Form SSA-1696: Claimant's Appointment of a Representative
Appoints an attorney or other representative to act for you in a Social Security claim, such as a disability application or appeal, and records the fee arrangement.
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Instructions for filling out Form SSA-1696: Claimant's Appointment of a Representative
This template is used for official filing and documentation. Below are detailed instructions for completing, requirement details, and submission rules.
Who needs to fill out this document?
This form is designed for use by legal entities, individuals, or authorized representatives in the following cases:
- Claimants hiring a disability lawyer or advocate.
- Attorneys and non-attorney representatives.
- Family members helping with a claim.
What you will need before starting
Before filling out the interactive form, prepare the following details and documents:
Step-by-step filling process
- Part 1: Claimant: Enter claimant information and claim types.
- Part 2: Representative: Representative's information and acceptance.
- Part 3: Fees: Choose how fees will be charged.
- Submit: Send to the Social Security office handling the claim.
Frequently Asked Questions (FAQ)
How are disability lawyers paid?
Usually 25% of past-due benefits, up to a cap set by SSA, and only if the case is won.
Can I have more than one representative?
Yes, but each needs their own appointment form.
How do I revoke the appointment?
Notify Social Security in writing.
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