Business Guide

Lesson One
The Disability Representative

Notice:  At the end of each lesson, you'll find a lesson completion notice.  In order to earn your Certificate of Achievement, this notice must be submitted to our training coordinator Dr. Jeff Scott for all sixteen lessons of both the online Study and Business Guides.

Welcome to lesson one of the on-line disability advocate Business Guide.  In this lesson, we're going to introduce you to the Social Security disability process from a business or operational perspective. Although this online version will contain much of the same information as seen in the DA Pro, the online materials will be presented in much greater detail.  Be sure to read each lesson in the DA Pro software first and then continue your training with the online lesson.


Practicing as a Representative

Disability representation can be an exciting career for anyone who wishes to offer a professional service from home or add a professional service to an existing enterprise.  Despite the enormous number of benefits associated with the field of disability advocacy, it is first and foremost a business.  Like any other business, disability advocacy will require a willingness to work hard and persevere.  The good news is that the profit potential in this business is enormous and well worth your time and effort.

If you’re currently employed, performing as a representative can still be a lucrative source of additional income, even if practiced on a part-time basis.  Keep in mind that no matter how much you practice, there are no free rides in business.  Although advocacy work may seem complicated at first, with time you’ll quickly develop the skills required to operate this service efficiently.  To help you, Disability Associates has created an impressive collection of custom software and services, each designed to bring greater ease and efficiency to your service.   Whether you use these tools or not, try to be patient and give yourself time to learn from both your successes and your failures

What is a Disability Advocate?

A Disability Advocate is an individual acting as the authorized representative for a person applying for Social Security disability benefits.  An advocate is referred to as a non-attorney representative by Social Security.  A non-attorney disability advocate is appointed by the person he/she is representing.  The advocate will act as that persons authorized delegate before the Social Security Disability program.  The appointed individual must meet all of the basic requirements as listed in the Code of Federal Regulations (CFR) number 410.685 for non-attorneys. 

The requirements for a non-attorney representative

Social Security has expanded both the rights and the privileges of a non-attorney representative.  One of the most important of these new privileges is the right to be paid directly from Social Security for the successful representation of a disability claim.  In order to utilize this privilege, the advocate must be experienced.  That is, the advocate must have represented at least five cases within the last year.  This restriction means that a new advocate will not be immediate eligible for this program.  I believe that’s a good thing because the more experience you have, the more success you can expect.

Social Security has created a five year pilot program that focuses on advocate certification.  The program requires that you pay for and pass a certification examination offered by Social Security.  If you have experience and you pass this examination, Social Security we allow you to enjoy the new advocate privileges.

There are a number of other minor qualifications associated with this new certification from Social Security.  Disability Associates is encouraging our students not to jump into this program right away.  There are a few downsides to this program that make us a little more cautious before we commit to program.  To learn more about this program and why we hesitate to take part, visit and review the “Direct Pay” segment in our Executive Web.

Basic Requirements of an Advocate

Despite Social Security’s expansion of advocate privileges, the basic qualifications to practice as a disability advocate remain pretty much the same.  These qualifications are:

A)  That he/she be of good character, good repute and have the necessary qualifications, (expertise) which would enable the representative to render valuable assistance to a claimant in connection with his/her claim. 

B)  He/She must not be disqualified or suspended from acting as a representative before the Social Security Administration.

C)  Is not prevented from acting as a representative due to any provisions of the law. This refers to individuals who are working in some direct capacity for Social Security.  It also refers to employees of the Federal government whose influence might affect the outcome of a given case.  This does not appear to affect state or county government employees in most cases.

Most individuals would easily meet all of the above basic qualifications with the exception of expertise.  Gaining the expertise required to represent a case is what our advocacy training program is all about.

Representative Responsibilities

The Disability Advocate's responsibilities include but are not limited to:

·         The acquisition of all relevant Social Security forms with the client's signature.

·         A notification to Social Security of your appointment to represent the client.

·         The request and acquisition of all relevant medical and vocational information needed to insure the proper analysis of specific case issues. 

·         The development and preparation of all appropriate forms and/or correspondence relevant to the case.

·         The proper and appropriate evaluation of the client's forms, medical and vocational documentation.

·         The creation of a comprehensive case argument based on the facts of the case.  The argument can be presented at any or all adjudicative levels.

More Responsibility!

The appointed and authorized representative is further responsible for advising the claimant in all matters associated with his/her disability case.  As a representative, you do not work for Social Security. You work for the client you're representing.  It is your duty as a representative to do all that is legally possible to help the client acquire his Social Security disability benefits in a timely fashion. 

A representative is not responsible for determining who's a good candidate for disability benefits.  If a client asks to be represented, there are at least five good reasons to turn him down.  These reasons are:

1.      He/she has a low assessment score.  If you're using our Case Assessment Navigator software, a low assessment score, below 70% for an apprentice advocates, indicates that the client’s case is probably not going to meet Social Security's criteria for disability.  Keep in mind that this can change quickly if the client’s disorder is progressive. 

2.      If the applicant and his spouse are both gainfully employed without special circumstances, with no intent of leaving their jobs, then pass on the case.  The person applying for disability benefits will be denied if he continues gainful work activity without special circumstances.

3.      The client was incarcerated or is not a legal resident of this country.   If the claimant was incarcerated during his period of disability or the disability was acquired during the commission of a crime, do not accept the case.

4.      You suspect for any reason that the claimant is in some way trying to acquire benefits fraudulently.

5.      The client make's you feel uncomfortable or he is not cooperating with your initial request or requirements.

6.      It is your duty as a representative to develop the best possible argument on behalf of the claimant, based on the claimant's available medical, vocational and collateral evidence.  If the claimant has no evidence, this may imply that he has no case.  It is highly unusual for a person suffering from a serious impairment not to seek some level of professional help.

Authority of Representative

An authorized representative working on behalf of a claimant shall be entitled to present or elicit evidence and allegations as to facts and law in any proceeding affecting the party he/she represents. The representative may also obtain information with respect to the claim to the same extent as the claimant himself.  The representative will receive notice of any administrative action, determination or decision in the case he/she is authorized to represent.

The representative may also request and receive evidence with the same force of law as would apply if the evidence had been requested by the claimant himself.  This statement of law can be found in Book 20 (CFR) ch. III, 410.686 for title II claims and (CFR) 416.1510 for title 16 claims.

Rules Governing the Representative

Under CFR 410.687, no representative shall with the intent to defraud in any matter concerning a disability case, willfully and knowingly deceive or mislead Social Security or the claimant in respect to facts or benefits associated with a disability case.

A representative may not charge or collect a fee for services rendered unless the fee has been authorized by SSA.  This rule does not prevent the representative from being paid for services rendered.  What this rule does is set in place the regulation that all fees must be submitted to SSA for approval.  The subject of fee collection will be covered in a later lesson.  Finally, a representative may not divulge any information furnished or disclosed to him/her by SSA or the claimant except as authorized by regulation.

Disciplinary Actions

Whenever it appears that a representative has violated a Social Security rule, that person can be restricted from performing as a representative in future cases. Before you can be prevented from acting as a representative, Social Security must follow a number of procedures to prove that you intentionally violated a regulation. You can easily avoid problems with Social Security by following the instructions given in this course concerning various critical subjects.

If during the course of a case you become confused, unsure of your rights or you need information concerning a specific case issue, use the Disability Associates Executive support service.  Our experienced Executive support staff will assist you by providing help in layman's terms on any business or Social Security issue you desire.

You may also contact your local Social Security District Office as a source of information.  However, be prepared to get the run-around or the wrong answer.  Also do not hesitate to refer to the CFR itself.  A copy of the Code of Federal Regulations can be found online at www.ssa.gov or at any public library.

As a representative, Social Security must supply you with any requested information you need to legally and effectively pursue a case. We will attempt to cover some of the more common situations you may encounter; so that dependence on Social Security for specific information can be kept to a minimum.

What You’re Fighting For:

You cannot become an effective representative if you do not understand the importance of what you’re fighting for.  As in any advocacy service, if you believe in what you’re doing, you’ll probably do it a lot better.

You have already been told of the difficulties an ordinary citizen has in finding help in applying for Social Security disability benefits.  But, do you understand the nature of the benefits themselves?

The average disability payment to an individual is approximately $870 a month, tax-free.  This benefit level increases with time and the income level of the applicant.  If the claimant is awarded Title II only benefits, that person could receive cash payments for years before a case review ( Continuing Disability Review) is ordered to determine if disability continues.

After two years on SSDI Title II benefits, the claimant will automatically become eligible for Medicare protection along with his monthly cash benefit.  Medicare is a government program designed to assist the claimant with the payment of medical, pharmaceutical and hospital costs.  Claimants are also entitled to training and other employment assistance from government programs like the "Ticket to Work" and the “Trial Work Period (TWP)” program.

Although throughout my course, I use terms like “fight” or “ammunition”, I am not implying that Social Security is the enemy.  Social Security is an enormous bureaucracy with a complicated mission.  As a result, working with Social Security can at times be extremely frustrating.  However, try to keep in mind that Social Security is made up of ordinary people just like you and I.  There is no reason to take these bureaucratic frustrations personally.  If you do take them personally, you’ll burn out fast in this industry.

Practice with Integrity

Don't compromise your moral standards or personal integrity when representing a case.  Base your arguments of real client evidence and you'll enjoy a long and prosperous career as a disability advocate.

Build with Imagination

Don't be afraid to use your life experiences and imagination to solve problems that may be unique to your business or circumstance.  Innovation and imagination are the keys to success in this field.  You’re very lucky you choose Disability Associates as your training source.  No other company has our experience and even fewer have come close to providing the number of incredible innovations offered in our course.  If you find that you have a problem, rest assured that Disability Associates has the solution. 

Creating Instant Credibility

Building instant credibility as a disability advocate is not difficult if you follow a few of our basic suggestions:

1. Register your company locally.
2. Purchase 2 URLs, one for your company name and a shorter, easier one for use in advertising.
3. Create a company web site.
4. Create a personal bio on your web site.
5. Join your local Better Business Bureau.
6. Display your training certificate from Disability Associates.
7. Consider SSA certification.  (Optional).
8. Expose yourself to as many local agencies as possible that work with those suffering from serious disorders.
9. Expose your company to as many SSA employees as possible.  If a local SSA employee has met you or heard good things about your service, this can be a tremendous advantage for your company.  If a potential client asks an SSA staffer for an opinion about your service, a known entity will almost always get a more favorable feedback.
10. Advertise locally.  The more exposure you create in your community, the greater the trust factor.

Lesson Two Preview

In lesson two, we'll discuss a number of important start-up considerations for a disability advocacy service.  Be sure to take the lesson one quiz in your DA Pro software before moving to the next lesson.

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