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  • Agreement between Certified Disability Advocate and Client

Agreement between Certified Disability Advocate and Client

Category:
Contracts - Disability
State:
Multi-State
Control #:
US-01812BG
Format:
Word
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Description

A Disability Advocate, also known as a Disability Consultant or non-attorney Representative, is a specially trained individual who assists others who are applying for Social Security disability benefits.


The duties of a Disability Advocate involve the execution of both formal and informal procedures on behalf of an applicant for Social Security disability benefits. These actions include, but are not limited to, the assessment of a case to determine the approximate percent chance of winning, and the development of a case by requesting copies of the client's medical records. By law, Social Security must consider the advocate's argument before making a final decision. If the advocate's argument is properly structured and supported by the evidence, it can greatly enhance the client's chances of winning benefits.

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You may send us your comments on our estimated completion time to SSA, 6401 Security Blvd., Baltimore, MD 21235-6401. Send only comments relating to our time estimate to this address, not the completed form.

First, the basics: Federal law generally limits the fees charged by Social Security disability attorneys to 25% of your backpay, or $6,000, whichever is lower. Back payments are benefits that accrued while you were waiting for Social Security to approve your case.

Contact your local hearing office and request an invitation to enroll. Receive in the mail an invitation notice and a specially marked Form SSA-1699, Registration for Appointed Representative Services and Direct Payment. Complete and sign the SSA-1699, then fax it to 1-877-268-3827 for processing.

Social Security Form SSA-1696-U4 is a form that allows you to appoint a third party to represent you when you deal with the Social Security Administration (SSA). You can choose to have an attorney as your representative or you can appoint any qualified individual you wish.

Name of claimant. Social security number. Wage earner. Social security number. Part 1 - Claimant's Appointment of Representation. Name of individual. Part 2 - Representative's Acceptance of Appointment. Name. Part 3 - Fee Arrangement. Signature.

Again, the maximum the disability attorney or nonattorney advocate can charge is 25% of your backpay for his or her services, up to a maximum of $6,000. For example, if your back-dated benefits are calculated to be $10,000, your representative will be paid $2,500 and you will receive $7,500.

A fee agreementalso called a retainer agreement or representation agreementsets out the fees, as well as the terms of the lawyer-client relationship.A fee agreement is a contract that binds both you and the lawyer.

When Should I Call a Lawyer? The general rule is "the earlier, the better." If you're even considering filing for disability, you should call a disability attorney for a free consultation. Your attorney can help you evaluate the strength of your case and assist you with your initial application.

Name and address. Social security claim number. Name of child beneficiary to whom this statement applies. Date child attains age 18. Current school attendance. Last school year. Signature of student. Certification by School Official.

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