To ensure that claimants receive competent services from their representatives and to protect the integrity of our administrative process, we formulated the Rules of Conduct and Standards of Responsibility for Representatives ("rules and standards") (20 CFR 404.1740 and 416.1540). These rules and standards establish affirmative duties and prohibited actions for representatives. If a representative violates these rules and standards, we may suspend or disqualify that representative from practicing before us.

The rules and standards are applicable at all levels of the administrative decision-making process and apply to all representatives regardless of whether they are currently appointed on a case, including those who serve as an entity’s point of contact (POC), as applicable to that role. For additional information about the role and responsibilities of a POC, see GN 03920.021.

A representative must:

1. 1. 

   Submit all known evidence timely and in its entirety.

   A representative must act with reasonable promptness to help obtain and submit, as soon as practicable, the information or evidence that the claimant must submit under our regulations. See DI 22501.002 for information on responsibilities for case development.

   • •

     A claimant must inform us about or submit all known evidence that relates to whether or not the claimant is blind or disabled, as required in 20 CFR 404.1512 and 416.912. A representative must assist the claimant in meeting this responsibility.

   • •

     At the administrative hearing level, a representative must help the claimant inform us about or submit any written evidence no later than five business days before the date of the scheduled hearing. If the claimant and representative do not satisfy this requirement, the administrative law judge may decline to consider or obtain the evidence unless the circumstances described in 20 CFR 404.935(b) or 416.1435(b) apply (see Hearings, Appeals, and Litigation Law (HALLEX) manual I-2-5-13).

   • •

     Although a claimant must inform us about or submit any written evidence no later than five business days before the date of the scheduled hearing to be considered timely, a representative should not wait until five days before the date of the scheduled hearing to submit evidence that was available to submit at an earlier date (see Social Security Ruling 17-4p: Titles II and XVI: Responsibility for Developing Written Evidence).

   • •

     When a representative, on behalf of the claimant, submits evidence received from another source, they must submit that evidence in its entirety, unless they previously submitted the same evidence to us or we instruct the representative otherwise. For definitions of nonessential evidence and duplicate evidence, refer to DI 20503.001 and DI 20503.003.

   NOTE 1: 

   For more information on our policy and the claimant's and representative's responsibilities to obtain and submit evidence, refer to DI 22505.000 for Development of Medical Evidence of Record (MER) and DI 22501.002 for Responsibilities for Case Development of Disability Claims. Representatives may submit evidence through our Electronic Records Express (ERE) portal. At the hearings or Appeals Council levels, representatives requesting direct fee payment must submit evidence electronically (see HALLEX I-5-1-23 and GN 03970.010B.4).

   NOTE 2: 

   Privileged communications between a claimant and a representative are not evidence, and the claimant and representative do not need to submit privileged communications to us. We consider the following to be privileged communications and apply these guidelines equally to attorney and non-attorney representatives:

   • •

     "Attorney-Client Privilege." The attorney-client privilege generally protects confidential oral or written communications between the claimant and their representative related to providing or obtaining advice about the claimant's claim(s), unless the claimant waives the privilege and voluntarily discloses the communication to us .

   • •

     "Attorney Work Product." The attorney work product doctrine generally protects a representative’s analyses, theories, mental impressions, and notes about the claim(s).

   However, neither the attorney-client privilege nor the attorney work product doctrine allows the claimant or the representative to withhold factual information, medical opinions, or medical and nonmedical evidence that we may consider in determining whether a claimant is entitled to benefits (see 20 CFR 404.1513(b) and 416.913(b); see also DI 24503.001).

2. 2. 

   Comply with our requests for information or evidence.

   A representative must assist the claimant in complying, as soon as practicable, with our requests for information or evidence. In disability and blindness claims, a representative must help the claimant acquire and provide, or authorize us to obtain, evidence about the claimant's:

   • •

     Medical source(s);

   • •

     Age;

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     Education and training;

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     Work experience;

   • •

     Daily activities both before and after the alleged onset date;

   • •

     Efforts to work; and

   • •

     Any other factors showing how the claimant's impairment(s) affects their ability to work.

   NOTE: 

   A representative's action or inaction need not be intentional to violate these two affirmative duties. However, when deciding whether to refer a representative's conduct to the Office of the General Counsel (OGC) under GN 03970.017, consider whether:

   • •

     The representative’s non-submission of required evidence is part of a pattern of conduct;

   • •

     The representative provides a reasonable explanation for not submitting the required evidence (e.g., a good-faith belief that it was unrelated to the pending claim); or

   • •

     The circumstances suggest that the representative intentionally concealed, deleted, or altered evidence.

   We will refer all representatives to OGC who have repeatedly engaged in behavior that potentially violates these affirmative duties.

3. 3. 

   Conduct their dealings in a manner that furthers the efficient, fair, and orderly conduct of the administrative decision-making process.

   This affirmative duty includes, but is not limited to, the following duties:

   a. Provide competent representation to a claimant.

   This affirmative duty requires that a representative know the significant issue(s) in a claim, have reasonable and adequate familiarity with the evidence in the case, and have a working knowledge of the applicable provisions of the Social Security Act (Act), our regulations, the Social Security Rulings, and any other applicable provisions of the law.

   b. Act with reasonable diligence and promptness.

   This affirmative duty requires that a representative provide prompt and responsive answers to our requests for information pertinent to the processing of a claim or an appeal.

   c. Provide information about availability for a hearing when we request it.

   This affirmative duty requires that a representative, in the manner we specify, respond to our request for potential dates and times that the representative will be available for a hearing. We will inform the representative how many potential dates and times we require to coordinate the hearing schedule.

   d. Withdraw representation in a non-disruptive manner.

   This affirmative duty requires that a representative ensure that their withdrawal will not disrupt the processing or adjudication of a claim and will allow the claimant adequate time to find new representation, if desired. We will make determinations on whether a representative has withdrawn in a disruptive manner on a case-by-case basis. Although we will not prevent a representative from withdrawing, if we determine the representative has withdrawn in a disruptive manner, we may refer the representative to OGC to consider pursuing sanctions.

   A representative should not withdraw after we set the time and place for the hearing except when extraordinary circumstances are present. Extraordinary circumstances include, but are not limited to, a medical emergency affecting the representative or an immediate relative, a natural disaster, or the loss of a family member.

   If another representative replaces the representative who is seeking to withdraw and there is no detrimental impact on the hearing process (e.g., delay of the hearing), we will not consider the withdrawal to be disruptive.

   e. Maintain prompt and timely communication with the claimant.

   This affirmative duty requires that a representative, among other things, keep the claimant reasonably informed of all matters concerning representation, consult with the claimant on an ongoing basis, and promptly respond to the claimant’s reasonable requests for information. When making determinations about this affirmative duty, we will consider the difficulty the representative may have in locating the claimant (e.g., because the claimant is homeless) and the representative’s efforts to fulfill this duty.

   NOTE: 

   This affirmative duty also requires that any representative who wishes to charge and collect a fee for representational services has a reasonable understanding of our fee authorization processes and informs the claimant about the amount of the fee that they intend to charge. If a representative intends to seek a fee using the fee agreement process, and the terms of the fee agreement allow for a fee up to the maximum fee set by the Commissioner (i.e., the current fee cap), the representative must inform the claimant of the current maximum dollar amount and that this amount may increase before the date of our favorable determination or decision. If a representative intends to request a fee using the fee petition process, the representative must provide a copy of the fee petition document to the claimant before submitting it to us.

4. 4. 

   Conduct business with us electronically at the times and in the manner we prescribe on matters for which the representative requests direct fee payment, as required by 20 CFR 404.1713 and 416.1513.

   We require a representative to file certain appeals through our Disability Appeal (iAppeals) portal in matters for which the representative requests direct fee payment (see 77 FR 4653 and 77 FR 13968). If a representative does not file the appeal electronically as required, we will still accept and process the paper appeal (e.g., SSA-561, HA-501, HA-520 or SSA-3441). However, we may refer the representative to OGC if they continually fail to comply with this affirmative duty and repeatedly submit paper appeals while requesting direct fee payment.

   For claims pending at the hearing and Appeals Council levels with a certified electronic claim file, we also require a representative to access and obtain a claim(s) file through the Appointed Representative Services (ARS) system in matters for which the representative requests direct fee payment. Except in the limited circumstances described below, we will not provide a compact disc (CD) copy of the electronic claim(s) file to an appointed representative who requests direct payment of fees (see 81 FR 22697 and HALLEX I-5-1-22).

   NOTE 1: 

   The mandate to use ARS does not change a representative's right to review the information in the claim(s) file or their right to request a fee for their services. The mandate does not require a representative to use direct deposit. It also does not affect a claimant's right to request a CD copy of their own claim(s) file.

   NOTE 2: 

   When a claimant has appointed multiple representatives, only the principal representative is subject to the mandate to use ARS if they are requesting direct payment. However, when the principal representative is required to use ARS, we will not provide a CD copy of the electronic claim(s) file to other appointed representatives who are affiliated with the same entity as the principal representative.

   A representative is not required to use ARS if:

   • •

     The case is pending at the initial or reconsideration level;

   • •

     The representative is a not a principal representative;

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     The representative is not seeking direct payment of fees;

   • •

     The representative cannot register for ARS due to technological issues outside their control (e.g., there is no cell phone coverage available to receive text messages in the area where the representative's office is located); or

   • •

     Our systems or other technological limitations preclude the representative's online access to the electronic claim(s) file.

   NOTE 3: 

   Representatives may use ARS to access and obtain a claim(s) file at the initial and reconsideration levels, but, as noted above, it is not a requirement at those levels.

5. 5. 

   Disclose required information about submitted medical or vocational opinions.

   This affirmative duty requires a representative to disclose the following information to us in writing at the time they submit a medical or vocational opinion to us or as soon as the representative is aware of the submission that:

   • •

     The representative's employee or any individual contracting with the representative drafted, prepared, or issued the medical or vocational opinion; or

   • •

     The representative referred or suggested that the claimant seek an examination from, treatment by, or the assistance of, the individual providing the opinion evidence.

     NOTE 1: 

     The agency must report to the Office of Management and Budget (OMB) the number of disclosures received pursuant to 20 CFR 404.1740(b)(5)-(9) and 416.1540(b)(5)-(9) and outlined here in GN 03970.010B.5-9. To assist with disclosure reporting requirements, staff at all levels of case adjudication should ensure that any disclosures described in this subsection (GN 03970.010B.5) are filed into the electronic claim(s) file (EDCS/eView) using the document type “Required Disclosure – Medical (3076)” or “Required Disclosure – Vocational (1088),” depending on the type of evidence submitted with the disclosure, using appropriate processing procedures.

     NOTE 2: 

     A representative must submit a separate disclosure each time they submit opinion evidence that meets the requirements in 20 CFR 404.1740(b)(5) and 416.1540(b)(5) and described in this subsection. A single disclosure for multiple opinions that meet those requirements is not sufficient.

     NOTE 3: 

     "Contracting" means entering into an agreement with the representative to assist with representation or provide evidence or information pertinent to the claim.

6. 6. 

   Disclose to us immediately if the representative discovers that their services are being used or were used by the claimant to commit fraud against us.

   This affirmative duty applies to all representatives at all times, even if the claimant has not yet appointed the representative, and even if the representative's services on a claim have ended. The representative must notify us when the representative discovers that a claimant used or is using the representative's services to commit fraud against us (e.g., the representative learns that the claimant, knowing that the failure to disclose could affect their eligibility for benefits, intentionally failed to disclose earnings, assets, or a full work history to us).

7. 7. 

   Disclose to us whether the representative is or has been disbarred or suspended from any bar or court to which they were previously admitted to practice.

   This affirmative duty includes instances in which a bar or court took administrative action to disbar or suspend the representative in lieu of disciplinary proceedings (e.g., acceptance of voluntary resignation pending disciplinary action). If the disbarment or suspension occurs after the appointment of the representative, the representative must immediately disclose the disbarment or suspension to us.

8. 8. 

   Disclose to us whether the representative is or has been disqualified from participating in or appearing before any Federal program or agency.

   This affirmative duty includes instances in which a Federal program or agency took administrative action to disqualify the representative in lieu of disciplinary proceedings (e.g., acceptance of voluntary resignation pending disciplinary action). If the disqualification occurs after the appointment of the representative, the representative must immediately disclose the disqualification to us.

9. 9. 

   Disclose to us whether the representative has been removed from practice or suspended by a professional licensing authority for reasons that reflect on the person's character, integrity, judgment, reliability, or fitness to serve as a fiduciary.

   This affirmative duty requires a representative to notify us promptly when a professional licensing authority removes them from practice or suspends them for reasons indicated above. The representative must inform us in writing about their removal from practice or suspension (e.g., by submitting an updated registration Form SSA-1699 or providing us with a copy of the suspension or disbarment notice). If the removal or suspension occurs after the appointment of the representative, the representative must immediately disclose their removal or suspension to us, and we may disqualify this representative from appearing before us.

10. 10. 

    Ensure that all of the representative's employees, assistants, partners, contractors, or any person assisting the representative on claims for which the representative has been appointed, comply with our rules of conduct and standards of responsibility for representatives, when the representative has managerial or supervisory authority over these individuals or otherwise has responsibility to oversee their work.

    This affirmative duty requires a representative to take remedial action when:

    • •

      The conduct of any of the representative's employees, assistants, partners, contractors, or other individuals who are assisting the representative with a claim has violated the rules of conduct and standards of responsibility; and

    • •

      The representative has reason to believe a violation of the rules of conduct and standards of responsibility occurred or will occur.

A representative must not:

1. 1. 

   In any manner or by any means threaten, coerce, intimidate, deceive, or knowingly mislead a claimant, or prospective claimant or beneficiary, regarding benefits or other rights under the Act. This prohibition includes misleading a claimant, or prospective claimant or beneficiary, about the representative’s services and qualifications.

2. 2. 

   Knowingly charge, collect, or retain, or make any arrangement to charge, collect, or retain, from any source, directly or indirectly, any fee for representational services in violation of any applicable law or regulation. This prohibition includes soliciting any gift or any other item of value, other than what is authorized by law.

3. 3. 

   Make or present, or participate in the making or presentation of, false or misleading oral or written statements, evidence, assertions, or representations about a material fact or law concerning a matter within our jurisdiction, in matters where the representative knows or should have known that those statements, evidence, assertions, or representations are false or misleading.

4. 4. 

   Through their own actions or omissions, unreasonably delay or cause to be delayed, without good cause (see 20 CFR 404.911(b) and 416.1411(b)), the processing of a claim at any stage of the administrative decision-making process. Unreasonable delay is delay that is not justifiable, or delay that is preventable with reasonable care.

5. 5. 

   Divulge, without the claimant's consent, except as may be authorized by our regulations or as otherwise provided by Federal law, any information we furnish or disclose about a claim or prospective claim.

6. 6. 

   Attempt to influence, directly or indirectly, the outcome of a decision, determination, or other administrative action by any means prohibited by law, or by offering or granting a loan, gift, entertainment, or anything of value to a presiding official, agency or Disability Determination Services (DDS) employee, or witness who is or may reasonably be expected to be involved in the administrative decision-making process, except as reimbursement for legitimately incurred expenses or lawful compensation for the services of an expert witness retained on a non-contingency basis to provide evidence.

7. 7. 

   Engage in actions or behavior prejudicial to the fair and orderly conduct of administrative proceedings, including but not limited to:

   • •

     Repeated absences from, or persistent tardiness at, scheduled proceedings without good cause (see 20 CFR 404.911(b) and 416.1411(b)); or

   • •

     Behavior that has the effect of improperly disrupting proceedings or obstructing the adjudicative process, including but not limited to:

     • –

       Directing threatening or intimidating language, gestures, or actions at a presiding official, witness, contractor, or agency employee;

     • –

       Providing misleading information or misrepresenting facts that affect how we process a claim, including, but not limited to, information relating to the claimant's work activity or the claimant's residence or mailing address in matters where the representative knows or should have known that the information was misleading and the facts would constitute a misrepresentation; and

     • –

       Communicating with agency staff or adjudicators outside the normal course of business or other prescribed procedures in an attempt to influence the proceedings or outcome of a claim.

8. 8. 

   Violate any section of the Act for which a criminal or civil monetary penalty is prescribed.

9. 9. 

   Refuse to comply with any of our rules or regulations.

10. 10. 

    Suggest, assist, or direct another person to violate our rules or regulations.

11. 11. 

    Advise any claimant or beneficiary not to comply with any of our rules or regulations.

12. 12. 

    Knowingly assist a person whom we suspended or disqualified to provide representational services in a proceeding under the Act, or to exercise the authority of a representative as described in 20 CFR 404.1710 and 416.1510.

13. 13. 

    Fail to comply with our sanction(s) decision.

14. 14. 

    Fail to oversee the representative’s employees, assistants, partners, contractors, or any other person assisting the representative on claims for which the representative has been appointed, when the representative has managerial or supervisory authority over these individuals, or otherwise has responsibility to oversee their work.

15. 15. 

    While serving as a POC for an entity, violate applicable affirmative duties, engage in prohibited actions, or conduct dealings with us in a manner that is untruthful or does not further the efficient and prompt correction of a fee error.

When we have evidence that a representative has violated the rules and standards, we may begin proceedings to suspend or disqualify that individual from acting in a representational capacity before us. If you suspect that a representative has violated any of the rules described above, refer the individual to OGC under the procedures for referrals of possible fee violations and non-fee violations, as described in GN 03970.017.

Although a POC need not be an attorney or non-attorney eligible for direct payment or appointed to any claim, matter, or other issue (e.g., a paralegal assistant or secretary), they are considered a “representative” for purposes of the Rules of Conduct and Standards of Responsibility (see 20 CFR 404.1703 and 416.1503). As such, a POC who violates any of the rules and standards, as applicable to their duties as a POC, may be referred for sanctions as described in GN 03970.017. If sanctioned, the individual will not be able to serve as a POC. For additional information about the roles and responsibilities of POCs, see GGN 03920.021C.

The Office of the General Counsel (OGC) has responsibility for pursuing administrative sanctions against representatives, including entity POCs, for violations of our rules and standards. Refer conduct that involves a possible violation of our rules to OGC using the instructions in GN 03970.017. See further information about OGC’s role in the sanctions process in GN 03970.030. Do not refer any possible violations involving attorneys to any external non-SSA entities or authorities (e.g., State bar or other Federal agency).