Effective Dates: 11/21/2023 - Present Previous | Next

TN 44 (11-23)

GN 03920.018 Eligible for Direct Payment Non-Attorney (EDPNA) Representatives

CITATIONS: Social Security Act (Act) §206(e); 20 C.F.R. 404.1717 and 416.1517

A. Background

To receive direct fee payment, a non-attorney representative must meet specific requirements under Section 206(e) of the Act and 20 CFR 404.1717 and 416.1517, and must register with us by completing Form SSA-1699 Registration for Appointed Representative Services and Direct Payment (see GN 03913.001 Access to Electronic Services, Direct Fee Payment, and Annual Tax Statements for Representatives).

Technicians must verify an EDPNA’s eligibility status via the EDPNA Query List in the Registration, Appointment, and Services for Representatives (RASR) system.

The Social Security Administration website provides comprehensive information about the EDPNA program at: https://www.ssa.gov/representation/nonattyrep.htm.

B. Requirements to become an EDPNA

To become an EDPNA, a non-attorney representative must:

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    Complete and submit a Form SSA-1691 Eligible Non-Attorney Representative Application;

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    Pay the application fee;

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    Possess a bachelor's degree from an accredited institution of higher learning or have at least four years of relevant professional experience and either a high school diploma or a General Education Development certificate;

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    Pass our criminal background investigation;

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    Take and pass a written examination we administer; and

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    Provide proof of professional liability insurance.

1. Application

A non-attorney who wants to become an EDPNA must apply to the program by completing and submitting a Form SSA-1691 Eligible Non-Attorney Representative Application. Form SSA-1691 and the dates of the annual application period can be located on our website: http://www.ssa.gov/representation/nonattyrep.htm.

We will only accept applications postmarked on or before the last day of the published application period. We will return applications postmarked after this date without considering them.

If any portion of the application form is defective (e.g., missing educational or professional work experience information, incorrect personal information, or missing a signature on either the application or authorized release of information form), we will notify the applicant of the deficiency. The applicant will have 10 calendar days from the date of notification to submit a corrected, completed, and signed application. If the applicant fails to submit a corrected, completed, and signed application within the prescribed time frame, we will reject the application, return the fee, and the applicant will not be eligible to take the examination. The applicant may reapply on or before the last day of the current application period or in any subsequent application period by submitting a completed application package with a new fee.

Examination Accommodation request

An applicant who requires a special accommodation to take the examination must make the request when completing the application. The applicant must provide supporting documentation from a professional qualified to determine the conditions requiring a special accommodation along with the application package. We will review the applicant's special accommodation request and provide a written response either approving or disapproving the applicant's request. An applicant who requires an accommodation to take the examination should refer to the procedures outlined in GN 00211.001 Section 504 of the Rehabilitation Act of 1973: Standard and Non-Standard Accommodations.

2. Payment of the application fee

The application fee, currently set at $1,000, must be submitted on or before the last day of the application period. If an applicant's payment is unsuccessful (i.e., a check is returned for insufficient funds), the applicant must resubmit the fee using a different method within 10 calendar days after being notified. The 10-day time frame for submission of an alternative form of payment may end after the last day of the application period. For more information about the application process and paying the application fee, visit our website: https://www.ssa.gov/representation/nonattyrep.htm.

We will refund the application fee in any situation except the following:

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    The applicant took and failed the examination; or

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    The applicant failed to sign in on time for the examination because of circumstances within the applicant's control that could have been anticipated and planned for (e.g., the online exam is scheduled for 3:00pm, but the applicant failed to sign in on time due to a failure to charge their laptop, as opposed to an unexpected power outage).

3. Educational and professional experience requirements

Before taking the examination, applicants must indicate on their application that they meet the educational or equivalent professional experience requirements listed in 20 CFR 404.1717 and 416.1517. We will ask applicants to submit proof of their education, appropriate training, or work experience after they pass the examination. Applicants must submit the evidence that they meet the education or relevant work experience requirement as described in the application to qualify for direct payment as an EDPNA.

a. Education

The applicant must demonstrate that they possess either:

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    A bachelor's degree from a post-secondary institution accredited by an accreditation body recognized by the U.S. Department of Education; or

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    Either a high school diploma, or a General Education Development (GED) certificate, with four years of professional experience relevant to our programs, as explained in GN 03920.018B.3.b.

In order for an applicant to qualify based on education completed in a foreign college or institution not accredited by an accreditation body recognized by the U.S. Department of Education, the education must be equivalent to education gained in an accredited U.S. educational program or must have been accepted by a U.S. post-secondary institution. Additionally, the applicant must show that a credential evaluation service specializing in interpreting non-U.S. education has evaluated the transcripts and deemed the education equivalent to education gained in an education program located in the U.S. For additional information, visit http://www.ed.gov.

b. Professional experience

We will consider relevant professional experience for the EDPNA program to be work through which the applicant has demonstrated familiarity with:

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    Medical evidence; and

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    The ability to understand and describe mental and physical limitations.

The applicant may gain this experience in professions such as teaching, counseling or guidance, social work, personnel management, public administration, public employment services, nursing, or health care. We will also consider relevant professional experience to include work involving claims for benefits under Titles II or XVI of the Act. Applicants may be able to rely on work experience obtained outside the United States if they demonstrate that the work qualifies as relevant professional experience.

NOTE: 

If an individual has completed some post-secondary education but has not obtained a bachelor's degree, we require four years of professional experience.

c. Verification of credentials and work experience

Examples of relevant documentation we accept include, but are not limited to:

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    Copies of an official education transcript;

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    Letters from an applicant's employer verifying the length and type of employment;

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    Copies of an Internal Revenue Service (IRS) Form W-2 (Wage and Tax Statement); and

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    IRS Form 1099-NEC and unmasked transcripts of Federal or state tax returns. Copies of masked transcripts of tax returns are not acceptable.

4. Background investigation

When an applicant timely submits a completed and signed application package, we will conduct a criminal background investigation. Applicants must attest within the application under penalty of perjury that they:

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    Have not been suspended or disqualified from representing claimants before us, and are not suspended or disbarred from the practice of law in any jurisdiction;

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    Have not had a judgment or lien assessed against them by a civil court for malpractice or fraud;

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    Have not had a felony conviction; and

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    Have not misrepresented information provided on their application package or supporting materials.

If we require additional information or documentation to finish the background check, such as verifying permanent residency or a name change, we will notify the applicant and instruct the applicant to submit the requested information within 10 calendar days to complete the application process. Failure to submit the required information or documentation within 10 calendar days will result in an incomplete application. In the event of an incomplete application, we will refund the application fee and the applicant will not be able to reapply until the next application period. Refer to GN 03920.018B.1.a. for information on the application review process.

NOTE: If an applicant has pending criminal charges during the application process, they cannot pass our background check until the criminal charges are resolved.

5. The EDPNA examination

All applicants must pass a written examination administered by us that tests their knowledge of the relevant provisions of the Act, the regulations, our Rulings, our policy, and court decisions affecting Titles II and XVI of the Act. Applicants have up to three hours to complete the examination, which consists of multiple-choice questions.

A passing score on the examination is 70 percent or higher. When grading examinations, we will round to the nearest whole percentage point. For example, if the applicant scores 69.50 percent or higher, we will round up to 70 percent. However, if an applicant scores 69.49 percent or lower, we will round down to 69 percent.

The EDPNA examination is held annually as announced on our website: https://www.ssa.gov/representation/nonattyrep.htm. We provide a link to the online examination and provide information regarding all technical requirements on the website. Applicants who fail the EDPNA examination may retake it during a future application period. For more information, refer to our website at: https://www.ssa.gov/representation/nonattyrep.htm.

6. Required documentation for eligibility

After completing the EDPNA examination, applicants will receive a notification regarding their test results. Applicants who score 70 percent or higher will be informed that they have passed the examination. We will provide successful applicants with instructions on how to submit the required documentation to complete the application for review. The required documentation includes proof of education or professional experience and professional liability insurance.

Beginning in 2023, applicants must provide the above documentation within 12 months of our notification regarding their test results; otherwise, they must reapply to the EDPNA program in a subsequent application period, pay the application fee, and retake the EDPNA examination. For additional information, please visit our website at: https://www.ssa.gov/representation/nonattyrep.htm.

NOTE 1: 

We will conduct a current background check (for sanctions and criminal records) for applicants who passed the EDPNA examination in 2022 or earlier but did not complete the application process by providing proof of education or professional experience and professional liability insurance. To complete the current background check, applicants must submit page 11 of Form SSA-1691 (Eligible Non-Attorney Representative Application) and all required documentation as explained at: http://www.ssa.gov/representation/nonattyrep.htm.

NOTE 2: 

After reviewing the required documents, eligible applicants will receive a separate notification informing them that they can register for direct payment as an EDPNA by submitting Form SSA-1699 (Registration for Appointed Representative Services and Direct Payment). EDPNAs can register for direct payment of authorized fees only after they receive this notification.

7. Professional liability insurance

After passing the examination, in addition to proof that an applicant meets the educational or professional experience requirements, an applicant must provide us with proof of professional liability insurance coverage. Upon receipt of this proof, we will issue the applicant a notice of eligibility for direct payment.

An applicant who becomes an EDPNA will be eligible to receive direct payment starting the month after the month in which we verify that the non-attorney representative has submitted adequate proof of insurance.

For additional information regarding professional liability insurance and continuous coverage, see GN 03920.018C.2.

C. Continuing eligibility for direct payment

To remain eligible for direct payment, an EDPNA must meet continuing education requirements and maintain continuous professional liability insurance coverage. We will find an EDPNA who has not timely submitted documentation of continuous professional liability insurance coverage or completion of required continuing education ineligible to receive direct payment for at least six full calendar months. If an EDPNA receives a notice of ineligibility, the EDPNA may protest our finding within 10 days. The ineligibility period begins with the month after the month the protest period ends, or with the month after the month we uphold our finding after a protest. For more information, see GN 03920.018D.

If the EDPNA provides the necessary documentation to satisfy the requirements in GN 03920.018C. at any time, the EDPNA may regain their eligibility for direct payment. The EDPNA’s eligibility will begin the month after the month we receive the documentation, but not earlier than the month after the month following the end of the six-month period of ineligibility.

1. Continuing education courses

The EDPNA must complete all required continuing education courses and must certify completion to us by September 30th of each year.

To certify completion of continuing education courses with us, the EDPNA must provide the following information related to the courses completed:

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    The title of the courses completed;

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    A synopsis of the course content;

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    The dates the courses were completed; and

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    The name of the organization(s) that provided the courses.

If the EDPNA fails to take the prescribed continuing education courses or certify completion by September 30th of each year, the EDPNA will be ineligible to receive direct fee payment for at least six months, beginning with the month after the month the protest period ends. EDPNAs may view the course requirements and send certifications as announced on our website: http://www.ssa.gov/representation/nonattyrep.htm.

2. Continuous professional liability insurance coverage

Section 206(e)(2)(c) of the Act requires every EDPNA to have professional liability insurance with a minimum annual aggregate coverage of $500,000 to protect claimants in the event of malpractice by the representative. Additionally, we require all EDPNAs to maintain continuous professional liability insurance, including coverage for malpractice, with a minimum coverage of $100,000 per incident for possible malpractice and a minimum annual aggregate coverage of $500,000.

a. Providing adequate proof of professional liability insurance

In addition to providing written proof of insurance to establish initial eligibility for direct pay, an EDPNA must provide written proof of professional liability insurance coverage for the minimum amounts listed above per incident and annual aggregate in the following circumstances:

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    When changing insurance providers;

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    After a period of ineligibility;

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    When the insurance policy is renewed; and

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    When requested during an audit.

NOTE: 

An EDPNA is not required to obtain individual professional liability insurance if covered under their employer's business liability malpractice insurance.

When a company covers an EDPNA with business liability malpractice insurance based on the number of the company's employees, the minimum annual aggregate coverage requirement is $500,000 for up to 10 employees. For additional information on the minimum aggregate amount based on the number of employees covered by a business liability malpractice insurance policy, see our website: http://www.ssa.gov/representation/nonattyrep.htm.

EDPNAs with business liability malpractice insurance policies must submit the certificate of insurance, or binder of insurance, containing the following:

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    Effective dates of the insurance policy;

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    Policy number; and

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    Limits of professional liability insurance for malpractice.

We do not accept proposals or quotes for insurance. EDPNAs can find more information on submitting proof of liability insurance under the Requirements for Continuing Eligibility, Professional Malpractice Liability Insurance section on our website: https://www.ssa.gov/representation/nonattyrep.htm.

b. Audit of active EDPNAs' insurance coverage

We may perform periodic audits of active EDPNAs to ensure professional liability insurance coverage is current and continuous. When we notify an EDPNA of an audit, the EDPNA must provide written proof of professional liability insurance coverage for the three years before the date of that notice. The EDPNA must submit such proof within 45 calendar days from the date of notification or they will be deemed ineligible to receive direct payment for at least six months.

We will not accept prior act coverage as continuous coverage if we discover a lapse in the EDPNA's professional liability insurance coverage.

c. Inactive status

An EDPNA may ask us to place them into inactive status. Once we review the request, we will confirm the inactive status with the EDPNA. Upon confirmation, the EDPNA will be put into inactive status, during which time they are ineligible to receive direct payment. While inactive, the EDPNA will not need to complete continuing education courses or maintain professional liability insurance coverage.

An inactive EDPNA who wishes to resume active status must submit a new certification of completion of continuing education and proof of current professional liability insurance coverage to again become eligible for direct payment.

D. Findings of ineligibility

An applicant or EDPNA may be found ineligible to receive direct payment of fees if they fail to meet certain requirements.

The applicant or EDPNA may protest our findings of ineligibility per 20 CFR 404.1717(d)(1) and 416.1517(d)(1). The protest must be in writing, must include all relevant supporting documentation, and must be submitted within 10 calendar days after the applicant or EDPNA is notified of our findings of ineligibility.

An applicant or EDPNA who fails to protest our findings within 10 calendar days from the date of the notice, or whose finding of ineligibility is upheld, will be ineligible for direct payment as an EDPNA. Ineligibility begins with the month after the month the protest period ends, or with the month after the month we uphold our finding after a protest.

When an applicant or EDPNA submits a timely written protest, we will make a final decision on the protest. If we uphold our finding of ineligibility and issue a decision, our response to the protest is final and not subject to further review. Our decision will result in one of the following types of ineligibility:

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    Applicant ineligibility; or

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    Active EDPNA ineligibility.

We will not process a protest for any reason not listed above.

1. Applicant Pre-Examination ineligibility

We will find an applicant permanently ineligible to be admitted to the EDPNA exam if they fail the initial criminal background check (i.e., have been convicted of a felony).

2. Applicant Post-Examination Ineligibility

We will find an applicant who passes the EDPNA examination ineligible to receive direct payment if they fail to provide the following proof:

The applicant may reapply to become an EDPNA in a future application period when they meet all requirements as listed in GN 03920.018B.

3. Active EDPNA ineligibility

An active EDPNA will become temporarily ineligible to receive direct fee payments if we uphold our findings of ineligibility based on a protest filed regarding:

NOTE: 

We will find an EDPNA permanently ineligible to receive direct fee payment if we at any time find that they do not meet the requirements listed in 404.1717(a)(4) and 417.1517(a)(4).

E. Verifying an EDPNA's status

When processing payments, technicians must verify the eligibility and direct payment status of an EDPNA.

1. Verifying the EDPNA's eligibility for direct payment

Technicians must verify the eligibility for direct payment by reviewing the following:

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    The Queries tab in RASR;

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    The Appointed Representative tab in RASR; and

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    The Form SSA-1696.

a. Review the Queries tab

Technicians must query the EDPNA list in the Queries tab in RASR to verify the EDPNA’s eligibility for direct payment when processing the written notice of appointment and again at the time of payment. If the EDPNA is deemed ineligible on the date we process the payment, we cannot directly pay any authorized fees. In these situations, the non-attorney representative must request payment of authorized fees directly from the claimant.

EXAMPLE: RASR shows that a non-attorney representative became an EDPNA on 10/1/2018. The EDPNA's eligibility ended on 7/31/2022. Starting 8/1/2022, we cannot directly pay the EDPNA any fee payments. If there are no other representatives eligible for direct payment and no court level involvement, we will release all the past-due benefits to the claimant and include language in the notice of award indicating that payment of the authorized fee is a matter between the representative and the claimant.

NOTE: If a non-attorney is not found on the EDPNA list in RASR, the non-attorney is not an EDPNA.

b. Review the Appointed Representatives tab for registration

Before issuing direct payment to an EDPNA, technicians must verify if a non-attorney representative is registered and eligible for direct payment as an EDPNA through the Appointed Representatives tab in RASR.

c. Reviewing the Form SSA-1696

Technicians must review Section 7 of the Form SSA-1696 Claimant's Appointment of a Representative or any other written notice of appointment to confirm that a non-attorney representative completed the direct payment information.

2. Request for direct payment by an ineligible non-attorney representative

If technicians determine that a non-attorney representative previously registered for direct payment, but the non-attorney representative's name is not on the EDPNA Query List in RASR, we will:

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    Terminate the direct payment link in RASR; and

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    Continue processing the claim to effectuate the favorable decision and, if there are no other representatives eligible for direct payment and no court level involvement, release any past-due benefits to the claimant and affected auxiliary beneficiary in a Title II case or eligible spouse in a Title XVI couple's case, if any.

If technicians believe the non-attorney representative intentionally misrepresented their eligibility for direct payment or if the non-attorney representative continues to submit direct payment information for other claims, refer to GN 03970.017B. (FO) or GN 03970.017C. (PC). For instructions about Disability Determination Services representative misconduct referrals, see DI 31001.010D.

3. Amending a written notice of appointment after the non-attorney representative becomes eligible for direct payment.

If a non-attorney representative becomes eligible for direct payment as an EDPNA after submitting a Form SSA-1696 or other written notice of appointment in a claim, the EDPNA must submit a supplemental written notice of appointment indicating the change to the representative's direct pay eligibility status in each case in which the EDPNA wishes to receive direct payment of authorized fees. Failure to comply with this requirement may result in the agency not issuing direct payment of authorized fees to the EDPNA in those cases.

For information on supplemental appointments, see GN 03910.040B.5.

4. Inquiries about eligibility for direct payment

Non-attorney representatives who want more information on becoming eligible for direct payment can visit our website:

https://www.ssa.gov/representation/nonattyrep.htm.

To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0203920018
GN 03920.018 - Eligible for Direct Payment Non-Attorney (EDPNA) Representatives - 11/21/2023
Batch run: 11/29/2023
Rev:11/21/2023