TN 20 (09-90)

DI 28055.005 How the EPE Works

A. Policy

1. When It Begins

The EPE begins the month immediately following the 9th TWP month (but no earlier than December 1980). If the TWP was completed before November 1980 and cessation was not appropriate, the EPE begins December 1980.

NOTE: A person need not be working in the first month after the TWP for the EPE to begin.

2. When Benefits Can Be Reinstated

Benefits can be reinstated through the earlier of:

  1. the month before the first month in which the impairment is not disabling, or

  2. the last day of the 36th (or 15th) month following the TWP.

3. When It Ends

The EPE ends the earlier of:

  1. the second month after the month in which the impairment is no longer disabling, or

  2. the later of:

    • the month before the first month of SGA earnings after the 36th month (or 15th month) following the TWP, or

    • the second month after the month disability ceased due to SGA.

NOTE: If an individual with a disabling impairment never engages in SGA and all other entitlement factors are met, payment of benefits will continue indefinitely. Nondisability events such as death and HA/DWB attainment of full retirement age will end the EPE.

4. The BTM

The BTM is first month no cash benefits are payable after the EPE. It is the earlier of:

  1. the third month after the month in which the impairment is no longer disabling, or

  2. the later of:

    • the first month of SGA earnings after the 36-month (or 15-month) following the TWP, or

    • the third month after the month disability ceased due to SGA.

NOTE: Absent medical improvement, a person whose benefits ceased due to SGA can be reinstated in the 37th (or 16th) month if earnings drop below SGA in that month since benefits could only terminate with the first month of SGA that occurs after the 36th (or 15th) month.

B. Examples

SETTING: A disabled wage-earner completes a 9-month TWP in 12/88. The EPE begins 1/89.

1. Example 1

Disability ceases 1/89 due to SGA and SGA continues. Payments are placed in suspense 4/89. The DDS finds that the person does not have a disabling impairment as of 10/89. The reinstatement period ends 9/89, i.e, the month before the first month the impairment is not disabling. The EPE ends 12/89, i.e., the second month after the month the person's impairment is not disabling. The BTM is 1/90, i.e., the third month after the month the person's impairment is not disabling.

2. Example 2

Disability ceases 1/89 due to SGA. Payments are placed in suspense 4/89. The DDS finds impairment severity continues. The worker continues to do SGA in all months. The reinstatement period ends 12/91, i.e., the last day of the 36th month after the TWP. The EPE also ends 12/91, i.e., the month before the first month of SGA after the 36th month. The BTM is 1/92, i.e., the first month of SGA after the 36th month.

3. Example 3

Disability ceases 1/89 due to SGA. Payments are placed in suspense 4/89. The DDS finds impairment severity continues. The worker performs SGA thru 5/ 91. Payments are reinstated 6/91. The worker returns to SGA in 6/94. The reinstatement period ends 12/91, i.e, the last day of the 36th month after the TWP. The EPE and payments end 5/94,i.e., the month before the first month of SGA after the 36th month. The BTM is 6/94, i.e., the first month of SGA after the 36th month.

4. Example 4

The DDS finds that disability continues after the TWP is completed and the work is not SGA; therefore, payments continue uninterrupted. The worker does not perform SGA until 6/93. The reinstatement period ends 12/91, i.e, the last day of the 36th month after the TWP. The EPE and payments end 8/93, i.e., the second month after the month disability ceased due to SGA. The BTM is 9/93, i.e., the third month after the month disability ceased due to SGA.


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http://policy.ssa.gov/poms.nsf/lnx/0428055005
DI 28055.005 -