We occasionally receive an allegation from a representative or claimant that we applied
an incorrect fee cap. The assertion usually involves the Commissioner's decision to
increase the fee cap, which the Commissioner may do from time to time. For example,
the Commissioner increased the fee cap from $7,200 to $9,200 for fee agreements approved
on or after November 30, 2024.
When the Commissioner increases the fee cap, the increased cap does not automatically
apply to all fee agreements; the fee agreement must contain language that provides
for the increased cap, often referred to as an escalation clause. Refer to GN 03940.003B.3 for guidance on fee agreement language.
When we apply an incorrect fee cap and the representative or claimant advises us of
the mistake, or we independently become aware of the mistake, we will correct the
error. We will not treat the communication from the party as a request for administrative
review.
During periods of transition to a higher fee cap, situations similar to the following
may occur:
EXAMPLE 1: A fee agreement with language consistent with a $9,200 cap was in file and approved
by the decision maker at the time of the favorable determination. The technician incorrectly
capped the fee at $7,200. The representative advises SSA that the fee agreement provided
for a fee cap of $9,200.
EXAMPLE 2: A fee agreement with a $7,200 cap was in file and approved by the decision maker
at the time of the favorable determination. There was no other agreement in file. The
technician incorrectly capped the fee at $9,200 and paid an amount in excess of $7,200
(the cap specified in the agreement) to the representative. The claimant advises us
that the fee agreement provided for a fee cap of $7,200.
NOTE: Refer to GN 03920.040 when the past-due benefits amount increases or decreases after the date we notify
the claimant and the representative of the authorized fee amount.