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EDPNA - technical exam QUESTIONS AND ANSWERS 100% CORRECT

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EDPNA - technical exam QUESTIONS AND ANSWERS 100% CORRECT

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EDPNA - technical exam QUESTIONS
AND ANSWERS 100% CORRECT
SSDI (Social Security Disability Insurance) - CORRECT ANSWERS Section 404 of 20 CFR
specifically outlines the regulations regarding Social Security Disability Insurance aka Title II aka
Disability Insurance Benefits - all of these are synonymous and are used interchangeably to describe this
program. It's a good idea to read the table of contents to 20 CFR 404 so you can get a better
understanding of which subparts discuss which topic regarding Social Security Disability Insurance.

Unlike SSI eligibility, SSDI eligibility is based on the work history of the applicant, not resource based.
After an applicant applies, SSA must make sure they meet the following technical requirements:



1. Is the applicant under full retirement age (66)?

2. Is the applicant fully insured?

3. Is the applicant insured for disability?



Also, unlike SSI, SSDI benefits can be paid to the disabled worker's family in some cases. This is called
auxiliary benefits and can be paid to dependent children under the age of 18 or spouse (or divorced
spouse if married for 10 years) under the age of 62 who has joint care of the children.



SSI - CORRECT ANSWERS The medical definition of disability for adults is exactly the same
for both SSDI and SSI. You'll see mirror images of many of these provisions under 20 CFR 404 for SSDI 20
CFR 416 for SSI. In many places the regulations read word for word, exactly the same.



One major difference is that under SSI, there is no work requirement; therefore, children can qualify as
disabled. This is described in 20 CFR 416.906. Also, there's no retroactivity for an SSI claimant, meaning
the claimant cannot be eligible for benefits any earlier than the date the claim is filed. Another
difference between the two programs is that for SSI there are very strict income and resource provision,
whereas under SSDI there are insured status provisions.



The definition of disability is exactly the same under Title II and Title XVI. - CORRECT ANSWERS
The law defines disability as the inability to do any substantial gainful activity (SGA) by reason of any

,medically determinable physical or mental impairment(s) which can be expected to result in death, or
which has lasted or can be expected to last for a continuous period of not less than 12 months.



Rule 3: You had a period of disability before age 31 - CORRECT ANSWERS You are insured in
a quarter for purposes of establishing a period of disability or becoming entitled to disability insurance
benefits if in that quarter-

(1) You are disabled again at age 31 or later after having had a prior period of disability established
which began before age 31 and for which you were only insured under paragraph (c) of this section; and

(2) You are fully insured and have QCs in at least one-half the calendar quarters in the period beginning
with the quarter after the quarter you became age 21 and through the quarter in which the later period
of disability begins, up to a maximum of 20 QCs out of 40 calendar quarters; however-

(i) If the number of quarters during this period is an odd number, we reduce the number by one;

(ii) If the period has less than 12 quarters, you must have at least 6 QCs in the 12-quarter period ending
with that quarter; and

(iii) No monthly benefits may be paid or increased under Rule Ill before May 1983.



Rule 1 - 20/40: - CORRECT ANSWERS You have to have 20 quarters of coverage in the 40-
quarter period ending with the quarter that you became disabled. This is called the 20/40 rule. Or
essentially, you have worked five years out of the last ten years, before you became disabled.



Rule 4: You are statutorily blind. - CORRECT ANSWERS (1) You are disabled by blindness as
defined in § 404.1581; and

(2) You are fully insured.



What if you become disabled prior to age 31? - CORRECT ANSWERS 20 CFR 404.130: You are
insured in a quarter for purposes of establishing a period of disability or becoming entitled to disability
insurance benefits if in that quarter-

(1) You have not become (or would not become) age 31;

(2) You are fully insured (next chapter); and

(3) You have Quarters of Coverage (QCs) in at least one-half of the quarters during the period ending
with that quarter after the quarter you became age 21; however-

, (i) If the number of quarters during this period is an odd number, we reduce the number by one; and

(ii) If the period has less than 12 quarters, you must have at least 6 QCs in the 12- quarter period ending
with that quarter.



Insured Status for Statutorily Blind Individuals - CORRECT ANSWERS Statutorily blind
individuals must only meet the fully disability insured status.



Definition of statutorily blindness for Social Security purposes:

We will consider you blind under the law for a period of disability and for payment of disability
insurance benefits if we determine that you are statutorily blind (404.130(e)).



Statutory blindness is defined in the law as central visual acuity of 20/200 or less in the better eye with
the use of correcting lens. An eye which has a limitation in the field of vision so that the widest diameter
of the visual field subtends an angle no greater than 20 degrees is considered to have a central acuity of
20/200 or less. (404.1581)



Fully Insured Status - CORRECT ANSWERS To be fully insured, you need at least one QC
(Quarter of Coverage) for each calendar year after you turned 21 and the earliest of the following:

• The year before you attain age 62,

• The year before you die, or

• The year before you become disabled.

The minimum number of QCs needed is 6. The maximum number needed is 40. Any year (all or part of a
year) that was included in a period of disability is not included in determining the number of QCs you
need.



Waiting Period for SSDI - CORRECT ANSWERS There is a 5-month waiting period in which a
claimant must have been disabled for 5 full consecutive months, beginning with the month that they
were both insured and disabled, before cash benefits can begin. Your waiting period can begin no earlier
than the 17th month before the month you apply-no matter how long you were disabled before then.

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