TN 56 (12-24)

GN 03920.019 User Fee for Direct Fee Payments

A. Background about the user fee on direct fee payment to representatives

1. User fee policy

Sections 206(d) and 1631(d)(2) of the Social Security Act (Act) require us to charge an assessment, or "user fee," to recover administrative costs associated with the direct payment of fees. Specifically, section 206(d)(2)(A):

  • Caps the user fee at a flat-rate dollar amount or 6.3 percent of the fee payment, whichever is lower, effective September 1, 2004; and

  • Adjusts the flat-rate dollar amount based on annual cost-of-living adjustments rounded to the next lowest $1 beginning December 1, 2006.

This user fee applies whenever we certify for payment an administrative or court-awarded fee from the claimant's past-due benefits. We will apply the user fee cap in effect at the time of payment.

For more information on the fee payment date, see GN 03920.001.

2. Current and previous user fee amounts

Effective Date

Flat Rate User Fee Cap

December 1, 2024

$120.00

December 1, 2023

$117.00

December 1, 2022

$113.00

December 1, 2021

$104.00

December 1, 2020

$98.00

December 1, 2019

$97.00

December 1, 2018

$95.00

December 1, 2017

$93.00

December 1, 2014

$91.00

December 1,2013

$89.00

December 1,2012

$86.00

December 1, 2011

$83.00

December 1, 2008

$79.00

December 1, 2006

$77.00

December 1, 2004

$75.00

B. How we collect the user fee

We collect the user fee by withholding it from the authorized fee we pay from claimants' past-due benefits.

We collect the user fee when we directly pay:

  • An administrative fee from either Title II or Title XVI past-due benefits under our fee agreement or fee petition process; or

  • A court-awarded fee from Title II or Title XVI past-due benefits. See GN 03920.060 for court attorney fee procedures; or

In a concurrent Title II and Title XVI claim, the user fee cap applies to the total fee we pay directly to the recipient from a combination of withheld Title II and Title XVI benefits.

1. Title II claims or Title XVI claims

In a favorably decided Title II or Title XVI claim with past-due benefits withheld for direct payment, we will:

  • Deduct the user fee from the amount of the authorized fee and pay the remainder of the authorized fee to the representative(s) or any eligible entities) assigned direct payment. For information on the representative’s fee from Title II past-due benefits, see GN 03920.030B. For information on the representative’s fee from Title XVI past-due benefits, see GN 03920.031B.;

  • Explain the authorized fee to the claimant in the notice of award and fee authorization notice;

  • Recover any outstanding prior overpayment to the claimant; and

  • Release any excess withheld funds to the claimant and any affected auxiliary beneficiary if we include the affected auxiliary beneficiary’s benefits in calculating the past-due benefits for fee purposes.

We release any excess withheld funds, if any, to a claimant, affected auxiliary beneficiary, or eligible spouse, unless any of the following exceptions apply:

  • There is another representative who is eligible for direct payment and has not yet been paid,

  • Concurrent Title II and Title XVI cases in which offset has not yet occurred,

  • Cases with Federal court involvement, or

  • Cases with a timely request for administrative review still pending.

2. Dual entitlement and concurrent claims

Dual entitlement claims involve more than one type of benefit under the same title (e.g., entitlement to Title II disability insurance benefits (DIB) based on a claimant's own Social Security number (SSN), as well as Title II child's benefits based on a parent's SSN). Concurrent claims involve benefits under more than one title (e.g., entitlement to Title II disability insurance benefits as well as eligibility for Title XVI supplemental security income).

When processing dual entitlement claims, we will authorize fees for a representative’s services on behalf of a claimant, an affected auxiliary beneficiary in a Title II claim, or an eligible spouse in a Title XVI couple’s claim that results in entitlement or eligibility for benefits or an increase in benefit payments.

a. Dual Entitlement claims

In Title II dual entitlement claims, the user fee cap applies to all authorized fees, which we calculate based on the total past-due benefits on all earnings records. In these claims, we will deduct the user fee from the first fee we pay and deduct any remaining user fee amount from any subsequent fees we pay up to the full amount of the user fee cap.

EXAMPLE:Jamie appoints Max as the representative on their DIB claim on their own record and disabled widows' benefits (DWB) claim on their spouse's record. In December 2024, we initially authorized a direct payment of $1,000 to Max based on Jamie's entitlement to benefits on their own earnings record. Since 6.3 percent of $1,000 is less than the user fee cap of $120, we deduct a $63 user fee from the first payment. Subsequently Jamie was awarded DWB, resulting in an additional authorized fee to Max of $500. Since we deducted a user fee less than the full amount of $120 when paying fees relating to Jamie’s DIB claim and since 6.3 percent of the total amount of fees authorized is still less than the full amount of the user fee cap, we will deduct an additional 6.3 percent from the $500 fee relating to Jamie’s DWB claim ($31.50), as well.

b. Concurrent claims

In concurrent Title II and Title XVI claims, we will deduct the user fee from the authorized fee we pay directly the recipient(s) from the Title II past-due benefits first and will deduct an additional or remaining user fee amount from any authorized fee we pay from the Title XVI past-due benefits, up to the full amount of the user fee cap. If we deduct the full user fee from the Title II fee payment, we will not deduct a user fee from the Title XVI fee payment. If we deduct a user fee less than the cap from the Title II fee payment, we will deduct 6.3 percent of the direct payment amount or the amount of the user fee cap remaining, whichever is lower, from the additional authorized fee due from the Title XVI past-due benefits.

Example:Wendy appoints Phil as the representative on their concurrent Title II disability and Title XVI supplemental security income claim. Wendy is awarded benefits on both claims in December 2024, and we authorize fees of $1,200 to Phil from Wendy's Title II claim and $800 from the Title XVI claim. Since 6.3 percent of $1,200 ($75.60) is less than the amount of the user fee cap of $120, we will assess $75.60 from the authorized Title II fee first. We will also deduct $41.40 from the authorized Title XVI fee because it is the lesser of 6.3 percent of $800 ($50.40) and the remaining amount of full user fee ($120-$75.60= $44.40).

  • For fees involving multiple records in Title II claims, see GN 03920.030B.3.

  • For information on calculating past-due benefits in a Title XVI couple’s claim, see GN 03920.031B.1.

3. Trust or escrow accounts

If notified of the amount in an established trust fund or escrow account before we make the direct payment, we will first subtract the escrow amount from the authorized fee and afterward calculate the user fee based on the remaining authorized fee that we will directly pay. For information on fees and trust or escrow accounts, see GN 03920.025.

4. Rounding when calculating the user fee

We round to the nearest cent when calculating the user fee. For more information on our rounding policy, see RS 00601.020B.

5. Prohibition on seeking reimbursement of the user fee from the claimant

Recipients of direct payment cannot directly or indirectly charge or seek reimbursement of user fees from the claimant. For information on the prohibition of reimbursement of the user fee from claimants, see Section 206(d)(4) of the Act.

If technicians become aware of an attempt to charge or obtain reimbursement of the user fee from a claimant, refer the matter to OGC as a possible fee violation, as explained in GN 03970.017B. (Field Office (FO)) or GN 03970.017C (Payment Center (PC)).

C. User fees and direct payment of authorized fees to multiple representatives

When a claimant has multiple appointed representatives eligible for direct payment and we directly pay the fees, each direct payment recipient pays a portion of the user fee. We deduct the total user fee in proportion to the share of the total directly paid fee.

For information on the payment of representative fees, see GN 03920.016.

For information on the assignment of direct payment of authorized fees to an entity, see GN 03920.021.

1. Fees authorized under the fee agreement process

Under the fee agreement process, we apply the user fee in equal shares to each representative receiving direct payment without regard to their affiliation.

We do not deduct a user fee for anyone who:

  • Waives their fee;

  • Waives direct payment of their fee; or

  • Is ineligible for direct fee payment.

For information on a fee waiver or waiver of direct fee payment, see GN 03920.020.

 

a. Once a fee has been authorized under a fee agreement, use the following steps to calculate the user fee for each representative:

  1. 1. 

    Divide the total authorized fee by the number of eligible representatives who all signed the single fee agreement as described in GN 03940.003D, and did not waive their fee (this includes representatives not entitled to direct payment).

  2. 2. 

    Calculate an equal portion of the user fee (on the total authorized fee) to all eligible representatives seeking direct payment.

  3. 3. 

    Pay all direct payment recipients, including any eligible entities their share of the authorized fee minus their proportional share of the user fee.

NOTE: When a claim involves multiple representatives who assign direct payment of a fee to an entity, the entity will receive direct payment of the authorized fees after we deduct the proportion of the user fee owed by each representative who made the assignment to that entity. This means the total authorized fee payable to the entity will be reduced by the user fee attributable to each representative(s) who assigned direct payment to that entity.

b. Examples of calculating the fee shares in fee agreement cases

EXAMPLE 1: Jennifer appointed three representatives from the same firm: Adam, Barbara, and Chris. Chris waived their right to a fee, and Adam and Barbara signed and submitted a single fee agreement. Adam and Barbara are authorized direct payment of $5,000 (25 percent of the past-due benefits of $20,000). We will pay one-half of the total authorized fee minus one-half of the user fee ($120.00/2=$60.00) each to Adam and Barbara. Accordingly, we will directly pay Adam and Barbara $2,440.00 ($2,500-$60.00 each.

EXAMPLE 2: Jennifer appointed Alice, Brad, and Carrie to handle Jennifer’s Title II disability claim. Alice, Brad, and Carrie signed a single fee agreement; however, Alice and Brad also waived their rights to a fee. Therefore, we will pay Carrie the entire fee we authorized under the fee agreement after deducting the full user fee.

EXAMPLE 3: In the same scenario as Example 2, Carrie is a non-attorney representative ineligible for direct payment. We will authorize the full fee to Carrie, but since we cannot directly pay Carrie the authorized fee, Carrie must collect the full fee amount from Jennifer, the claimant. We do not assess a user fee because we will not make direct payment.

EXAMPLE 4: In the same scenario as Example 3, all representatives waived their right to a fee. We will release all past-due benefits to Jennifer unless there is court involvement or if we receive a request for review of the fee authorized.

EXAMPLE 5: John appoints Alice from All Disability Matters law firm (ADM) as the representative on their Title II disability claim. Alice assigns direct payment of the authorized fee of $4,500 to ADM (25 percent of the past-due benefits of $18,000). We will certify direct payment of the authorized fee minus the total user fee to ADM.

EXAMPLE 6: James appoints Alice from All Disability Matters law firm (ADM) and William from Disability Fast Actions law firm (DFA) as the appointed representatives on James’s Title II disability claim. Both Alice and William signed a single fee agreement and assign direct payment of their authorized fee to their respective entities, ADM and DFA. In this scenario, we will calculate the authorized fee for each representative and pay one-half of the total authorized fee minus one-half of the user fee to each entity.

EXAMPLE 7: James appoints Alice, Bill, and David from All Disability Matters law firm (ADM) as the appointed representatives on James's Title II disability claim. The authorized fee awarded in this case is $5,600. Alice and Bill assign direct payment of their authorized fee to ADM; however, David has not assigned direct payment of the authorized fee to the entity. In this scenario, we will calculate the portion of each representative's fee by dividing the total fees authorized ($5,600) by the total number of representatives (3), resulting in fees of $1,866.66 per representative. Since Alice and Bill assigned direct payment of their fees to ADM, we will combine the fees authorized to them ($3,733.32) and deduct their combined portions of the user fee from the amount paid to ADM. We will directly pay David the remaining authorized fee amount and deduct his portion of the user fee.

Example 7 Calculations

 

Action

Calculation

1.

Calculate each representative's portion of the authorized fee.

Amount due to Alice.

Amount due to Bill.

Amount due to David.

$5,600/3=$1,866.66

$1,866.66

$1,866.66

$1,866.66

 

2.

 

Divide the amount of the user fee by the total number of representative(s) authorized a fee.

 

$120/3= $40.00

3.

Calculate each representative’s authorized fee minus each representative’s portion of the user fee. (From Step 1 and Step 2)

Alice $1,866.66-$40=$1,826.66

Bill $1,866.66-$40=$1,826.66

David $1,866.66-$40 =$1,826.66

4.

Calculate the combined authorized fee minus the portion of the user fee from Alice and Bill to determine the fee amount to be directly paid to the entity ADM.

 

$1,826.66 for Alice + $1,826.66 for Bill =$3,653.32 for ADM

5.

Release the appropriate share of the authorized fees to ADM and David after deducting each representative's portion of the user fee.

 

$3,653.32 to ADM

 

$1,826.66 to David

2. Fees authorized under the fee petition process

Under the fee petition process, when we authorize fees at the same time for multiple representatives, we pay the authorized fee minus a proportional amount of the user fee to each representative eligible for direct payment at the time we make the payment. If the authorized fees exceed the withheld amount, the PC for Title II and the FO for Title XVI claims must distribute (i.e., prorate) the withheld past-due benefits amount among the eligible representatives in proportion to the fee authorized for each representative and prorate the user fee accordingly. Under the fee petition process, when we authorize fees at different times for multiple representatives, prorate the user fee as explained in GN 03930.066D.2.b.

EXAMPLE: Barbara submits a Title II only claim with two appointed representatives, Diana and Nancy. At the hearing level, the administrative law judge (ALJ) issues a fully favorable decision, resulting in past-due benefits of $22,400, but disapproves the fee agreement. After receiving the favorable decision, Diana and Nancy each submit a fee petition to the ALJ. The ALJ reviews their fee petitions and authorizes $3,540 for Diana and $2,360 for Nancy for a total of $5,900 in fees. We must determine each representative’s share of the user fee.

Step

Action

Calculation

1.

List and add the amount(s) authorized for each representative seeking payment or fee. Deduct amounts each representative holds in an escrow or trust account from their fee.

The result equals the authorized fees not held in escrow or trust account.

$3,540 - $0 (Diana) +

$2,360 - $0 (Nancy) = $5,900

2.

Divide the amount of each appointed representative(s) authorized fee not held in escrow or trust by the total authorized fee from Step 1 and round to the nearest cent to find the individual percentage of the total authorized fee not held in escrow or trust.

$3,540/$5,900 = 0.60 (60% for Diana) $2,360/$5,900 = 0.40 (40% for Nancy)

3.

List Barbara’s total withheld past-due benefits (PDB) amount (25% of $22,400).

$5,600

4.

Determine each representative's share of the withheld amount by multiplying the withheld amount (from Step 3) by each representative's percentage of the total fee (from Step 2).

$5,600 x 0.60 = $3,360 for Diana $5,600 x 0.40 = $2,240 for Nancy

5.

Add each representative's share of the withheld amount (from Step 4) to ensure that it corresponds to the withheld past-due benefits amount (from Step 3).

$3,360 for Diana + $2,240 for Nancy = $5,600

6.

Calculate each representative's share of the user fee and subtract it from each appointed representative(s) share of the withheld amount.

In this example, we capped the user fee at $117. See GN 03920.019B.5. for information on the user fee cap in effect at the time of the payment.

$5,600 x 0.063 > $120 Therefore, the user fee is $120

$120 x 0.60 = $72 for Diana's share of the user fee.

$120 x 0.40 = $48 for Nancy's share of the user fee.

7.

Release the remaining share of the withheld amount minus the user fee (from Step 6) to each eligible representative or entity.

$3,360 - $72 = $3,288 to Diana.

$2,240 - $48 = $2,192. to Nancy.

D. Fees paid for an affected auxiliary beneficiary in a Title II case or an eligible spouse in a Title XVI couple's case

How we apply the user fee cap depends on whether an affected auxiliary beneficiary in a Title II case or an eligible spouse in a Title XVI couple's case is independently represented.

NOTE: Unless informed otherwise, we consider a primary claimant’s appointed representative to also represent the primary claimant’s affected auxiliary beneficiaries or eligible spouse. For more information, see GN 03910.025C.

1. Title II affected auxiliary beneficiary or Title XVI spouse not independently represented

 

In Title II auxiliary and Title XVI couple’s cases, the user fee cap applies to the total fee we pay from past-due benefits withheld from the primary claimant and any affected auxiliary beneficiary or Title XVI eligible spouse not independently represented. We pay the authorized fee from the primary claimant’s withheld past-due benefits first and deduct the user fee accordingly.

When the user fee assessed from the primary claimant's Title II past-due benefits is less than the user fee cap, we will deduct either 6.3 percent of the direct payment or the remaining cap amount, whichever is lower, from any fee paid from the auxiliary beneficiary or eligible spouse’s past-due benefits. We will deduct a user fee from each successive fee payment until the total user fee we have collected equals the user fee cap in effect on the date of the payment.

EXAMPLE 1: Stacy filed concurrent Title II and Title XVI claims. Stacy appointed Robert as the representative. At the reconsideration level, we issued a favorable determination. At the same time, we processed a claim for Stacy’s child, who lives in the same household as Stacy and does not have independent representation. Robert timely submitted a fee petition, and we authorize a fee of $7,000.

Step

Action

Calculation

1.

Amount of Stacy’s past-due benefits

$12,000

2.

Amount of Stacy’s child’s past-due benefits

$6,000

3.

Total amount of Stacy’s and her child’s past-due benefits we withheld for direct payment of Robert’s fee:

  • 25% of Stacy's past-due benefits: $3,000 plus

  • 25% of Stacy's child's past-due benefits: $1,500.

 

$4,500

4.

Amount we authorized after evaluating Robert's fee petition

$7,000

5.

Amount we pay Robert after we deduct the full user fee of $120 from 25% of Stacy’s past-due benefits ($3,000)

$2,880

6.

Remaining amount of the authorized fee we pay Robert from Stacy’s child’s past-due benefits. We do not collect an additional user fee.

$1,500

EXAMPLE 2: Chris files a Title II only claim. Chris appoints Matt as their representative. Chris and Matt signed a fee agreement that sets the fee at the lesser of $7,200 or 25 percent of Chris's past-due benefits. At the hearing level, the ALJ issues a favorable decision, which results in $3,200 in past-due benefits for Chris. The ALJ reviews and approves the fee agreement. Later, Chris's two children file claims based on Chris's SSN and are not independently represented.

Step

Action

Calculation

1.

Amount of Chris's past-due benefits

$3,200

2.

Amount of Chris’s past-due benefits we withhold for direct payment of Matt’s fee (25% of $3,200)

$800

3.

Amount of the user fee (6.3% of $800)

NOTE: As noted in GN 03920.019A., we cap the user fee at a flat-rate dollar amount or 6.3 percent of the fee payment, whichever is lower.

$50.40

4.

Amount we directly pay Matt from Chris’s withheld past-due benefits ($800 - $50.40)

We subsequently processed the claims for Chris’ two children, who lived in separate households and were not independently represented. Each of Chris’s children is due $400 in past-due benefits.

$749.60

5.

Amount of each child’s past-due benefits we withhold for direct payment of Matt’s fee (25% of $400)

$100

6.

Amount when we multiply 6.3% by the direct payment amount (6.3% of $100)

$6.30

7.

Amount we directly pay Matt from each child ($100 - $6.30)

$93.70

EXAMPLE 3: Rachel filed a Title XVI only claim and appointed Adam as the representative. At the hearing level, the ALJ issued a favorable decision. The ALJ approved the fee agreement between Rachel and Adam, who is eligible for direct payment. Because of Rachel’s Title XVI eligibility, Rachel’s spouse, Mike, who does not have a representative and has been receiving Title II and Title XVI benefits for several years, receives an additional Title XVI retroactive payment.

Step

Action

Calculation

1.

Amount of the couple’s past-due benefits resulting from Rachel’s Title XVI eligibility

$2,176

2.

Amount of the couple’s past-due benefits we withheld for direct payment of Adam’s fee (25% of $2,176)

$544

3.

Amount when we multiply 6.3% by of the direct payment amount (6.3% of $544)

$34.27

4.

Amount we directly pay Adam ($544 - $34.27)

$509.73

2. Title II affected auxiliary beneficiary or Title XVI eligible spouse is represented independently

If the primary claimant and affected auxiliary beneficiary in a Title II case or eligible spouse in a Title XVI couple’s case is independently represented, we consider these to be two or more cases and we will apply separate user fee caps to:

  • The fee we pay to the primary claimant's representative(s) and the fee we pay to the affected auxiliary beneficiary's representative(s) (or to any eligible entity to which a representative assigned direct payment); or

  • The fee we pay to each spouse's representative(s) (or any eligible entity to which a representative assigned direct payment) in a Title XVI couple’s case.

In a Title II case, we will deduct the user fee when we directly pay fees to the representative(s) of the primary claimant, and we will apply a separate user fee when we pay fees to the representative(s) of the auxiliary beneficiary in a Title II case. The user fee deducted from fees paid to the primary claimant’s representative(s) will not affect the user fee deducted from fees paid to the representative(s) of the independently represented auxiliary beneficiary because their claims are separate.

The user fee deducted from the fee we pay to the representative of one spouse in the Title XVI couple’s case does not affect the user fee we deduct from the fee we pay to the representative of the other spouse in the Title XVI couple’s case.

The same process applies when whether we are directly paying representatives or entities to which representatives assigned direct payment.

For more information on withholding policy when an auxiliary beneficiary is independently represented, see GN 03920.035B.

EXAMPLE 1: Sue filed a disability claim under Title II and appointed Robert as the representative. At the reconsideration level, we issue a favorable determination and approved Sue and Robert's fee agreement. At the same time, Calvin, Sue's divorced spouse appoints James to independently represent him in an auxiliary claim for spouses benefits and both sign their own fee agreement. Since Calvin is independently represented by James, we approve their timely submitted fee agreement and authorize a fee to James based on Calvin's pat due benefits.

Step

Action

Calculation

1.

Amount of Sue’s past-due benefits

$12,000

2.

Total amount of Sue’s past-due benefits we withheld for direct payment of Robert’s fee (25%):

$3,000

3.

Amount we authorized after evaluating Robert's fee agreement:

 

$3,000

4.

Amount we pay Robert after we deduct the full user fee of $120:

$2,880

5.

Amount of Calvin’s past-due benefits:

$6,000

6.

Amount of Calvin’s past-due-benefits we withheld for direct payment of James’ fee (25%):

$1,500

7.

Amount of the fee we authorize to James based on the second fee agreement:

$1,500

8.

Amount we pay James after we deduct the user fee of $94.50 (6.3% of $1,500) from Calvin’s past-due benefits:

$1,405.50

E. Additional fee paid based on a more favorable decision in the same case – Approved Fee Agreement

We will apply the user fee cap in effect at the time of payment to the total fee we pay when:

  • We make an initial fee payment based on an approved fee agreement;

  • We later issue a more favorable determination or decision in the same case; and

  • The more favorable determination or decision results in additional past-due benefits and a larger fee for the representative.

We will not deduct an additional user fee from the fee paid as a result of the more favorable determination or decision if the maximum user fee has not changed and we previously deducted the maximum user fee. However, if we initially deduct less than the maximum user fee or if the maximum user fee increases, we will deduct 6.3 percent of the direct payment or the difference between the user fee previously paid and the current maximum user fee cap, whichever is lower, from the subsequent fee payment.

NOTE: If a subsequent application is involved and the criteria in GN 03940.038C.1 apply, we will consider both the prior and subsequent applications to constitute one claim for the purposes of approving or disapproving a fee agreement. In such situations, we will approve only one fee agreement and will apply the user fee instructions above as if only one case were involved. If the criteria in GN 03940.038C.1 do not apply, unless an ALJ or the Appeals Council consolidates the claims into one case, we will treat the prior and subsequent claims as separate cases and will authorize fees, directly pay those fees (if applicable), and assess user fees independently.

For more information on fee agreements policy when subsequent applications are involved, see GN 03940.038.

IMPORTANT

If a subsequent application was filed while a prior claim was pending in Federal court, we must treat the two claims as separate cases for fee agreement purposes, unless an ALJ or the Appeals Council consolidates the two claims into one case.


To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0203920019
GN 03920.019 - User Fee for Direct Fee Payments - 12/06/2024
Batch run: 12/06/2024
Rev:12/06/2024