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EDPNA – technical Questions with Correct Answers
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EDPNA – technical Questions with Correct Answers
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EDPNA – technical Questions with Correct AnswersSSDI (Social Security Disability Insurance) Correct Answer-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 Answer-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 Answer-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 Answer-
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 Answer-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 Answer-(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 Answer-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.
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