EDPNA ACTUAL EXAMS ALL ANSWERS AND
QUESTIONS SET A+
✔✔Resources - ✔✔Citation: 416.1201 (Subpart L - Resources & Exclusions)
divided into two categories:
• Liquid resources can be converted into cash within 20 days. The 20 days excludes
certain non-workdays as described in 20 CFR 416.120(d);
• Non-liquid assets cannot be turned into cash within 20 days (ex. Loan agreements,
vehicles, machinery, livestock, buildings, and land that the claimant does not live on).
Non-liquid resources are evaluated according to their equity value except as otherwise
provided. 20 CFR 416.1218
Remember: Income is anything that comes in during the month that you can use to
provide food or shelter. Resources anything that you already had before a month began
that you can use to provide food and shelter.
✔✔Fee Approval - ✔✔Citation: 404.1720, 404.1730**
A representative may not charge a fee for any work performed on behalf of a claimant
for Social Security benefits unless the fee is specifically approved by the SSA.**
✔✔Fee Agreement - ✔✔Citation: 404.1720, 404.1730
Fees are limited to 25% of past-due benefits limited to a regulatory cap (not to exceed
$7200 as of November 30, 2022). Past-due benefits has very specific definitions which
are a little different for Title 2 and for Title XVI claims
✔✔Fee Petition - ✔✔Citation: 404.1720, 404.1730
Another way that you can request and be approved to receive a fee is by fee petition.
Under fee petition you have to show exactly what you did and ask the adjudicator to
approve an amount that you request based on the work and the amount of time you
spent on the case. There is no technical limit to the amount Social Security could
approve under a fee petition.
✔✔Administrative Finality - ✔✔Citation 404.987 and 416.1487
Once the Commissioner (DDS/ALJ/AC) decides about whether or not the claimant is
disabled, and the claimant does not request review within the time period (usually 60
days +5 for mailing) or SSA does not notify the claimant of its intent to revise the
,determination or decision, it becomes final and the claimant loses his or her right for
further review.
✔✔Reopening - ✔✔Citations 404.988 and 416.1488
A final determination or decision can be reopened under the following conditions:
• Within 12 months of the date of the initial determination for any reason.
• In SSI claims, within 2 years of the date of the initial determination if SSA finds there is
good cause.
• In SSDI claims, within 4 years of the date of the initial determination if SSA finds there
is good cause.
Once a decision is final, it cannot be changed unless SSA reopens it. Either SSA or the
claimant can request reopening. When a claimant requests that a prior claim be
reopened, the decision as to reopen is at the discretion of SSA/DDS and there are very
specific conditions
✔✔"good cause" for reopening - ✔✔Citations 404.988 and 416.1488
• New and material evidence is furnished.
• A clerical error in benefit computation was made.
• The evidence that was considered clearly shows on its face that an error was made.
✔✔Res Judicata - ✔✔SSA has previously decided based on the same facts, same
issues, same parties and same adjudicative period. If a claim is filed for the same facts
and issues as a previous denied claim and if for the same time period as the previous
claim, it will be dismissed.
For SSDI cases, applies when both of the following factors occur:
• A subsequent claim has been filed.
• The last determination has become final and the claimant has a DLI in the past.
✔✔Collateral Estoppel - ✔✔Citations 404.950(f) and 416.1450(f)
"issue already decided"
when a subsequent claim is filed alleging the same issues as a previous claim that was
decided under a different program. Unlike Res Judicata, the concept of Collateral
Estoppel can be the basis of an allowance or denial.
Receiving SSI and also filing for DAC
✔✔Common Law Marriage - ✔✔Citation: 404.726
SSA does recognize common-law marriage if the state (note - there are only a few
states that still recognize it) where the couple lived does, but needs the following
"preferred evidence" as proof:
1. If both spouses are alive, their signed statements and those of two blood relatives;
2. If either spouse is dead, the signed statement of the one who is alive and those of
two blood relatives of the deceased person; or
3. If both the spouses are dead, the signed statements of one blood relative of each;
in addition:
• A deed listing both spouses
• Any legal document showing one spouse has assumed the married surname
, • Employment records listing the common-law spouse as a immediate family member
• Insurance policies naming the other party as a beneficiary
• Bank statements showing joint ownership of an account
✔✔Unsuccessful Work Attempt (UWA) - ✔✔Citation 404.1574c
An effort to do work in employment or self-employment that discontinues or reduces to
the non-Substantial Gainful Activity (SGA) level after a short time (no more than 6
months) because of the impairment or the removal of special conditions related to the
impairment that are essential to the further performance of work.
✔✔Income Exclusions - ✔✔416.1112
Certain earned or unearned income situations include Impairment Related Work
Expenses (IRWE) and earnings under a Plan to Achieve Self Support (PASS)
✔✔Impairment-Related Work Expenses (IRWE) - ✔✔Income Exclusion: items and
services needed or used to enable the claimant to work such as attendant care
expenses; medical devices such as wheelchairs, canes, crutches; pacemakers;
residential modifications; necessary medications; medical services; special
transportation needs. It does not matter if the claimant also uses these items and
services for non-work activities.
IRWE will be deducted for SGA purposes when:
• The item(s) or service(s) enables the claimant to work;
• The claimant needs the item(s) or service(s) because of a physical or mental
impairment;
• The claimant pays for the item(s) or service(s) and are not reimbursed by another
source such as Medicare, Medicaid, or a private insurance carrier; and
• The cost is "reasonable", that is, it represents the standard charge for the item or
service in the claimant's community.
✔✔Plan to Achieve Self Support (PASS) - ✔✔Allows claimants to set aside income
and/or resources for a specified period of time so that they can pursue a work goal that
will reduce or eliminate the SSI or Social Security Disability Insurance benefits they are
currently receiving. Income and resources set aside under PASS are not counted as
income or resources for SSI eligibility. The criteria for PASS are very specific and
experts are available to help claimants with setting up a pass account. Can include
supplies to start a business, school expenses, equipment and tools, transportation,
uniforms and other items or services you need to reach your employment goal.
✔✔SVP 1-2 - ✔✔unskilled work
✔✔SVP 3-4 - ✔✔Semi-Skilled Work
✔✔SVP 5-10 - ✔✔Skilled work
QUESTIONS SET A+
✔✔Resources - ✔✔Citation: 416.1201 (Subpart L - Resources & Exclusions)
divided into two categories:
• Liquid resources can be converted into cash within 20 days. The 20 days excludes
certain non-workdays as described in 20 CFR 416.120(d);
• Non-liquid assets cannot be turned into cash within 20 days (ex. Loan agreements,
vehicles, machinery, livestock, buildings, and land that the claimant does not live on).
Non-liquid resources are evaluated according to their equity value except as otherwise
provided. 20 CFR 416.1218
Remember: Income is anything that comes in during the month that you can use to
provide food or shelter. Resources anything that you already had before a month began
that you can use to provide food and shelter.
✔✔Fee Approval - ✔✔Citation: 404.1720, 404.1730**
A representative may not charge a fee for any work performed on behalf of a claimant
for Social Security benefits unless the fee is specifically approved by the SSA.**
✔✔Fee Agreement - ✔✔Citation: 404.1720, 404.1730
Fees are limited to 25% of past-due benefits limited to a regulatory cap (not to exceed
$7200 as of November 30, 2022). Past-due benefits has very specific definitions which
are a little different for Title 2 and for Title XVI claims
✔✔Fee Petition - ✔✔Citation: 404.1720, 404.1730
Another way that you can request and be approved to receive a fee is by fee petition.
Under fee petition you have to show exactly what you did and ask the adjudicator to
approve an amount that you request based on the work and the amount of time you
spent on the case. There is no technical limit to the amount Social Security could
approve under a fee petition.
✔✔Administrative Finality - ✔✔Citation 404.987 and 416.1487
Once the Commissioner (DDS/ALJ/AC) decides about whether or not the claimant is
disabled, and the claimant does not request review within the time period (usually 60
days +5 for mailing) or SSA does not notify the claimant of its intent to revise the
,determination or decision, it becomes final and the claimant loses his or her right for
further review.
✔✔Reopening - ✔✔Citations 404.988 and 416.1488
A final determination or decision can be reopened under the following conditions:
• Within 12 months of the date of the initial determination for any reason.
• In SSI claims, within 2 years of the date of the initial determination if SSA finds there is
good cause.
• In SSDI claims, within 4 years of the date of the initial determination if SSA finds there
is good cause.
Once a decision is final, it cannot be changed unless SSA reopens it. Either SSA or the
claimant can request reopening. When a claimant requests that a prior claim be
reopened, the decision as to reopen is at the discretion of SSA/DDS and there are very
specific conditions
✔✔"good cause" for reopening - ✔✔Citations 404.988 and 416.1488
• New and material evidence is furnished.
• A clerical error in benefit computation was made.
• The evidence that was considered clearly shows on its face that an error was made.
✔✔Res Judicata - ✔✔SSA has previously decided based on the same facts, same
issues, same parties and same adjudicative period. If a claim is filed for the same facts
and issues as a previous denied claim and if for the same time period as the previous
claim, it will be dismissed.
For SSDI cases, applies when both of the following factors occur:
• A subsequent claim has been filed.
• The last determination has become final and the claimant has a DLI in the past.
✔✔Collateral Estoppel - ✔✔Citations 404.950(f) and 416.1450(f)
"issue already decided"
when a subsequent claim is filed alleging the same issues as a previous claim that was
decided under a different program. Unlike Res Judicata, the concept of Collateral
Estoppel can be the basis of an allowance or denial.
Receiving SSI and also filing for DAC
✔✔Common Law Marriage - ✔✔Citation: 404.726
SSA does recognize common-law marriage if the state (note - there are only a few
states that still recognize it) where the couple lived does, but needs the following
"preferred evidence" as proof:
1. If both spouses are alive, their signed statements and those of two blood relatives;
2. If either spouse is dead, the signed statement of the one who is alive and those of
two blood relatives of the deceased person; or
3. If both the spouses are dead, the signed statements of one blood relative of each;
in addition:
• A deed listing both spouses
• Any legal document showing one spouse has assumed the married surname
, • Employment records listing the common-law spouse as a immediate family member
• Insurance policies naming the other party as a beneficiary
• Bank statements showing joint ownership of an account
✔✔Unsuccessful Work Attempt (UWA) - ✔✔Citation 404.1574c
An effort to do work in employment or self-employment that discontinues or reduces to
the non-Substantial Gainful Activity (SGA) level after a short time (no more than 6
months) because of the impairment or the removal of special conditions related to the
impairment that are essential to the further performance of work.
✔✔Income Exclusions - ✔✔416.1112
Certain earned or unearned income situations include Impairment Related Work
Expenses (IRWE) and earnings under a Plan to Achieve Self Support (PASS)
✔✔Impairment-Related Work Expenses (IRWE) - ✔✔Income Exclusion: items and
services needed or used to enable the claimant to work such as attendant care
expenses; medical devices such as wheelchairs, canes, crutches; pacemakers;
residential modifications; necessary medications; medical services; special
transportation needs. It does not matter if the claimant also uses these items and
services for non-work activities.
IRWE will be deducted for SGA purposes when:
• The item(s) or service(s) enables the claimant to work;
• The claimant needs the item(s) or service(s) because of a physical or mental
impairment;
• The claimant pays for the item(s) or service(s) and are not reimbursed by another
source such as Medicare, Medicaid, or a private insurance carrier; and
• The cost is "reasonable", that is, it represents the standard charge for the item or
service in the claimant's community.
✔✔Plan to Achieve Self Support (PASS) - ✔✔Allows claimants to set aside income
and/or resources for a specified period of time so that they can pursue a work goal that
will reduce or eliminate the SSI or Social Security Disability Insurance benefits they are
currently receiving. Income and resources set aside under PASS are not counted as
income or resources for SSI eligibility. The criteria for PASS are very specific and
experts are available to help claimants with setting up a pass account. Can include
supplies to start a business, school expenses, equipment and tools, transportation,
uniforms and other items or services you need to reach your employment goal.
✔✔SVP 1-2 - ✔✔unskilled work
✔✔SVP 3-4 - ✔✔Semi-Skilled Work
✔✔SVP 5-10 - ✔✔Skilled work
