This is an archival or historical document. It may not reflect current policies or procedures.

We welcome those who wish to help another person apply for disability benefits. You may be a friend, relative, attorney, paralegal, employer, or member of an advocacy group or organization.

We may ask for information about you (the form completer), your relationship to the person you are applying for and, if applicable, the organization you work for.

Authorized Representatives

You do not need to be appointed as the representative of the person you are helping in order to help him or her apply for benefits. But if the person you are helping wants to officially appoint you as his authorized representative to do business with Social Security, you must submit form SSA-1696-U4 (Appointment of Representative).

To get a copy and an explanation of the representative process, visit our web page, Representing Social Security Claimants.

Who Can "Sign" the Application

If the person you are helping is, or will be with you and able to sign the completed application, he or she must be the one to sign it (i.e., electronically apply). The application will then be automatically forwarded to us and we will begin processing.

However, if the person is not with you or not able to sign the application, we will mail it to him or her for verification and signature.

Note: It is important that the person you are helping sign the application - not you.

Please Tell Us Who You Are Helping:

I am helping someone who wants to apply for disability benefits who: