The statute restricts a decision maker's right to request administrative review to
two situations. Therefore, for SSA to modify a fee authorized under a properly approved
agreement based on a decision maker's request, the decision maker must establish one
of the following:
The representative did not represent the claimant's interest adequately.
EXAMPLE: A representative delayed the claim(s) by making procedural errors or by repeatedly
requesting extensions of time to submit readily available information or evidence.
The fee is clearly excessive in light of the services provided.
EXAMPLE ONE: The CR was about to issue a favorable determination when the FO received the claimant's
recent appointment of representative and a fee agreement. The CR as decision maker
approved the fee agreement but timely requested a reduction of the amount of the fee
under the agreement after receiving a copy of the notice authorizing the fee. The
decision maker stated in his request that the $6,000 fee resulting from the fee agreement
was clearly excessive for the time it took the representative to interview the claimant,
complete the appointment of representative and the fee agreement, and submit them.
The reviewer concluded that the decision maker properly approved the agreement. He
also agreed with the decision maker's statement. Therefore, the reviewer considers
modifying the fee amount.
EXAMPLE TWO: The decision maker timely requested a reduction of the amount of the fee under the
agreement after receiving a copy of the notice authorizing the fee. He stated “the fee was too high because SSA would have made a favorable determination even
if the claimant had chosen to be unrepresented. Also, Administration employees
would have provided the same services at no cost to the claimant.” The reviewer concluded that the decision maker properly approved the agreement. However,
she considered the decision maker's rationale immaterial and did not find evidence
of a clearly excessive fee for the services the representative provided. Therefore,
the reviewer did not consider modifying the fee amount.