Email FacebookTwitterMenu burgerClose thin

Social Security Form SSA-1696-U4


The Social Security Administration (SSA) is an enormous organization, and the decisions it makes regarding your benefits can have a big impact on your finances. It’s not unusual to feel overwhelmed when you’re applying for benefits or appealing a decision. In some circumstances, you can benefit from having a qualified individual such as an attorney represent you before the SSA. To establish this kind of representation, you’ll need to complete Social Security Form SSA-1696-U4.

What Is Form SSA-1696-U4?

Social Security Form SSA-1696-U4 is a form that allows you to appoint a third party to represent you when you deal with the Social Security Administration (SSA). You can choose to have an attorney as your representative or you can appoint any qualified individual you wish. If you like, you can choose to have multiple representatives. Note that you can’t appoint a group, like a law firm, to be your representative; but you can appoint multiple attorneys from a firm.

Once you appoint a representative, he or she can retrieve information from your file; appoint associates with your permission; provide the SSA with information about and evidence for your claims; accompany you to any meetings or interviews with the SSA; request reconsideration of decisions; and assist you and your witnesses with any preparation.

How to Fill Out Form SSA-1696-U4


Form SSA-1696-U4 contains three separate parts. The first part is for you to list your information and the name of your representative. You’ll need to provide your name and your Social Security Number (SSN), as well as the matters for which you’re seeking representation. You also need to provide the name and contact information of your chosen representative.

You’re given four choices for which issues you’re representative will be handling. These are Retirement, Survivors and Disability Benefits (covered by Title II of the Social Security Act), Supplemental Security Income (Title XVI), Medicare (Title XVIII) and Special Veteran’s Benefits (VII). You’re welcome to check off more than one if that suits your situation. You also have the option to appoint multiple representatives. If you choose this route, provide the name of the principal representative. Also, make sure to check the box that indicates you’ll have multiple representatives.

Your representative will be responsible for completing the second section of the form. He or she will accept the appointment with a signature. Then, he or she will answer a few questions pertaining to their fitness to represent you before the SSA. These include if they are an attorney; if they’ve ever been disbarred; and if they’ve ever been disqualified from participating in a federal program or appearing before a federal agency. If you are appointing multiple representatives, each of them will have to fill out this section individually, so you’ll need multiple copies of the form.

The third section of the form deals with the fee arrangement between you and your representatives. Check the appropriate box to indicate how (or if) your representative is being compensated for their assistance. If your representative is charging a fee, he or she will need to either file a fee petition with the SSA or submit for approval a fee agreement that you’ve both signed. To review all the details about acceptable fee arrangements, you can refer to the Information for Representatives section of the form.

How to Submit Form SSA-1696-U4

To submit form SSA-1696-U4, you can mail or fax a copy to your local Social Security Office. You’ll need to make sure that each representative has completed a copy of section two if you’re appointing multiple representatives. Additionally, make sure that your representative is submitting the proper paperwork for the fee arrangement that you have agreed upon.

To find your local Social Security Office, you can head to the Social Security website. You can also call the toll-free Customer Service line at 1-800-772-1213.


The Bottom Line

Navigating the intricacies of the SSA can sometimes feel like a job in and of itself. It’s made even more difficult if you’re seeking benefits because you’re dealing with a disability or an illness of some kind. Fortunately, you can appoint representatives that can assist you and act on your behalf. That way, you can be confident that your interests are being represented properly and to the greatest extent possible. That’s why form SSA-1696-U4 exists.

Tips for Preparing for Your Retirement

  • Having an expert represent you before the SSA can make the process much easier and more transparent. Talking with a financial advisor can have that effect on your whole financial life. Finding a financial advisor doesn’t have to be hard. SmartAsset’s free tool matches you with up to three vetted financial advisors who serve your area, and you can interview your advisor matches at no cost to decide which one is right for you. If you’re ready to find an advisor who can help you achieve your financial goals, get started now.
  • If you want to predict your Social Security retirement benefits, SmartAsset’s Social Security calculator can help you do just that. If you enter your year of birth and your annual income, the calculator can tell you your annual benefit and show how it increases or decreases depending on the age when you start taking benefits.
  • Saving for retirement is a long process with plenty of moving parts. You need to get an idea of how much you’ll need to save. This is where SmartAsset’s retirement calculator can come in handy. You can enter information about your income and savings and find out how you’re pacing.

Photo credit: ©, ©, © Manustrong