We must only approve a fee agreement when the claim or post-entitlement or post-eligibility (PE) favorable decision results in past-due benefits for a single claim or at least
one title in concurrent claims. If we initially approved a fee agreement on the condition
that there are past due benefits, but, at the time we effectuate the favorable decision,
we find that there are no past-due benefits, we cannot process the fee agreement approval.
In these situations, we must notify the representative(s) and the claimant that the
representative(s) must file a fee petition in order to charge and collect a fee. For
notice language, refer to NL 00720.050.
The fee agreement process applies to claims for initial entitlement, as well as PE
actions that involve new entitlement for additional benefits or reopening after termination.
We must disapprove fee agreements received in connection with processing PE actions
that only adjust benefit amounts or remove payment suspensions from benefits for which
we have already established entitlement (e.g., changes in workers’ compensation offset,
resolution of earnings discrepancies, increased payments from work ending while disabled),
even though the decisions may result in past-due benefits.
NOTE: Other actions may result in past-due benefits; however, the fee agreement process
applies only to claims for entitlement.