TN 5 (05-95)
GN 03910.060 When a Representative's Authority Expires
In most cases, a claimant engages a representative to handle a particular matter before SSA. A representative's authority expires when the representative's services in that particular matter end, unless the claimant specifically indicates that the representative's services, and the representative's authority to act on his or her behalf, are ongoing.
2. When a Representative's Services End
SSA presumes that a representative's services in a particular matter end at the earliest point that one of the following occurs:
SSA completes action in a claim, PE matter, or other issue (see GN 03910.060A.3.), and the period to appeal a determination or decision (including any determinations or decisions on auxiliary beneficiaries) ends (i.e., 60 days from the date the claimant receives the notice(s));
in a fee petition case (see GN 03930.001), the representative submits a petition for a fee and declares that his or her services in the case have ended;
the claimant advises SSA that he or she has revoked the representative's authority (see GN 03910.040C.);
the representative advises SSA that he or she has withdrawn from the case; or
a suspension or disqualification decision made by OGC regarding the representative has become final (see GN 03970.000 and GN 03970.050).
3. When SSA Completes Action
SSA completes action in a particular matter when it makes a determination or decision on all issues in a claim or PE action and issues any required notices, including any notices regarding auxiliary beneficiaries.
In the case of a favorable determination or decision, SSA completes action when it effectuates the determination or decision and issues the award notice(s), including any notices regarding auxiliary beneficiaries.
In concurrent Titles II and XVI claims involving a common issue, e.g., disability, SSA completes action in the matter when it issues notices regarding entitlement or eligibility under both titles, including any notice(s) regarding auxiliary beneficiaries under Title II. In such cases, the matter the claimant engages the representative to handle, common to claims under both titles, is entitlement to benefits based on disability. The representative's services include his or her actions to establish the claimant's entitlement under both Titles II and XVI based on a finding of disability.
4. Fee Agreement Cases
In the fee agreement process (see GN 03940.001), the representative does not submit a document declaring that his or her services have ended, as is the case in the fee petition process. Therefore, in fee agreement cases, SSA presumes that a representative's services end when the appeals period(s) expire(s) in the case (see GN 03910.060A.2., first bullet), unless the claimant specifically indicates that the representative's services continue beyond that date (see GN 03910.060A.5.).
This rule applies whether or not SSA has authorized the statutory maximum fee of $6,000 payable under the terms of an approved fee agreement before the expiration of the appeals period(s) in the case. In fee agreement cases, SSA may authorize a fee of $6,000 based on past-due benefits before all issues arising from the claim(s) are adjudicated. In such cases, SSA presumes, absent indication to the contrary, that the representatives services, and the representative's authority to act on behalf of the claimant (see GN 03910.025), continue until the remaining issues are adjudicated.
EXAMPLE 1: In a Title II claim, SSA authorizes a fee of $6,000 based on the primary claimant's past-due benefits, but there are delayed auxiliary claims that SSA has not adjudicated. In this case, SSA presumes that the representative's services continue until the delayed auxiliary claims are adjudicated.
EXAMPLE 2: In a concurrent Titles II and XVI claim, SSA authorizes a fee of $6,000 based on the claimant's Title II past-due benefits, but SSA has not completed adjudicating one or more issues affecting payment of benefits (e.g., windfall offset, Title II income adjustment). In this case, SSA presumes that the representative's services continue until the remaining issues are adjudicated.
5. Services of a Representative May Continue
If SSA completes an action as described in GN 03910.060A.3. but:
the representative has not declared, e.g., by filing a fee petition, that his or her services have ended; and
the claimant signs a statement indicating that the representative continues to perform services on the claimant’s behalf on the particular claim or PE action; and
the representative has not been suspended or disqualified by SSA.
Then, SSA will recognize the representative's ongoing authority to act on behalf of the claimant and will assume that the representative's authority continues until any of the above events takes place or SSA is notified by either party that the representation agreement has terminated.
6. Situation Unclear
Situations may arise in which it is difficult to determine readily whether a representative's authority has expired under the policy stated in GN 03910.060A.1. and GN 03910.060A.2., for several reasons.
Because information regarding the expiration of the appeals period is not on the MBR, it may be difficult to determine whether the representative's authority has expired if the claim file is not available in the component handling the inquiry, e.g., if a representative phones a TSC for information after SSA has made a decision or determination in a claim.
The QRID, which reads representative data from the MDI, the Special Message field of the MBR, and the SSR, reflects the data as originally input indefinitely, until the information is revised by subsequent input. The instructions for the Special Message field of the MBR require a date of input to indicate whether information regarding the representative is current (SM 00510.075); however, there is currently no dedicated field to enter a date of input of representative identification information on the MDAU or the SSR. Therefore, a QRID containing representative identification information obtained only from the MDI or the SSR may not be a reliable indicator of the representative's current involvement in the case in a PE situation.
Representatives and claimants sometimes assume that the representative's authority is ongoing after SSA completes action in a claim, but the claim file is not documented with a specific statement to that effect.
Accordingly, in situations in which a question arises as to whether an appointed representative's authority to act on behalf of the claimant is still in effect under the criteria in GN 03910.060A.1. and GN 03910.060A.2., the issue can usually be resolved satisfactorily only through direct contact with the parties involved.
NOTE: Contact the claimant first per GN 03910.050A. Do not share any claim information with the representative until you confirm the representative’s authority continues.
B. Appointment of Representative in Subsequent Applications
1. Appointment Subsequent Application Cases
Effective July 28, 2011, with few exceptions, we will not accept a new disability application if a prior disability claim for the same title and benefit type is pending at any level of administrative review. See DI 51501.001 for those instances when we may accept a subsequent disability application. When our rules allow us to accept a new application while a prior claim has been appealed to the Appeals Council, secure a new SSA-1696-U4 if the claimant is represented in the new claim. A new SSA-1696-U4 is necessary even if the representative is the same as on the prior claim. For the detailed procedure on handling the new application while a request for review is pending at the Appeals Council see GN 03104.370A.1.
2. Documenting the Appointment of a Representative and a Fee Agreement in Subsequent Applications
a. Claimant represented
If a claimant is represented in the subsequent application, SSA must document the representation.
Claimant appoints the same representative as in the prior application:
Document the file with a new notice of appointment of representative, Form SSA-1696-U4 (Appointment of Representative) or an equivalent statement. Accept a copy of a notice filed in the prior application, if any, but it must be signed and currently dated by the claimant and the representative if he or she is a non-attorney.
Claimant appoints a different representative or a representative for the first time:
Document the file with a new appointment of representative. Also, inquire about any prior representation and document the subsequent application file accordingly.
SSA will accept any fee agreement filed with the subsequent application. SSA will accept a photocopy of a fee agreement, including a photocopy of a fee agreement filed in the prior application (GN 03940.001D.).
b. Claimant Not Represented
If SSA does not receive an annotated copy of a previous appointment or a new appointment, SSA will presume that the claimant is not represented in the subsequent application. Therefore, SSA will NOT:
Notify any representative, including any representative appointed in the prior application, of any decision made in the subsequent application.
Withhold any past-due benefits based on the subsequent application.
Authorize a fee to any representative, including any representative appointed in the prior application, for work on the subsequent application.
1. Resolving Unclear Situations
Assume, absent evidence to the contrary, that a representative's authority expires at the earliest point that one of the events listed in GN 03910.060A.2. occurs. However, contact the claimant directly if:
SSA's records reflect an appointed representative; and
you cannot resolve a question as to whether the representative's authority to act on behalf of the claimant has ended under the criteria in GN 03910.060A.2. (e.g., because of conflicting information in file); and
the claim file does not contain a statement indicating that the authority of the representative is ongoing.
Ask the claimant whether the representative continues to represent him or her.
If YES, obtain a signed statement from the claimant indicating that the representative's authority is ongoing.
If you do not have the claim file, forward the statement to the component in which the file is located.
If NO, deal with the claimant directly in the matter, unless and until the claimant again appoints a representative.
2. Representative Dies
Contact the claimant if the representative dies before SSA completes action in the claim or other matter, unless the claim file is with ODAR.
Ask the claimant whether he or she will be represented by another individual.
If YES, obtain a notice of appointment of the new representative. Document the file and the system concerning the action and any new appointment of representative under the procedure in GN 03910.040H., GN 03910.040I., or GN 03910.040J., as appropriate.
If NO, deal with the claimant directly in the claim or other matter, unless and until the claimant again appoints a representative.
3. Claimant Dies
If the claimant dies before SSA completes action in the claim or other matter, assume that a representative's authority continues until one of the events listed in GN 03910.060A.2. occurs, unless:
the representative withdraws earlier; or
a survivor of the claimant to whom an underpayment may be made, in the order of priority stated in GN 02301.030A.1. for Title II claims and in SI 02101.003 for Title XVI claims, revokes the appointment of the representative.
If the representative withdraws or a survivor revokes the appointment, document the file and the system concerning the action and any new appointment of representative under the procedure in GN 03910.040H., GN 03910.040I., or GN 03910.040J., as appropriate.
4. Representative Reenters Case
If a representative reenters a case after his or her authority has expired, have the claimant reappoint the representative, and document SSA's records under the procedure in GN 03910.040 regarding the new period of representation.