EDPNA - TECHNICAL EXAM WITH COMPLETE
SOLUTIONS LATEST UPDATE
SSDI - Social Security Disability Insurance
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, which is resource-based eligibility, SSDI requires that the applicant's
eligibility be based upon the work history of an applicant. Once an applicant applies,
SSA must ensure they are able to satisfy the following technical requirements:
1. The applicant is under full retirement age, age 66.
2. Applicant is fully insured.
3. Applicant is 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
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-a claimant cannot be eligible for benefits any earlier
than the date the claim is filed. Another difference between the two programs involves
the fact that for SSI there are very strict income and resource provisions, whereas
,under SSDI there are insured status provisions.
The definition of disability is precisely the same under both Title II and Title XVI.
Under the law, disability means "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
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 in this period is odd, we subtract one from this number;
(ii) If the period contains less than 12 quarters, the individual must have at least 6 QCs in
the 12-quarter period ending with that quarter; and
(iii) No monthly benefits could be paid or increased under Rule III prior to May 1983.
Rule 1 - 20/40:
You must 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.
, (1) You are disabled by blindness as defined in § 404.1581; and
(2) You are fully insured.
What if you become disabled before age 31?
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 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.
Insured Status for Statutorily Blind Individuals
Statutorily blind individuals need meet only fully disability insured status.
Definition of statutorily blindness for Social Security purposes:
We will consider you blind under the law for a period of disability and for payment of
disability insurance benefits if we determine that you are statutorily blind. (404.130(e)).
SOLUTIONS LATEST UPDATE
SSDI - Social Security Disability Insurance
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, which is resource-based eligibility, SSDI requires that the applicant's
eligibility be based upon the work history of an applicant. Once an applicant applies,
SSA must ensure they are able to satisfy the following technical requirements:
1. The applicant is under full retirement age, age 66.
2. Applicant is fully insured.
3. Applicant is 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
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-a claimant cannot be eligible for benefits any earlier
than the date the claim is filed. Another difference between the two programs involves
the fact that for SSI there are very strict income and resource provisions, whereas
,under SSDI there are insured status provisions.
The definition of disability is precisely the same under both Title II and Title XVI.
Under the law, disability means "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
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 in this period is odd, we subtract one from this number;
(ii) If the period contains less than 12 quarters, the individual must have at least 6 QCs in
the 12-quarter period ending with that quarter; and
(iii) No monthly benefits could be paid or increased under Rule III prior to May 1983.
Rule 1 - 20/40:
You must 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.
, (1) You are disabled by blindness as defined in § 404.1581; and
(2) You are fully insured.
What if you become disabled before age 31?
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 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.
Insured Status for Statutorily Blind Individuals
Statutorily blind individuals need meet only fully disability insured status.
Definition of statutorily blindness for Social Security purposes:
We will consider you blind under the law for a period of disability and for payment of
disability insurance benefits if we determine that you are statutorily blind. (404.130(e)).
