The Social Security Administration (SSA) does not pay provisional benefits on an EXR
request if the claimant previously requested EXR for the same period of eligibility
and received provisional benefits based on that request, regardless of how many months
he or she received provisional payments on the previous request. However, we can pay
provisional payments on a subsequent EXR request if the claimant:
was approved for EXR on a previous request;
completed the initial reinstatement period (IRP);
completed a trial work period (TWP);
completed his or her extended period of eligibility (EPE);
had his or her benefits later terminated due to substantial gainful activity (SGA),
filed a new request for EXR within 60 months of that termination, or we can find good
cause for late filing.
Subsequent request example #1:
Ms. Jones requests EXR on March 4, 2008 and we approve the request on May 4, 2008.
She receives 3 months of provisional benefits before she is re-entitled to disability
benefits. She completes her IRP, TWP and EPE. After completing the EPE, Ms. Jones’s
benefits terminate due to SGA in January 2015. On April 12, 2015, Ms. Jones again
files for EXR because she is no longer performing SGA. As Ms. Jones completed the
IRP, TWP, and EPE on the new entitlement period, had her benefits terminated for SGA,
and then filed a new EXR request within 60 months of that termination, she is eligible
to request a subsequent EXR and receive provisional benefits.
Subsequent request example #2:
Mr. Smith requests EXR on March 4, 2008 and we medically deny the request on May 4,
2008. He received 3 months of provisional benefits. Mr. Smith refiles for EXR on May
2010. Because we paid at least one month of provisional benefits on the prior request,
we cannot pay provisional benefits on the subsequent request.