TN 8 (02-05)
GN 03930.110 Notifying the Representative and the Claimant of the Fee Authorized Under the Fee Petition Process for Services Below the Hearing Level
The fee reviewer generally notifies the representative and the claimant of the fee amount and how SSA arrived at the decision. If GN 03930.105D.2. applies (i.e., the recommended fee amount(s) exceeds $10,000), the Attorney Fee Officer in the Office of Disability Adjudication and Review Attorney Fee Branch (AFB) will notify the representative and the claimant by preparing and releasing the Form SSA-1560A-U5 (Authorization to Charge and Collect a Fee) with the attachment.
B. Procedure - Preparing the Fee Authorization
Use the Form SSA-1560A-U5 (Authorization to Charge and Collect a Fee) or electronic version of the form to notify the representative and the claimant of the fee SSA authorized. Attach to the SSA-1560A-U5 or include in the electronic version a brief, but complete explanation tailored to the circumstances.
1. Completing the Form SSA-1560A-U5
Prepare, or instruct the typist to prepare the form as follows:
NOTE: Prepare more than one Form SSA-1560A-U5 when there is more than one family unit.
Enter the identifying information. If one or more auxiliary beneficiaries are involved, add “and Family” after the claimant's name. If the title XVI spouse is involved, add “and Spouse.”
Enter the representative's name and address. If he/she is an attorney, use one of the following with the address:
Enter the fee amount. Make sure it agrees with the amount finally authorized, as shown on the SSA-1178.
Enter the address to which a party must send any request for administrative review.
Designate the appropriate paragraph about the means of fee payment, as well as the reference to the attached notice.
Enter the authorizing official information, and the name and address of the claimant or auxiliary beneficiary(ies).
EXCEPTION: Do not complete Form SSA-1560A-U5 or the electronic version of the form if GN 03930.105D.2. applies (i.e., you are recommending a fee greater than $10,000).
2. Formatting the Explanation Attached
Follow the sequence below when explaining your conclusions and the weight or significance you attached to the various factors.
a. Opening Statement
State the amount of the fee.
b. Positive Aspects
Summarize those services which advanced the development of the claim or contributed significantly to a favorable determination. If the fee you are authorizing is greater than that requested, explain here why it is reasonable.
c. Neutral or Negative Aspects
Summarize those services:
which were not provided in proceedings before SSA;
which negatively affected the development of the claim;
the value of which is compromised because the time spent is unreasonable; or
which, although neutral, do not justify a fee in the amount requested.
d. Additional Explanation
Address any additional considerations.
The means of fee payment if the representative has funds held in a trust or escrow account.
The authorized fee is for all services provided the claimant and his/her family before SSA.
The authorized fee is for all services provided in connection with both claims (e.g., titles II and XVI cases involving a common substantive issue).
A portion of the authorized fee is for services in connection with a specific claim when there was more than one claim decided.
See GN 03930.160 for a sample fee authorization notice (i.e., the completed SSA-1560A-U5 with attached explanation).
C. Procedure - Subsequent Actions
1. Release of the Notices
Attach a copy of the explanation to each copy of the SSA-1560A-U5.
Using window envelopes, send the original to the representative and the first copy of the SSA-1560A-U5 to the claimant or title II auxiliary beneficiary(ies) or title XVI spouse.
Place the third copy in the claim file with the SSA-1178.
In concurrent claims situations (as GN 03930.080 defines them) when SSA is not withholding title XVI past-due benefits, send the second copy to the field office (FO). See GN 03930.110C.4., if it is a concurrent claim and SSA is withholding title XVI past-due benefit, or it is a title XVI only claim. (The FO must receive the SSA-1560-A in all title XVI cases.)
Discard the remaining copy.
2. Update the MBR
For title II cases, update the MBR special message with the authorized fee amount and date authorized.
3. PC Action When SSA Is Withholding
Prepare or designate the required notices, and provide the benefit authorizer (BA) or benefit technical examiner (BTE) with instructions about releasing the title II past-due benefits withheld.
4. Title XVI Cases
a. No Title XVI Withholding for Direct Fee Payment
b. Title XVI Withholding for Direct Fee Payment
Fax the SSA-1560-A to the servicing FO. (The CTE will instruct the BTE to fax the fee authorization to the FO.)
Annotate the fax transmittal sheet with “Authorized Fee – SSI Past-due Benefits Withheld for Direct Fee Payment. For your necessary action.” In concurrent claims, also include the following: $(Amount paid to representative from title II past-due benefits before assessment deduction) of the authorized fee ($amount of authorized fee) paid from title II past-due benefits.”
5. Administrative Review Requested
a. SSA Is Withholding
If you receive a request for administrative review and SSA has not certified direct payment of the representative's fee, advise the BA/BTE to defer releasing past-due withheld title II benefits. In title XVI claims, the CR will defer releasing past-due withheld title XVI benefits. Then, refer to GN 03950.005 for jurisdiction and necessary action.
b. SSA Is Not Withholding
Refer to GN 03950.005 for jurisdiction and necessary action.