What Is The Five-Year Rule For Social Security Disability? (2024)

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Being approved for Social Security disability benefits can be a lengthy process. If you’ve been through the ordeal once, you may have heard there’s a “five-year rule” that can streamline things if you ever need to seek a new round of disability payments after you’ve gone back to work.

The Social Security Administration doesn’t really have any formal five-year rule, though it does have something called the expedited reinstatement process, or EXR. It’s part of the agency’s incentive program to encourage disability recipients to return to work; EXR allows them to do that and not worry that they can never collect benefits again.

Once your benefits stop, you have five years to reapply through expedited reinstatement and qualify for temporary payments while you wait for a decision. Each year, this five-year grace period helps thousands of workers get back on benefits slightly faster than if they started a new application from scratch.

What Is the Five Year Rule for Social Security Disability?

The Social Security five-year rule is the time period in which you can file for an expedited reinstatement after your Social Security disability benefits have been terminated completely due to work.

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, then move on to your extended period of eligibility. 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

During your trial work period, you have a total of nine 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 extended period of eligibility. Work only counts as a trial work period 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 extended period of eligibility 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 extended period of eligibility goes on for three years, and it is a bit different than your trial work period. During your extended period of eligibility if your income from work reaches what the Social Security Administration 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.

In 2024, the monthly SGA amount is $1,550 for non-blind individuals and $2,590 for blind individuals. So if you earn $1,549.99 gross in a month at work, and you’re in your extended period of eligibility, you get your Social Security disability check. If you earn $1,550 or more in a month, you don’t.

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 extended period of eligibility, you have a five-year period where you can get benefits reinstated through the EXR process, as long as you’re earning under SGA.

Expedited Reinstatement

The EXR is the final step in the work incentives program. You can only file for an EXR if you’re within five years of when your benefits stopped due to work. After that five-year period, you must start a new disability application from scratch.

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.

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.

Currently, 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.

What Is The Five-Year Rule For Social Security Disability? (2024)

FAQs

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

The Five-Year Rule for Work Credits

What are the exceptions to the 5 year rule for social security disability? ›

To get coverage, you must have a qualifying disability and meet the work requirements for SSDI. Exemptions to the five-year rule apply for people younger than 31 years of age, with disability onset before age 22, the blind, certain severe medical conditions and veterans with service-related disabilities.

How does the Social Security 5 year rule work? ›

You must have worked and paid Social Security taxes in five of the last 10 years. If you also get a pension from a job where you didn't pay Social Security taxes (e.g., a civil service or teacher's pension), your Social Security benefit might be reduced.

What is the disability 5 year rule? ›

The VA disability 5 year rule allows the VA to ex-examine your VA disability rating within 5 years of your initial examination if your condition is expected to improve over time.

How do you answer Social Security disability questions? ›

When answering these questions, remember:
  1. Be careful not to contradict other answers you gave in this form or in your application.
  2. Describe your abilities on your worst or average days.
  3. Explain if you've modified activities to make them more achievable. ...
  4. Only mention limitations caused by your disability.
Oct 12, 2022

What is the most approved disability? ›

What Is the Most Approved Disability? Arthritis and other musculoskeletal system disabilities make up the most commonly approved conditions for social security disability benefits. This is because arthritis is so common. In the United States, over 58 million people suffer from arthritis.

What conditions are not considered a disability? ›

Some examples of impairments not covered under ADA may be: appendicitis, short bouts of depression, weight conditions within normal ranges, normal height deviations, traits and behaviors, cultural or economic disadvantages, normal pregnancies, quick temper, poor judgment, irritability, physical characteristics such as ...

What is the 12 month rule for SSDI? ›

The 12-month duration-of-disability requirement also applies in establishing disability for SSI applicants. A medically determinable physical or mental impairment or combination of impairments must keep an adult from engaging in substantial gainful activity for at least 12 months in a row.

What is the maximum back pay for SSDI? ›

The Social Security Administration will pay a maximum of 12 months of back pay. Suppose your application took 24 months to be approved. In that case, you are entitled to 12 months of back pay. Even though it may seem as though you're entitled to 19 months of back pay, the maximum amount of back pay is 12 months.

What is the 5/10 rule for SSDI? ›

Generally, you must have worked for at least 5 of the last 10 years to qualify for Disability. People under the age of 24 may not need to have worked as long. Sign in and look under “More Benefits” to see if you've worked long enough to qualify.

What is the 55 rule for disability? ›

Revaluating VA Disability Ratings

Once you turn 55, you are typically "protected" and will no longer have to attend an exam to prove that your condition has not changed unless there is reason to suspect fraud. This is sometimes called the 55-year rule.

What is considered to be a permanent disability? ›

Permanent disability (PD) is any lasting disability from your work injury or illness that affects your ability to earn a living. If your injury or illness results in PD you are entitled to PD benefits, even if you are able to go back to work.

What is the SSA disability rule? ›

In general, we pay monthly benefits to people who are unable to work for a year or more because of a disability. Generally, there is a 5-month waiting period and we'll pay your 1st benefit the 6th full month after the date we find your disability began.

What not to say to a Social Security doctor? ›

To best support your SSDI or SSI claim, you should never:
  • Say You Are Okay. Do not tell the doctor you are “o*kay,” “fine,” or “pretty good” when you are there for an assessment of your condition. ...
  • Tell Them You Are Not in Pain. ...
  • Downplay Your Condition. ...
  • Exaggerate Your Symptoms or Disabilities. ...
  • Give Your Opinion.

What can you not say in a Social Security disability interview? ›

Ten Things You Should Never Say When Applying For Social Security Disability
  • “It's not that bad. ...
  • “I'm getting better.” ...
  • “I can work, but no one will hire me.” ...
  • “It hurts.” ...
  • “I'm not being treated.” or “I stopped treatment.” ...
  • “I have a history of drug use/criminal activity.” ...
  • “My relative gets disability.”
Oct 6, 2023

What not to say at disability hearing? ›

Don't Exaggerate or Minimize Your Symptoms

With so much at stake, some claimants—possibly nervous that the judge won't understand their struggles—overstate their symptoms. But exaggerating your symptoms is the quickest way to sink an otherwise valid disability claim.

What is the 20-40 rule for SSDI? ›

You have disability insured status if you: Have at least 20 credits during a 40-calendar quarter period (the 20/40 rule); The 40-calendar quarter period ends with the quarter that you are determined to be disabled; and. You are fully insured in that calendar quarter as explained in §203.

At what age does Social Security disability turn into regular disability? ›

Social Security Disability can stay active for as long as you're disabled. If you receive benefits until age 65, your SSDI benefits will stop, and your retirement benefits will begin. In other words, your SSDI benefits change to Social Security retirement benefits.

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