Effective Dates: 07/30/2004 - Present Previous | Next

TN 7 (07-04)

GN 03930.100 Review of Itemized Services Provided Below the Hearing Level

A. Policy

A signed fee petition itemizing services constitutes an allegation that the representative provided the services listed. The petition's value, as proof that the services were provided, is strengthened when the claimant does not question or disagree with the entries.

The representative is ultimately responsible for substantiating alleged services. However, evidence in SSA's records (e.g., the claim file or the MCS development worksheets) is reliable documentation that services were provided. Field office (FO) and processing center (PC) employees document the file or the system to reflect that the representative has submitted materials or contacted SSA about a substantive matter (as GN 03910.040H through GN 03910.040J and GN 03910.050B require).

B. Procedure - SSA Records Support Alleged Services

After ensuring that the claimant has had an opportunity to comment on the fee petition (see GN 03930.095B.4.), rely on materials in the claim file or entries to the development worksheets to conclude whether the representative provided services listed.

Examples of factors to consider include:

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    Forms in a paper claims file with typed entries or forms with crease marks indicating they were mailed to SSA, as the representative alleges.

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    Letters from a representative that transmitted evidence he/she obtained.

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    Letters or reports of contact between the representative and the FO.

C. Procedure - SSA Records Do Not Support Alleged Services

Do not expect the claim file or the development worksheets to reflect every item of service shown on a fee petition.

1. Presume Expected Services Provided

First, ensure that the claimant has had an opportunity to comment on the fee petition (see GN 03930.095B.4.). Then presume, in the absence of evidence to the contrary, that the representative provided services listed which you may reasonably expect to have occurred.

EXAMPLES:

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    The representative interviewed the claimant for background information.

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    The representative and the claimant spoke by telephone several times and the conversations totaled an hour or less.

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    The representative and the claimant spoke several times, and the meetings or conversations seem to follow actions taken by SSA or the Disability Determination Services (DDS).

2. Contact Claimant

You need not contact the claimant unless the circumstances described in GN 03930.100C.2.a. apply.

a. Claimant Questioned or Disagreed with One or More Entries on Fee Petition

If the claimant questioned or disagreed with one or more entries on the fee petition, contact him/her for an explanation when:

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    documentation in the file or on the development worksheets does not support the services in question and you cannot infer (under GN 03930.100B) that the representative provided the services; or you must clarify the claimant's comment(s); and

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    the services in question are material to the fee determination.

b. Convey Claimant’s Objection to Representative

Convey the claimant's objection to the representative and give him/her an opportunity to respond.

c. Direct Contact Not Feasible or Desirable

If direct contact is not feasible or desirable, develop through the FO. Ask the FO to:

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    determine the reason(s) for the claimant's objection; and

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    convey the claimant's objection to the representative and give him/her an opportunity to respond.

Diary the case for the time estimated for completion (as shown in GN 03930.095B.7.).

3. Contact FO

NOTE: You need not contact the FO unless the circumstances described in GN 03930.100C.3.a. apply.

a. When to Contact FO for Additional Information

Contact the FO to obtain additional information when:

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    documentation in the file or on the development worksheets does not support the representative's allegations about contacts with the FO,

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    the volume of uncorroborated services is material to the fee determination, and

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    you cannot infer or presume (under GN 03930.100B or GN 03930.100C.1.) that the representative provided the services.

b. What to Ask FO Personnel About Contacts with the Representative

Ask the FO personnel who developed and processed the claim or postentitlement/eligibility action what they recall about the frequency and type of contacts with the representative.

4. Contact Representative

a. Consider Other Possibilities

Remain open to other possibilities.

EXAMPLES:

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    More than one person may have provided services. (Refer to GN 03930.020, about when separate fee petitions are required.)

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    The representative may not have provided some or all of the listed services in connection with proceedings before SSA (e.g., services related to a court proceeding, a worker’s compensation claim, or a claim against an insurance company).

b. Contact the Representative if Necessary

Contact the representative for an explanation when:

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    documentation in the file or on the development worksheets does not support the representative's allegations,

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    the uncorroborated services would significantly affect the amount of the fee authorized, and

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    you cannot infer or presume (under GN 03930.100B or GN 03930.100C.1.) that the representative provided the services.

Call or write the representative unless direct contact is not feasible or indicated. If direct contact is not appropriate, contact the representative through the FO. Diary the case if necessary (as shown in GN 03930.095B.7.).

D. References

To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0203930100
GN 03930.100 - Review of Itemized Services Provided Below the Hearing Level - 07/30/2004
Batch run: 12/18/2024
Rev:07/30/2004