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EDPNA Exam – Questions and Verified Answers (2026/2027 Newly Updated)

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This document provides the newly updated 2026/2027 EDPNA Exam questions with fully verified correct answers. It covers all core areas of the ESRD program, including Medicare eligibility, coverage rules, documentation standards, appeals and reconsideration processes, beneficiary rights, and responsibilities of an EDPNA representative. The content follows current CMS guidelines and offers a complete, accurate resource for effective exam preparation.

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EDPNA Exam Questions and Verified
Answers (2026/ 2027 Newly Updated)
1. Under Section 404.335 of the CFR (Who is Entitled to Widow's or Wid- ower's Benefits),
in order to receive benefits as the widow or widower of a person who was fully insured
when he or she died, what is the minimum amount of time the relationship must have
lasted between the insured and the insured's widow/widower?


a. 9 months
b. 1 year
c. 2 years
d. 5 years: Answer: a. 9 months

2. The re-entitlement period of eligibility is applicable to a claim if,


a. The claimant previously received disability benefits under Title II of the Social
Security Act but returned to work and within 5 years stopped working again due
to the exact same medical condition and limitations they were previously
approved for.


b. The claimant previously received disability benefits under Title II of the
SocialSecurity Act and who completes a nine month trial work period and
continues to have a disabling impairment resulting in SSA providing the claimant
with a 36 month re entitlement period.


c. The claimant previously received disability benefits under Title II of the Social
Security Act and became disabled again less than 3 years from the date of benefit
cessation due to a more severe disabling condition.


d. The claimant previously received disability benefits under Title II of the Social
Security Act and returned to work before they were medically able thereby
qualifying them for a 9 month trial work period where if they stop working, they
remain eligible for their monthly benefit.: Answer: b. The claimant previously

, received disability benefits under Title II of the SocialSecurity Act and who
completes a nine month trial work period and continues to have a disabling
impairment resulting in SSA providing the claimant with a 36 month re
entitlement period.

3. A claimant files a Title XVI application on 2/13/18, alleging disability since October of
2017 due to a stroke, she has not regained the ability to use her right arm and leg
effectively, with her arm hanging flaccidly at her side, and her leg dragging behind her.
SSA finds her disabled as of her AOD. Benefits will begin:


a. 3/1/18, the first of the month following the month the application was filed.
b. 10/1/17, the first of the month of her stroke
c. 4/1/18, five full calendar months after her alleged onset date
d. No earlier than 1/1/18, because the claim must be medically deferred for three
months following the stroke.: Answer: a. 3/1/18, the first of the month following
the month the application was filed.

4. Joe Bob Smith represents Dorothy James, a 56 year old former paralega who is unable to
work due to lumbar radiculopathy. Joe Bob filed a request for hearing by mail on 2/26/18
and they received a notice of hearing on 6/20/18 that the hearing would be held on
8/8/18. In preparation for the hearing, Joe Bob had a difficult time getting records. He
requested records from Dorothy's pain management doctor, however despite three written
requests and two phone calls, the office reported that they would not be able to provide
the records due to her outstanding balance. Joe Bob also requested records from
Dorothy's chiropractor, along with a medical source statement. The chiropractor returned
records and a completed med- ical source statement that was not supportive of disability
and indicated malingering. Joe Bob submitted the chiropractor records on 8/4/18 but did
not submit the completed statement since it was not supportive. In the interest of time,
Joe Bob did not request Dorothy's primary care records. At the hearing, the judge was
very vocal about the missing pain management records and primary care records and did
not admit the chiropractor records into evidence. The ALJ issued a denial on 10/12/18.
Joe Bob chose not to appeal the denial and sent Ms. James an invoice for $2400 for 20
hours that he spent on her claim, which she paid before finding an NADR member to
appeal the claim for her. Which of the following is true given the above scenario?

a. Joe Bob Smith waived the required 75 day notice for hearing scheduling.
b. This claim has a collateral estoppel issue.
c. Ms. James is approaching retirement age.

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