Frequently Asked Questions

What exactly is an EDPNA, and how is it different from a lawyer?

EDPNA stands for "Eligible for Direct Payment Non-Attorney" representative. It's a formal designation from the Social Security Administration that allows a qualified non-attorney to represent claimants at every stage of a disability claim — including hearings before an Administrative Law Judge — and to receive fees directly from SSA, the same way an attorney does.

The key difference is licensing: an attorney has a state law license and can represent clients in any legal matter, including civil litigation in federal court. An EDPNA's authority is specific to SSA proceedings. For the vast majority of SSDI/SSI claims — application through Appeals Council — that distinction doesn't limit what an EDPNA can do for you.

Can a non-attorney really argue my case in front of a judge?

Yes. SSA regulations (20 CFR § 404.1705 and § 416.1505) specifically authorize qualified non-attorney representatives to appear at hearings, question witnesses, present evidence, and make legal arguments on your behalf — the same functions an attorney would perform at that stage.

What happens if my case needs to go to federal court?

If the Appeals Council denies your case, the only remaining option is filing a civil action in federal district court. This falls outside what a non-attorney representative is authorized to handle, since it's federal civil litigation rather than an SSA administrative proceeding. At that point, your representative should refer you to a disability attorney experienced in federal court appeals — ideally someone they already have a working relationship with, so the transition is smooth rather than starting from zero.

Will I work with the same person throughout my case?

That depends on who you hire. Solo practices and small representative firms typically mean you work directly with the same person from your first call through the final decision. Larger, high-volume disability firms often assign cases to paralegals or rotate staff, meaning you may not speak with the same person twice. Neither approach is inherently better, but it's worth asking directly when you're evaluating who to work with.

How much does it cost to hire a representative?

Nothing upfront. Fees for SSDI/SSI representation are governed by SSA's fee agreement process and are almost always structured as a contingency — a percentage of your past-due benefits (back pay), paid only if your claim is approved. The exact percentage and cap are set by SSA regulation and must be approved before any fee is collected.

What if my claim is denied — do I owe anything?

Under a standard contingency fee agreement, no. If there's no approval and no past-due benefits, there's typically no fee owed. This is one of the reasons contingency-based representation is the norm in this field — it aligns the representative's incentive with actually winning your case.

Are there any costs besides the representation fee?

Sometimes. Obtaining copies of medical records can involve small fees charged by hospitals or clinics, and these are typically separate from the representation fee itself. Ask your representative upfront how these costs are handled — some cover them, others pass them through directly.

How long does the whole process take?

It varies significantly by stage and by region. Initial applications typically take a few months for a decision. Reconsideration adds more time. Hearings can involve the longest wait — often a year or more from request to actual hearing date, depending on the local hearing office's backlog. There's no way to guarantee a timeline, but a representative can often tell you what's typical for your specific SSA field office and hearing office.

What's the difference between SSDI and SSI?

SSDI (Social Security Disability Insurance) is based on your work history and the Social Security taxes you've paid — it functions like an insurance benefit you've earned. SSI (Supplemental Security Income) is a needs-based program available to people with limited income and resources, regardless of work history. Some people qualify for both simultaneously (often called "concurrent" claims), depending on their financial circumstances and work record.

My claim was denied twice already. Is it too late to keep going?

Not necessarily. Most successful claims include at least one denial — often two — before ultimately being approved. What matters most is filing your next appeal within the deadline stated on your most recent denial notice, which is typically 60 days from the date on the letter. Missing that deadline is a much bigger problem than having prior denials on your record.

What is a Continuing Disability Review (CDR), and do I need help with that too?

A CDR is a periodic review SSA conducts on approved claims to confirm your disability is ongoing. These reviews happen on a schedule set at the time of your approval (often every 3, 5, or 7 years, depending on how your condition is expected to change). Representation can help during a CDR the same way it can during an initial claim — making sure updated medical evidence is submitted correctly and on time, so your benefits continue without interruption.

What if SSA says I was overpaid?

An overpayment notice means SSA believes you received more in benefits than you were entitled to, for reasons ranging from unreported income changes to administrative errors on SSA's end. You generally have the right to request a waiver (arguing the overpayment wasn't your fault and repaying it would cause hardship) or reconsideration (disputing that an overpayment occurred at all). These have their own deadlines and evidence requirements, similar to a denial appeal.

What medical evidence actually matters most?

SSA weighs evidence that connects your diagnosis to specific functional limitations — what you can and can't do because of your condition — more heavily than a diagnosis alone. Detailed treatment notes, objective test results (imaging, labs), and a treating physician's assessment of your functional capacity (how long you can sit, stand, lift, concentrate, etc.) tend to carry more weight than a brief note simply stating a diagnosis.

Can I still work part-time while my claim is pending?

It depends on how much you earn. SSA uses a threshold called "substantial gainful activity" (SGA) — earning above that monthly amount generally disqualifies you from disability benefits, regardless of how severe your condition is. The exact dollar threshold changes periodically, so it's worth confirming the current figure before assuming part-time work is safe for your claim.

Does my age affect my chances of approval?

Yes, in a specific, regulation-defined way. SSA's medical-vocational guidelines (sometimes called "the grid rules") become more favorable at certain age thresholds — notably 50 and 55 — because SSA recognizes that transitioning to different types of work becomes harder as people age, particularly for those with physically demanding work histories. This doesn't mean younger claimants can't be approved, but age is a real factor SSA formally considers.

What if I have a mental health condition rather than a physical one?

Mental health conditions are evaluated under their own specific criteria and are just as valid a basis for a claim as physical conditions. Documentation from treating psychiatrists, psychologists, or therapists — including how your symptoms affect concentration, social functioning, and ability to complete tasks — is central to these claims, similarly to how functional capacity evidence works for physical conditions.

Do I have to meet my representative in person?

No. Hearings are frequently conducted by phone or video, and most representative-client communication (calls, document exchange, email) can happen entirely remotely. This makes it possible to work with a representative outside your immediate local area.

What should I have ready before my first conversation?

Nothing is strictly required to have a first conversation, but it helps to know roughly what stage your claim is at (if you've already applied), and to have your most recent SSA denial notice or correspondence on hand if you have one. Detailed medical records and work history can be gathered afterward.

What if I decide not to move forward after the free evaluation?

That's completely fine — a free case evaluation is exactly that: a conversation, not a commitment. No representative-client relationship exists until a written fee agreement is signed, and there's no obligation to proceed after an initial evaluation.