1. a. 

   If either of the following applies, consider the requester's statements and proceed to GN 03960.057B.3:

   • •

     You are reversing the decision maker's approval and disapproving the fee agreement.

   • •

     GN 03960.040C.2.c applies, i.e., you are modifying an incorrectly calculated fee amount under the terms of the fee agreement in a manner consistent with the party's request; and no other party objected during the comment period.

   Otherwise, proceed to GN 03960.057B.1.b.

2. b. 

   Consider the requester's statements.

   Is the requester protesting the fee amount authorized under the agreement or is the requester:

   • •

     Protesting the proposed manner of payment, e.g., direct payment from an auxiliary beneficiary's past-due benefits (GN 03960.040C.5 discusses the policy.);

   • •

     Objecting to the direct payment when the representative or eligible entity, if there is a valid assignment as described in GN 03920.021, has funds held in a trust or escrow account (see GN 03920.016D.4.); or

   • •

     Seeking payment from the claimant because we did not withhold benefits or released withheld benefits (see GN 03920.055C.).

1. a. 

   Consider the factors listed in GN 03960.050C.1 and any additional information or comments received.

2. b. 

   Determine whether the fee is reasonable, adhering to the instructions in GN 03960.050 and, when applicable,
   
   GN 03960.040C.4 or GN 03960.040C.5. If the fee authorized under the fee agreement process:

   • •

     Reasonably reflects the value of the services provided, affirm the fee amount.

   • •

     Does not reasonably reflect the value of the services provided, authorize a reasonable fee based on your evaluation of all of the factors listed in GN 03960.050C.

c. Then proceed to GN 03960.057B.3.

1. a. 

   Follow GN 03960.070 to prepare a letter to the requester, consistent with the following instructions, for release with the appropriate official's signature (see GN 03960.070A.2). Refer to GN 03960.085 for model letters.

2. b. 

   State the authority for administrative review if a party questioned or challenged our authority to review or to authorize the fee under an approved agreement.

   NOTE: Do not cite regulations pertaining to administrative review of fees determined under the fee petition process. They do not apply to fees determined under the fee agreement process.

3. c. 

   If the requester did not file timely and you did not resolve the issue in your acknowledgment or interim letters, include a brief explanation of your good cause finding.

4. d. 

   State whether you are affirming, decreasing, or increasing the fee amount.

   EXCEPTION: This step does not apply if you are disapproving the fee agreement. Instead, provide notice that you are disapproving the fee agreement as explained in GN 03960.040C.1.b.

5. e. 

   Respond to the issue(s) raised.

6. f. 

   State that the determination is not subject to further review.

7. g. 

   Discuss the method of payment (e.g., we will certify direct payment of all or a portion of the fee to the eligible representative or an eligible entity if there is a valid assignment as per GN 03920.021; that the claimant is responsible for all or a portion of the fee; or the representative must refund any excess amount previously certified or paid, including funds held in trust or escrow account).

   NOTE: For additional information regarding the recovery of an excess fee payment and when we will pursue recovery, see GN 03920.051. For procedures on how to recover excess fees payments, refer to GN 03920.052. See GN 03920.016 for the definition of "representative eligible to receive direct fee payment" and policy on direct payment to representatives and entities with valid assignments.

8. h. 

   State that you are sending copies of the determination to the parties named.

9. i. 

   Send copies of the determination to the other parties, as GN 03960.040D requires. Because of Privacy Act considerations, ensure that the mailing address and other personal information of the claimant, any auxiliary beneficiary, or eligible spouse is redacted from the copy of the notice sent to any other party (the proper parties described in GN 03960.001B.10) except the representative(s).

10. j. 

    See GN 03960.060 or GN 03960.065, or both, for subsequent actions, which vary depending on the result.