We received written notice that [claimant name] has appointed you to act as his or her representative for his or her claim(s). Therefore, we will deal directly with you on matters that concern this claim(s).
We have processed the Form SSA-1695 “Identifying Information for Possible Direct Payment of Authorized Fees” that you submitted for [claimant name].
We have processed your updated direct payment information for the representation of [claimant name].
We have recorded [firm name] with the EIN […] as your affiliation for this claim.
If you plan to charge a fee for services, you must file either a fee petition or a fee agreement with us. In either case, you cannot charge more than the fee amount we authorize you.
Fee Agreement Process
You must submit your fee agreement to us before we make the first favorable decision on the matter on which you worked. We will approve your agreement if it meets certain requirements. We will consider the fee agreement only if we favorably decide the claimant’s case and our decision results in past-due benefits. Find more information about fee agreements on our website at www.ssa.gov/representation/fee_agreements.htm.
Fee Petition Process
You must submit your fee petition to us after your services end, even if the matter you worked on is still pending decision. For convenience, you may use Form SSA-1560, available on our website at www.ssa.gov/online/ssa-1560.html or through your local Social Security office. If you are eligible for and seek direct payment, note that there are important deadlines for submitting a fee petition so that we withhold funds to pay the fee directly to you. Find more information about fee petitions on our website at www.ssa.gov/representation/fee_petitions.htm.
We withhold up to 25 percent of the claimant’s past-due benefits. We will pay the authorized fee after deducting the assessment as required by the Social Security Act. You cannot charge or collect this expense from the claimant. When the fee exceeds the withheld amount or the representative is not eligible for direct payment, the representative must seek payment from the claimant.
If You Waive Your Fee
If you choose to waive either a fee or direct payment of a fee, you can do so by updating your fee arrangement on the notice of appointment.
Early filing of the waiver enables us to prevent withholding of past-due benefits for direct payment.
Important Note: After your appointment ends, you will no longer have access
to the claimant’s records or personal information.
Suspect Social Security Fraud?
If you suspect Social Security fraud, please visit http://oig.ssa.gov/r or call the
Inspector General’s Fraud Hotline at 1-800-269-0271 (TTY 1-866-501-2101).
If You Have Questions
Please visit our Representing Claimants website at www.socialsecurity.gov/representation for general information.
If you have questions, please call us at 1-800-772-6270. If you are deaf or hard of hearing, you may call the TTY number, 1-800-325-0778 between 7:00 a.m. and 7:00 p.m. Eastern time, Monday through Friday. We can answer most of your questions over the phone. When you call, please have this letter with you to help us answer your questions.
If you have questions about reporting income or Form 1099-MISC, please contact the Internal Revenue Service.