---
kind: "range"
citation: "20 C.F.R. §§ 416.999a–416.999d"
title: "20"
from: "416.999a"
to: "416.999d"
count: 4
url: "https://uscodex.org/cfr/20/416.999a..416.999d"
---

# §416.999a. Who is eligible for expedited reinstatement?

- (a) **You can have your eligibility to benefits reinstated under expedited reinstatement if—**
  - (1) You were previously eligible for a benefit based on disability or blindness as explained in [§ 416.202](/cfr/20/416.202.md);
  - (2) Your disability or blindness eligibility referred to in [paragraph (a)(1)](#a-1) of this section was terminated because of earned income or a combination of earned and unearned income;
  - (3) You file your request for reinstatement timely under [§ 416.999b](/cfr/20/416.999b.md); and
  - (4) **In the month you file your request for reinstatement—**
    - (i) You are not able or become unable to do substantial gainful activity because of your medical condition as determined under [paragraph (c)](#c) of this section.
    - (ii) Your current impairment is the same as or related to the impairment that we used as the basis for your previous eligibility referred to in [paragraph (a)(2)](#a-2) of this section,
    - (iii) You are disabled or blind, as determined under the medical improvement review standard in §§ [416.994](/cfr/20/416.994.md) or [416.994a](/cfr/20/416.994a.md), and
    - (iv) You meet the non-medical requirements for eligibility as explained in [§ 416.202](/cfr/20/416.202.md).
- (b) You are eligible for reinstatement if you are the spouse of an individual who can be reinstated under § 416.999a if—
  - (1) You were previously an eligible spouse of the individual;
  - (2) You meet the requirements for eligibility as explained in [§ 416.202](/cfr/20/416.202.md) except the requirement that you must file an application; and
  - (3) **You request reinstatement.**
- (c) We will determine that you are not able to do substantial gainful activity because of your medical condition, under [paragraph (a)(4)(i)](#a-4-i) of this section, when:
  - (1) You certify under [§ 416.999b(e)](/cfr/20/416.999b.md?p=e) that you are unable to do substantial gainful activity because of your medical condition;
  - (2) You are not able or become unable to do substantial gainful activity in the month you file your request for reinstatement; and
  - (3) **We determine that you are disabled under paragraph (a)(4)(iii) of this section.**

# §416.999b. How do I request reinstatement?

- (a) You must make your request for reinstatement in writing.
- (b) You must have filed your request on or after January 1, 2001.
- (c) You must provide the information we request so that we can determine whether you meet the eligibility requirements listed in [§ 416.999a](/cfr/20/416.999a.md).
- (d) We must receive your request within the consecutive 60-month period that begins with the month in which your eligibility terminated due to earned income, or a combination of earned and unearned income. If we receive your request after the 60-month period, we can grant you an extension if we determine you had good cause, under the standards explained in [§ 416.1411](/cfr/20/416.1411.md), for not filing the request timely.
- (e) You must certify that you are disabled, that your current impairment(s) is the same as or related to the impairment(s) that we used as the basis for the eligibility you are requesting to be reinstated, that you are unable to do substantial gainful activity because of your medical condition, and that you meet the non-medical requirements for eligibility for benefits.

# §416.999c. How do we determine provisional benefits?

- (a) You may receive up to six consecutive months of provisional cash benefits and Medicaid during the provisional benefit period, while we determine whether we can reinstate your disability benefit eligibility under [§ 416.999a](/cfr/20/416.999a.md)—
  - (1) We will pay you provisional benefits beginning with the month after you file your request for reinstatement under [§ 416.999a(a)](/cfr/20/416.999a.md?p=a).
  - (2) If you are an eligible spouse, you can receive provisional benefits with the month your spouse's provisional benefits begin.
  - (3) If you do not have an eligible spouse, we will pay you a monthly provisional benefit amount equal to the monthly amount that would be payable to an eligible individual under [§§ 416.401 through 416.435](/cfr/20/416.401..416.435.md) with the same kind and amount of income as you have.
  - (4) If you have an eligible spouse, we will pay you and your spouse a monthly provisional benefit amount equal to the monthly amount that would be payable to an eligible individual and eligible spouse under [§ 416.401 through 416.435](/cfr/20/416.401..416.435.md) with the same kind and amount of income as you and your spouse have.
  - (5) Your provisional benefits will not include state supplementary payments payable under [§§ 416.2001 through 416.2176](/cfr/20/416.2001..416.2176.md).
- (b) **You cannot receive provisional cash benefits or Medicaid a second time under this section when—**
  - (1) You request reinstatement under [§ 416.999a](/cfr/20/416.999a.md);
  - (2) You previously received provisional cash benefits or Medicaid under this section based upon a prior request for reinstatement filed under [§ 416.999a(a)](/cfr/20/416.999a.md?p=a); and
  - (3) Your requests under paragraphs [(b)(1)](#b-1) and [(b)(2)](#b-2) are for the same previous disability eligibility referred to in [§ 416.999a(a)(2)](/cfr/20/416.999a.md?p=a-2) of this section.
  - (4) **Examples—**
- (c) We will not pay you a provisional benefit for a month where you are not eligible for a payment under §§ [416.1322](/cfr/20/416.1322.md), [416.1323](/cfr/20/416.1323.md), [416.1325](/cfr/20/416.1325.md), [416.1327](/cfr/20/416.1327.md), [416.1329](/cfr/20/416.1329.md), [416.1330](/cfr/20/416.1330.md), [416.1334](/cfr/20/416.1334.md), and [416.1339](/cfr/20/416.1339.md).
- (d) We will not pay you a provisional benefit for any month that is after the earliest of either: the month we send you notice of our determination on your request for reinstatement; or, the sixth month following the month you requested expedited reinstatement.
- (e) **You are not eligible for provisional benefits if—**
  - (1) Prior to starting your provisional benefits we determine that you do not meet the requirements for reinstatement under [§§ 416.999a(a)](/cfr/20/416.999a.md?p=a); or
  - (2) We determine that your statements on your request for reinstatement, made under [§ 416.999b(d)(2)](/cfr/20/416.999b.md?p=d-2), are false.
- (f) Determinations we make regarding your provisional benefits under [paragraphs (a) through (e)](#a..e) of this section are final and are not subject to administrative and judicial review under [subpart N of part 416](/cfr/20/part416-subpartN.md).
- (g) If you were previously overpaid benefits under title II or title XVI of the Act, we will not recover the overpayment from your provisional benefits unless you give us permission.
- (h) If we determine you are not eligible to receive reinstated benefits, provisional benefits we have already paid you under this section that were made prior to the termination month under [paragraph (d)](#d) of this section will not be subject to recovery as an overpayment unless we determine that you knew, or should have known, you did not meet the requirements for reinstatement in [§ 416.999a](/cfr/20/416.999a.md). If we inadvertently pay you provisional benefits when you are not entitled to them because we have already made a determination described in [paragraph (e)](#e) of this section, they will be subject to recover as an overpayment under [subpart E of part 416](/cfr/20/part416-subpartE.md).

# §416.999d. How do we determine reinstated benefits?

- (a) If you meet the requirements for reinstatement under [§ 416.999a(a)](/cfr/20/416.999a.md?p=a), we will reinstate your benefits with the month after the month you filed your request for reinstatement. We cannot reinstate your eligibility for any month prior to February 2001.
- (b) We will compute your reinstated benefit amount and determine benefits payable under the applicable paragraphs in [§§ 416.401 through 416.435](/cfr/20/416.401..416.435.md). We will reduce your reinstated benefit due in a month by a provisional benefit we already paid you for that month. If your provisional benefit paid for a month equals or exceeds the reinstated benefit due, we will treat the difference as an overpayment under [§ 416.536](/cfr/20/416.536.md).
- (c) Once you have been reinstated under [§ 416.999a](/cfr/20/416.999a.md) you cannot be reinstated again until you have completed a 24-month initial reinstatement period. Your initial reinstatement period begins with the month your reinstated benefits begin under [paragraph (a)](#a) of this section and ends when you have had 24 payable months of reinstated benefits. We consider you to have a payable month for the purposes of this paragraph when you are due a cash benefit of any amount for the month based upon our normal computation and payment rules in [§ 416.401](/cfr/20/416.401.md) through [§ 416.435](/cfr/20/416.435.md) or if you are considered to be receiving SSI benefits in a month under [section 1619(b)](/cfr/20/1619.md?p=b) of the Social Security Act. If your entire benefit payment due you for a month is adjusted for recovery of an overpayment under §§ [416.570](/cfr/20/416.570.md) and [416.571](/cfr/20/416.571.md) or if the amount of the provisional benefit already paid you for a month exceeds the amount of the reinstated benefit payable for that month so that no additional payment is due, we will consider the month a payable month.
- (d) Your eligibility for reinstated benefits ends with the month preceding the earliest of the following months—
  - (1) The month an applicable terminating event in [§§ 416.1331 through 416.1339](/cfr/20/416.1331..416.1339.md) occurs;
  - (2) The third month following the month in which your disability ceases; or
  - (3) **The month in which you die.**
- (e) Determinations we make under this section are initial determinations under [§ 416.1402](/cfr/20/416.1402.md) and are subject to review under [subpart N of part 416](/cfr/20/part416-subpartN.md).
- (f) If we determine you are not eligible for reinstated benefits, we will consider your request filed under [§ 416.999a(a)](/cfr/20/416.999a.md?p=a) your intent to claim benefits under [§ 416.340](/cfr/20/416.340.md).