The disability determination services (DDS) make one of the following determinations on a request for EXR:

1. 1. 

   Unfavorable determination for not "same as or related"; or

2. 2. 

   Unfavorable determination due to medical improvement (MIRS); or

3. 3. 

   Unfavorable determination due to failure to cooperate; or

4. 4. 

   Favorable determination under MIRS.

   NOTE: For paper cases, DDS sends the folder to the field office (FO) upon determination.

If the impairment is not the same as or related to that of the individual's most recent disability entitlement the individual is not eligible for EXR. Deny the request for EXR by taking the following actions:

1. 1. 

   Document that the alleged impairment is not the same as or related to the comparison point decision (CPD) impairment.

2. 2. 

   Complete an SSA-832-C3/U3 or an SSA-833-C3/U3 per DI 28057.020F.

3. 3. 

   Prepare and send the denial notice. Include a personalized explanation with the rationale for the finding.

4. 4. 

   Close out the EXR in Disability Case Processing System (DCPS). The National Disability Determination Services System will show a System Override code of "N."

5. 5. 

   Scan all documentation in the electronic folder.

   NOTE: The "not the same as or related" decision is made after the evidence is obtained.

If the individual has experienced medical improvement related to the ability to work and the individual is capable of engaging in substantial gainful activity (SGA), determine the individual is not eligible for EXR. Take the following actions:

1. 1. 

   Complete an SSA-832-C3/U3 or an SSA-833-C3/U3 per DI 28057.020F.

2. 2. 

   Prepare and send the denial notice. Include the personalized explanation with the rationale for the finding.

3. 3. 

   Close out the EXR in DCPS. NDDSS will show a System Override code of "N".

4. 4. 

   Alert the FO using an electronic folder (EF) message in eView when a beneficiary is concurrently entitled. The FO must initiate a medical CDR on the other title. For paper cases, put all remarks on the routing slip.

5. 5. 

   Scan all documentation in the electronic folder.

If no medical improvement related to the ability to work has occurred, find the individual eligible for EXR. Take the following actions:

1. 1. 

   Determine the appropriate month of entitlement (refer to DI 28057.015E).

2. 2. 

   Complete an SSA-832-C3/U3 or an SSA-833-C3/U3 per DI 28057.020F; and

3. 3. 

   Close out the EXR in DCPS. NDDSS will show a System Override code of "N".

4. 4. 

   Scan all documentation in the electronic folder.

   NOTE: The program center (PC) issues the award notice.

If the individual does not cooperate, follow the Failure to Cooperate procedures in DI 28075.005 and take the following actions:

1. Complete the SSA-832-C3/U3 or an SSA-833-C3/U3, per DI 28057.020F; and

2. Prepare and send the denial notice. Include the personalized explanation with the rationale for the finding.

3. Close out the EXR in DCPS. NDDSS will show a System Override code of "N".

4. Scan all documentation in the electronic folder.

Document the EXR determination on forms SSA 832-C3/U3 or SSA-833-C3/U3 with DI 28084.000 except as follows for EXR determinations:

1. 1. 

   Item 5: Enter the established onset date from the most recent period of entitlement ( SSA-831).

2. 2. 

   Item 9:

   • •

     If the individual is under a disability, check block A.

   • •

     If the individual is not under a disability or the impairment is not the “same as or related”, check both blocks B and C. The date for both is the date of the EXR request.

3. 3. 

   Item 10: Check block D, “Other”

4. 4. 

   Item 11:

   • •

     Title II Cases: For a determination that the current impairment is not the “same as or related to” the CPD impairment, show code 28.

   • •

     Title XVI Cases: For a determination that the current impairment is not the “same as or related to” the CPD impairment, show code 61.

   • •

     For a determination that the individual is not under a disability based on MIRS, use the codes for a CDR MIRS cessation, see DI 28084.015.

5. 5. 

   Item 20: Enter WRM code of 31 (defined as “Expedited Reinstatement”).

6. 6. 

   Item 24: Enter remark, “Expedited Reinstatement”. For cases where the individual is found to be under a disability, also enter “MOE MMYY”. This date is the new EXR month of entitlement date for Title II cases or the new month of eligibility for reinstatement in Title XVI cases. This is based upon the individual's disability and the work determination on the SSA-823.

   • •

     Review the remarks section of the SSA-454 for the month of the EXR request; and

   • •

     Review the SSA-823 for the SGA determination and identification of the earliest possible month of non-SGA in the 12-month retroactive period. See DI 28057.015E. for determining the Title II month of entitlement, and DI 28057.015F. for determining the Title XVI month of entitlement.

7. 7. 

   Item 29: Leave blank.

Most EXR cases are electronic, however, for any paper cases, follow these procedures to clear the case:

1. 1. 

   If the determination is to deny the EXR request, add a remarks to route the slip, "Terminate provisional payments"; If the determination is favorable, fax the EXR determination (SSA-832/833) to the FO, so the FO can initiate necessary non-medical development, see DI 11010.340.

2. 2. 

   Forward the folder to the FO under cover of a route slip and note any appropriate action.