What Is The Five-Year Rule For Social Security Disability?

Personal Finance

Getting approved for Social Security disability can be tough. On average, only 30% of claims are awarded in this program. To encourage people to return to work after going through this arduous claims process, Social Security offers several incentives and policies.

One of these is the five-year rule, also known as the expedited reinstatement process. However, this rule does not apply to Supplemental Security Income, or SSI, recipients. SSI is a needs-based program for people with modest income.

The five-year rule also does not apply to what many people think of as “regular” Social Security benefits. “Regular” retirement and spousal and ex-spousal benefits, which generally are payable starting at age 62, are benefits that have been earned by work and by building up sufficient Social Security credits.

What Is the Five Year Rule for Social Security Disability?

The Social Security five-year rule is rarely applied and relates specifically to Social Security disability benefits. Commonly referred to as an expedited reinstatement, or EXR, this provision helps you get back on benefits faster after they are completely terminated.

In 2022, 11,367 people received provisional benefits under expedited reinstatement, and 8,709 people had their benefits reinstated, according to SSA’s statistics. You can apply for an EXR as long as you start the process within five years from the month your benefits were terminated.

While expedited is in the name, it’s a bit of a misnomer. EXRs can process faster than initial applications, but they don’t always occur at the speed people are hoping for. While you’re waiting for a decision on your EXR, you can request to receive provisional payments for up to six months.

If you work and earn over the Substantial Gainful Activity amount while waiting, you’ll have to pay back your provisional payments. In 2024, the monthly SGA amount is $1,550 for non-blind individuals and $2,590 for blind individuals.

However, you don’t need to worry about filing for an EXR or having your disability payments cut off if you go back to work. An EXR is the final step in the process after several years of working successfully, and it is part of Social Security’s work incentives program.

If you’re currently receiving Social Security disability benefits and thinking about going back to work, contact your local Social Security office and ask to be connected with your Area Work Incentives Coordinator. This person can help connect you with local programs and explain all of your options around trying to work while receiving disability payments.

How Work Impacts Social Security Disability Payments

Before you end up needing to file an EXR, you have to go through multiple tiers of work incentives that the Social Security Administration offers.

You start with a trial work period, or TWP, then move on to your extended period of eligibility, or EPE. Finally, you move into the five-year period after benefits terminate when you’re still able to file an EXR. You could potentially go back to work for decades and never even get through your trial work period.

Here’s how all of this works:

Trial Work Period

The trial work period sounds confusing, but it doesn’t have to be. You have nine total months to try out work without your benefit checks being impacted at all. These months do not have to be consecutive, and once your nine months are up, you move into your EPE. Even better, work only counts as a TWP month if you earn over a certain amount.

In 2024, a month only counts as a trial work period month if you earn $1,110 gross or more. This means that you could earn up to $1,099 per month before taxes for a decade and still have all nine of your trial work period months left to use at the end of it. However, if you started working on January 1, 2024 and earn $1,110 or more per month, you’ll use up your last trial work period month in September and move into your EPE in October.

Extended Period of Eligibility

After you use up all nine of your trial work period months, you go into your extended period of eligibility. Your EPE goes on for three years, and it is a bit different than your TWP. During your EPE if you earn over the amount SSA considers substantial gainful activity, or SGA, you won’t be due for a check in that month. If you earn under the amount for SGA, then you’re still due for a check.

At the end of this three year period, if you earn under the SGA limit, your benefits will continue. But once you earn over the amount for SGA in a single month, you stop being eligible for benefits. If you earn over the limit and your benefits stop at the end of your EPE, you have a five-year period where you can get benefits reinstated through the EXR process, as long as you’re earning under SGA.

How To Apply for an EXR

Before applying for an EXR, it’s a good idea to contact your local Social Security office or log in to your My Social Security account at ssa.gov. You’ll need to verify that the last month you were eligible for benefits is within the last five years. If it’s been more than five years, you’ll need to start a new disability application, which you should complete online.

Currenly, EXR applications cannot be filed online. They’re also one of the only types of applications that require a paper folder to be shipped around the country from office to office as your claim is being processed. Obviously, paper folders can get misplaced in transit or in offices. It’s highly recommended to keep copies of everything you send in.

You’ll need to print out, complete and mail the following forms together to your local Social Security office to apply for an Expedited Reinstatement.

  • SSA 16 Application for Disability Insurance Benefits. This is the primary application that people must file to receive disability benefits from the Social Security Administration.
  • SSA 3368 Disability Report.You’ll need to complete this description of health conditions that affect your ability to work and list any medical providers you’ve seen since your last medical review was completed by SSA.
  • SSA 821 Work Activity Report—Employee. If you worked for an employer that issued you a W-2, you must file an SSA 821.
  • SSA 820 Work Activity Report—Self-Employed. If you were self-employed or a gig worker receiving a 1099, then you must file an SSA 820 instead of an SSA 821. If you were both self-employed and worked for an employer, you’ll need to submit both SSA 821 and SSA 820. You’ll also need to submit paystubs for the period since your last work review was completed by SSA.
  • SSA 795 Statement of Claimant. This is a blank form. You’ll need to fill out your personal information. Also, in the large blank section on the first page, you must include a statement saying either that you want Medicare during your provisional payment period or that you do not want Medicare during your provisional payment period.
  • SSA 827 Authorization To Disclose Information to the Social Security Administration, Medical Release Form. Remember, this form needs a witness to your signature.
  • SSA 371 Request for Reinstatement. This is the form to request that your Social Security benefits be reinstated.

Several of these forms tell you to send in copies of any medical records you already have in your possession. However, all of your medical records will be requested directly from your providers. You’ll only need to collect medical records if SSA can’t obtain them, and this is rare with modern medical record keeping. Anything you submit yourself will be considered of lower probative value, and duplicates will simply clog your file.

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The views and opinions expressed herein are the views and opinions of the author and do not necessarily reflect those of Nasdaq, Inc.

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