TN 17 (03-05)

GN 03940.045 Title XVI - Field Office Processing of Fee Agreements - General

A. Procedure – Favorable Decision(s) - Systems Controls

1. Title XVI Only – Claims Representative (CR) Actions

In title XVI only claims, after completing the procedures described in GN 03940.010, take the following actions:

  1. Ensure that the representative data is correctly entered to the UATH (see MSOM BUSSR 002.013) screen and the UFEE screen (see MSOM BUSSR 002.014). NOTE: If there is more than one representative, code the "Multiple Authorized Representatives" field on the UFEE screen "Y." (See MSOM BUSSR 002.014.)

  2. Determine if a representative is eligible for direct payment of the fee (see GN 03920.017. Refer to GN 03920.018 for specific policy on direct payment to non-attorney representatives). For non-attorney representatives, if not previously recorded, 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."

  3. If the non-attorney stated he/she is eligible for direct payment, but is not, advise the representative that SSA cannot make direct payment. Model language to include in the fee notice 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 their approved representatives' fees withheld and paid directly from a claimant's past-due benefits. However, [Select the appropriate conclusion]

    • you do not meet all the qualifications to be eligible for direct payment or

    • you did not meet all the qualifications to be eligible for direct payment until after we effectuated the favorable decision on your client's claim. or

    • you failed to maintain your eligibility for direct payment.

    The law does not permit us to make direct payment of a fee in this case. Accordingly, SSA is not withholding (claimant's name)'s past-due benefits for fee payment purposes and will not pay any authorized fee directly to you. You must look to the claimant for payment of the 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.

  4. File the fee agreement at the top of the non-medical portion of the claim(s) file.

2. Concurrent Title II and Title XVI

a. Title II CR Actions

  • Complete the procedures in GN 03940.010.

  • Provide a copy of the fee agreement to the title XVI CR.

b. Title XVI CR Actions on All Concurrent Cases

  • Ensure that the representative data has been correctly entered to the UATH screen and on the UFEE screen. If the representative is a non-attorney, check the EDPNA ISSUE on the MCS DW01 or the MDW screen. The representative's status on the UATH screen and on the UFEE screen should correspond to the status recorded on the title II system.

  • If the non-attorney representative's direct payment status is not recorded, SSA did not pay the title II portion of the fee to the representative, and the representative was eligible for direct payment when the decision was effectuated on the title II claim, pay the representative directly from the title XVI past-due benefits and notify the title II CR to follow the procedures in GN 03920.055, Benefits Not Available to Certify Direct Payment to a Representative.

    NOTE: On the NOT2 screen (MSOM MCS 009.009 ), when the non-attorney representative is eligible for direct payment, the Representative Type will be “1, attorney” AND the address line will show “REP FOR.”

  • File a copy of the fee agreement in the title XVI claims(s) file.

B. Procedure - Unfavorable Decision

Take no action under the fee agreement process if SSA does not favorably decide the title XVI claim or post-eligibility action.

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