Representing SSA Claimants - Direct Payment to Eligible Non-Attorney Representatives

Important Information

Continuing Education announcement

The required 2023 continuing education courses for EDPNAs are now available. To remain eligible for direct payment, an EDPNA must certify the completion of each of these courses by email to StratComm, Inc. on or before September 30, 2023.

The EDPNA program is now being serviced by StratComm, Inc. For any questions that are not answered on this website, please contact StratComm at:

Email:
Street:

EDPNA@StratCommInc.com
24 Superior Drive, Suite 103
Natick, MA 01760

What is an Eligible for Direct Pay Non-Attorney (EDPNA)

An EDPNA is a non-attorney representative who provides representation for claimants during the Social Security disability adjudicatory process. Qualified EDPNAs are eligible for direct payment of authorized fees for representing claimants. The EDPNA’s scope of representation is specified in writing by the claimant and determines the EDPNA’s authority in a pending claim, matter, or issue that they have been appointed to handle. An EDPNA can be appointed by a claimant to represent them with a pending claim or issue at any level of administrative review.

Overview

Requirements for Direct Payment to Non-Attorney Representatives

The rules for representation of claimants before the Social Security Administration (SSA) can be found in 206 [42 U.S.C. 406] of the Social Security Act (Act) and 20 CFR 404.1700 and 416.1500. Specifically, Section 206(e) of the Act and 20 CFR 404.1717 and 416.1517 provide the rules for the Eligible for Direct Payment Non-Attorney (EDPNA) program.

To receive direct payment of fees authorized under Titles II and XVI of the Act, a non-attorney representative must:

Complete and sign an application;
Submit the completed application with payment of the application fee;
Have the required education, which is:

a bachelor's degree from an U.S. accredited institution of higher learning, or
at least four years of relevant professional experience and either a high school diploma or General Education Development (GED) certificate;

Pass our criminal background investigation;
Attest under penalty of perjury that they have not:

Been suspended or disqualified from practice before us, or disbarred from the practice of law in any jurisdiction;
Had a judgment or lien assessed against them by a civil court for malpractice or fraud;
Been convicted of a felony; and
Misrepresented information provided on their application or supporting materials for the application;

Pass a written examination that we administer. This examination tests the knowledge of the relevant provisions of the Act and any recent changes in SSA policy and court decisions affecting Titles II and XVI of the Act;
Secure and maintain continuous professional liability insurance or equivalent insurance that we determine to be adequate to protect claimants in the event of malpractice by the representative; and
Demonstrate the ongoing completion of qualified courses of continuing education, including education regarding ethics and professional conduct, which are designed to enhance professional knowledge in matters related to entitlement to, or eligibility for, benefits based on disability under titles II and XVI of the Act.

We have authorized StratComm, Inc., to manage the EDPNA program, including administering our examinations and ensuring non-attorney representatives meet and maintain the requirements for direct fee payment. For all inquiries regarding the EDPNA program contact StratComm, Inc.

Application to the EDPNA Examination

We generally open the application period for the EDPNA examination from February 1 through February 28 each year. However, we may change these dates at our discretion, so be sure to check for updates. To apply, you must complete Form SSA-1691 (Eligible Non-Attorney Representative Application). We will accept applications that are received or postmarked on or before the last day of the application period and must return any application that is postmarked after this date without considering it. You must submit your application package to StratComm, Inc.

An application package is complete only if it includes:

A completed and signed application;
A completed and signed applicant authorization for release of information form; and
An application fee payment of $1,000.

Application Form Requirements

Be sure to complete your application form before submitting. If you submit an incomplete application, you will be required to resubmit another complete application within ten calendar days. This may delay your background check and your acceptance to the examination.
If we find your re-submitted application defective for any reason, we cannot approve your application. In this situation, you will be permitted to reapply by the last day of the current application period or in any subsequent year with payment.

NOTE: We require documentation that you meet the educational and any equivalent professional qualifications and the liability insurance requirements detailed below, after you take and pass the examination.

Application Fee

The Act allows us to assess a reasonable fee to cover the cost of administering the written examination and conducting background checks. The application fee is currently $1,000.00 and is due no later than the last day of the application period. This fee must accompany your application form and applicant authorization for release of information. Acceptable forms of fee payment are:

Personal check; and
Money order.

We cannot refund your application fee for the following reasons:

You take and do not pass the examination; or
You fail to begin the examination on time without good cause.

You must pay your application fee to StratComm, Inc. If you choose to pay by check and your check is returned for non-sufficient funds, we require that your resubmitted payment be in the form of a money order.

Application Completion Checklist

Section A - Background Information

You must provide your full name, any other names used, Social Security Number, date of birth and citizenship status.

If you are a naturalized citizen or alien authorized to work in the U.S, we may request proof of your citizenship or work permit for the background check.

Contact information must include a valid mailing address, phone number, and email address.

An email address is required for access to the online portal as well as for setting up the online exam.

You must provide a Yes or No response to each of the Background Information questions (1 through 9, as well as answer any applicable follow-up questions).

Section B – Education/Equivalent Qualifications

If you indicate that you have a bachelor's degree from an accredited U.S. college or university, you must include the name and location of the institution, the dates attended, and the degree granted.
If you indicate that you have a high school diploma or General Education Development (GED) certificate, you must provide the name and location of the institution and the date your diploma or GED was issued.
If you indicate that you have a high school diploma or GED, you must also provide details regarding your relevant professional work experience including your title, name of employer, employer contact information, and a detailed description of your duties.

Section C – Examination Information

We administer the EDPNA examination through a remotely proctored online portal whether taken at a private location or a testing center. On the SSA-1691 under Section C, you must indicate your preferred location for taking the examination, which may be remotely at home or in another private location or at one of our approved testing center locations. (see Requirements for Your Examination Environment below.)
If you require any special accommodation, you must request this on the application and provide supporting documentation as required. Your request for ADA accommodations must follow the requirements on the ADA.gov homepage

Acknowledgements

Using your initials, you must acknowledge that you have read and understand the following statements:

Privacy Act Statement;
Paperwork Reduction Act Statement;
Substantial Misrepresentation or Material Discrepancy Statement;
Application Fee Statement; and
Statement of Understanding.

However, a dated, handwritten signature is required in acknowledgement of the Penalty of Perjury Statement.

Applicant Authorization for Release of Information

You must complete the Applicant Authorization for Release of Information in its entirety.

Ensure that you enter all your personal information and that it is consistent with the information you provide on Page 4 of the application.

You must provide residency information for the past five years, including the first and last months and year of residency.

You must provide a dated, handwritten signature, and daytime phone number in acknowledgement of the Application Authorization for Release of Information form.

REVIEW your application for completeness. Remember to sign both the application and the authorization form.

Educational or Relevant Professional Experience

Before taking the examination, you must indicate on the application that you meet the educational or equivalent professional experience requirement as listed in 20 CFR 404.1717 and 416.1517. We will ask for proof of your education, appropriate training, or work experience after you pass the examination. You will not qualify for direct fee payment until you submit evidence that you meet the educational or relevant work experience requirement.

Examples of relevant documentation we may accept include, but are not limited to:

Copies of an official education transcript;
Letters from an applicant's employer verifying the length and type of employment:
Copies of an Internal Revenue Service (IRS) Form W–2 (Wage and Tax Statement); and
IRS Form 1099-NEC, and unmasked transcripts of federal or state tax returns. Please note that copies of masked transcripts of tax returns will not be acceptable.

Education Requirement

To receive direct fee payment, The Act requires that you have:

A bachelor's degree from an accredited U.S. college or university; or
A high school diploma or GED certificate and equivalent qualifications derived from work experience.

You must provide proof of your education and any relevant professional work experience after you pass the examination. The kinds of proof we accept to verify the education requirement include, but are not limited to, an official copy of either a college or university degree, a high school diploma, or a GED certificate.

Relevant Professional Work Experience

If you do not have a bachelor's degree from an accredited U.S. college or university, you must demonstrate that you have at least four years of relevant professional work experience and either a high school diploma or GED certificate.

We will consider relevant professional experience for the EDPNA program to be a full four years of work through which the applicant demonstrates familiarity with medical reports and the ability to describe and assess mental or physical limitations. You may gain this kind of experience in fields such as teaching, counseling or guidance, social work, personnel management, public employment service, nursing, or health care professions. We will also continue to consider relevant professional experience to include work involving claims for benefits under title II or XVI of the Act. However, we cannot offer guidance to individuals based on their descriptions of past work

EDPNA Examination

The EDPNA examination consists of fifty (50) multiple-choice questions. You have up to three hours to complete the examination and must obtain a score of seventy percent or greater to pass.

During the examination, the Electronic Code of Federal Regulations (20 CFR, Chapter III, Part 404) will be available as a reference source.

Test Question Examples

Short Question Format

Question:

Into which education category does a person who obtained a 7th grade through 11th grade level of formal education generally fall?

Answers:

Limited education (Correct)
High school education and above (Incorrect. High school and above education require formal schooling at a 12th grade level or above, or a GED)
Marginal education (Incorrect. Marginal education includes schooling at a 6th grade level or less)
Illiteracy (Incorrect. Illiteracy includes only people who cannot read or write a simple message, even though they may be able to sign their name)

Reference:

20 CFR 404.1564 and 416.964.

Scenario Format

Question:

A client comes to you asking for representation for their Title II claim for benefits due to chronic heart failure. In reviewing the claimant’s medical records, you see that recent medical evidence shows your client has diastolic failure with left ventricular posterior wall plus septal thickness of 2.7 cm and an enlarged left atrium of 4.3 cm with normal elevated ejection fraction during periods of stability. The record also shows that your client has experienced three episodes of acute congestive heart failure within the last year.
Does your client’s chronic heart failure meet a Listing?

Answers:

No, because chronic heart failure is not considered in the Listings. (Incorrect. Chronic heart failure is listed under section 4.02)
Yes, because their impairment meets either subsection A or B of the appropriate Listing. (Incorrect. 4.02 requires that both sections A and B be met)
No, because their impairment does not meet or medically equal the requirements for both subsections A and B of the appropriate Listing. (Correct)
Yes, because their impairment meets subsections A, B, and C of the appropriate Listing. (Incorrect. There is no subsection C for 4.02)

Reference:

Appendix 1 to Subpart P of Part 404 – Listing of Impairments.

Requirements for the Examination

Requirements for Your Examination Environment

Find a quiet, distraction-free area to take your exam. You may take the test from a location of your choice during the time you schedule. No other individuals are allowed in the testing room with you during the online exam. A suitable testing environment is an enclosed room with a closed door. Rooms with large glass walls or windows that cannot be covered are not suitable for testing. There will be no breaks during the 3-hour exam, unless previously approved by us in response to an American Disability Act (ADA) request.

Ensure you have current valid government-issued photo ID. You must show ID to be admitted into the online exam session. Only a state driver’s license or identification card, passport, civil service ID, or military identification card will be accepted. Expired photo ID(s) will not be accepted.

Obtain an erasable hand-held whiteboard and erasable marker. This may be used in place of scratch paper. Absolutely no scratch paper will be permitted. After completing your exam, the proctor will verify that you have completely erased the whiteboard. These types of boards can be purchased inexpensively through retail stores and online retailers.

Familiarize yourself with electronic reference materials before the examination. You will have the Electronic Code of Federal Regulations accessible to you during the examination, which you may refer to as needed within the exam platform. You may not use any hard-copy reference materials, notes, or other unauthorized forms of information during your online examination session.

Remove prohibited items from your testing area. You are not allowed to access notes or personal items including, but not limited to, purses, briefcases, backpacks, fanny packs, study materials, beepers, pagers, cellular phones, calculators, headphones, etc.

Verification will be conducted via webcam to ensure a clear testing environment, meaning the webcam will need to be able to clearly see you and your surroundings at all times.

Technical Requirements by Vendor

Test your equipment! You must have a reliable personal computer with a high-speed internet connection with a minimum upload speed of 1.5 Mbps, a microphone, speakers, and a webcam (internal or external). If your equipment fails after you begin the examination because it does not meet the requirements, you will fail the examination.

Supported operating systems: Windows 8 and higher, Mac OS X and higher, Chrome OS and most Linux distributions (64-bit Ubuntu 14.04+ (Currently incompatible with Ubuntu 22.04. (Update needed), Debian 8+, openSUSE 13.3+, or Fedora Linux 24+)

Supported browser: Latest version of Google Chrome

Pre-Examination Check. Before taking the examination, you must acknowledge that you have tested your equipment for proper operating condition and confirm that it meets our requirements.

Log on early. It is recommended that you log on approximately 15 minutes prior to your appointment time to conduct a final computer system check. Please allow for additional time when planning for your exam session. You may experience a wait of up to 60 minutes to connect with a remote proctor during peak times.

Registering and Updating Your Personal Information

Once you receive your notice of eligibility, you must register with us using Form SSA-1699 (Registration for Appointed Representative Services and Direct Payment) to receive direct payment. If your information or status changes, you must update your name, physical address, email, phone number, and payment information by submitting Form SSA-1699 again. Be aware that submitting Form SSA-1699 is only part of the process. You must also submit your updated information directly to StratComm, Inc. to keep their files updated.

Requirements for Continuing Eligibility

To retain eligibility, you must take and certify annual continuing education courses and continuously maintain professional liability insurance.

Continuing Education

All continuing education courses must meet the standards that we prescribe. We select courses with the goal of enhancing your professional knowledge in matters such as benefits, ethics, the listings of impairments, and other disability topics under Titles II and XVI of the Social Security Act. These courses may be completed in person, online, or by reviewing written course materials, but must be completed during the current reporting period.

You must take and certify continuing education courses provided by us and one ethics course that meets our requirements listed below and provided by an accredited college or university, state bar association, organization accredited by a state bar, government agency, or professional organization such as the American Bar Association, the National Organization of Social Security Claimants' Representatives, and the National Association of Disability Representatives.

We announce all required courses on our website in the first quarter of each calendar year.

You have until September 30 of each year to complete and certify that you have completed the required courses. You must submit proof of your completed ethics course for review and approval. Certify that you have completed your required courses by sending an email to StratComm, Inc. You may send a certification email after you have attended each continuing education course or you may wait until you have taken all your required courses before sending your certification to StratComm, Inc. You must provide the following information:

Title of the course(s);
Date the course(s) was completed; and
The organization that provided the course.

If you do not complete and certify the required continuing education courses by September 30, you will be ineligible for direct fee payment for at least six full calendar months, beginning December 1.

Ethics and Professional Conduct Course

You must complete an ethics and professional conduct course that covers topics pertinent to your representation of claimants.

To qualify as an ethics and professional conduct course, the course syllabus must indicate that the course’s primary focus is to cover at least one of the following criteria:

The rules of conduct and standards of responsibility for representatives listed in 20 CFR 404.1740 and 416.1540 and related sub-regulatory guidance;

Maintaining a professional representative-claimant relationship as it relates to the personal ethics of a representative, such as maintaining appropriate boundaries with clients;
Ethical application of Disability or Health Insurance Portability and Accountability Act (HIPAA) regulations;
The ethics of billing and/or receiving fees for representing clients; or
Cybersecurity and the ethical duty and process of protecting clients' privacy (i.e., personally identifiable information or other data and credentials) and notifying clients of systems breaches or loss of personally identifiable information.

Many sources provide a variety of qualifying ethics courses, including in-class and online programs. To ensure you are able meet our ethics and professional course requirements on or before September 30, we encourage you to be aware of alternate courses and times in the event that your primary source is not available or conflicts in your schedule should arise.

To ensure that you receive timely and accurate ethics education, we cannot accept any course or training created by your employer. We can only provide credit for an ethics course or training from an institute of higher learning if that institute is accredited. We also cannot provide credit for courses or trainings completed during a previous calendar year. All ethics courses must be consistent with our most recent ethics requirements in order to receive credit. Finally, we cannot provide credit for any ethics course or training that you have attended more than once. We reserve the right to reject any course or training if we determine that the course or instructor does not meet our requirements.

NOTE: If you are unsure whether a particular course meets our requirements, you may provide a copy of the course syllabus for us to review prior to enrolling for the course.

Please take a few minutes to complete the optional end of course survey.

EDPNA Sickle Cell Disease for: Fiscal Year 2023

EDPNA Best Practices and Reminders for: Fiscal Year 2023

EDPNA Presumptive Disability and Presumptive Blindness: Fiscal Year 2023

Professional Malpractice Liability Insurance

If you pass our examination and we determine that you meet the requirements for eligibility for direct pay, we will issue you a Notice of Eligibility for direct pay. At this time, you must submit the initial proof of your insurance to us before you can be eligible for direct payment. You must maintain continuous liability insurance coverage at all times, and you must submit proof of such to us each time you change insurance providers or after any period of ineligibility. All insurance documents must be submitted to us through StratComm, Inc.

You must carry professional liability insurance coverage of at least $100,000 per incident and a minimum annual aggregate coverage of $500,000 (see 2005 FR Vol 70 No.136). For a business liability malpractice insurance policy, the minimal annual aggregate amount is determined in accordance with the following schedule:

Number of Covered Employees	Minimum Aggregate Amount
1 to 10	$500,000
11 to 25	$1 million
26 to 50	$2 million
51 to 100	$3 million
101 to 200	$4 million
201 or more	$5 million

We consider business liability insurance to constitute insurance equivalent to professional liability insurance provided the business insurance provides coverage that satisfies the required minimum per-incident and aggregate amounts. You must submit your certificate of insurance, binder of insurance, or other actual policy containing the following information:

Effective dates of the insurance policy;
Policy number; and
Limits of professional liability insurance for malpractice.

Proposals, quotes for professional liability insurance, or any other document that does not clearly establish that a policy meeting our requirements has been purchased, are not acceptable. Your professional liability insurance must be in effect at the time you submit proof to us. If you fail to submit proof of sufficient professional liability insurance, you will not be eligible for direct payment.

You must provide your insurance information to us by 3:00 p.m. EST on the last business day of the month to qualify for direct fee payment on the first day of the following month. If we do not receive and approve your documents by the 3:00 p.m. EST deadline, you will not be eligible for direct fee payment until the month after the month we receive and approve your documents.

If you are establishing eligibility for direct pay for the first time, you must submit a completed Form SSA-1699 on or after your assigned date of eligibility.

Annual Audits

To protect claimants and maintain the integrity of the EDPNA program, we periodically audit insurance coverage and conduct additional background checks for program participants. Failure to meet our requirements during an audit will make you ineligible for direct fee payment for at least six months.

Insurance Audit

If you are selected for an insurance audit, we will send you a notice requesting proof of insurance coverage before the deadline set out in the notice. A lapse in your insurance coverage, except as described below, is a violation of the EDPNA program rules that will result in a period of ineligibility and preclude you from receiving direct payment from us for no less than six months.

“Prior Act” insurance coverage is not compliant with the statutory and regulatory requirement that you maintain continuous liability insurance coverage.
There may be situations in which we will not consider a lapse of coverage a violation of the EPDNA program rules, such as:

Periods of pre-approved inactivity (e.g., you no longer practice, either temporarily or permanently); or
Changes in status (e.g., you become licensed to practice law or you are an attorney who was previously an EDPNA but are no longer licensed to practice law for non-disciplinary reasons).

If your status changes, notify us in writing at StratComm, Inc. After receiving the necessary information, we will advise you whether you may discontinue your liability insurance coverage during the period of inactivity without adverse action by us. You must also notify us if you wish to resume your practice. Before we will change your status to resume eligibility for direct payment, you must submit to us proof of liability insurance and certification of continuing educational courses.

NOTE: You may continue to represent claimants during a period of ineligibility for direct payment; however, you will be unable to receive direct payment during any such period.

If you do not maintain continuous liability insurance coverage or do not provide sufficient proof of continuous coverage within our deadline, and we have not informed you that you are excepted from this requirement while inactive, we will find you ineligible for direct payment for at least six full calendar months. You can find information about our ineligibility and protest procedures below.

Examples of Breaks in Insurance Coverage

Example 1:

You have practiced as a non-attorney representative since first becoming eligible. Last year, you realized that you had a lapse in your insurance coverage, so you purchased “prior act” coverage to cover the lapse period. This year, you were selected to participate in the liability insurance audit and are currently covered. As we do not recognize the prior act coverage, you will be ineligible for direct payment per 20 CFR 404.1717.

Example 2:

You temporarily stopped working as a non-attorney representative before us and cancelled your liability insurance. However, you did not inform us that you became inactive at this time. Later, when you started practicing before us again, you purchased new insurance. During an audit, we found out about the lapse in your liability insurance coverage. Because each EDPNA is required to maintain continuous liability insurance, you will be ineligible for direct payment per 20 CFR 404.1717.

Example 3:

You temporarily must stop working as a representative and properly informed us that you would be inactive. We then changed your status to inactive and you were no longer able to receive direct payment. Once you were ready to practice again, you purchased and submitted your proof of insurance to us. At that time, we changed your status to eligible again. During a later audit, we reviewed your insurance history and found this information. Because you notified us in advance of your break in representation and you have been continuously insured since you started to work again, you will remain eligible for direct payment per 20 CFR 404.1717.

Background Audit

You must meet the criteria in our criminal background check at all times in order to remain eligible to receive direct payment of fees.

If selected for a background check, you must complete the Authorization for Release of Information section (last page) of Form SSA-1691; and submit it within the specified time. We will complete the background check and inform you of the results.

If you do not pass the background check, we will find you permanently ineligible for direct payment. You will have the right to protest our finding that you do not meet the requirements of our criminal background check in writing. You can find information about our ineligibility and protest procedures below.

False or Misleading Information

We will find you permanently ineligible to receive direct payment of fees if we discover that you have falsified or misrepresented information in your application, or subsequent communications with us. Examples include false or misleading information about:

Any suspension or disqualification from practice before us, or suspension or disbarment from the practice of law in any jurisdiction;
A judgment or lien assessed against you by a civil court for malpractice or fraud;
A felony conviction; or
Information provided on the application or supporting materials for the application.

If we find you ineligible for direct payment resulting from a false or misleading statement, and you believe we have made an error, you can protest our action(s). If you do not protest, you will be permanently ineligible to receive direct fee payment beginning with the month after the month the protest period ends. If you protest and we confirm our earlier finding, you will be permanently ineligible to receive direct fee payment the month after the month we uphold our finding. You can find information about our ineligibility and protest procedures below.

If our background check concludes that you have misrepresented information about your education, background, continuing education courses, or liability insurance coverage, we may refer this information to our Office of the General Counsel for consideration of further sanctions.

Ineligibility for Direct Payment

If you do not meet the requirements above, you will become ineligible for direct payment.

For findings leading to temporary periods of ineligibility, after the 6-month period of ineligibility is over, you will again be eligible for direct fee payment in the first month after the month you meet the requirements for direct payment. You may submit required documentation at any time during, or at the end of the 6-month period of ineligibility.

If you do not pass our criminal background check or provide us with false or misleading information, you will be permanently ineligible for direct payment.

Protest Procedures

If you disagree with a finding of ineligibility, you may file a protest. To do so, you must provide all relevant supporting documentation to us within ten calendar days after the date we notify you of our finding of ineligibility. If our review confirms our original finding, you will be ineligible for direct payment as explained in Ineligibility for Direct Payment above.

You must send all protests to StratComm, Inc.