TN 3 (03-95)
GN 03960.015 Receipt and Routing of Requests for Administrative Review Under the Fee Agreement Process by SSA Office Not Having Jurisdiction
SSA's notices advise claimants, auxiliary beneficiaries, and representatives to send requests for administrative review under the fee agreement process to the Attorney Fee Branch (AFB) in ODAR's Office of Appellate Operations (Suite 805 Skyline, 5107 Leesburg Pike, Falls Church, Virginia 22041-3255). However, a claimant, auxiliary beneficiary, or representative may file a request for administrative review with any SSA office. (See C. below for the procedure when an SSA office other than the AFB receives the request for administrative review.)
The AFB takes the following actions when receiving a request for administrative review under the fee agreement process.
Date stamps the request.
Advises the designated contact in the appropriate PC by telephone or facsimile, if the AFB believes SSA is withholding title II past-due benefits for possible direct payment to an attorney representative. (The PC takes the actions in GN 03960.020 below.)
NOTE: Each PC designates its primary and alternate contacts.
Routes the request to the reviewing component with a copy of its acknowledgment.
1. FO Receives Request
Take the following actions if you receive a request for administrative review under the fee agreement process. (See 2. below for handling telephone inquiries.)
Date stamp the request.
Obtain a written explanation for untimely filing, if the party requests administrative review in person more than 15 days after the date he/she received notice of either a disapproved agreement or a determination of the amount of the fee. (This applies in a face-to-face interview or a telephone interview preceding receipt of the written request for administrative review.)
If SSA is withholding title II past-due benefits for possible direct payment to an attorney representative, call the PC module to prevent premature release. (The PC takes the actions in GN 03960.020.)
Acknowledge receipt. (See model notices in GN 03960.075.)
Route the request directly to the reviewing component with a copy of your acknowledgment and the claim(s) file, if available. Also, send a copy of the request to the AFB (for reporting purposes).
For title II purposes, enter a special message to the master beneficiary record (MBR) data, following the procedure in MSOM T2PE 007.008: “[Date - mm/yy] -Request for administrative review of fee agreement [disapproval or amount] filed by [claimant, affected auxiliary beneficiary, representative, or decision maker] .” For title XVI purposes, enter a remark to the Supplemental Security Record (SSR), following the procedure in SM 01301.841: “[Date - mm/yy ]- Request for administrative review of fee agreement [ disapproval or amount]filed by [claimant, representative, or decision maker].”
2. SSA Receives Oral Request
If the Teleservice Center (TSC) or other SSA office receives an oral inquiry, take the following action once you determine the caller is requesting administrative review of the disapproval of a fee agreement or fee amount determination:
Ask the caller his/her reason(s) for requesting administrative review and complete a Form SSA-795 (Statement by Claimant or Other Person) with the explanation (see sample at GN 03960.095).
Tell the caller that you will send him/her a statement to review and sign.
Advise the caller that the request for administrative review must be in writing and to immediately sign and return the statement in the envelope provided.
Explain to the caller that he/she must include a late filing explanation on the SSA-795 statement, if he/she does not request review timely, i.e., the caller requests review more than 15-days after receiving notice of the fee agreement disapproval or notice of the fee amount determination.
Place the TSC or other office code and the date of the call in the upper right corner of the SSA-795.
Send the SSA-795 to the caller with a c