Effective Dates: 01/10/2023 - Present
Retention Date: 07/10/2023
|Intended Audience:||All RCs/ARCs/ADs/FOs/PSCs/OCO/OCO-CSTs|
|Originating Office:||DCO OPSOS|
|Title:||Updates to Expedited Reinstatement (EXR) Processing Instructions|
|Type:||EM - Emergency Messages|
|Link To Reference:||See References at the end of this EM.|
This emergency message provides technicians with updated instructions for processing Expedited Reinstatements (EXRs).
EM-20010 SEN REV 8 and EM-22021 REV provided instructions on processing EXRs and other workloads during the COVID-19 pandemic and the agency’s “Reentry Period”. The EXR instructions allowed technicians to make critical payments beyond the 6-month provisional benefits period and provided an alternative signature method for several forms required in the EXR process. This EM replaces prior EXR instructions, eliminates instructions to establish new critical payment system (CPS) payments beyond the provisional period, and allows continued use of alternative signature methods on specified forms while the agency works on updating systems to allow for a long-term solution.
C. Provisional benefits
Begin provisional benefits via the Post Entitlement Online System (POS). Do not use CPS to initiate provisional payments. Do not issue critical payments after provisional benefits have terminated unless all statements below are true:
EXR cases should be expedited through all steps of the adjudication process, including the creation and effectuation of the EF101. Make every effort to effectuate payment prior to the expiration of provisional benefits.
Note: Do not terminate existing CPS payments that were issued based on prior instructions unless the EXR has been denied per DI 13050.065. If the FO becomes aware that the CPS payment was erroneously terminated prior to the DDS decision, and prior instructions would allow CPS payments to continue beyond 6- months, the FO may reinstate the CPS in dire need situations. When Payment Center (PC) technicians become aware of CPS payments that have been active longer than 6 months, they should
- The Disability Determination Services (DDS) has made a medical allowance on the claim, and
- The EF101 has been completed and transferred to the PC, and
- The Master Beneficiary Record (MBR) has not yet been updated after the tickle expires per DI 13050.060C3, and
- The claimant alleges dire need (DI 13050.100)
For inquiries on Medicare and the Provisional Period, see HI 00801.164 and HI 00801.165.
D. EXR Forms and Processing
Under this EM, technicians remain able to complete all items in the EXR Request Package electronically. No pen-and-ink signatures/paper forms are required
- Check the Disability Determination Services Query (DDSQ) to see if the EXR is pending in the DDS
- If not pending at the DDS, send an email to the Field Office of jurisdiction alerting them to the aged EXR.
- PC technicians should extend the diary date out 60 days
· Complete all necessary forms in DI 13050.045B.2. and DI 13050.050B.1.
· Complete forms SSA-454-BK, and SSA-3367 electronically.
· Complete the SSA-827 via EDCS.
· Complete the SSA-8240 via the Wage and Employment Information Authorization (WEIA) application.
· Access the remaining forms within EDCS (if available) or InForms, and document the alternative signature method, where applicable, per section E. below
· Establish an EXR claim in the Disability Control File (DCF) using the following steps (DI 13050.045B.3):
Ø On the MCDR screen, select 8 = Establish Disability Review
Ø On the ECDR screen, select 2 = EXR
Ø Complete the DRES screen to establish the EXR event.
NOTE: The electronic versions of the paper forms SSA-16-Application for Disability Benefits, SSA-10-BK-Application for Widow(er)’s Insurance Benefits, SSA-4-BK-Application for Child’s Insurance Benefits and the SSA-8000-BK-Application for Supplemental Security Income serve as supplements to the EXR request. Since they are not serving as an application for benefits, they do not require a signature.
- Create an issue of EXRPKG on the DCF Development Worksheet (CDRW).
- Receipt with the date of the interview and put your name and office code on the Remarks section of the CDRW.
E. EXR Alternative Signature Method
· Use initial claims attestation scripts prior to and after filling out forms with the beneficiary.
F. Transferring the EXR to DDS
· In the “Witness Address” field of the SSA-371, the EXR 795, and the SSA-820-BK/821-BK, type in
“Completed by” and list your name, your office code and the date (e.g., Completed by John Doe DO123, 3/31/2020”).
· You may use the click and sign feature in Uniforms to complete form SSA-823.
· Store all the forms in eView (or Evidence Portal if eView is unavailable per DI 13050.045)
· You may attest form SSA-827 per DI 11005.056D.2.
· You may attest form SSA-8240 per GN 00204.150.
Per DI 13050.045B.9 and DI 13050.050.B.10
NOTE: EXR awards and denials are high priority actions. Expedite EXR cases through all levels of the adjudication process, including the creation and effectuation of the EF101.
Direct all program-related and technical questions to your Regional Office (RO) support staff using vHelp or Program Service Center (PSC) Operations Analysis (OA) staff. RO support staff or PSC OA staff may refer questions, concerns or problems to their Central Office contacts.
Transfer the case to the DDS via EDCS
Transfer the DCF EXR event to the servicing DDS per DI 13010.620.
Establish an issue (for example EXRDDS) on the DCF development worksheet (CDRW) to control for the DDS determination. For more information about the CDRW, see DI 13010.605
DI 10505.005 Determining and Verifying Gross Earnings from Employment
DI 13050.001 Expedited Reinstatement (EXR) Overview
DI 13050.025 Provisional Benefits for Title II Claimant
DI 13050.030 Provisional Payments - Title XVI
DI 13050.045 Expedited Reinstatement (EXR) Title II Interview
DI 13050.050 Expedited Reinstatement (EXR) Title XVI Interview
DI 13050.060 Field Office (FO) Procedures for Title II Expedited Reinstatement (EXR) Awards
DI 13050.065 Title II and Title XVI Expedited Reinstatement (EXR) Medical and Technical Denials
EM-23000 - Updates to Expedited Reinstatement (EXR) Processing Instructions - 01/10/2023