"Claimant" is an individual claiming a right under the old-age, disability, dependents', or survivors' benefits program. It also refers to beneficiaries or other recipients whose benefit rights are the subject of a post-entitlement or post-eligibility (PE) action.

A "pending claim, matter, or issue" (hereafter "case") is any claim for benefits, any asserted right under any of our programs (e.g., an individual's declaration or statement of eligibility for or entitlement to payments or other benefits), or an issue that awaits our decision at any stage of the administrative process (e.g., PE or Medicare issue).

Examples of a case include, but are not limited to:

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  When the claimant files a signed application;

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  When the claimant files an appeal in writing;

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  PE issues not yet on appeal such as a medical continuing disability review; or

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  When the claimant or representative requests administrative review of a fee authorization. See GN 03950.000 and GN 03960.000 for information on administrative review of fee authorizations under the fee petition and fee agreement processes.

A "representative" is an individual who meets all the requirements of GN 03910.020A1 or A.2. and whom the claimant appoints to represent them in the claimant's dealings with us. For purposes of our rules of conduct and standards of responsibility for representatives (see GN 03970), "representative" also includes an individual who provides representational services, regardless of whether they have been formally appointed, and an individual who is listed as a point of contact for an entity, as applicable to their identified role. For information on the appointment of a representative, see GN 03910.040.

NOTE: Individuals such as friends, neighbors, or relatives can be appointed as the claimant's representative but do not need to be appointed if they are providing general assistance to the claimant. For information on types of general assistance not considered "representational services,"see GN 03910.020D.