notice to transmit the reinstatement request and related forms to the claimant for signature and to request any needed information/evidence to process the reinstatement request. Close out the protective writings for EXR and a new initial claim using the EXR Cover and Close-Out Notices provided in DPS. The Cover and Close-Out notice should be given to all individuals who file for EXR.
In order for the protective filing date to be used as the filing date of the request, the individual must file the EXR request within 60 days of when the individual received the notice (it is assumed that the individual received the notice within 5 days of the notice date). The EXR cover and closeout notices inform the individual of this deadline. The notices also inform the individual about the normal closeout periods, during which the individual can file an initial claim and have the protective filing date used for the new claim.
Place a copy of the cover and closeout notice in the claims file as documentation of both the information requested and the protective filing closeout date.