OMB control number
Request for Reinstatement (Title II)
OMB 0960-0742 · SSA.
OMB 0960-0742
SSA allows certain previously entitled disability beneficiaries to request expedited reinstatement (EXR) of benefits under Title II of the Social Security Act when their medical condition no longer permits them to perform substantial gainful activity. SSA uses Form SSA-371 to obtain: (1) A signed statement from individuals requesting an EXR of their Title II disability benefits, and (2) proof the requestors meet the EXR requirements. SSA maintains the form in the disability folder of the applicant to demonstrate the requestors’ awareness of the EXR requirements, and their choice to request EXR. Respondents are applicants for EXR of Title II disability benefits.
The latest form for Request for Reinstatement (Title II) expires 2027-05-31 and is listed under ICR 202112-0960-004.
Latest Forms, Documents, and Supporting Material
| Document | Type |
|---|---|
 Form SSA-371 Request for Reinstatement (Title II) | Form |
 Supporting Statement - 0742 (Final).docx | Supporting Statement A |
| Addendum 0742 (final).docx | Supplementary Document |
 Request for Reinstatement (Title II) |
Form |
All Historical Document Collections
| Reference | Filing | Received | Concluded | Action |
|---|---|---|---|---|
| 202112-0960-004 | Revision of a currently approved collection | 2022-01-12 | Approved with change | |
| 201807-0960-005 | Revision of a currently approved collection | 2018-11-14 | Approved without change | |
| 201507-0960-013 | Revision of a currently approved collection | 2015-10-28 | Approved without change | |
| 201208-0960-002 | Revision of a currently approved collection | 2013-01-15 | Approved without change | |
| 200909-0960-007 | Revision of a currently approved collection | 2009-12-09 | Approved without change | |
| 200609-0960-028 | Existing collection in use without an OMB Control Number | 2007-02-20 | Approved with change |