EDPNA Exam (2023/ 2024 Update) |Verified
Answers with Rationales
Q:
Jack filed a SSDI claim on 1/5/15 based on a rare skin condition. The claim was eventually
adjudicated by an ALJ on 5/1/17. His DLI was 3/31/17, so he could not file a subsequent SSDI
application. On 8/1/17, he filed a subsequent SSI application alleging an onset date of 5/2/17, the
day after the ALJ's decision but did not allege any change in the severity or symptoms of his
condition, nor any changes in vocational factors (age category remained the same). What
outcome should he expect?
Answer:
Collateral Estoppel
Rationale: Because the skin disorder issue has been previously decided, and there are no
changes, the prior determination of not disabled will be adopted under the concept of Collateral
Estoppel.
Q:
Bill and Ted never had a legal ceremony but have lived together in
Seattle, WA (Washington does not recognize common-law marriage) for 35 years and
considered themselves to be married. Ted did not work consistently, so he is not insured for
disability or retirement benefits. Bill worked his whole life and started drawing retirement
benefits at age 66. One year later, Bill suffered a massive heart attack and died. Is Ted, age 63,
eligible for widower's benefits?
Answer:
Common Law Marriage
Rationale: First, ask "Did they live in a state that recognized common-law marriage?" The
answer is no. So therefore, even though SSA recognizes same sex marriages, because Bill and
Ted never actually got married, Ted is not eligible for any survivors' benefits based on
Bill's record.
,Q:
If a couple lived in New Hampshire (a state that recognizes common law marriage) for 40 years
and then moved to Arkansas (which does not recognize common law marriage) to retire, will the
couple be eligible to receive spousal benefits if they meet the other criteria?
Answer:
Common Law Marriage
Rationale: Yes, regardless of where they live now and where they file, SSA will recognize the
couple as married since they lived in a state that recognized it and met the criteria.
Q:
James filed for SSDI on 8/1/18 with an onset date of 4/1/18. He comes to you to help him appeal
the initial denial. Upon review of the file, you notice that
he worked consistently up until 6/4/17 when he had to quit due to his impairment. He went back
to work 12/18/17 making $4000 per month, until 4/1/18 when he was fired for frequent
absenteeism and low productivity. You ask him about how he came up with the AOD of 4/1/18
and he replied that the Claims Representative at the field office just asked him when his last day
of work was. How should you proceed?
Answer:
Unsuccessful Work Attempt (UWA)
Rationale: You should advise James that his work should be counted as a UWA and that he
should amend his onset date to 6/4/17 which could result in much more back pay as well as an
earlier start date for Medicare should his claim be approved.
Q:
A potential client calls you because she is unable to work due to chronic pain. She has not been
diagnosed with any condition that could reasonably be expected to cause the pain because she
cannot afford medical care and there are no free clinics near her. What should you anticipate for
this claim?
Answer:
Medically Determinable Impairment
, Rationale: A CE. SSA will need to rely on medically acceptable clinical and laboratory
diagnostic techniques as objective evidence supporting an MDI. Her case will likely depend on
the results of a consultative exam.
Q:
AJ Swatt, an NFL football player calls your office because he tore his ACL during last night's
game and his medical team is telling him he will be out for the rest of the 2018-2019 football
season. He would like to apply for disability benefits. What do you tell Mr. Swatt?
Answer:
Medically Determinable Impairment
Rationale: He will not meet SSA's definition of disability as his impairment is not expected to
result in death, nor is it expected to last for more than 12 months. While your Monday night
football watching won't be the same, you can't forward his claim.
Q:
On January 17th, 2018 Ms. Walker was arrested as an accomplice in a bank robbery. She was in
the getaway car that ultimately crashed into a McDonald's sign in an attempt to evade police. She
immediately filed a claim for disability benefits after being released from the hospital because
her back was now going to require surgery. She had long suffered from DDD. During your
intake call, Ms. Walker read you a letter from her attorney stating that all charges against her had
been dropped. How do you proceed?
Answer:
When SSA Will Not Consider Your Impairment
Proceed with filing the claim, as her DOD started years ago and Ms. Walker was no longer being
prosecuted for her involvement in the bank robbery.
Q:
Trisha has a broken foot from a recent fall off her back porch. She broke her foot in two different
places and her doctor believes she will be in a walking cast and on crutches for at least 4 months.
This week Trisha had testing done which confirmed her suspicions that she was anemic. With
Answers with Rationales
Q:
Jack filed a SSDI claim on 1/5/15 based on a rare skin condition. The claim was eventually
adjudicated by an ALJ on 5/1/17. His DLI was 3/31/17, so he could not file a subsequent SSDI
application. On 8/1/17, he filed a subsequent SSI application alleging an onset date of 5/2/17, the
day after the ALJ's decision but did not allege any change in the severity or symptoms of his
condition, nor any changes in vocational factors (age category remained the same). What
outcome should he expect?
Answer:
Collateral Estoppel
Rationale: Because the skin disorder issue has been previously decided, and there are no
changes, the prior determination of not disabled will be adopted under the concept of Collateral
Estoppel.
Q:
Bill and Ted never had a legal ceremony but have lived together in
Seattle, WA (Washington does not recognize common-law marriage) for 35 years and
considered themselves to be married. Ted did not work consistently, so he is not insured for
disability or retirement benefits. Bill worked his whole life and started drawing retirement
benefits at age 66. One year later, Bill suffered a massive heart attack and died. Is Ted, age 63,
eligible for widower's benefits?
Answer:
Common Law Marriage
Rationale: First, ask "Did they live in a state that recognized common-law marriage?" The
answer is no. So therefore, even though SSA recognizes same sex marriages, because Bill and
Ted never actually got married, Ted is not eligible for any survivors' benefits based on
Bill's record.
,Q:
If a couple lived in New Hampshire (a state that recognizes common law marriage) for 40 years
and then moved to Arkansas (which does not recognize common law marriage) to retire, will the
couple be eligible to receive spousal benefits if they meet the other criteria?
Answer:
Common Law Marriage
Rationale: Yes, regardless of where they live now and where they file, SSA will recognize the
couple as married since they lived in a state that recognized it and met the criteria.
Q:
James filed for SSDI on 8/1/18 with an onset date of 4/1/18. He comes to you to help him appeal
the initial denial. Upon review of the file, you notice that
he worked consistently up until 6/4/17 when he had to quit due to his impairment. He went back
to work 12/18/17 making $4000 per month, until 4/1/18 when he was fired for frequent
absenteeism and low productivity. You ask him about how he came up with the AOD of 4/1/18
and he replied that the Claims Representative at the field office just asked him when his last day
of work was. How should you proceed?
Answer:
Unsuccessful Work Attempt (UWA)
Rationale: You should advise James that his work should be counted as a UWA and that he
should amend his onset date to 6/4/17 which could result in much more back pay as well as an
earlier start date for Medicare should his claim be approved.
Q:
A potential client calls you because she is unable to work due to chronic pain. She has not been
diagnosed with any condition that could reasonably be expected to cause the pain because she
cannot afford medical care and there are no free clinics near her. What should you anticipate for
this claim?
Answer:
Medically Determinable Impairment
, Rationale: A CE. SSA will need to rely on medically acceptable clinical and laboratory
diagnostic techniques as objective evidence supporting an MDI. Her case will likely depend on
the results of a consultative exam.
Q:
AJ Swatt, an NFL football player calls your office because he tore his ACL during last night's
game and his medical team is telling him he will be out for the rest of the 2018-2019 football
season. He would like to apply for disability benefits. What do you tell Mr. Swatt?
Answer:
Medically Determinable Impairment
Rationale: He will not meet SSA's definition of disability as his impairment is not expected to
result in death, nor is it expected to last for more than 12 months. While your Monday night
football watching won't be the same, you can't forward his claim.
Q:
On January 17th, 2018 Ms. Walker was arrested as an accomplice in a bank robbery. She was in
the getaway car that ultimately crashed into a McDonald's sign in an attempt to evade police. She
immediately filed a claim for disability benefits after being released from the hospital because
her back was now going to require surgery. She had long suffered from DDD. During your
intake call, Ms. Walker read you a letter from her attorney stating that all charges against her had
been dropped. How do you proceed?
Answer:
When SSA Will Not Consider Your Impairment
Proceed with filing the claim, as her DOD started years ago and Ms. Walker was no longer being
prosecuted for her involvement in the bank robbery.
Q:
Trisha has a broken foot from a recent fall off her back porch. She broke her foot in two different
places and her doctor believes she will be in a walking cast and on crutches for at least 4 months.
This week Trisha had testing done which confirmed her suspicions that she was anemic. With
