TN 17 (03-05)
GN 03940.010 Receipt of the Fee Agreement in the Field Office and Processing Center
A. Procedure - General
On receipt of a fee agreement, document the date of receipt (date stamp, etc.), if it is not already stamped or otherwise date-documented, and determine whether you have jurisdiction over the claim or post entitlement (PE) action. If you do not have jurisdiction, forward the fee agreement to the proper component.
B. Procedure - FO Jurisdiction - Pending Claim or PE Action
When the field office (FO) receives a fee agreement and has jurisdiction over the claim or PE action, the claims representative (CR) must:
Ensure the agreement is date-stamped, or otherwise date-documented.
Determine whether the file contains a Form SSA-1696-U4 (Appointment of Representative) or a written statement appointing the representative (see GN 03910.040). If SSA has not acknowledged the appointment, refer to GN 03910.040H.5.
Determine if the representative is eligible to receive direct payment of the fee (see GN 03920.017). Record the information on the MCS and/or MSSICS DW01 or MDW screen as appropriate. For non-attorney representatives, record the following based on the type of case being processed on the MCS and/or MSSICS DW01 or MDW screen :
ISSUE - EDPNA (stands for "eligible direct payment non-attorney)
REC - Input date of verification
REMARKS - Based on information on the list, type "Elgble for Direct Pymnt" (or "EDP"), "Not elgble for direct pymnt" (or "NEDP"), or "Not on list."
In a Title II claim, code the NOT2 screen in accordance with MSOM MCS 009.009,Check/Notice 2 (NOT2). In a Title XVI claim, code the UATH screen in accordance with MSOM BUSSR 002.013, Direct SSR Authorized Representative (UATH).
Non-attorney representatives whom SSA determines are eligible for direct payment may receive direct payment in a case only if the representative has, on or after February 28, 2005, entered into an agreement with the claimant for representation. If a non-attorney representative is on the Intranet website list described in GN 03920.018(B)3 and has not waived direct payment, verify that the claimant and the representative signed the appointment of representative or that a signed supplemental statement is in file on or after February 28, 2005. If not, request the representative to submit a supplemental appointment document.
If the non-attorney states he or she is eligible to receive direct payment, but SSA's records establish that he or she is not eligible, advise the representative that he or she is not eligible for direct payment. Model language to use in these situations follows:
You advised your client, (Beneficiary's name), and indicated on the appointment of representative that you are eligible for direct payment. Under titles II and XVI of the Social Security Act, certain non-attorney representatives have the option to have an approved representative's fee withheld and paid directly from a claimant's past-due benefits. However, [select the correct conclusion]
Therefore, if at a later date, we approve the fee agreement between you and your client and authorize a fee, the law will not permit us to pay the fee to you unless SSA makes a timely determination that you are eligible for direct payment. You will have to look to your client for payment of any fee authorized in this case.
Refer to GN 03920.018(B)3c for possible referral to the Office of the General Counsel, Office of General Law, Representative Conduct and Civil Rights Division.
Complete Form SSA-1128 (Representative Involved) as appropriate and staple it to the outside lower right of a paper claim(s) file(s). (See GN 03910.040H.6.) For an Electronic Disability Collect Systems (EDCS) case, select the "Representative Involved" flag.
Document the representative's name and address in the system as required in GN 03910.040H.7. Enter the representative's information on any auxiliary claims and/or the eligible spouse's claim also if the auxiliary(ies) or spouse are not independently represented.
In concurrent titles II and XVI claims, photocopy the fee agreement. File the original in the title II claim(s) file and a photocopy in the title XVI claim(s) file. If the CR is processing a favorable decision on a concurrent claim, follow GN 03940.050 and MSOM BUSSR 002.016 .
If the CR is processing a favorable decision on a title II claim, follow GN 03940.015, MSOM MCS 008.004 and MSOM MCS 009.009, to process the fee agreement. If the CR is processing a favorable decision on a title II PE action, follow GN 03940.015G.
If the CR is processing a favorable decision or PE action on a title XVI claim, follow GN 03940.046, SM 01901.950, MSOM MSSICS 023.008, MSOM BUSSR 002.012, MSOM BUSSR 002.013, MSOM BUSSR 002.014, and MSOM BUSSR 002.015 to process the fee agreement.
NOTE: If the FO receives new information about a non-attorney's eligibility for or waiver of direct payment after initially completing the representative fields on the UATH and UFEE screens, follow the procedures in GN 03940.010B.3. to determine if the information warrants a change in the representative's direct payment status and to make the necessary changes.
C. Procedure - FO Jurisdiction - Receipt after Systems Input to Pay but before Notice of Favorable Decision Issued
1. Title II Claim
When the CR receives a fee agreement after the favorable determination has been input into the system on a title II only claim or the title II portion of concurrent title II and title XVI claims, but before SSA issues the title II notice of favorable decision, the CR will:
Take the actions described in GN 03940.010B.
Fax the agreement and the fee agreement determination to the processing center (PC) paperless fax number.
Fax a cover sheet with the agreement and determination. On the cover sheet, include a brief explanation of the situation and a reference to GN 03940.001B. and request that the material be directed to CA PROC for issuance of a corrected notice with appropriate fee agreement language, including the fee agreement approval, past-due benefit amount, authorized fee amount, and right to request administrative review.
If the PC receives the fee agreement approval in time to incorporate the action into the award notice, it will do so. However, in most cases, once the Earnings Computation trigger is done, the PC will not receive the fee information in time to correct the initial notice to the claimant to reflect the determination on the fee agreement. In such a case, the PC must issue a corrected award notice to reflect SSA's approval or disapproval of the fee agreement and, if the decision maker approved the fee agreement, information on the payment of the fee.
2. Title XVI Claim
a. Title XVI Only
When the title XVI claim is adjudicated, or when a claim was previously denied and the appeal is now reversed with a partially or fully favorable decision, SSA issues the automated SSI Notice of Award (SSA-8025) the same day the title XVI claim is adjudicated (i.e., there are no days in between adjudicating the claim to pay and preparing the Notice of Award), unless the user suppressed the automated notice. If the user suppressed the automated notice, so that the fee agreement receipt date is prior to the date of the award notice, the CR will:
NOTE: An automated fee notice will be produced when the fee is approved/resolved. See MSOM BUSSR 002.014 for information regarding fee agreement notices excluded from automated processing.
b. Concurrent Title II and Title XVI Claims
In concurrent titles II and XVI claims, the PC will issue the notice to reflect SSA's approval or disapproval of the fee agreement. If the PC approves the fee agreement, the CR issues a fee notice to advise the claimant and the representative of:
NOTE: An automated title XVI fee notice is produced when the fee is resolved.
D. Procedure - Receipt in the PC - Pending Claim
When the PC receives a fee agreement and has jurisdiction over the claim, process the fee agreement as described in GN 03940.020 or GN 03940.025.
E. Procedure - Receipt After SSA Has Made a Favorable Decision
When SSA, through the FO or PC, receives a fee agreement after SSA has made a favorable decision (GN 03940.001B. discusses “date SSA makes a favorable decision”):
EXCEPTION: If the PC receives the fee agreement on concurrent titles II and XVI claims or a title II only District Office Final Authorization (DOFA) claim, the PC technician will disapprove the fee agreement.
F. Procedure - Receipt after SSA has made an Unfavorable Decision
When the FO or PC receives an appointment of representative and a fee agreement after SSA has made an unfavorable decision:
determine the location of the claim(s) file;
file the fee agreement in the claim(s) file;
annotate the SSA-1128 if there is a paper file (see GN 03910.040H.6. for instructions regarding the SSA-1128.) or select the “Representative Involved” flag for an EDCS case;
ensure that the representative's name and address are documented in the system as described in GN 03910.040H.7. (e.g., the Authorized Representative Data Base, QRID, or MBR Special Message Field);
if handled in the PC, send a copy of the fee agreement to the FO so that the title XVI CR can document the supplemental security record (SSR) regarding the representation in case the denial is reversed on appeal; and
take no further action on the fee agreement.
Do not return the fee agreement to the claimant or the representative. The claimant may file an appeal, at which time the fee agreement will be material.
NOTE: If the system reflects the representative's appointment prior to receiving the fee agreement, no further systems input is required relative to the fee agreement until the claimant appeals the unfavorable decision.