A previously entitled beneficiary may become eligible for EXR if their medical condition no longer permits them to perform substantial gainful activity (SGA) within 60 months of their prior termination. If an individual does not request EXR within the consecutive 60-month period beginning with the month that entitlement or eligibility terminated, the individual can ask for an extension of time to request reinstatement if there is good cause for not filing the request timely. An individual's request for an extension of time must be in writing and must give the reason(s) why the EXR request was not made within the stated time period. If the reason(s) shows that the individual has good cause for missing the deadline, then an extension of time for requesting EXR can be given. Note: Granting good cause for late filing has no effect on the 12-month maximum retroactivity for reinstatement. In the example below, the earliest possible EXR month of entitlement would be July 2021, even though SGA ended in 2020. For more information on examples of good cause requests see, GN 03101.020 and SI 04005.015.

EXAMPLE: In July 2022, the field office (FO) makes a work CDR determination which terminates an individual’s entitlement back to 2016 (date of benefit cessation (DBC) of 04/16). The individual has not engaged in SGA since 2020. The individual files for EXR in July 2022. As the individual was not notified that their benefits were terminated until July 2022, the FO establishes good cause for the late filing and processes the EXR request with a filing date of July 2022.

Take the following actions to document and evaluate for good cause:

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  Obtain the individual's reason for making the request after the 60-month period and upload in eView or the Evidence Portal (EP) (e.g. written statement, letter, facsimile, submission of additional evidence, SSA-795, Statement of Claimant or Other Person). Note: The SSA-795 is a free-form, completely dictated statement, using the claimant or other person’s own words as closely as possible.

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  Determine whether good cause exists using the standards described in GN 03101.020 and SI 04005.015 and document the decision on an SSA-553-Special Determination, or SSA-5002-Report of Contact, and upload in eView or the Evidence Portal (EP).

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  Process the decision.

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    If good cause for late filing cannot be established, inform the individual that they are ineligible for EXR and discuss filing a new application for benefits. If the individual wishes to file a request for EXR, accept the request, and issue an EXR technical denial notice, per DI 13050.065.

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    If good cause exists, process the request for EXR.