TN 31 (12-24)

GN 03930.035 Title II - Adjudicating Claims Involving Representatives Who May File Fee Petitions - Overview

A. Introduction

The claims specialists (CS) in the field office (FO), the program service centers (PSC), and the Office of Central Operations adjudicate Title II claims involving representatives who petition to obtain our approval of fees for their services. The procedures below, and in the two next sections, highlight the key CS responsibilities based on the processing system: the Modernized Claims System (MCS) or the Manual Adjustment, Credit, and Award Processes (MADCAP). The instructions in this section apply to all cases where there was one or more appointed representatives eligible for direct payment, there is no approved fee agreement, and at least one eligible representative did not waive their fee or right to direct payment of their fee. Refer to GN 03930.015 for information about which office has jurisdiction to authorize a fee under the fee petition process.

For those cases in which the representative is eligible for direct fee payment and the representative did not waive a fee or the right to direct payment of a fee, including cases with a valid assignment (see GN 03920.021), MCS and MADCAP propagate representative information into the Single Payment System (SPS) for creation of a payment record. For fee petition cases, the action will hold (i.e., pend) payment in SPS until action is taken to release the representative fee (i.e., the fee is authorized and input). See GN 03920.017C., Direct Payment to Representatives – Title II Cases.

NOTE: For cases with a valid assignment, the SPPT screen in SPS will show the appointed representative's name. Select the iteration to get to the APQY screen to see if the fee was paid to the entity next to the "Fee Assigned To" line.

The CS must refer to Program Operations Manual System (POMS) or Modernized System Operations Manual (MSOM) sections for complete instructions about processing limitations or exclusions and coding required entries.

B. CS Responsibilities

The CS (or other processing center (PC) position designated to perform these functions) must:

  • prepare any necessary forms and make data entry necessary to use the most expeditious processing system available;

  • ensure that we withhold funds from past-due benefits for possible direct payment, when required;

  • provide correct notice to the claimant and the claimant's representative; and

  • set the diary for receipt of the fee petition or fee authorization when we are withholding past-due benefits for possible direct payment to a representative or to an entity if there is a valid assignment (see GN 03920.021). For information about setting this diary, refer to GN 03930.045.

NOTE: Although a representative who has withdrawn or whose representation was revoked by the claimant may file a fee petition, do not send a copy of the award notice or other protected information (e.g., the claimant’s information) unless it is the minimum amount necessary for the former representative to review it to resolve fee-related issues. For information that is not relevant or necessary to resolve fee-related issues, only disclose it if the claimant has expressly consented in writing on a Form SSAA-3288 or other written consent that meets the requirements of GN 03305.003. Similarly, even in the limited circumstances described in GN 039030.020A when a POC may file a fee petition, do not send a copy of the award notice or other protected information (e.g., the claimant's information) to the entity's POC unless it is the minimum amount necessary for the POC to review it to resolve fee-related issues. For information that is not relevant or necessary to resolve fee-related issues, only disclose it if the claimant has expressly consented in writing on a Form SSA-3288 or other written consent that meets the requirements of GN 03305.003. For more information about the assignment of direct payment of fees, including the roles and responsibilities of POCs, see GN 03920.021.

C. Identify MCS Processing Limitations

Some characteristics currently prevent final claims processing through MCS using its earnings computation (EC) screens. Refer to MS 03504.002, MS 03504.003, and SM 00834.900 for MCS processing limitations.

D. Determine Representative's and Entity's Eligibility for Direct Fee Payment

Determine a representative's and, if there is a valid assignment, the entity's eligibility for direct fee payment as follows:

  1. 1. 

    Review GN 03920.016 to determine if the representative is eligible to receive direct payment. If the representative is eligible and assigned their right to receive direct payment to an entity, review GN 03920.021 to determine if the entity is eligible to receive direct payment.

  2. 2. 

    If the representative is a non-attorney, check Registration, Appointment and Services for Representatives (RASR) to determine if the representative is eligible to receive direct payment.

    • If the representative states that they are eligible for direct payment but is not listed on that date, take the action in GN 03930.035D.4.

    • If the representative did not state they are eligible for direct payment and is not listed, go to GN 03930.035E.

    • If the representative is listed, proceed to GN03930.035D.3.

  3. 3. 

    If RASR indicates the representative is eligible to receive direct payment and they have not waived direct payment, verify that the claimant and the representative both signed the Form SSA-1696 (Claimants Appointment of a Representative). If yes, go to GN 03930.035E. If not, request the representative submit a copy of the previously filed Form SSA-1696 signed by both the claimant and representative.

  4. 4. 

    If the representative is a non-attorney who states they are eligible for direct payment, but RASR shows the non-attorney representative is not eligible for direct payment, notify the representative that we cannot make direct payment (using the following model language), send a copy to the claimant and go to GN 03930.035E.

Model language to use in these situations follows:

You advised your client, (beneficiary's name), and indicated on the Form SSA-1696 (Claimant's Appointment of a Representative) that you are eligible to have your approved representatives' fees withheld and paid directly from the claimant's past-due benefits. However, [select the conclusion that describes the status]

  • you are not eligible to receive direct payment of your fees from the claimant’s past-due benefits, or

  • you did not become eligible to receive direct payment of your fees from the claimant’s past-due benefits until after we effectuated the favorable decision on your client's claim, or

  • you failed to maintain your eligibility to receive direct payment of your fees from the claimant’s past-due benefits and were no longer eligible on the date we effectuated the favorable decision on your client's claim.

Accordingly, we will not pay any authorized fee directly to you. You should look to the claimant for payment of the fee authorized in this case.

See GN 03920.017C, Policy – Direct Payment to Representatives in Title II Cases.

E. Procedure - Claims Processing

1. MCS

a. MCS Check/Notice 2 Screen

Use the MCS Check/Notice 2 (NOT2) screen to provide the data to tell the system whether to withhold from past-due benefits. For complete coding of representative data on the MCS clearance screens, see MS 03509.009. Note that court cases and court remand cases where the administrative fee is paid based on an approved fee agreement are an MCS exclusion.

When the representative is eligible for direct fee payment and has not waived a fee or the right to receive direct payment, we must withhold past-due benefits for that purpose. To withhold from past-due benefits, complete the MCS NOT2 screen as follows:

  • Authorized Representative Type: 1 or 4

    (Use “1” for an attorney or "4" for an eligible for direct payment non-attorney)

  • Fee Waived: N

  • Direct Payment Waived: N

  • If there is a valid assignment, use the "PE" for entity payment indicator

  • Last Withholding Date: Calendar month and year before the calendar month and year you are adjudicating the claim unless it is a closed period of disability.

NOTE 1: The last withholding date for auxiliaries is the same as that of the claimant if protective filing exists, regardless of when the auxiliaries' claims are adjudicated.

  • Attorney/Rep Name: This information will propagate to the NOT2 screen from RASR. Make any changes or corrections in RASR.

  • Pending Fee Agreement Amount: Do not complete.

  • Fee Agreement Type: Do not complete this field on the NOT2 screen for fee petition cases.

Completing the MCS NOT2 screen as described above will result in fee withholding and establish the FEE AMT on the AAPFEE line on the Master Beneficiary Record (MBR). The ATY indicator on the DW01 will generate an SPS record. See MS 03508.004 E 17-C for a list of DW indicators. There is an additional indicator of ATYPE which will make the payment to the entity on the record.

NOTE 2: If a non-attorney alleges that they are eligible for direct payment, but RASR indicates they are not eligible. Refer to GN 03930.035E for language to include in a notice if we have not previously communicated with the representative about their status.

b. DW01 Screen

If the representative is an attorney or a non-attorney eligible for direct payment, include the Attorney Issue code ATY04, which means “Petition Awaiting Authorization,” on the MCS Development Worksheet (DW01) screen. The Attorney Issue Code ATY04 will “pend” the payment in SPS until the petition/authorization is complete.

c. DECI Screen and Diary

The system automates a diary in MCS on the DECI screen for the fee petition cases at the initial and reconsideration levels (diary code 098), and at the Office of Hearings Operations (OHO) and the Office of Appellate Operations (OAO) levels (diary code 099). See MS 03509.013 for additional information. If an ATFEE action control record (ACR) is already pending, the adjudicator will delete the systems generated diary (GN 01040.010A.).

NOTE: In the Office of Central Operations (OCO), when processing an OHO or OAO level case, the CTE prepares a 60-day Processing Center Action Control System (PCACS) diary related to the existing “ATFEE FEEPAY” ACR and routes the claims file to the development holding file (DHF PAY) pending receipt of the petition/authorization. In cases with Federal court involvement, the CTE prepares a 120-day diary related to the existing “ATFEE COURT” ACR.

2. Withholding With MADCAP

A101 or EF101

When completing the A101 or EF101, which MADCAP processing requires, take the actions shown if you are withholding past-due benefits for possible direct payment.

  • Code the BCF fields on the BCRN screen following instructions in MS 03514.006.

  • Show in the REMARKS field on the BCRN screen the following remarks: “FEE WITHHOLDING CASE - Fee Petition Expected”; and “Withhold 25 percent of (HA's, HB's, HC1's, or other appropriate entry) past-due benefits for possible direct payment to representative.”

  • Enter the fee petition paragraph (ATY055, ATY056, ATY057, ATY058, or ATYPE as appropriate) and paragraph 160 in the NOTICE field on the BCRN screen per NL 00708.100 and NL 00720.050.

3. No Withholding With MADCAP

A101 or EF101

When completing the A101 or EF101, which MADCAP processing requires, take the actions shown if you are not withholding past-due benefits for possible direct payment.

  • Add the remark to the BCRN screen. See MS 03514.006.

  • Show the appropriate paragraph (981.1, 981.2, 981.3, or 983) to indicate whether the representative has waived a fee or just waived direct payment of the fee. If the fee itself has not been waived, include paragraph 160 per NL 00708.100.

4. Manual Adjustment Credit and Award Data Entry (MACADE) Cases

a. Coding to Withhold Past-Due Benefits When Representative Eligible for Direct Payment

Input direct data entry through MACADE. Enter the following special coding:

  • In the HST screen “MR” column, the 25 percent withholding amount.

  • In the HST screen “TO” column, the “AD” special entry. We use the special entry AD to withhold the legal payment and post the amount withheld to the PHUS.

    NOTE: See SM 00842.013 and SM 00848.360 for further instructions.

  • Enter the Attorney Payment Indicator (API) of “04” on the MACADE ATT screen. The API of 04 will establish the payment in SPS in pending status until the petition/authorization is complete.

  • On MACADE REM screen, show “Fee Petition Case.”

b. Diary

For MACADE processed claims, the benefit authorizer (BA) or CS must establish a Processing Center Action Control System (PCACS) ATFEE PETPAY diary. Begin the diary period when the notice is released, which is usually five days after the MACADE action. To determine the length of the diary for a specific case, refer to GN 03930.045.

NOTE: In OCO, in processing an OHO- or OAO-level case, the CS or other designated technician prepares a 60-day PCACS diary related to the existing “ATFEE FFEPAY” ACR and routes the claims file to the DHF PAY pending receipt of the petition/authorization. In cases with Federal court involvement, the BTE prepares a 120-day diary related to the existing “ATFEE COURT” ACR.

See GN 03930.090 for the follow up procedure when no fee petition or fee authorization is received before the diary matures.

c. Windfall

If possible windfall (Title II or Title XVI) offset is involved, refer to SM 00815.100 through SM 00815.500 for required MADCAP coding.

d. Notice Paragraphs

Designate necessary paragraphs for inclusion in the fee notice and instruct staff to prepare additional copies. Refer to GN 03930.040 for appropriate language. Or, if trained in AURORA, complete the necessary paragraphs in that system.

5. Prepare Special Message

Prepare a message for the MBR stating a fee petition/authorization is pending.

For cases involving appointed representatives below the court level:

  • Access the Special Message screen through MONET (or MACADE) and select special message 52; and

  • Process the standard special message 52 to the MBR.

Special Message 52 will display:

APPOINTED REPRESENTATIVE(S) INVOLVED – SEE RASR, APPREP, AND APPFEE DATA LINES FOR ADDITIONAL INFORMATION

For court cases with court attorney involvement (see GN 03920.060):

  • Code the special message field to read: COURT CASE/REPINVOLVED/DO NOT RELEASE 25% WITHHELD PENDING COURT FEE AND ADMIN FEE; and

  • If the case is a court remand for additional administrative proceedings, replace “COURT CASE” with “COURT REMAND.”

F. References

The following sections provide specific instructions for related CR or CA/CTE functions.

  • GN 03910.040H through GN 03910.040J FO or PC actions on receiving the Form SSA-1696 (Claimant's Appointment of a Representative)

  • SM 00842.016 Coding the Atty/Rep/ALJ Name and Address Screen when sending a copy of the MADCAP notice to the attorney/representative

  • SM 00834.000 MCS and MADCAP propagation into SPS

  • MS 03509.009 Check/Notice 2 (NOT2)

  • MS 03510.003 Reconsideration Request 1 (RCN1)/FEDRO Review (FDR1)

  • MS 03510.005 Hearing Request 1 (HNG1)

  • MS 03510.006 Hearing Request 2 (HNG2)

  • MS 05701.006 Using SPS

  • GN 03910.050 Contacting a represented claimant

  • GN 03920.020D.3 FO or PC action when representative waives a fee

  • GN 03930.025 Receipt and routing of fee petitions


To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0203930035
GN 03930.035 - Title II - Adjudicating Claims Involving Representatives Who May File Fee Petitions - Overview - 12/09/2024
Batch run: 12/09/2024
Rev:12/09/2024