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EDPNA Exam -Sample test questions.
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EDPNA Exam -Sample test questionsJohn 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? -
CORRECT ANSWER-*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 for claimants to have representation. If John started over at
initial instead of appealing it, he could have potentially lost months or years of
benefits.
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 closed. Claimant was unable to find work
thereafter. He has no other work history. On New Year's Eve, 2015 the claimant
was jogging near his home when he was struck by a driver and sustained
multiple leg and back injuries. Was he insured at the time of his accident? -
CORRECT ANSWER-*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? - CORRECT
ANSWER-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? - CORRECT
ANSWER-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? - CORRECT ANSWER-*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? - CORRECT
ANSWER-*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.
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