The effectuating component will:
•
Issue a notice of award. After effectuating a fully or
partially favorable Title II and/or Title XVI decision in a case, in which
the claimant was represented and there was not fee agreement in the file,
or the fee agreement was disapproved, the appropriate processing center
(PC) or field office (FO) sends a notice of award to the claimant and
principal representative.
•
Set a 60-day diary from the date of the decision. For
cases with Federal court involvement, this diary period is
extended from 60 days to 120 days. See POMS GN 03930.045B.
•
For hearings-level cases, email the staff of the
decision maker who issued the decision (includes Special Review Cadre)
at the end of the 60-day or 120-day diary period if the effectuating
component has not received a fee authorization or information that the
representative was granted an extension of time. The PC or, in Title XVI
only cases, the FO will send an email requesting status to the decisional
office.
•
For Appeals Council (AC) cases,
contact Disability Compliance, Hearings In-Line
Quality Review (Hearings ILQR) at ^DA
DICompliance Hearings ILQR Fees at the end of the 60-day or
120-day diary period if the effectuating component has not received a
fee authorization or information that the representative was granted an
extension of time. The PC or, in Title XVI only cases, the FO will send
an email requesting status to Hearings ILQR.
The notice of award informs the claimant and the representative
of:
•
The amount of benefits due,
•
The amount withheld for the payment of a representative(s)
fee, and
•
In cases where a fee petition is required for a fee
authorization, the requirement that the representative(s) eligible for
direct fee payment file a fee petition, or written notice of the intent to
file a fee petition, within 60 days of the date of the decision notice
in order for the representative(s), or the entity if there is a valid
assignment of fees to an entity, to receive direct payment of a fee from
withheld benefits.
If there is a valid assignment of direct
payment of fees to an entity, the Social Security Administration
(SSA) may also share the award notice with the entity's point of
contact (POC) if it is necessary to resolve a fee-related matter. For
information on assignment of direct payment of fees, including the
roles and responsibilities of a POC, see Program Operations Manual
System (POMS) GN
03920.021.
If a hearings-level decision maker issued the fully or partially
favorable decision and he or she has not received a fee petition
or waiver statement, check if an extension has been requested or
granted. If no extension has been requested or granted, the PC or FO
will send the representative or POC a 20-day closeout notice and diary
the case for 45 days. If there is evidence of the limited circumstances
described in Hearings, Appeals, and Litigation Law (HALLEX) manual
HA 01120.053A
(see also POMS GN
03920.020A), the effectuating component sends this notice
to the entity's POC or the representative's estate executor, as
appropriate.
If an AC decision maker issued the fully or partially
favorable decision, the PC or FO will email ^DA
DICompliance Hearings ILQR Fees to request a closeout notice be
issued. The PC or FO will diary the case for 45 days.
At the end of the 45-day diary period, the PC or FO will
contact the hearings-level staff or ^DA
DICompliance Hearings ILQR Fees to determine whether the PC or
FO may release the past-due benefits.
•
If the contacted office has not received the fee
petition or an indication that the representative, or an individual,
in the limited circumstances described in HALLEX HA 01120.053A, will file a fee petition
by the end of any extension of time granted, that office's staff will
immediately advise the PC or FO to release the past-due benefits if
there is no other reason to withhold them, e.g., other representatives
who may receive direct payment, or court involvement.
•
If the staff has received or expects to receive a fee
petition by the end of any extension of time granted, it will advise
the PC or FO to continue to withhold payment.