Give special handling to claims in which the PC identifies the following conditions:
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partial adjudication is involved (e.g., WC or PDB offset);
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an approved fee agreement is in file;
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the past-due benefits amount used to authorize the representative's fee was based
on unverified evidence such as WC or PDB offset amount; and
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SSA determines that the WC or PDB offset amount was incorrect.
In these cases, SSA must adjust the amount of the authorized fee (see GN 03920.040B., first bullet). When you determine the correct amount of the WC or PDB offset or
other previously unverified evidence, and recompute the amount of the past-due benefits,
recalculate the amount of the representative's fee based on the revised amount of
the past-due benefits.
Remember to withhold 25 percent of any additional past-due benefits towards direct
payment of an authorized fee when the representative is eligible for direct payment
(unless the maximum fee under the fee agreement already has been authorized).
Notify the claimant, affected auxiliary beneficiary(ies), if any, the representative,
and the decision maker, if appropriate, of the following:
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the revised past-due benefits amount for the period through the month before the month
in which SSA effectuated the original decision favorable to the claimant;
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the revised past-due benefits payable amount;
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the revised fee amount; and
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the right to request administrative review of the amount of the fee within 15 days
of receiving the notice.
(See the discussion of adjustments to the past-due benefits and fee amounts in GN 03920.040B. and GN 03920.040D.)