PROGRAM OPERATIONS MANUAL SYSTEMPart DI – Disability InsuranceChapter 310 – Representation of Claimants and InquiriesSubchapter 01 – Representation of ClaimantsTransmittal No. 20, 12/06/2024
Audience
Originating Component
ODP
Effective Date
12/09/2024
Background
We published a final rule on August 21, 2024. The regulation establishes a process for representatives to assign direct payment of fees to entities and the mandatory use of the form SSA-1696. The changes implemented in this section are part of several changes to our subregulatory guidance in accordance with the First Circuit Court decision in Marasco & Nesselbush, LLP v.Tara Collins and Social Security Administration.
Summary of Changes
DI 31001.001 Representation of Claimants
We integrated this language in Section A.
Subsection A. Representation of claimants
We revised the subsection title to "Overview of representative policy."
We removed language that is duplicate to GN 03910.040.
We clarified instructions and reorganized the subsection.
Subsection B. Addressing potential issues arising while the case is at DDS
We renamed the chapter and removed unnecessary language.
We revised the process for DDS handling forms submitted to the DDS.
Subsection C. Case at the hearing or appeals level
We removed the OHO and OAO process as they do not affect the DDS.
Subsection D. Exhibit - DDS "Dear Colleague" letter
We deleted the Exhibit since it is no longer necessary.
A representative is an individual who meets the qualifications shown in GN 03910.020A.1. or 2, and whom the claimant appoints for representation in the claimant's dealings with us. The claimant must use Form SSA-1696 (Claimant's Appointment of a Representative) or the e1696 to appoint a representative before us and must complete the appointment process as explained in GN 03910.040. For the definition of who is a representative, see GN 03910.001.
Prior to recognizing a claimant's appointment of a representative, we require the representative to:
Meet the qualifications, as explained in GN 03910.020A; and
Register with us as explained in GN 03913.005;
Individuals who are providing general assistance or who are serving as representative payees do not need to be appointed as representatives, but they do not have the authority of an appointed representative.
We do not require individuals such as relatives, friends, or neighbors to be appointed as a representative if they are only providing general assistance to the claimant. For information on types of general assistance not considered "representational services," see GN 03910.020D.
A representative payee is a person, agency, organization, or institution selected by us to receive and manage benefits on behalf of a beneficiary or recipient who we have determined is incapable of managing or directing the management of benefit payments in their best interest. A legal guardian is a person with the legal authority to make decisions on behalf of another person. Representative payees and legal guardians do not have the authorities outlined below in DI 31001.001A.2. While a representative payee or legal guardian can provide general assistance to a claimant if they want to act with the authority of an appointed representative they must be appointed by the claimant or another person who has the right to appoint a representative on behalf of the claimant. A representative payee or legal guardian cannot appoint themselves as representatives. For information about who can appoint a representative, see GN 03910.040.
For more information on qualifications for and recognition of representatives, see GN 03910.020. See 20 CFR 404.1703 and 416.1503 for a definition of "representational services."
Once we recognize the appointment, an appointed representative has authority to act on behalf of the claimant on the case the appointment covers (i.e., pending claim, matter, or issue).
For additional information about the scope of authority, delegation of duties, and disclosure responsibilities for appointed representatives, see GN 03316.125 and GN 03910.025. In addition, for the representative’s role in telehealth consultations, see DI 22510.014.
Issues about representation may arise while the claimant’s case is at DDS. Address any issues related to a claimant’s representation as outlined in this section.
If DDS receives any documents relating to representation in the mail or by fax, scan the documents into the electronic folder and send an assistance request (AR) to the field office (FO). DDS must document their actions using a Form SSA-5002 (Report of Contact (ROC)) in the Disability Case Processing System (DCPS) and destroy the unprocessed paper documents after scanning. For information about destruction of documents, see DI 81020.055. DDS must not update DCPS with any representative's information.
If DDS staff receives a Form SSA-1696 from the claimant or representative for the appointment of a representative, then DDS must take the following steps:
Scan the document into the B section of the electronic folder; and
Send an AR to the FO to process the form.
The FO will process the Form SSA-1696 and will:
Ensure that the representative’s appointment information propagates from Registration, Appointment, and Services for Representatives (RASR) to Electronic Disability Collect System (EDCS).
Add flags and annotate the appropriate systems that the claimant has an appointed representative consistent with GN 03910.040F through EDCS, if not already added by the system. This creates an Update After Transfer (UAT) to update DCPS.
Once these steps are completed, RASR sends appointment confirmation notices to the appointed representative and the claimant.
For more information about RASR appointment notices, see GN 03905.035.
If a claimant with an appointed representative contacts DDS with questions or concerns about potential misconduct by an appointed representative, DDS staff must refer the claimant to the FO.
If appropriate, staff may also direct the claimant to our websitewww.ssa.gov/pubs/ and our publication “06-10075 Your Right to Representation” for more information. If a claimant leaves a voice mail message, DDS must contact the claimant directly and record the contact on a Form SSA-5002 Report of Contact (ROC). For more information about DDS handling claimant inquiries, see DI 31005.005.
NOTE: If DDS employees suspect an appointed representative is preventing us from obtaining information or evidence that the claimant must inform us about or submit, has violated their affirmative duties, or has engaged in prohibited conduct (see specific examples in Form SSA-166), they must refer the representative to the appropriate regional contact listed in DI 31001.010D.1. For definitions of the representative's affirmative duties and prohibited conduct, see GN 03970.010.
If a DDS employee suspects an appointed representative is committing a non-fee related violation that may qualify as a criminal violation and the evidence suggests possible fraud or similar fault, they must complete a Form SSA-166 (Report of Representative Misconduct) for OGC and submit a potential referral to the Office of Inspector General (OIG) through the Allegation Referral Intake System (ARIS) for possible investigation. See DI 31001.010D.4.
IMPORTANT: DDS staff must address questions by the claimant or appointed representative related to the claimant’s application and status, including but not limited to querying whether the DDS has received evidence submitted by the representative.
An individual does not have the authority of an appointed representative until we fully process and recognize the appointment. If DDS is unable to determine if an individual is a duly appointed representative, the DDS staff will proceed as follows:
Do not discuss any aspect of the case, including any information about the claimant, with the individual.
Do not assume that the individual is the appointed representative.
Inform the individual that they must contact the FO.
Prepare a ROC in DCPS and include the individual’s name, phone number, and address.
Inform the FO about the contact with the unappointed individual through an AR. For paper cases, send a copy of the ROC to the FO.
IMPORTANT: If the DDS receives an inquiry from an unrepresented claimant about obtaining representation, DDS will refer the claimant to their servicing field office (FO) to obtain a representation referral list. For more information on the referral list, see GN 03910.030A.3.
An appointed representative is not authorized to make changes to the claimant's personal or contact information (e.g., change of name or address) without the claimant’s independent verification of the change. For more information about the authority of a representative, see GN 03910.025.
If the appointed representative informs DDS that there is a change to the personal or contact information of the claimant, DDS staff will:
With the appointed representative's consent, contact the claimant to verify the information change.
If confirmed, the DDS will enter the updated information into DCPS to continue case development activities, and
Send an AR to the FO requesting an update of the contact information by MCS or MSSICS with release of a UAT when completed.
However, if the claimant does not verify the updates to their personal or contact information or the representative does not provide consent, DDS will:
NOT make any updates through DCPS, and
Send an AR to the FO to contact the claimant regarding incorrect information or possible fraudulent activity by the appointed representative.
To make changes to the representative's contact information, a representative must submit a Form SSA-1699 to the address or fax number listed on the form. For more information about registration, see GN 03913.005.
IMPORTANT: Do not enter a representative’s information into DCPS. It will be updated when the FO processes the SSA-1696 and clears the AR in EDCS. Also, verify that the representative flag is present or if it needs to be added based on the case facts.
The claimant may revoke the appointment of a representative at any time. While the representative may withdraw from representing the claimant at any time, they may violate an affirmative duty and face possible sanctions if they withdraw in a manner that disrupts the processing or adjudication of the case. See GN 03970.010B.3.d for information regarding representative withdrawal. The revocation or withdrawal request must be in writing and signed. For more information regarding representative withdrawal, see GN 03970.010B.3.d.
If the claimant or the representative tells the DDS verbally (e.g., telephone or voice message) that they are revoking the appointment or withdrawing from representation, DDS will take the following steps:
Instruct the claimant or representative to provide a signed and dated written notice to the servicing FO confirming the revocation or withdrawal, and
Document the claims folder with a ROC detailing the verbal contact with the claimant or representative.
If the claimant or representative submits written notice of revocation or withdrawal of the representative’s appointment to the DDS, take the following steps:
Scan the document into section B of the electronic folder or add it to the equivalent section of the paper folder; and
Send an AR to the FO requesting that the FO process the termination. The FO will remove the flag if the representative was the only appointed representative.
NOTE: If the DDS receives any other documents relating to the representation (e.g., Form SSA-1696 or fee documents) in the mail or by fax, scan the document into the electronic folder and send an AR to the FO. DDS must document their actions using a ROC and destroy the unprocessed documents. For information about destruction of documents, see DI 81020.055.
If DDS receives any inquiries about representative fees, refer the inquirer to the FO or our website www.ssa.gov/representationfor more information.
When a case is at the hearing or Appeals Council level, refer any inquiries to the Office of Hearing Operations (OHO) or the Appeals Council (AC), as appropriate. OHO and AC employees can enter appointment information into RASR. Follow the same process as described in DI 31001.001B.