If you have a disability, you may have received Social Security disability (SSDI) benefits. If you tried working again, your benefits might have stopped because you were earning more than the "substantial gainful activity" (SGA) limit ($1,350 per month in 2022).
If you stop working again or your earnings drop below the monthly SGA cap again, there's a fast way for you to get your benefits reinstated. You can ask the Social Security Administration (SSA) for "expedited reinstatement" (EXR) of your disability benefits and avoid the long process of filing a new SSDI application.
This article will explain what expedited reinstatement is, the application process, how to get provisional benefits, and how your application can affect your Medicare coverage.
When you need your SSDI benefits reinstated, you can apply for expedited reinstatement or file a new disability application. In most cases, it makes sense to file for expedited reinstatement because you can get "provisional benefits" right away (see below), and you won't have to endure the long wait for a decision on a new application. But there are a few situations where you might want to file a new application.
If your most recent earnings were significantly higher than before your initial disability application was approved, you might want to file a new application. The more recent earnings might be high enough to raise your monthly benefit amount. This can be especially beneficial if you don't expect to return to work any time soon.
On the other hand, if you choose expedited reinstatement, your monthly benefit amount would be based on your previous earnings and wouldn't take into account any recent earnings. The SSA can tell you what your monthly benefit amount would be under each scenario so that you can decide if it's worth waiting for a new application to be approved.
If you've been receiving Medicare coverage while you were earning over the SGA limit, you could lose it if Social Security denies expedited reinstatement because your medical condition has improved. But Medicare benefits are less likely to end if Social Security denies an initial application.
You can apply for expedited reinstatement the same month you stop working or doing SGA. But you have a limited amount of time to file for EXR. You have five years after your disability benefits were terminated because you were working too much to file. Or, be prepared to show Social Security that you have good cause for filing late.
There are several forms Social Security will have you complete when you ask for expedited reinstatement. Those include:
Once your local Social Security office has received all the paperwork for your application for expedited reinstatement, it will forward the application to your state's Disability Determination Services (DDS) agency. When DDS reviews your EXR application, it'll look to see if you have the same disability that qualified you for benefits before—or a related disability—and whether your condition has improved.
You'll likely meet the disability standard to have your benefits reinstated if your condition hasn't improved enough so that you can work a significant amount. Whether you've had significant medical improvement is the key here.
To deny your EXR application, Social Security must prove that the condition that initially qualified you for benefits—or a closely related condition—is no longer severe as it was. And the SSA must show you've improved enough that you can now work above the SGA level. (For more information, read about the SSA's medical improvement standard.)
If you have a new medical condition that's forced you to stop working again, you'll have to file a new application for benefits.
Either way, DDS might send you for a consultative exam if it can't make a decision based on your medical records alone. Learn more about how consultative examinations work.
You can get up to six months of disability benefits and Medicare coverage while you wait for Social Security to decide on your request for expedited reinstatement. The SSA calls these payments "provisional benefits." The monthly payments would be the same amount you previously received in SSDI, plus normal cost of living increases since you last collected benefits.
The provisional payments start in the month that you apply for expedited benefits (another reason you shouldn't delay). The payments end after six months or when Social Security approves or denies your application for expedited reinstatement, whichever comes first.
Even if Social Security hasn't decided on your application yet, the provisional benefits will end after six months. But, provisional payments usually don't have to be paid back if you're denied disability benefits.
If Social Security approves your application for expedited reinstatement, you'll start receiving regular monthly disability benefits again. If, at any time, your earnings exceed the SGA limit, your benefits (provisional or regular) will stop again.
If the SSA denies your EXR application, you have the right to appeal. You can also choose to file a new application for disability benefits at the same time. If you're trying to decide between filing an appeal, a whole new application, or both, you might want to speak with a lawyer specializing in Social Security law.
Updated June 16, 2022