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EDPNA Exam 2024|Questions and answers with 100% correct solutions | Graded A+
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EDPNA Exam 2024|Questions and answers with 100% correct solutions | Graded A+
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EDPNA Exam 2024|Questions andanswers with 100% correct solutions |
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Fully Insured Status (SSDI Only) ✔✔404.110
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 (SSDI Only) ✔✔There is a 5-month 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.
Medicare Waiting Period ✔✔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.
To become eligible for Medicare a claimant has to have 24 months of disability eligibility, meaning
they have been paid 24 months of cash benefits. 24 months after SSDI payments begin, the claimant
will be automatically eligible for Medicare.
,Disabled Adult Child (DAC) (SSDI Only) ✔✔An adult who was disabled before age 22 may be eligible for
child's benefits if a parent is deceased, or receiving Social Security retirement, or receiving Social
Security disability benefits. SSA considers this Disabled Adult Child claim a "child's" benefit because it is
paid on the parent's earnings record. To meet requirements, the adult child -- including an adopted
child, or, in some cases, a stepchild, grandchild, or step grandchild - must
1. be unmarried;
2. be age 18 or older;
3. have a disability that started before age 22;
4. meet the SSA definition of disability for adults, and
5. not have substantial earnings to be insured for Title 2 on their own record.
Disabled Widow Benefits (DWB) ✔✔Citation: 404.335
A widow or widower may be eligible for Disabled Widow(er)'s benefits if these requirements are met:
1. The widow(er) is between 50 and 60 years old;
2. The widow(er) meets the SSA definition of disability for adults;
3. The widow(er)'s disability began before or within seven years after the spouse's death.
4. The deceased spouse must have been on Title 2 disability or had Title 2 insured status at death.
Substitution Of Party (SSDI) ✔✔POMS DI 23510.035
Substitution of Party is limited to a surviving spouse who was living with the decedent at the time of
death or within six months immediately preceding death, or to the parent or parents of a disabled or
blind child who was living with the parent or parents at the time of death or within six months
immediately preceding the month of death. Title XVI may also be pursued on a deceased claimant if
Medicaid benefits had been paid on the claimant's behalf.
,Substitution Of Party (SSI) ✔✔1. Surviving spouse living with claimant or entitled to benefits on the
claimant's account in the month of death;
2. Any child entitled to monthly benefits on the claimant's SSN for the month in which the claimant died;
3. Parent(s) of the claimant entitled to monthly benefits on the claimant's SSN for the month in which
the claimant died;
4. Surviving spouse of the claimant;
5. Child(ren) of the claimant;
6. Parent(s) of the claimant;
7. Legal representative of the estate of the claimant.
Appeal Deadlines ✔✔Test Tip: 60 days +5 days for mailing= 65 days to appeal!
Levels of Appeal ✔✔The three levels of appeal relevant to non-attorney representatives are:
· Reconsideration
· Administrative Hearing
· Appeals Council
Timely Appeals ✔✔Important to file because administrative finality.
A determination or decision becomes final and binding if it is not appealed timely.
Trial Work Period (SSDI Only) ✔✔Citation: 404.1592, (no equivalent in 416)
The worker does have a period of time during which they can work without risk of losing their benefits.
, The trial work period is 9 months and it can be 9 different months so it doesn't have to be consecutive. A
beneficiary can work in January and then again in May and then again in September and that's only
three months of their trial work period (TWP) the trial work period cannot begin in a month that cannot
be considered TWP month if the work occurred during the waiting period.
There are dollar amounts that Social Security applies to decide if you use one of your TWP months. In
2017 that was $840.00 in 2018 it is $850.00. If a person works and earns $500, they have not used
one of their 9 trial work period months but if they work and earn $900 in a month then 1 of their 9
TWP months has been used.
Rules: 9 months within a 60 month rolling period
Income (SSI Only) ✔✔test tip: Income does not have to be cash to be counted against a claimant.
Income is defined in the regulations at 20 CFR 416.1104. You will find that income is anything that you
received during a calendar month, that can be used to meet your needs for food or shelter. It may be
cash or non-cash. Non-cash items they consider "in-kind" income. "In-kind" income is an item of food or
shelter or something that you can use to get food or shelter. Additionally, Social Security breaks all
income down into two categories; either earned income or unearned income.
Earned Income (SSI Only) ✔✔Citations: 416.1112 "Earned Income We Do Not Count"
Test Tip: Remember the two disregards are $20.00 no matter what, and $65.00 additionally, if
the income is considered "earned income."
Wages OR net profit from self-employment are both considered under this provision.
Wages are counted when they are received and credited to the claimant or recipient.
Self-employment net earnings are counted by a taxable year, where they take the net profit, divided
by 12 months - 1 /12th of the net profit is counted as income in each of those twelve months.
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