Role of an Authorized Representative in a Disability Case

Federal law permits an authorized representative to pursue a third-party’s application for social security disability benefits. An authorized representative assists a disabled individual in applying for, obtaining or appealing a denial of social security disability benefits. The authorized representative can be anyone, but is usually a licensed attorney. The third-party applicant selects and pays the representative for his/her efforts. The federal government has no input in hiring or using a representative for an application, and also does not pay the representative for his/her work.

Why Use a Representative?

An authorized representative is usually employed when applicants are unable to apply on their own for benefits. This can be the case in situations of severe disability. Parents can hire a representative to apply for disability benefits for their child.

An individual may also hire a representative when uncertain about how to complete the application procedure or when worried about denial. Providing the SSA with the materials and evidence necessary for an application can be a confusing and complex process. A representative with experience with the process can make the process simpler and prevent the applicant from becoming stressed during the process.

Job of a Representative

Representatives are responsible for every aspect of the application and any subsequent appeals. This means that they gather medical records, complete the application, work with the SSA case worker to investigate the application, provide the SSA with any additional requested paperwork after an application is filed, and attend any hearings held by the SSA concerning the application. In an appeal of a denial, the representative is responsible for completing the appeal form and gathering any records or other documents that disprove the reason for the denial. They also appear in court to represent the applicant, if necessary.

A representative has three main responsibilities: gathering medical records, applying and appealing a denial. The specific duties change in each situation, depending on the applicants and their disability.

Gathering Medical Records

The representative’s first step is to obtain all of the information necessary to include in a disability benefit application. This includes medical records, opinions, test and lab results, and information about the onset, diagnosis and prognosis of the disability. Representatives gather this information directly from physicians, clinics and hospitals.

Applying for Benefits

The next step is for the representative to apply for benefits. This is done in the same way an applicant would apply, by filing a paper or electronic application to the SSA’s local office. The representative is responsible for including all required documents and fulfilling any requirements for further information made by the SSA.

Appealing a Decision

Should the SSA deny the application, the representative will be responsible for an appeal. This may require filing additional documents, legal papers or even appearing in court or at administrative hearings. The last two potential requirements are the reason why many representatives are attorneys.

Who Can Be an Authorized Representative?

You will notify Social Security that you are appointing an authorized representative by filing Form SSA-1686. There are sections of the form that you will complete and sign and sections that your representative will also complete and sign.

There are essentially two categories of authorized representatives: those who are attorneys and those who are not. If you are appointing someone who is not an attorney there are several questions you should consider:

• Does the person have the ability to provide you with effective, valuable help?
• Has the person ever been convicted of a crime? If so, they are not likely to be eligible to be your representative.
• Has Social Security ever disqualified that person in the past from acting as a representative? The SSA will disqualify representatives who do not follow the rules, or who are found to take advantage of past clients.
• Is the person willing to be your representative?

Authorized Representative Differentiated

An authorized representative only works to obtain benefits on behalf of a disabled individual. The representative is not entitled to receive benefits on behalf of the individual, called an “authorized recipient.” The representative is also different from a “medical review representative,” who gathers and investigates an applicant’s medical records prior to applying for benefits to determine whether he or she will have a successful claim. An authorized representative’s job ends when an application is approved or all appeals have been filed and denied and the recipient is unable to receive benefits.