Building the EDPNA Pipeline: Remove the Barriers Without Lowering the Bar

 

Earlier this week, a colleague asked me to identify the barriers to entry for Eligible for Direct Payment Non-Attorney representative. What a good question. Social Security disability representation occupies an unusual place in the American safety net. An Eligible for Direct Payment Non-Attorney representative, commonly called an EDPNA, can represent disability claimants throughout Social Security's administrative process and receive authorized fees directly from past-due benefits. The work requires knowledge of Social Security law, medical evidence, vocational analysis, administrative procedure, ethics, and the practical realities of working with people who may be seriously ill or financially desperate. Yet there is no law school, established professional school, or conventional career pipeline that reliably produces these representatives. If we want more qualified people doing this work, the answer should not be to lower professional standards. The answer should be to examine the barriers that make entering and sustaining the profession unnecessarily difficult (Social Security Administration [SSA], 2026a).

The work is also much closer to social work than the term "representative" initially suggests. A good disability representative does not simply write a brief and appear at a hearing. Representatives talk repeatedly with clients, explain notices, obtain medical histories, track treatment, communicate with family members, identify missing evidence, deal with crises, and keep people engaged during a process that can last many months. Many clients have physical, mental, cognitive, financial, or housing challenges that make consistent communication difficult. The Bureau of Labor Statistics reports that the median annual wage for social workers was $61,780 in May 2025, which gives us a reasonable benchmark when asking whether disability representation can support a middle-class professional career. The problem is that the EDPNA compensation system bears little resemblance to a $60,000 salaried job (Bureau of Labor Statistics [BLS], 2026).

Barrier One: The Economics Look Better on Paper Than They Are in Practice

Under SSA's fee-agreement process, the authorized fee generally cannot exceed the lesser of 25 percent of the claimant's past-due benefits or $9,200. That means a claimant must have at least $36,800 in applicable past-due benefits before the representative can even reach the $9,200 ceiling. SSA also deducts an assessment from direct fee payments, currently limited to the lesser of 6.3 percent of the fee or $123 for payments made after December 1, 2025. A representative who receives the full $9,200 therefore receives approximately $9,077 after that assessment. Seven such maximum-fee cases would produce about $63,539, which sounds at first like a reasonable path to a $60,000 income. The problem is that seven maximum-fee cases are not the same thing as seven clients (SSA, 2026b; SSA, 2026c).

The following illustration shows how quickly the economics change when the average fee falls below the statutory ceiling. The final columns use hypothetical fee-producing success rates only to illustrate the size of the intake pipeline that would be required, not to estimate an actual industry win rate. These figures also exclude insurance, technology, staff, office expenses, taxes, marketing, record retrieval costs, and uncompensated time. A practitioner seeking $60,000 of actual personal compensation would therefore need more revenue than the table suggests. The table demonstrates why the $9,200 ceiling should never be confused with an average fee. It is a best-case ceiling under the ordinary fee-agreement process.

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Average authorized fee	Approximate net after SSA assessment	Paid cases needed for $60,000	Clients needed if 70% generate a fee	Clients needed if 50% generate a fee
$9,200	$9,077	7	10	14
$6,000	$5,877	11	16	22
$5,000	$4,877	13	19	26
$4,000	$3,877	16	23	32
$3,000	$2,877	21	31	42

 

There is an important qualification to this argument. The $9,200 amount is the ceiling for the ordinary fee-agreement process, not an absolute ceiling on every fee SSA can authorize. Representatives may use the fee-petition process in appropriate circumstances, under which SSA evaluates the services performed and authorizes a reasonable fee. That distinction should be acknowledged because otherwise critics can correctly argue that the compensation system is more complicated than a simple $9,200 cap. It does not change the underlying economic problem because the fee-agreement process is designed to provide a relatively predictable path to payment and remains tied to successful outcomes and past-due benefits. A new practitioner cannot build a household budget around the possibility that a later fee petition might produce additional income (SSA, 2026d).

Cash flow may actually be the greater barrier. SSA's fiscal year 2026 performance plan identified average processing-time goals of 220 days for initial disability claims, 248 days for reconsiderations, and 270 days for hearing decisions. These numbers should not simply be added together and presented as the exact lifetime of an individual claim because they measure separate workloads rather than a single claimant cohort. They nevertheless demonstrate the length of the process at each stage and the financial exposure carried by representatives while cases are pending. An EDPNA may be talking with a client, reviewing records, submitting evidence, filing appeals, and maintaining the case for months before receiving any compensation. For someone entering the profession without an established firm's financial backing, the first barrier may therefore be working capital rather than knowledge (SSA, 2026e).

There is even a policy tension buried inside this compensation structure. Everyone should want SSA to make accurate decisions faster because disabled individuals should not have to wait unnecessarily for benefits. Faster favorable decisions, however, usually produce fewer months of past-due benefits. Because the standard fee agreement is tied to a percentage of those past-due benefits, faster service can also mean a smaller representative fee. No one should interpret that as an argument for delay. It is instead evidence that the compensation model is imperfectly aligned with the policy goal of obtaining correct decisions as early as possible. A modern representation system should reward good evidence development and early resolution rather than depend economically on accumulated delay.

Barrier Two: The Training Is Technical and the Learning Path Is Fragmented

The second barrier is education. Disability representation requires an understanding of Titles II and XVI, insured status, substantial gainful activity, sequential evaluation, medical listings, vocational evidence, residual functional capacity, onset dates, appeals, fee rules, and representative responsibilities. SSA's EDPNA examination contains 50 multiple-choice questions, allows up to three hours, and requires a score of at least 70 percent. The examination tests relevant provisions of the Social Security Act along with SSA policy and court developments. These are appropriate areas in which to demand competence because a claimant's livelihood can depend on the representative knowing the rules. The problem is not that the material is difficult, but that the pathway for learning it has historically been fragmented and often painfully technical (SSA, 2026a).

This is an area where the advocacy community can help rather than simply ask SSA to solve the problem. ACRD has developed an EDPNA Mastercourse and Academy training aimed at helping disability professionals learn the work in a more structured and practical manner. That model works because the best training is not memorizing policy in isolation. A prospective representative should be able to work through a simulated claim from intake through adjudication, including incomplete medical records, conflicting evidence, earnings questions, missed appointments, vocational issues, and difficult client communications. Training should teach people how to think through a case rather than merely how to pass a test. Competency should remain the goal, but competency can be taught much better than it often has been (Advocates, Counselors, and Representatives for the Disabled [ACRD], n.d.).

Barrier Three: SSA Has Created an Artificial Annual Gate

The third barrier is unusually easy to fix. SSA accepts applications for the EDPNA examination during a single annual period from February 1 through February 28. The 2026 examination cycle has already concluded, and SSA states that the next application period will not begin until February 1, 2027. Applicants must also submit a $1,000 application fee. Someone who becomes interested in the profession in September can therefore be ready, willing, and qualified to begin training but still face months of waiting simply to enter the application cycle. If that individual misses the deadline or fails the examination, another lengthy delay may follow (SSA, 2026a; SSA, 2026f).

That limitation makes even less sense now that SSA administers the examination remotely rather than requiring candidates to travel to testing centers. The Social Security Act requires eligible non-attorney representatives to pass an examination administered by the Commissioner, but the statute does not prescribe a once-a-year examination schedule. SSA should therefore examine moving immediately to quarterly testing and ultimately toward rolling applications with monthly or continuously available testing windows. The competency standard would remain exactly the same. The background investigation, insurance requirements, education requirements, and continuing education obligations would remain exactly the same. The only thing removed would be an administrative calendar that artificially restricts entry into the profession (Social Security Act § 206(e), 42 U.S.C. § 406; SSA, 2026a).

Barrier Four: Evidence Development Is a Production Problem

The fourth barrier is the extraordinary amount of labor required to assemble a disability case. Medical evidence may be spread among hospitals, primary-care practices, specialists, therapists, imaging centers, laboratories, rehabilitation providers, and behavioral-health systems. Older records may be difficult to locate, provider organizations may have merged or closed, and electronic systems do not necessarily communicate cleanly with one another. Representatives must determine what is missing and whether the existing evidence actually describes functional limitations rather than merely diagnoses. They may also need records covering years of treatment, which turns evidence collection into a longitudinal research project. The work is high touch for the claimant and highly manual for the representative.

Information blocking is part of this problem, although it is important not to call every difficult record request information blocking. The 21st Century Cures Act established an expectation that electronic health information should be accessible, exchangeable, and usable, subject to defined exceptions. Federal rules describe information blocking as certain practices likely to interfere with access, exchange, or use of electronic health information. Even when conduct does not meet the legal definition of information blocking, fragmentation and poor interoperability still impose real costs on representatives and their clients. Every hour spent chasing records is an hour that is not spent analyzing the case itself. Improving electronic health-information exchange could therefore improve both disability outcomes and the economics of representation (Office of the National Coordinator for Health Information Technology [ONC], 2026).

The long-term answer should be to make evidence retrieval dramatically easier for an authorized representative. A claimant should be able to authorize access once and allow relevant medical evidence to move electronically through standardized health-information networks rather than requiring a representative to repeatedly chase individual providers. Historical records will always present problems because not all records exist electronically and not all old information can be reconstructed. That limitation is precisely why representatives should spend their time identifying meaningful evidentiary gaps rather than functioning as human fax machines. Better interoperability would not eliminate the need for representatives. It would let them spend more of their time actually representing people.

Barrier Five: Entry Comes With Professional-Level Compliance Costs

The EDPNA program properly requires more than passing an examination. Applicants must satisfy educational or qualifying professional-experience requirements, undergo a criminal background investigation, and maintain professional liability insurance. SSA requires at least $100,000 of coverage per incident and at least $500,000 in annual aggregate professional liability coverage for an individual representative. EDPNAs must also complete required continuing education and ethics training to maintain eligibility for direct fee payment. Failure to meet continuing education or continuous-insurance requirements can result in at least six months of ineligibility for direct payment. Those safeguards protect claimants and should not simply be discarded (SSA, 2023; SSA, 2026a).

The pressure-test question is whether the overall structure is proportionate to the economic opportunity being offered. SSA has effectively created professional-level qualification, insurance, ethics, education, and compliance requirements around a contingent compensation model with uncertain and delayed revenue. An attorney joining an established firm may have infrastructure and salary support while learning a practice area. A new independent EDPNA may have to pay the application fee, purchase insurance, build technology, learn the practice, find clients, develop evidence, and finance months of work before the first substantial payment arrives. Individually, none of these requirements is unreasonable. Collectively, they create a meaningful barrier to entry that policymakers should acknowledge.

Barrier Six: SSA's Own Administrative Systems Add Friction

Certification does not mean that the newly qualified EDPNA can immediately operate efficiently. Representatives must register with SSA, establish appointments, maintain their information, and rely upon SSA systems to recognize their relationship with individual claimants. SSA's Appointed Representative Services system allows representatives to view electronic folders, download records, upload evidence, and review pending cases. SSA also acknowledges that a representative may be unable to access an initial or reconsideration case because the SSA-1696 appointment has not yet been processed by the field office. Until that processing occurs, the representative may not have electronic access to the case they have been retained to handle. What looks like a small administrative delay to SSA becomes uncompensated production time for the practitioner (SSA, 2024; SSA, 2026g).

This matters because small practices survive on efficient workflow. A representative cannot economically serve more claimants simply by working longer hours. The profession needs reliable electronic appointments, immediate case visibility, modern document exchange, accurate status information, and dependable fee processing. Every manual intervention raises the cost of serving a claimant. Every phone call to correct a registration or locate a missing appointment consumes money that cannot be billed separately. The representative-facing technology environment is therefore a claimant-access issue as much as an administrative issue.

Barrier Seven: We Have a Certification Path, but Not a Professional Pipeline

The final barrier is less visible because it begins after someone passes the examination. Certification does not teach a new practitioner how to find clients, establish office procedures, select technology, manage deadlines, obtain insurance, develop referral relationships, interview difficult clients, supervise support staff, or decide which cases should never have been accepted. Those capabilities are normally learned through apprenticeship and professional networks. An EDPNA starting alone may instead be expected to acquire them through trial and error while simultaneously managing vulnerable clients and contingent cash flow. That is a poor environment for building a profession. We should think about the EDPNA pipeline as extending well beyond the examination.

This is another place where professional organizations can play an important role. ACRD's training infrastructure could evolve into mentoring, supervised case reviews, practice-management instruction, shared technical tools, evidence-development services, and structured support for newly qualified representatives. Experienced EDPNAs could mentor new entrants during their first year and help them recognize problems before those problems affect claimants. The profession could also develop better referral pathways so that new practitioners do not need to become marketers before they can become advocates. Shared infrastructure could reduce the cost of insurance, technology, vocational resources, and medical evidence collection. Building a profession requires more than certifying individuals.

What Reform Should Look Like

The objective should not be to make disability representation easy. Claimants deserve competent representatives who understand the law, protect sensitive information, behave ethically, and recognize the enormous consequences of bad advice. SSA should keep the examination, background investigation, insurance requirements, and continuing education. At the same time, SSA should dramatically increase testing frequency, simplify representative registration, accelerate electronic appointment processing, and improve representative access to claims information. HHS and SSA should continue pushing toward electronic medical evidence exchange that reduces the need for manual record chasing. Professional organizations should complement those reforms with practical training, mentoring, shared technology, and a real entry pipeline.

The compensation system also deserves a longer-term review. Raising the fee ceiling alone would not solve the problem because a higher ceiling does nothing for a case that produces little past-due benefits or takes years to resolve. Policymakers should study median fees actually paid to EDPNAs, the length of time between appointment and fee payment, the percentage of represented claims that produce no fee, and the cost required to maintain an active disability practice. SSA should also publish the number of EDPNA applicants, examination takers, passers, active practitioners, and departures from the program each year. Without those numbers, we are debating workforce policy without knowing the size or health of the workforce. Better data would tell us whether the largest problem is recruitment, qualification, retention, economics, or some combination of all four.

The best way to describe the reform is simple. We should make becoming an EDPNA easier without making being an EDPNA easier. There is no public benefit in forcing an otherwise qualified candidate to wait most of a year for an examination window. There is no claimant protection created by making representatives repeatedly chase records that could move electronically or by making them wait for an appointment form to be processed before they can see a case. High standards protect disabled people, but unnecessary friction does not. If we want more talented people willing to spend their careers helping disabled Americans navigate Social Security, we need to distinguish between the two.

References

Advocates, Counselors, and Representatives for the Disabled. (n.d.). Training for disability representatives. https://www.acrd.org/training

Bureau of Labor Statistics. (2026). Social workers: Occupational Outlook Handbook. U.S. Department of Labor. https://www.bls.gov/ooh/community-and-social-service/social-workers.htm

Office of the National Coordinator for Health Information Technology. (2026). Information blocking. U.S. Department of Health and Human Services. https://healthit.gov/information-blocking/

Social Security Administration. (2023). POMS GN 03920.018: Eligible for Direct Payment Non-Attorney representatives. https://secure.ssa.gov/poms.nsf/lnx/0203920018

Social Security Administration. (2024). An update to Appointed Representative Services. https://www.ssa.gov/news/en/advocates/2024-03-19-a.html

Social Security Administration. (2026a). Representing Social Security claimants: Eligible for Direct Payment Non-Attorney representatives. https://www.ssa.gov/representation/nonattyrep.htm

Social Security Administration. (2026b). Fee agreements: Representing SSA claimants. https://www.ssa.gov/representation/fee_agreements.htm

Social Security Administration. (2026c). Overview: Direct payment of a fee to a representative. Social Security Administration.

Social Security Administration. (2026d). The fee petition process: Representing SSA claimants. https://www.ssa.gov/representation/fee_petitions.htm

Social Security Administration. (2026e). Annual Performance Plan, Fiscal Years 2025–2026. https://www.ssa.gov/budget/assets/materials/2026/FY26-JEAC.pdf

Social Security Administration. (2026f). Representation news updates: 2026 EDPNA examination. Social Security Administration.

Social Security Administration. (2026g). Appointed Representative Services. https://www.ssa.gov/ar/

Social Security Act § 206, 42 U.S.C. § 406. https://www.ssa.gov/OP_Home/ssact/title02/0206.htm