Fill Out SSA Form SSA-1696 Online
Claimant's Appointment of a Representative
Social Security Administration
Appoints a representative, such as an attorney, to act on your behalf in matters before the SSA.
Reviewed July 2026
How it works
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Form SSA-1696, Claimant's Appointment of a Representative, tells the Social Security Administration that you have chosen someone, often an attorney or an experienced non-attorney advocate, to act for you in a claim, appeal, or other matter before the agency. Once the appointment is on file, the SSA can share your case information with your representative and accept filings from them on your behalf.
You can complete Form SSA-1696 in the Universal PDF editor and download the finished PDF for signatures. Both you and your representative sign before it goes to the SSA.
What is Form SSA-1696 used for
The form creates an official representative relationship for matters such as disability applications, appeals and hearings, overpayment disputes, and other claims. Your representative can review your file, submit evidence, receive copies of SSA notices, and speak for you at hearings.
The form also documents how the representative will be paid. Representative fees in SSA matters generally must be approved by the agency, and the form records whether the representative is charging a fee, waiving it, or being paid by a third party.
Who files Form SSA-1696
Claimants who want help with an SSA matter file the form, most commonly people pursuing Social Security Disability Insurance or SSI claims. You can appoint an attorney or a qualified non-attorney; the representative must meet SSA rules and accept the appointment by signing.
You can appoint more than one representative, and you can revoke an appointment later by notifying the SSA in writing.
How to fill out Form SSA-1696
Have your claim details and your representative's information on hand. In most cases the representative's office prepares the form and asks you to review and sign it.
- Claimant section: your name, Social Security number, and contact details, plus the wage earner's name and number if you are claiming on someone else's record
- Representative section: the representative's name, address, and phone, and whether they are an attorney or a non-attorney
- Fee arrangement: indicate whether the representative will seek a fee subject to SSA approval, waive the fee, or be paid by a third party such as an insurer
- Signatures: you sign to make the appointment and the representative signs to accept it, including required attestations
How to submit it
Send the signed form to the SSA office handling your claim: your local field office for initial claims or the hearing office if your case is at that stage. Representatives can also submit appointment information through the SSA's electronic channels for representatives. Keep a copy, and expect SSA notices to go to both you and your representative once the appointment is processed.
Frequently asked questions
No. You can appoint either an attorney or a qualified non-attorney representative. The form itself simply records the appointment; choosing whether to hire representation is up to you.
Representative fees in Social Security matters generally require SSA approval, usually through a fee agreement or fee petition. In many disability cases the approved fee is paid out of past-due benefits.
Yes. You can revoke the appointment at any time by telling the SSA in writing, and a representative can also withdraw. The agency then stops sending your case information to that person.
The appointment applies to the claims and issues identified on the form. If you later have a separate matter, a new appointment may be needed, so ask the SSA or your representative what your form covers.
Submit it to the office working on your claim, typically your local Social Security office or the hearing office for cases at the hearing level. Your representative usually handles the submission.
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