TN 59 (12-24)

GN 03920.001 Overview of the Fee Authorization Processes

A. Introduction

A claimant may appoint an individual (attorney or non-attorney) to provide representational services in matters before us. A representative who wants to charge or collect a fee for services provided in any proceeding before us must first obtain our authorization, except when the conditions described in GN 03920.010 apply. Additionally, a Federal court may authorize fees to an attorney for representation provided before the court.

For a general overview of representation and representative's fees, see GN 03910.020 and GN 03920.001.

For policies and specific procedures that apply to the fee petition process, see GN 03930.001.

For policies and specific procedures that apply to the fee agreement process, see GN 03940.001. For information and instructions about the Rules of Conduct and Standards of Responsibility for Representatives, including fee violations, see GN 03970.010.

B. Definitions

1. Affiliate: To associate with an entity through our prescribed registration process.

2. Assignment: The transfer of the right to receive direct payment of an authorized fee from a representative to an entity. For more information about assignments, see GN 03920.021.

3. Concurrent claim: The term is used when an individual has a claim for benefits pending at the same level of review under both Titles II and XVI of the Social Security Act (Act). For more information on how we define the Title XVI past-due benefits amount in concurrent Title II and Title XVI claims, see GN 03920.031A.2.

4. Date of the first favorable determination or decision: The date of the first favorable determination or decision is the date on:

  • The notice of award at the initial and reconsideration levels.

  • The notice of decision at the hearing or Appeals Council levels.

IMPORTANT: As used in this sub-chapter, the "date we notify the claimant of the first favorable determination or decision" and the "date of the first favorable determination or decision" have the same meaning and refer to the same date.

5. Dual entitlement: Dual entitlement is when a claimant may be entitled to more than one type of benefit under the same title of the Act. (e.g., disability insurance benefits on their own record and surviving child benefits on a deceased number holder's record). Note that this differs from concurrent claims, which involve benefits under more than one title.

6. Entity: Any business, firm, or other association, including but not limited to partnerships, corporations, for-profit organizations, and not-for-profit organizations.

7. Fee agreement: A written statement, signed by the claimant and their representative(s), specifying the fee that the representative expects to charge and collect, and that the claimant expects to pay, for the representative's services provided before us.

8. Fee authorization date: The fee authorization date is the date we notify the claimant and representative of the authorized fee amount under either the fee agreement or fee petition process.

For more information on the authorization date, adjustments to past-due benefits withholding amount, or the representative's authorize fee amount, see GN 03920.040A.

9. Fee payment date:

a. The fee payment date is:

  • The day after the input action is processed by the technician in the field office (FO) or processing center (PC) when the fee payment is initiated through the Modernized Claims System (MCS), Manual Adjustment Credit and Award Processes (MADCAP), Report of Contact page; or

  • The day that payment is set in PAID status by the technician in the FO or PC when the fee payment is manually issued in the Single Payment System (SPS) and set to PAID.

b. The fee payment date is never:

  • The date of the notice generated in connection with the fee payment; or

  • The date the Department of the Treasury issues the actual check.

10. Fee petition: A written statement signed by the claimant's representative, requesting the fee the representative wants to charge and collect for representational services they provided in pursuing the claimant’s benefit rights in proceedings before us.

11. Ineligible for direct payment entity (IDPE): An entity that we have determined is not eligible to receive direct payment of authorized fees from us. For more information about IDPEs, see GN 03920.052.

12. Point of Contact (POC): An individual who registers as a representative in the manner we prescribe, is selected by an entity to speak and act on the entity’s behalf, and who assumes the affirmative duties and obligations we prescribe. For more information on the POC, see GN 03920.021.

13. Registration: The process by which an individual or entity provides the information we require to conduct business with us.

14. Registration, Appointment, and Services for Representatives (RASR): The application we use to store and manage information about representatives, entities, appointments, and direct payment data, and to send automated notices to representatives and entities.

15. Representative: An attorney or individual other than an attorney who meets all of our requirements and is appointed to represent claimants in dealings with us. In subchapter GN 03920.000, and for the purposes of our rules of conduct and standards of responsibility for representatives, “representative” also includes an individual who provides representational services and an individual who is listed as a POC for an entity, as applicable to their identified role.

16. Representative Identification (RepID): The 10-character identifier we issue to representatives to use instead of their Social Security number (SSN). A representative must use the RepID on our forms when requested. We assign Rep IDs when representatives register with us.

17. Representational services: Services performed for a claimant in connection with any claim the claimant has before us, any asserted right the claimant may have for an initial or reconsidered determination, and any decision or action by an administrative law judge or the Appeals Council.

C. Fee authorization processes

To obtain our authorization to charge and collect a fee, a representative must use one of two mutually exclusive fee authorizations processes: the fee agreement process or the fee petition process. Unless a specific situation dictates otherwise, a representative may choose between the fee agreement or fee petition processes. The two fee authorization processes are not interchangeable. We will not authorize a fee under both processes in the same case.

Unless the representative or claimant files a fee agreement before the date we make the first favorable determination or decision the representative worked towards achieving, we presume that the representative will either file a fee petition or waive the fee.

1. Fee Agreement Process

Under the fee agreement process, the representative or the claimant may submit a fee agreement before the date of the first favorable determination or decision on the claim that the representative worked towards achieving. Generally, we will approve an agreement signed by the claimant and the representative(s) if the other statutory conditions are met, and no exceptions apply. See GN 03940.003.

Representatives may submit a fee agreement by using our standard Form SSA-1693 (Fee Agreement for Representation Before the Social Security Administration), or an equivalent written statement, signed by the claimant and all representatives who intend to charge and collect a fee. Whether submitted on a Form SSA-1693 or equivalent written statement, we will approve a fee agreement only if it meets the conditions specified in GN 03940.003.

If we approve the fee agreement, the fee specified in the agreement is the maximum the representative may charge and collect. If a party to the fee agreement disagrees with our approval or disapproval of the fee agreement or the amount awarded under the fee agreement process, they may request administrative review of our approval or disapproval of the fee agreement as well as the amount of the fee we authorize.

For detailed information on the fee agreement process, see GN 03940.001.

For more information on fee agreement administrative review, see GN 03960.001.

For more information on the applicable fee cap limits, see GN 03920.006.

2. Fee Petition Process

A fee petition may only be submitted once the representative's services have ended. Based on the fee petition, we may approve a "reasonable" fee for the specific services provided. In determining a reasonable fee, we consider the criteria in GN 03930.010.

For more information on the fee petition process in general, see GN 03930.020.

NOTE: While there is no time limit to file a fee petition, to receive direct payment of all or part of an authorized fee, a representative must submit a fee petition or an intent to file a fee petition within 60 days of the date we mail the notice of the first favorable determination or decision. For more information of direct payment of fees under the fee petition process, see GN 03920.016.

In certain circumstances, representatives are required to file a fee petition to obtain our fee authorization. A representative must file a fee petition if any of the following apply:

  • The representative and the claimant have not timely submitted a written fee agreement.

  • A reviewing official affirmed the decision maker's disapproval of a fee agreement.

  • A reviewing official reversed the decision maker's approval of a fee agreement.

  • The decision maker approved a fee agreement, and we subsequently disapproved the fee agreement because no past-due benefits resulted from the favorable determination or decision at the administrative level. For more information if a Federal court makes the final decision, see GN 03930.005B.4.

  • The decision maker issued an unfavorable decision.

  • The decision maker disapproved the fee agreement and no party requested administrative review.

If a claimant, affected auxiliary beneficiary, or representative disagrees with the fee, if any, we authorize under the fee petition process, they may protest that authorization by requesting administrative review. For more information on administrative review under the fee petition process, see GN 03950.001.

NOTE: In limited circumstances, we will accept a fee petition from an individual other than the representative. For more information on these limited circumstances, see GN 03930.020A (fee petitions).

3. Two-tiered arrangement

Within a fee agreement, the representative and the claimant may choose to use a two-tiered arrangement under which they limit the application of the fee agreement to services through a specific level of the administrative review process (e.g., initial, reconsideration, hearing, or Appeals Council).

When evaluating a fee agreement that includes a two-tiered fee arrangement, the adjudicator must first determine which tier of the fee structure applies, and then approve or disapprove the fee agreement based on the level of review at the time of the decision. The adjudicator will approve a fee agreement if, considering the tier that applies to the level at which the claim was first favorably decided, the fee agreement meets the statutory conditions for approval and no exceptions apply, even if the fee agreement contains language applicable to a different tier that would otherwise require disapproval.

For more information on the two-tiered fee agreement process, see GN 03940.005.


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GN 03920.001 - Overview of the Fee Authorization Processes - 12/12/2024
Batch run: 12/19/2024
Rev:12/12/2024