TN 3 (03-95)

GN 03960.005 Responsibility for Conducting Administrative Review Under the Fee Agreement Process - Jurisdiction

A. Policy - Favorable Decision Below the Hearing Level

In all cases favorably decided below the hearing level, responsibility for conducting administrative review is the same under both the fee agreement and the fee petition processes. See GN 03930.001 ff.; GN 03950.005B.1.; and, if necessary, GN 01050.055 ff. for PC jurisdiction. (PCs include the Program Service Centers (PSCs) and the Office of Central Operations (OCO).)

The chart below shows those employees delegated authority to conduct administrative review in all cases decided below the hearing level, including title XVI only cases.

COMPONENTREVIEWER
PSCSpecial Case Review Analyst (or someone in an equivalent position) in the Center for Security and Integrity.
ODODisability Specialist in the Special Appeals and Class Action Section
OIOReconsideration Reviewer

The Assistant Regional Commissioners for Management and Budget in the PSCs and the Director of the Office of Central Operations may delegate authority to others in equivalent positions, as necessary.

B. Policy - Favorable Decision at or Above the Hearing Level

In cases favorably decided at or above the hearing level, responsibility for conducting administrative review varies depending on the issue for review.

1. Review of the Disapproval of the Fee Agreement

When the issue for administrative review is a disapproval of the fee agreement, the identity of the decision maker controls who has authority to conduct the review. The chart below shows those delegated authority to conduct administrative review in all such cases decided at or above the hearing level, including title XVI only cases.

 

DECISION MAKERREVIEWER
ALJRegional Chief ALJ
Regional Chief ALJDeputy Chief ALJ
Deputy Chief ALJChief ALJ
AAJDeputy Chair, Appeals Council
Deputy Chair, Appeals CouncilChair, Appeals Council

2. Review of the Fee Amount

When the issue for administrative review is the amount of the fee under the fee agreement process, the identity of the requester controls who has authority to conduct the review.

  1. If the claimant, affected auxiliary beneficiary, or representative requested administrative review, those delegated authority to conduct administrative review in all such cases decided at or above the hearing level, including title XVI only cases, are as follows:

    • if the case is decided at the hearing level, then the reviewer is the ALJ;

    • if the case is decided at the Appeals Council level, then the reviewer is the Attorney Fee Officer, ODAR.

  2. If the decision maker requested administrative review, delegation of authority to conduct administrative review in all such cases decided at or above the hearing level, including title XVI cases, is the same as shown in GN 03960.005B.1.


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