HA 01120.041 Fee Agreement Administrative Review — General Policy

A. Administrative Review Processes

There are two separate and distinct administrative review processes for fee agreements:

•
The review of the determination approving or disapproving a fee agreement, and
•
The review of the amount of the fee authorized under a fee agreement.

For information and the delegation of authority for conducting administrative review of the approval or disapproval of a fee agreement, see Hearings, Appeals, and Litigation Law (HALLEX) Manual HA 01120.042. For information and the delegation of authority for conducting administrative review of the amount of the fee authorized under the fee agreement process, see HALLEX HA 01120.044.

B. Who May Request Review

Only the claimant or representative can request administrative review of SSA's determination approving or disapproving the fee agreement.

The claimant, affected auxiliary beneficiary, representative, or decision maker may request administrative review of SSA's authorization of the amount of the fee.

Two requests for administrative review may be filed in the same case:

1.
If the individual disagrees with the approval or disapproval of the fee agreement.
2.
If the individual objects to the amount of the fee authorized under the fee agreement.

NOTE:

An entity is not a party to a fee agreement even where an appointed representative validly assigned direct payment of their fee to that entity. As such, the entity and its point of contact (POC) generally do not have the right to file for administrative review under the fee agreement process. However, if a representative who has validly assigned direct payment of any authorized fees dies, and at least one other representative remains active on the claim (see HALLEX HA 01120.012 B.3.), or the representative dies after the agreement was approved and an initial fee was authorized, the entity's POC may request administrative review under the fee agreement process. When the POC files the request for administrative review, they must also provide proof of the representative's death (e.g., copy of an obituary or copy of a death certificate). For more information about the assigning direct payment of fees, including the roles and responsibilities of POCs, see Program Operations Manual System (POMS) GN 03920.021. In the case of a deceased representative who did not assign direct payment to an entity, a legal representative of the deceased representative's estate can file the request.

C. Time Limit for Requesting Review

The timeframe for requesting administrative review of the approval or disapproval of the fee agreement or the amount of the fee authorized under the fee agreement is 15 days from the date of receipt of the respective fee agreement determination or fee authorization notice. In the absence of evidence to the contrary, SSA assumes receipt within 5 days of the date of the notice. In foreign cases, SSA assumes receipt within 14 days of the date of the notice.

If a request is filed more than 15 days after the date the notice was received, the requestor must state in writing why it was not filed on time. In such cases, SSA will conduct administrative review only if it determines that there was good cause for not filing the request on time.

D. Finality of Determination

SSA's determination on administrative review for the fee agreement process is final and binding and is not subject to further administrative or judicial review. See sections 206(a)(3)(C) and 1631(d)(2)(A) of Act.

To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/2501120041

HA 01120.041 - Fee Agreement Administrative Review — General Policy (I-1-2-41) - 12/09/2024
Batch run: 04/20/2025
Rev:12/09/2024