GN 03943.010 Procedures for Field Offices (FOs) and Processing Centers (PCs) Actions, Including Initial Fee Authorization
A. Procedure for processing fee agreements
FOs and PCs must follow the procedures in GN 03940.000 and GN 03960.000 respectively to process fee agreements and requests for administrative review.
Review the claim file to locate the approved fee agreement and to look for any revised agreements. If more than one fee agreement is in the file, absent evidence to the contrary, presume that the decision maker acted on the latest dated fee agreement. When the decision maker has approved a fee agreement with language such as that in GN 03940.003A.3, the applicable cap used to evaluate the fee agreement is based on the date of fee agreement approval as follows:
for fee agreements approved before June 22, 2009, the specified dollar cap is $5,300; and
for fee agreements approved on and after June 22, 2009, the specified dollar cap is $6,000.
B. Modernized Claim System (MCS) processing for Title II
NOT2 screen entries: In the PENDING FEE AGREEMENT AMOUNT field on the CHECK/NOTICE 2 (NOT2) screen, enter the dollar cap amount specified in the fee agreement, (e.g., $5,300, $6,000, or less than those amounts, if agreed to by the claimant and the representative). The amount entered in this field cannot exceed $6,000. For further information on the NOT2 screen, see MSOM MCS 009.009, Check/Notice 2(NOT2).
The Earnings Computation (EC) process compares the amount shown in the NOT2 FEE AGREEMENT % RATE to the amount shown in the NOT2 PENDING FEE AGREEMENT AMOUNT field. The lesser of these amounts is posted to the Master Beneficiary Record (MBR) in the APPREP-AUTHORIZED FEE field and is shown as the authorized fee amount in the award notice.
For cases involving a representative who receives direct payment, MCS withholds the lesser of the NOT2 PENDING FEE AGREEMENT AMOUNT field or the NOT2 FEE AGREEMENT % RATE field and posts that amount to the APPFEE – AMT WITHHELD field on the MBR.
EXAMPLE: If the NOT2 FEE AGREEMENT % RATE is 25 percent ($7,500), and the NOT2 PENDING FEE AGREEMENT AMOUNT is the applicable fee cap ($6,000), MCS withholds the lesser of these two amounts ($6,000).
C. SSI system processing for Title XVI
1. Procedure for Modernized Supplemental Security Income Claims System (MSSICS)
When the FO receives a fee agreement decision, go to page 1 of the Representative Fee Update Data (UFEE) screen and update the FEE SITUATION field from “1=UNKNOWN OR UNRESOLVED FEE” to “2=RESOLVED FEE.” If the FEE STATUS = either “1=FEE AGREEMENT APPROVED BY HEARING OFFICE” or “2=FEE AGREEMENT APPROVED BY FIELD OFFICE” on UFEE page 2, complete the FLAT FEE AMOUNT field on UFEE page 3 with the fee cap amount specified in the fee agreement (e.g., $5,300, $6,000, or less than those amounts, if agreed to by the claimant and the representative). The amount entered in this field cannot exceed $6,000.
The system posts the money amount in this field to the AGR (FLAT AMOUNT) field in the SSR AUTH segment. The SSI computations process uses the money amount in the AGR field in determining the amount of the Title XVI portion of the authorized fee. For information on the UFEE screen, see MSOM BUSSR 002.014 Representative Fee Update Data (UFEE).
NOTE: In concurrent cases, the SSI system uses either the AUTHORIZED FEE or FEE AMT in the APPREP segment on the MBR to compute the Title XVI fee amount. The SSI system only uses the FEE AMT if AUTHORIZED FEE is not present. The SSI system uses the total of the Title II and Title XVI fee amounts in the windfall offset computation.
2. Special SSI notice procedures
a. If all of the following conditions apply, then complete the actions in GN 03943.010C.2.b. (in this section) to prevent the system from generating an incorrect automated fee notice:
The fee agreement applies to only one representative (MULTIPLE AUTHORIZED REPRESENTATIVES = N/the MAR field in the SSR AUTH segment = N);
Direct payment of the fee is not elected or is not applicable (IF ATTORNEY OR ELIGIBLE NON-ATTORNEY, DIRECT PAYMENT WAIVED = Y or blank/the DP field in the SSR AUTH segment = W or blank);
The fee agreement is disapproved because it sets a fee amount that exceeds the lesser of 25% of past-due benefits or the specified dollar cap (e.g. $5,300, $6,000);
The applicable specified dollar cap is $5,300;
The fee agreement is disapproved before June 22, 2009;
The disapproval of the fee agreement is not updated to the SSR until June 22, 2009 or later,
b. Complete the following procedures to prevent the system from generating an incorrect automated fee notice:
On UFEE page 1, update FEE SITUATION = “3=WAIVED”.
Enter the following comment in the SSR REMARKS: “Disapproved fee agreement/set a fee amount greater than 25 percent of past-due benefits or $5,300/Manual fee notice issued.”
Issue a manual fee notice.
NOTE: The system does not generate an automated fee notice if:
The fee agreement covers more than one representative (MULTIPLE AUTHORIZED REPRESENTATIVES =Y/the MAR field in the SSR AUTH segment = Y), or
The fee agreement is disapproved because it sets a fee amount that is more than 25 percent of past-due benefits or the maximum fee amount (FEE STATUS = 7=DISAPPROVED FEE AGREEMENT (>25 percent OR MAXIMUM FEE AMOUNT)/the FST field in the SSR AUTH segment = T) AND direct payment of the fee is elected (IF ATTORNEY OR ELIGIBLE NON-ATTORNEY, DIRECT PAYMENT WAIVED = N/the DP field in the SSR AUTH segment = D)
These situations already require a manual fee notice. For additional manual fee notice situations see MSOM BUSSR 002.014.