EDPNA EXAM -SAMPLE TEST QUESTIONS FULLY SOLVED.

John filed an initial application but lost his housing and became homeless before a determination was made on his claim. DDS denied the claim and SSA sent the notice to his previous address. John did not receive it and when he goes into the SSA Field Office to find out about the status of his claim, they tell him that it was denied three months ago. He comes to you for help. What are his options? Good Cause For Late Filing Since the determination is now final (remember administrative finality?), he could start over with a new application, however his alleged onset date cannot be before the date of the initial determination, meaning he would lose potentially thousands in back due benefits if approved. A knowledgeable and experienced representative such as yourself, realizes that if John can prove that he was homeless and did not receive the notice, he can argue that he had good cause for a late appeal. You advise him to get a statement from the shelter he was staying at during the time the notice was mailed. Perhaps a director at the shelter can confirm that he did not receive mail forwarding, or any mail at all, while staying at the shelter. You sign on as John's representative, help him get the statement and submit a statement of good cause for late filing, with the letter from the shelter, along with the Request for Reconsideration. This action is one reason it is important The claimant was born September 15, 1991. He began work at age 21 for a company owned by a friend of his father. He loaded trucks at a grain storage warehouse. He traveled across State lines from his home--where he lived with his parents--to the job site each day. He made enough money to be credited with four (4) quarters of coverage in 2013. He made enough money to be credited with two (2) quarters of coverage in 2014. In May, 2014 the business owner was indicted for tax fraud and the company c Special insured status Yes. He turned 21 in 9/2012, one quarter after turning 21 = 12/2012 (404.130(3). Onset is 12/31/2015. Between the 4th quarter of 2012 and the 4th quarter of 2015 there are 13 quarters. If the number of quarters is odd you subtract one, which leaves us with 12 quarters. Half of 12 is 6. He has 6 QC's total and is insured for disability insurance benefits. His date last insured (DLI) is 12/31/2015. If Sam applies for benefits on 12/3/2017 and says that he became disabled on 11/8/2014 (assuming he is awarded SSDI as of that alleged onset date of 11/8/14), the five-month waiting period would begin when? 7/1/2016 - 17 full months before date of filing If Marie applies on 7/1/2016 and claims her onset of disability was 3/3/2016, she would not be eligible for benefits payments until when? 9/1/2016. Due to the full five-month waiting period, March cannot be counted as a full month because she did not become disabled on the first day of March. Mark's established onset date of disability was March 15, 2018. When will his Medicare access begin? Medicare Waiting period September of 2020- March 2018 does not count as a full month, so the 5-month waiting period begins 4/18. (April, May, June, July, August= waiting period) His benefits begin September 2018 and his Medicare will begin 2 years later in September, 2020. Test Tip: Include the 5-month waiting period in your calculation and count 29 months forward from established onset date to get the date the Medicare eligibility would begin. Susan is seriously injured in a motor vehicle accident two days after her 19th birthday and is expected to have permanent loss of much of the use of her arms and legs. Susan was in college at the time of the accident and has never worked and was not married. Susan's father was a bank executive, but died when Susan was only 11 years old. Will Susan be eligible for DAC benefits? Disabled Adult Child (DAC) Yes, she meets all the criteria: unmarried, 18 or older, disabled before age 22, meets listings with loss of use of four extremities, and no work record of her own. If Susan had been married, then she might be eligible for SSI, but not for DAC benefits. Mrs. Smith is 55 years old this year, 2019. Mr. Smith was working and fully insured when he died of cancer in 2011. Since then, Mrs. Smith has struggled to pay the bills with her job as a Walmart greeter. This year she had to quit her job because she was put on oxygen 24/7 due to advanced COPD. Can she apply for disabled widow's benefits? *Disabled Widow Benefits (DWB) No. Mrs. Smith meets all the criteria for DWB except that her disability began more than 7 years after her husband died. Mrs. Smith may be eligible for SSI. Jake filed an initial application and received a Notice of Denial dated May 2, 2017 on May 5, 2017. When is the appeal due? Start counting with the date after the date of the notice (5/3). 5/3 plus 60 days = 7/1. BUT...we have to add in the 5-day assumption to get to the technical due date. 7/1 plus 5 = 7/6/2017. Jake has to submit an appeal 7/6/2017 or earlier for it to be considered timely filed. Jack, who has not done any work since 2012 and has been on the Ticket to Work program since 2014, feels better due to new medication. He is able to find a job and starts working full time on June 15, 2018. He earned $789 the month of June and $2378 in July. The stress of working got to him and he had to stop on August 4th making his total earnings in August $182. How many trial work months did he use during this work attempt? He only used one. The work done in June and August was under SGA and therefore did not count as a TWP month. Morgan is twenty years old and currently lives with her mom and step-dad and they do not require her to pay rent or contribute to buying groceries. What would SSA consider this income source? Test Tip: Income does not have to be cash to be counted against a claimant. In-kind income. Morgan is receiving support from her parents in the way of food and lodging; therefore, SSA will determine that she is receiving "in-kind" support/income. Steve works part time to make ends meet and he earns $891.00 gross the first month he works. Without the earned income disregards, his income would put him over the SSI limit for earnings - which is known as the Federal Benefit Rate (FBR). The current FBR for 2022 is $841 for individuals and $1,261 for couples. At this earnings level, he would be disqualified from receiving SSI for that month. If SSA applies the disregards properly, how much will SSA deduct from his FBR and what will his monthly To find this calculation, we start with $891.00 (Steve's current earnings) and subtract the first disregard of $20.00 to get $871. From $871.00, we subtract the second disregard of $65.00 to get $806.00. We then divide that total, $806.00 by 2 (or in half) to get $403.00 as countable income. So Social Security will deduct $403.00 from the FBR (currently $841) for the month: $841 - $403 = $438. Ultimately, $438 will be payable to Steve as an SSI payment. Sam receives $640 in SSI benefits each month. He recently received $100 from his sister. How much will his next SSI payment be reduced by? Unearned Income His next payment will be reduced by $80, making it $560. Unearned Income is deducted dollar for dollar, but the first $20 is excluded. Travis is 22 and lives with his mom and dad at their home. They do not have an agreement for Travis to pay rent for his room or for him to pay for his portion of the utilities or food. Will SSA consider this "unearned" income? In-Kind Support Yes, SSA will consider this arrangement "in-kind" support which is a form of "unearned" income. Travis is 22 and lives with his mom and dad at their home. They do not have an agreement for Travis to pay rent for his room or for him to pay for his portion of the utilities or food. The federal benefit rate for 2022 is $841. Assuming Travis has no additional income sources (earned or unearned), what would his monthly SSI benefit be? One Third Reduction Rule (TVR) Travis would receive a monthly benefit check of $560.67 after the ⅓ reduction rule is applied. Paul lives with a friend in a small apartment and SSA had sent him a notice with his monthly amount reduced by 1/3 because he is not paying rent. He comes to you, his representative, because he feels this is unfair as his rent would not be worth more than $150. Presumed Max Value If he can establish his pro-rata share of the value of that shelter is only $150.00 then Social Security would only deduct $150.00 from his SSI check instead of fully reducing his check by 1/3. Review 416.1140 for more information about rebuttal of PMV. Amy files for 551 and she has two cars, one valued at $3,000 and another valued at $2,500, could she still be eligible for SSI? resources Maybe. The first vehicle does not count regardless of its value. The second would be counted as a resource, but if its equity value - meaning the current market value minus what she owes on it, is less than $2000 then she could still be eligible for SSI because she is under the $2,000 limit. Or, if she is married and living with her husband, that limit would be $3,000. Jim files for SSI. He lives on the family farm which is a house, a barn and 20 acres of land all on the same deed. The value of the family farm is $150,000. If Jim has no other resources, is he eligible for SSI? resources Yes. Because he lives in the home and the land it sits on is contiguous with the farmland, i.e. all on the same deed, it is all excluded. Bob files a concurrent (both SSDI and 551) claim on 7/9/17 alleging an onset date of 6/1/16. DDS denied the claim at the initial level on 1/5/18. Bob did not request review (appeal) within the appeal time period. Bob comes to you on 4/4/18 to ask for your help in appealing the determination. He admits that he had no good cause for late filing; he just didn't do it. How should you proceed? Administrative Finality You should explain to Bob that because he did not appeal within the allowed period, that determination is now final and he cannot appeal it or file a new claim alleging disability from 6/1/16-1/5/18 as that time period has been adjudicated. HOWEVER. .. Bob may still have some options! See Section Labeled "Reopening" for Bob's additional options.