3.4 Role of Representatives Flashcards
“What are the responsibilities of representatives during appeals?”
Answer:
“1. Submitting evidence and legal arguments.”
“2. Preparing claimants for hearings.”
“3. Cross-examining experts at ALJ hearings.”
Explanation: “Representatives play a key role in advocating for claimants and ensuring their rights are protected.”
Source: SSA Representative Rules
“Can representatives charge fees without SSA approval?”
Answer: “No, representatives must have their fee agreements approved by SSA.”
Explanation: “Fee agreements ensure claimants are not overcharged and comply with SSA regulations.”
Source: CFR §404.1720
“What strategies can representatives use during appeals?”
Answer:
“1. Highlighting inconsistencies in prior decisions.”
“2. Providing strong medical and vocational evidence.”
“3. Using expert testimony to counter SSA conclusions.”
Explanation: “Effective strategies can significantly improve the chances of a favorable outcome.”
Case Scenario: Paul’s representative submits a fee agreement for approval before assisting with his ALJ hearing. The agreement specifies that the representative will receive 25% of Paul’s past-due benefits or $7,500, whichever is less.
Question: Does the fee agreement comply with SSA rules?
Answer: No, the fee agreement does not comply because the fee cap for representatives in 2025 is $7,200.
Legal Explanation: The SSA sets a cap on fees for representatives assisting in disability cases. In 2025, the cap is 25% of past-due benefits or $7,200, whichever is less. Fee agreements exceeding this cap are not approved.
Representative Fee Cap (2025):
25% of past-due benefits or $7,200, whichever is less.
