Extended Period of Eligibility

To encourage disabled individuals to attempt to work, Congress enacted section 303 of the 1980 amendments that provided a re-entitlement period under title II to an individual who completes 9 months of trial work and continues to have a disabling impairment. This provision, referred to as the extended period of eligibility (EPE), provides that an individual can be re-entitled to benefits any time during the re-entitlement period that his or her work activity falls below the SGA level. The EPE re-entitlement period begins with the month immediately following completion of the trial work period and ends 36 months later (or 15 months later if the beneficiary is not entitled to benefits after 12/1987). However, if the beneficiary is not engaging in SGA when the re-entitlement period ends, the EPE provision allows benefits to continue until SGA is performed (or medical cessation is determined). When an SGA disability cessation determination is made within the EPE, the termination month is the first month of substantial gainful activity (SGA) after the 36-month re-entitlement period ends. When a disability cessation has not already been determined, the termination month is the third month after the first month of SGA after the 36-month period. If an individual’s payments stop because disability has ceased due to work activity and, subsequently, but within the EPE re-entitlement period, his/her earnings fall below SGA, benefits may be reinstated if all other entitlement factors are met. A new application, and disability determination, is not required to reinstate payments in these cases. The extended period of eligibility does not change the definition of disability. A beneficiary is eligible for payments as long as he/ she continues to meet the definition of disability. The EPE does not limit the payment of disability benefits after disability ceases; e.g., an individual whose disability ceases is eligible for title II payments for the month of cessation and 2 additional months. The main effect of the EPE provision is that it permits benefit reinstatement during the re-entitlement period when a beneficiary’s benefits have stopped because of SGA and the beneficiary’s earnings subsequently fall below SGA levels (see DI 13010.215 B).

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