CPS HR Consulting
Social Security Administration

SSA LogoDirect Payment to Non-Attorney Representatives

Insurance Requirement

Types of Insurance

If you want to receive direct fee payment, the PRA requires you to have professional liability insurance or equivalent insurance, which we determine to be adequate to protect claimants in the event of malpractice by you. You must use a firm legally permitted to provide insurance in the State in which you conduct business to underwrite the insurance policy. The policy also must provide coverage for professional liability insurance claims made in those states in which you represent claimants before SSA.

You must carry professional liability insurance coverage of at least $100,000 per incident. The minimum annual aggregate coverage amount for an individual's professional liability insurance is $500,000. For a business liability 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

Eligibility Requirement

If you want to receive direct fee payment, you must provide your initial proof of insurance coverage after passing the examination. You will not qualify for direct payment until you submit proof of your liability insurance coverage to us. If you fail to submit proof of sufficient liability insurance, you will not be eligible for direct payment until you provide this information.

You must submit a certificate of insurance, binder of insurance, or other actual policy showing the following:

  1. Effective dates of the insurance policy

  2. Policy number

  3. Limits of liability insurance

Proposals or quotes for insurance are not acceptable. Your liability insurance must be in effect at the time you submit proof to us, after passing the examination.

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 qualify 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 then submit a completed form SSA-1699 on, or after the date of eligibility you have been assigned.

Once you submit the initial proof of your liability insurance to us, you must maintain continuous insurance coverage to remain eligible for direct payment. At various times, we will require you to provide proof that you have maintained continuous professional or business liability insurance coverage in the amounts we prescribe. You will receive a notice from us when it is time to verify your insurance coverage. Therefore, you should only submit proof of your liability insurance in these instances: After passing the examination, at any time we request that you provide this proof to us, and after any period of period of ineligibility as outlined in the next paragraph. You can send your insurance documents to us through our email address or mailing address before the deadline we establish.

If you do not maintain continuous liability insurance coverage since the last time we requested verification, you will be ineligible for direct payment for at least six (6) full calendar months. You have the opportunity to protest our finding that you have not provided sufficient proof that you maintained continuous liability insurance coverage. If you do not protest, you will be ineligible for direct fee payment for six (6) full calendar months beginning with the month after the month the protest period ends. If you file a protest and the action we take in response to the protest confirms our earlier finding, you will be ineligible for direct payment for six (6) full calendar months beginning with the month after we uphold our finding. You must provide us with documentation that you have the required liability insurance coverage no earlier than the sixth month of the period of ineligibility. After the 6-month period of ineligibility is over, you will be eligible for direct fee payment in the first month after the month we find that you have the required insurance coverage. 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 find that you have misrepresented information about your liability insurance coverage, we may refer this information to our Office of the General Counsel for their decision about initiating a sanction action against you.