Form SSA 1693 Instructions

If you hire professional representation for Social Security matters, they may ask you to sign Form SSA 1693 as part of your agreement. In this article, we’ll walk through Form SSA 1693, so you can better understand more about:

  • How to complete Form SSA 1693
  • How fee agreements work
  • Things you should look out for

Let’s start by going through this Social Security form.

How do I complete Form SSA 1693?

This Social Security form is relatively straightforward. We’ve broken this form into several sections, which we’ll tackle in order.

Representative’s information

The representative’s information goes into this section. Most likely, you will not be responsible for completing this portion of the form.

However, it might be important for you to be familiar with some of the information in this section, so we’ll go over this as if you were completing this section.

Representative’s Rep ID

This ten-digit field contains the representative’s ID number. The Rep ID number is assigned to that representative by the Social Security Administration.

If you encounter a problem with your appointed representative, having the rep ID number could be a good reference point for any conversations you may have with the SSA.

Representative name

No surprises here. You should expect the full name of the representative to be reflected here.

If the name is different from that of the person that you’re familiar with, this might be a good opportunity to ask why.

Address

You’ll want to make sure that the address matches the contact information that you’ve been given separately by your representative. If not, you should ask to understand whether this is the address of their main office or office building related to your claim.

form ssa 1693, representative's information

Phone number

You should take note of the listed phone numbers and make sure that you have them in your records.

Claimant’s information

In this section, you’ll enter your personal information.

Claimant’s Social Security number

Enter your complete Social Security number here.

First name & Last name

Enter your first name and last name as they appear on your Social Security card.

Mailing address

Enter your complete mailing address here.

claimant's information

City, state, ZIP code

Enter your city, state, and ZIP code information in this field.

Phone number

Enter your phone number here. Although your representative should be handling most issues on your behalf, you should be available in case workers from the Social Security Administration need additional information.

Standard fee agreement

This field contains the standard fee agreement. Before we complete this information field, we should better understand what the federal government will allow as part of a standard fee agreement.

What does the standard fee agreement say?

The Social Security Act allows representatives to charge a reasonable fee for services rendered, either as a flat fee or as a percentage of past-due, or retroactive benefits.

The standard fee is a single fee agreement that clearly outlines a specific percentage of retroactive benefits or a flat dollar amount. As of November 30, 2022, the maximum allowable standard fee is the lesser of:

  • 25% of past-due benefits, based upon a favorable decision, or
  • $7,200

In the fine print below, there are a couple of key points that you should be aware of:

  • The SSA may authorize fees requested by your representative based upon past-due benefits awarded to another beneficiary, even if they were not represented
  • You may protest any fee authorized within 15 days of the authorization
  • Your representative may still ask for a fee in the case that you are not awarded past-due benefits, or if you reach a decision that is not favorable
  • You may be responsible for paying fees directly under certain conditions
    • If you do not receive enough benefits to pay the fee
    • If your representative is not eligible for direct payment by the SSA
form ssa 1693, standard fee agreement

Once you read and understand the agreement, you’ll need to choose the fee selection that you and your representative have agreed to, then initial in the lower right-hand sign, where it states ‘Claimant initials.’

Two-tiered fee agreement

The two-tiered fee agreement is an optional agreement, in which you may authorize your representative to seek a higher fee through what’s known as a fee petition. However, this section states that the fee petition would only apply if

  • The SSA provides a favorable claim decision
  • That favorable decision occurred at a higher level than the one indicated in the agreement
form ssa 1693, two-tiered fee agreement

In other words, if your representative has to go through additional administrative steps, which may be more time consuming, then they can seek a higher fee.

This is not an additional fee. In this situation, the standard fee is voided, and replaced with the fee authorized by the SSA. The SSA must authorize the new fee in any case.

In this situation, your representative will probably indicate the administrative level at which this applies.

Escrow/trust accounts or third-party payments

This optional section applies only if:

  • Your representative uses an escrow or trust account, or
  • Someone other than you, your spouse, or one of your auxiliary beneficiaries has paid your fee or will pay your fee for you
escrow/trust accounts or third party payments

In this section, you’ll check the applicable box or both boxes.

The first box indicates that your representative will establish, or has established, a separate account with a specific dollar amount.

The second box indicates that another party is paying this fee, and that you are not financially responsible for any additional fee to the representative unless separately authorized by the Social Security Administration.

Most likely, this will be pre-filled for your benefit.

Claimant and representative signatures

At the bottom, you and your representative will sign and date the completed form. This is a legally-binding signature for both parties.

form ssa 1693, claimant and representative signatures

Additional signatures

If necessary, this page will contain extra information fields for additional representatives. Each additional representative must enter their unique Rep ID number, complete name, and signature.

additional signatures

Regardless of how many additional signatures appear, there is no additional fee beyond that which you’ve previously agreed to.

Video walkthrough

Watch this instructional video to learn more about fee agreements for Social Security representation and Form SSA 1693!

YouTube video

Frequently asked questions

Does Form SSA-1693 accept electronic signatures?

It does not appear that this SSA form can be filed electronically. Electronic signatures are not allowed on the version that appears on the SSA website.

Does this form authorize my representative to talk to the IRS?

The Internal Revenue Service has a separate appointment of representative form, known as IRS Form 2848, Power of Attorney and Declaration of Representative.

Can my representative charge fees that I did not agree to on Form SSA-1693?

No. However, there are two exceptions. They may charge an additional fee authorized by an administrative law judge in Federal court, and they may seek reimbursement for certain out of pocket expenses incurred, such as making copies of medical records for disability claims.

Do I need a representative to file for disability benefits?

Absolutely not. You can work with your local Social Security office if you believe you have a medical condition that warrants a disability claim. However, because this can be complex, some people hire a representative that have significant experience with disability claims.

Where can I find Form SSA 1693?

You may find Form SSA 1693 on the SSA website. However, we’ve included the most recent version of this form here in this article.

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