TN 10 (04-09)

A. Disability Insurance Benefits (DIB)

NOTE: Completion of item 20 is not required.

1. Occupational Years

Show in the "OCC YRS" block the number of years that the claimant worked in the customary occupation, if determined, or, if not determined, in the longest full-time occupation.

NOTE: When such information is not reflected on the SSA-3369-BK it may appear elsewhere in the file.

Where there are broken periods of employment in that occupation, determine the total number of years the individual was employed in the shown occupation. If the number of occupational years is unknown, enter "unk" in the OCC YRS block.

2. Educational Years

In the “ED YRS” block, enter the highest grade of school or college completed by the claimant in the following manner:

• The claimant may have attended classes either full-time or part-time and in the daytime or nighttime. “12th grade” will indicate the claimant completed high school, “13th grade” will indicate one year of college, etc.

• If the claimant also attended a specialized school, such as nursing school, accounting school, ungraded vocational school, etc., also enter “See 34.” Then in Item 34, “Remarks,” enter the type of school and years completed.

• If the number of years of education is unknown, enter “unk” in the “ED YRS” block.

B. Disabled Widow(er) Benefits (DWB)/DWB Medicare only

Complete Item 20 for DWB cases per the DIB guidelines in subsection A.

C. Childhood Disability Benefits (CDB)

Complete Item 20 for CDB cases per the DIB guidelines in subsection A.

D. Title XVI

If the claimant is age 18 or older at the time of adjudication, complete item 20 per DI 26510.035A . If the claimant has no work history, enter ”None”. If the claimant has not attained age 18 at the time of adjudication, do not complete item 20.