Effective Dates: 12/18/2024 - Present Previous | Next

TN 35 (12-24)

GN 03930.060 Title II and Title XVI - Releasing Past-Due Benefits Withheld for Possible Direct Payment of Authorized Fees

A. Policy

We release Title II and Title XVI past-due benefits withheld for possible direct payment of authorized fees in the following situations:

  • •

    To the representative who is eligible for direct payment or to an eligible entity, if there is a valid assignment per GN 03920.021, when we have authorized fees for services (refer to GN 03930.085).

  • •

    To a court attorney who is eligible for direct payment when a Federal court has authorized fees for services performed before the court. See GN 03920.060 for information on court fees.

  • •

    To the claimant when:

    • –

      All representatives and court attorneys (if applicable) have waived their fee or direct payment of their fee;

    • –

      We have released payment to all representatives, court attorneys (if applicable)), and entities (if applicable) and the total fee(s) was less than the amount of past-due benefits withheld; or

    • –

      In cases with no court involvement, we have notified the representative(s) and the claimant of the time limit that applies in order to receive direct payment of a fee for administrative level services, and the representative(s) has not filed a fee petition or a written request for an extension of time within 20 days from the date of the notice.

See GN 03930.001C. for the definition of a representative “eligible for direct payment” and GN 03920.021B.2 for the requirements for an entity to be eligible to receive direct payment.

B. Process

The Form SSA-1560A (Authorization to Charge and Collect a Fee) and other documents described in GN 03930.001C.5 record the fee authorized under the fee petition process for services provided in proceedings before us. The processing center (PC) fee reviewer, claims technical expert (CTE), senior claims processing specialist (SCPS), Administrative Law Judge (ALJ), or Administrative Appeals Judge (AAJ) instructs the benefit authorizer (BA), benefit technical examiner (BTE), or post entitlement technical expert (PETE) to release Title II funds. The FO claims specialist (CS) releases Title XVI funds.

1. Title II

Generally, the BA/BTE or PETE certifies direct payment to the representative, or entity if there is a valid assignment per GN 03920.021, in fee petition process cases when we have authorized a fee and to the court attorney when the court has authorized a fee.

NOTE: An individual PC may require that the CS/fee reviewer (e.g., CTE, SCPS, or disability specialist) instruct the BA/BTE or PETE about releasing funds and sending notices.

2. Title XVI

The field office (FO) CS releases Title XVI funds and sends notices (see GN 03930.030 and GN 03930.032).

C. Procedure - Identify Situations Preventing Payment

When the PC technician or the Title XVI CS receives the SSA-1560A or another fee authorization document, first review the authorization and the electronic file for situations that preclude or delay certification of direct payment. For non-electronic cases, review the folder if necessary. Note that the authorization reflects the fee approved and generally addresses the means of payment.

1. Situations Requiring Referral to the Reviewer

Do not proceed with payment in the following situations. Instead, in the PC, refer the file to the PC CTE/SCPS or fee reviewer, advise the fee reviewer of the reason(s) you did not certify direct payment, request clarification, and set a diary (as GN 03930.060C.4. describes).

NOTE: In a Title XVI only claim, a FO CS reviews the file for impediments to payment from the withheld Title XVI past-due benefits; however, if the fee authorizer is aware of an impediment, the fee authorizer must identify the impediment for the CS. In concurrent Titles II and XVI claims, if the CS identifies an impediment to direct payment from the Title II withheld benefits, the CS will advise the PC of the impediment.

  1. a. 

    A statement on the fee authorization prevents payment.

    EXAMPLES:

    • •

      The representative is not eligible for direct payment.

    • •

      The fee amount determined for certification of direct payment exceeds the 25 percent withheld from Title II or Title XVI past-due benefits.

    NOTE: If the representative has assigned direct payment of an authorized fee to an entity and that entity is not eligible to receive direct payment, the technician must not honor the assignment (see GN 03920.021 for more information) and will instead pay the representative directly, unless they are also ineligible for direct payment.

  2. b. 

    The fee amount(s) authorized exceeds $15,000, and:

    • •

      in a case decided at initial or reconsideration level, the Form SSA-1560A is not signed by an official from the Attorney Fee Branch within the Office of Appellate Operations; or

    • •

      in a case decided by an ALJ, the fee authorization notice is not signed by the Regional Chief ALJ or other authorizing official shown in GN 03930.015D.

    NOTE: Some offices require that the fee reviewer verify the proper authorization of fees exceeding $15,000.

  3. c. 

    The fee amount authorized does not reflect dollars and cents.

  4. d. 

    An amended award reduced the past-due benefits withheld to an amount less than the fee amount determined for certification of direct payment.

  5. e. 

    An amended award increased the past-due benefits, and the fee amount authorized exceeded the amount determined for certification of direct payment.

  6. f. 

    Material in the claim(s) file indicates the representative’s services are continuing.

  7. g. 

    There is evidence of a trust or escrow account, or payment of the fee from some other source, which the fee authorizer did not consider. (See GN 03920.025C. for a discussion of the effect of funds held in a trust or escrow account.)

  8. h. 

    Any other question which requires clarification.

2. Another Representative Petitions

Do not proceed with payment if, when processing the action, you receive or learn of a fee petition filed by another representative who is eligible for direct payment. In multiple representative situations, we presume each representative who did not waive their fee or file a fee agreement will submit a fee petition (see GN 03930.005B.5.). Do not proceed with payment unless we have a fee authorization for all such representatives who are eligible for direct payment, or the diary for receipt of the fee petition or authorization specified in GN 03930.045B. expires.

Instead of certifying payment, refer the file to the person who authorized the fee you are considering, advise the fee authorizer of the reason(s) you did not certify direct payment, request clarification, and set a diary as GN 03930.060C.4. describes.

3. Request for Administrative Review

Do not proceed with payment if, when processing the action, you receive or learn of a fee protest or request for administrative review. Instead, refer the claim file to the appropriate person or component for administrative review. See GN 03950.005 to determine which component has jurisdiction to conduct the administrative review and GN 03950.010B for instructions on routing the request to the proper component. Set a diary per GN 03930.060C.4.

4. Diary

a. Referral to the Reviewing Component

If you refer the file to the component with jurisdiction to conduct the administrative review, or you expect the fee reviewer will do so, diary the case for 60 days. Show the reason for the diary as “Fee Authorization.”

b. No Referral to the Reviewing Component

Diary the case for 60 days. Show the reason for the diary as “Fee Petition.”

D. Procedure - Release Benefits Withheld

If none of the issues or "impediments" listed in GN 03930.060C. precludes or delays direct payment, release the benefits withheld (as shown generally for Title XVI claims in GN 03930.035 and for Title II claims in GN 03930.060D.1. and GN 03930.060D.2., but see the anomalies in GN 03930.060D.3.). Note that for purposes of this subsection, payment from another source would include funds in a trust or escrow account. (See GN 03920.025 for a discussion of the effect of funds held in a trust or escrow account and GN 03920.019 for information about the assessment or “user fee” associated with direct payment.)

NOTE 1: In a concurrent claim, ensure that offset is completed before authorization and again after the Title II authorized fee is known before releasing Title II past-due benefits.

NOTE 2: If the representative has assigned direct payment of an authorized fee to an entity refer to GN 03920.021 for more information.

NOTE 3: In court remand cases, verify court fee issues are resolved.

1. No Payment Expected from Other Source(s)

Situation

Action
  1. a. 

    Fee equals or exceeds amount of benefits withheld

 

After deducting the assessment, pay to the representative or entity if there is a valid assignment all benefits withheld and authorized for the fee payment. In a concurrent case, verify the Title XVI withholding amount with the FO.

  1. b. 

    Amount of benefits withheld exceeds fee

 

After deducting the assessment, pay the fee to the representative (or entity if there is a valid assignment) and, unless GN 03930.060D.3.a. applies, release the remainder based on the priority of payment policy.

2. Payment Expected from Other Source(s)

Situation

Action
  1. a. 

    Payment expected from other source(s) equals or exceeds fee

 

Unless GN 03930.060D.3. below applies, release all of the benefits withheld based on the priority of payment policy.

  1. b. 

    Fee equals or exceeds the sum of the amount of benefits withheld and the payment expected from other source(s)

After deducting the assessment, pay to the representative (or entity if there is a valid assignment) all benefits withheld and authorized for fee payment.

  1. c. 

    The sum of the benefits withheld and the payment expected from other source(s) exceeds the fee

 

After deducting the assessment, pay the appropriate portion of the fee to the representative (or entity if there is a valid assignment) and, unless GN 03930.060D.3. applies, release the remainder based on the priority of payment policy.

(See GN 02301.000 for Title II underpayment payment policy and SI 02101.000 for priority of payment policy for Title XVI cases.)

3. Anomalies

Exercise caution when certifying direct payment or releasing any excess past-due benefits withheld in the situations identified above in GN 03930.060D.3.a and GN 03930.060D.3.b.

a. Case Decided in Federal Court Proceedings ("True Court Cases") or on Court Remand

When you certify direct payment to the representative, or entity if there is a valid assignment, and the administrative fee(s) authorized in connection with the fee petition(s) is less than 25 percent of the past-due benefits, continue to withhold the remainder if a Federal court may award an additional fee to an attorney under §206(b) or §1631(d) of the Social Security Act. Do not release the remainder to any beneficiary or recover an overpayment in this situation.

b. Payment Expected from Other Source(s) in Concurrent Titles II and XVI Cases

If the representative, or entity if there is a valid assignment, has funds in a trust or escrow account that the representative or entity will collect for services unique to the Supplemental Security Income (SSI) program, reduce both the amount you consider as held in trust or escrow and the fee amount authorized for direct payment purposes from Title II past-due benefits. For an example, refer to GN 03930.060D.4.b. in this section. The Title XVI CS will deduct the escrow funds for services unique to the SSI program from the fee amount authorized from Title XVI past-due benefits, as appropriate.

4. Examples

a. Funds Held in Escrow - No Fee Amount Attributable to Title XVI Exclusively

We withheld $2,600 and the representative had $1,000 held in a trust or escrow account. The fee authorizer approved a fee of $2,500. Consistent with GN 03930.060D.2.c. and the information provided in the fee authorization, you deduct the assessment ($94.50), certify $1,405.50 for direct payment to the representative and release the $1,100 remainder to the claimant. In addition, we release any Title XVI past-due benefits withheld for direct payment because the Title II past-due benefits satisfied the full fee amount. The representative collects the $1,000 fee balance from the trust or escrow account.

$ 2,600.

Amount withheld

+ 1,000.

Amount in trust or escrow

$ 3,600.

Total available

- 2,500.

Fee authorized

$ 1,100.

 

Remainder for claimant

$ 2,600.

Amount withheld

- 1,100.

Remainder for claimant

$ 1,500.

- 94.50

$ 1,405.50

Amount for direct payment before assessment

Assessment

Amount for direct payment

b. Funds Held in Escrow – Portion of Fee Designated as Attributable to Title XVI Exclusively

As in the previous example in GN 03930.060D.4.a., we withheld $2,600 in Title II past-due benefits and the representative had $1,000 held in a trust or escrow account. However, the fee authorizer approved a fee of $2,500 and designated $500 of that as attributable to Title XVI exclusively.

As shown, you must reduce by $500 both the amount you consider in trust or escrow and the fee authorized for direct payment purposes from the Title II benefits. Consistent with GN 03930.060D.2.c. and GN 03930.060D.3.b., and the information provided in the fee authorization, you deduct the assessment ($94.50), certify $1,405.50 for direct payment to the representative, and release the $1,100 remainder to the claimant. In addition, the CS releases any Title XVI past-due benefits withheld for direct payment because the representative collects the $1,000 fee balance from the trust or escrow account.

$ 2,600.

Amount withheld

 

Amount in trust or escrow

+ 500.

($1,000 -$500 for SSI)

$ 3,100.

Total available

- 2,000.

Fee authorized ($2,500 - $500)

$ 1,100.

Remainder for claimant

$ 2,600.

Amount withheld

- 1,100.

Remainder for claimant

$ 1,500.

- 94.50

$ 1,405.50

Amount for direct payment before assessment

Assessment

Amount for direct payment

If instead you had considered the full amount in trust or escrow ($1,000) but reduced by $500 the fee authorized for direct payment purposes, you would erroneously certify $1,000 for direct payment to the representative and release the $1,600 remainder to the claimant. Although the representative could collect $1,000 from the trust or escrow account, the claimant would have to repay the representative the $500 fee balance.

NOTE: In concurrent cases, the fee attributed only to the Title XVI claim cannot be used to lower the Title II income. See GN 02610.000 and SI 02006.000.

 

To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0203930060
GN 03930.060 - Title II and Title XVI - Releasing Past-Due Benefits Withheld for Possible Direct Payment of Authorized Fees - 12/18/2024
Batch run: 12/19/2024
Rev:12/18/2024