HA 01120.042 Administrative Review of the Approval or Disapproval of the Fee Agreement — Overview

A. Filing the Request

When the claimant or representative disagrees with the Social Security Administration (SSA)'s determination approving or disapproving a fee agreement, they may protest that determination by requesting administrative review (see Hearings, Appeals, and Litigation Law (HALLEX) manual HA 01120.041B for more information on who may request administrative review). The party requesting administrative review must do so within 15 days of receiving the notice of the determination approving or disapproving the fee agreement (see HALLEX HA 01120.041C).

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 request 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 01120.012B.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. For more information about 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.

B. Reviewing Official

An official who did not serve as the initial fee decision maker has the authority to review the fee agreement determination. See HALLEX HA 01120.006B.2. to identify the reviewing official.

C. Informing the Parties

The reviewing official must:

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Acknowledge receipt of the request for administrative review;
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Notify all other parties of the request, including the decision maker; and
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Afford the other parties 15 days to submit written information responding to the request.

Because of Privacy Act considerations, do not reveal any Privacy Act protected information (e.g., personally identifiable information (PII)) without applicable disclosure authority (e.g., consent, routine use, etc.), including:

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The claimant's mailing address, Social Security number (SSN), or beneficiary notice control (BNC) number, which may be included in copies of a letter addressed to the claimant, or the claimant's request for administrative review, sent to a party other than the claimant's representative or the decision maker.
•
The auxiliary beneficiary's mailing address or SSN, which may be included in copies of a letter addressed to the beneficiary, or the beneficiary's request for administrative review, sent to a party other than that beneficiary's representative or the decision maker.

In these situations, the address and any other protected information must be redacted before mailing.

D. Reviewing the Fee Agreement Approval or Disapproval

The reviewing official will consider:

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The fee agreement,
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The approval or disapproval of the fee agreement,
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The request for administrative review, and
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Any additional information provided.

The reviewing official will affirm or reverse the decision maker's determination on the fee agreement.

E. Issuing Notice of the Administrative Review Determination

The reviewing official must issue a notice of the determination made on administrative review to:

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The claimant,
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Each appointed representative who signed the fee agreement (or other individual who filed in their place, see HALLEX HA 01120.041, NOTE), and
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The fee decision maker.

The notice will advise the parties that the determination is not subject to further review.

Because of Privacy Act considerations, do not reveal any Privacy Act protected information (PII) without applicable disclosure authority (e.g., consent, routine use, etc.), including:

•
The claimant's mailing address SSN, or BNC, which may be included in copies of a letter addressed to the claimant, or the claimant's request for administrative review, sent to a party other than the claimant's representative or the decision maker.
•
The auxiliary beneficiary's mailing address or SSN, which may be included in copies of a letter addressed to the beneficiary, or the beneficiary's request for administrative review, sent to a party other than that beneficiary's representative or the decision maker.