Sam and Charlotte filed for SSI on 05/30/22. Charlotte also filed for Title II benefits.
Charlotte appointed a representative, who submitted a fee agreement. The fee agreement
called for a fee of the lesser of 25% of past-due benefits or the specified dollar
cap at the time of $7,200.00. Sam's SSI claim was approved and Sam began receiving
SSI payments in 06/22. Sam was paid the full FBR for an individual for 06/22 - 08/23
because Charlotte's initial claim was denied.
In July 2023, the ALJ issued a favorable Title II and Title XVI decision finding Charlotte
disabled as of 02/10/22, and approved the fee agreement. Charlotte received the retroactive
SSI payment of $5,886.00 in August 2023 (the difference between the couple's FBR and
the individual's FBR). Charlotte's Title II waiting period was 03/22 - 07/22. Charlotte
received the first monthly Title II check in September 2023, a CMA of $509.00. SSA
withheld Title II retroactive benefits of $6,064.00 for the months of 08/22 - 07/23
(benefits that would have been paid in 09/22 - 08/23) pending windfall offset and
representative fee adjustment. Charlotte's Title II MBA rates are shown on the MBR
as $498.00 for 08/22 - 11/2, and $509.00 for 12/22 and continuing.
Determine the representative's fee based on Charlotte's fee agreement with the representative
by following steps a. through e. in GN 03940.052C.2:
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•
The representative fee based on Title II past-due benefits is $1,516.00 according
to the amount on the APPREP data line on the MBR. Based on the fee agreement between
Charlotte and the representative, and based on the statutory limits outlined in GN 03940.003B.3, we may authorize total representative fees (based on Title II and Title XVI past
due benefits) in an amount not to exceed the lesser of 25% of past due benefits or
the specified dollar cap.
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•
Determine Charlotte's SSI past-due benefits for the fee computation. Per GN 03940.052C.2.c, determine the amount the couple would have received for each month included in Charlotte's
retroactive payment, if Charlotte's retroactive Title II benefits had been paid first
and when due.
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•
Subtract the actual amount of SSI that Sam has already been paid for the same months.
See summary calculation in the table below.
MMYY
|
Amount Couple Due If Charlotte's T2 Was Paid on Time
|
SSI Paid to Sam
|
Past Due Benefits
|
06/22
|
956.00* (see explanation below)
|
637.00
|
319.00
|
07/22
|
956.00
|
637.00
|
319.00
|
08/22
|
956.00
|
637.00
|
319.00
|
09/22
|
956.00
|
637.00
|
319.00
|
10/22
|
956.00
|
637.00
|
319.00
|
11/22
|
478.00** (see explanation below)
|
637.00
|
-159
|
12/22
|
478.00
|
637.00
|
-159
|
01/23
|
522.00*** (see explanation below)
|
674.00
|
-152
|
02/23
|
522.00
|
674.00
|
-152
|
03/23
|
522.00
|
674.00
|
-152
|
04/23
|
522.00
|
674.00
|
-152
|
05/23
|
522.00
|
674.00
|
-152
|
06/23
|
522.00
|
674.00
|
-152
|
07/23
|
522.00
|
674.00
|
-152
|
08/23
|
522.00
|
674.00
|
-152
|
Total Past-Due Benefits
|
|
|
$61.00
|
$1,261.00 (Couple FBR for 2022)
- 0.00 (No Title II retro due for 06/22 - 10/22; no countable income)
*$1,261.00 (Amount couple due for 6/22 - 10/22)
$1,261.00 (Couple FBR for 2022)
-
$478.00 (Charlotte's Title II rate of $498.00 - $20.00)
**$783.00 (Amount couple would have been due for 11/22 - 12/22)
$1,371.00 (Couple FBR for 2023)
-
$489.00 (Charlotte's Title II rate of $509.00 - $20.00)
***$882.00 (Amount couple would have been due for 01/23 - 08/23
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•
If the “Amount Couple Due” for a month is MORE than what Sam received for that month,
the difference is the SSI past-due benefit for that month. If the “Amount Couple Due”
for a month is LESS than what Sam received for that month, then there are no past-due
benefits for that month. Offset any negative amount for a month against any additional
amounts due for other months in the withholding period to arrive at the past-due benefits.
In this case, there are past-due benefits of $61.00.
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•
Authorize a fee that is the lesser of:
-
–
25 percent of the SSI past-due benefits (25 percent of $61.00 is $15.25)
OR
-
–
The dollar cap. To calculate the remaining representative fee we could authorize from
Title XVI past-due benefits based on the dollar cap, subtract the Title II fee already
authorized from the applicable dollar cap. In this example, the dollar cap at the
time was $7,200.00 ($7,200.00 - $1,516.00= $5,684.00);
Since $15.25 is less than $5,684.00, we will authorize a fee of $15.25 based on Title
XVI past-due benefits.
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•
Prepare and issue the SSI Fee Agreement Notice authorizing a Title XVI fee of $15.25.