Identification Number:
GN 03905 TN 4
Intended Audience:See Transmittal Sheet
Originating Office:ORDP ODP
Title:Forms, Exhibits and Notices for Representatives
Type:POMS Transmittals
Program:Disability
Link To Reference:
 

PROGRAM OPERATIONS MANUAL SYSTEM
Part GN – General
Chapter 039 – Representation and Representative's Fee
Subchapter 05 – Forms, Exhibits and Notices for Representatives
Transmittal No. 4, 02/04/2020

Audience

Originating Component

ODP

Effective Date

Upon Receipt

Background

This is a Quick Action Transmittal. These revisions do not change or introduce new policy or procedure.

Summary of Changes

GN 03905.035 Registration, Appointment, and Services for Representatives (RASR) Appointment, Revocation, and Withdrawal Notices

B. Exhibits

1. RSR103 - Appointment confirmation to appointed representative

Updated language to match revised UTIs RSR031 and RSR037.

3. RSR106 - Appointment revocation to appointed representative

Updated language to match revised UTIs RSR056 and RSR036.

4. RSR107 - Appointment withdrawal to claimant

Updated language to match revised UTI RSR040.

GN 03905.035 Registration, Appointment, and Services for Representatives (RASR) Appointment, Revocation, and Withdrawal Notices

A. When to use

The claimant and the representative must submit a notice of appointment (e.g., Form SSA-1696 or "equivalent writing") for the appointment of a representative to take effect. Once we complete entering the information into RASR, the system automates the release of notices to appointed representatives and their claimants. This section contains the notices related to appointment, withdrawal, and revocation of a representative.

B. Exhibits

1. RSR103 - Appointment confirmation to appointed representative

We received written notice that [claimant name] has appointed you to act as his or her representative for his or her claim(s). Therefore, we will deal directly with you on matters that concern this claim(s).

We have processed the Form SSA-1695 “Identifying Information for Possible Direct Payment of Authorized Fees” that you submitted for [claimant name].

We have processed your updated direct payment information for the representation of [claimant name].

We have recorded [firm name] with the EIN […] as your affiliation for this claim.

If you plan to charge a fee for services, you must file either a fee petition or a fee agreement with us. In either case, you cannot charge more than the fee amount we authorize you.

Fee Agreement Process

You must submit your fee agreement to us before we make the first favorable decision on the matter on which you worked. We will approve your agreement if it meets certain requirements. We will consider the fee agreement only if we favorably decide the claimant’s case and our decision results in past-due benefits. Find more information about fee agreements on our website at www.ssa.gov/representation/fee_agreements.htm.

OR

Fee Petition Process

You must submit your fee petition to us after your services end, even if the matter you worked on is still pending decision. For convenience, you may use Form SSA-1560, available on our website at www.ssa.gov/online/ssa-1560.html or through your local Social Security office. If you are eligible for and seek direct payment, note that there are important deadlines for submitting a fee petition so that we withhold funds to pay the fee directly to you. Find more information about fee petitions on our website at www.ssa.gov/representation/fee_petitions.htm.

We withhold up to 25 percent of the claimant’s past-due benefits. We will pay the authorized fee after deducting the assessment as required by the Social Security Act. You cannot charge or collect this expense from the claimant. When the authorized fee exceeds the withheld amount or the representative is not eligible for direct payment, the representative must seek payment from the claimant.

If You Waive Your Fee

If you choose to waive either a fee or direct payment of a fee, you can do so by updating your fee arrangement on the notice of appointment.

Early filing of the waiver enables us to prevent unnecessary withholding of past-due benefits for direct payment.

Important Note: After your appointment ends, you will no longer have access to the claimant’s records or personal information.

Suspect Social Security Fraud?

If you suspect Social Security fraud, please visit http://oig.ssa.gov/r or call the

Inspector General’s Fraud Hotline at 1-800-269-0271 (TTY 1-866-501-2101).

If You Have Questions

Please visit our Representing Claimants website at www.socialsecurity.gov/representation for general information.

If you have questions, please call us at 1-800-772-6270. If you are deaf or hard of hearing, you may call the TTY number, 1-800-325-0778 between 7:00 a.m. and 7:00 p.m. Eastern time, Monday through Friday. We can answer most of your questions over the phone. When you call, please have this letter with you to help us answer your questions.

If you have questions about reporting income or Form 1099-MISC, please contact the Internal Revenue Service.

2. RSR104 - Appointment confirmation to claimant

We received written notice that you appointed [representative’s name] to represent you for your claim(s). Therefore, we will deal directly with [representative’s name] on matters that concern your claim(s), unless you tell us otherwise.

Suspect Social Security Fraud?

If you suspect Social Security fraud, please visit http://oig.ssa.gov/r or call the Inspector General's Fraud Hotline at 1-800-269-0271 (TTY 1-866-501-2101).

If You Have Questions

For general information about Social Security, we invite you to visit our website at www.socialsecurity.gov on the Internet. For general questions and specific questions about your case, you may call us toll-free at 1-800-772-1213. You can also call your local Social Security office at 888-329-5721. We can answer most questions over the phone. If you are deaf or hard of hearing, you may call our TTY number 1-800-325-0778. If you do call or visit an office, please have this letter with you. It will help us answer your questions.

3. RSR106 - Appointment revocation to appointed representative

[Claimant’s name] asked us to revoke your appointment on [date]. We no longer recognize you as the appointed representative for [claimant’s name].

Important Note: After your appointment ends, you will no longer have access to the claimant's records or personal information.

What Happens Next

With limited exceptions, if you plan to charge a fee for your services, you must file a fee petition with us and may not charge more than the fee amount we approve. Any fee petition should be submitted as soon as possible. We will make a decision on your fee petition after we make a final decision on the claim. To find out how to file a fee petition visit www.ssa.gov/representation/fee_petitions.htm

If You Waive Your Fee

If you wish to waive a fee, you can do so by returning the enclosed waiver as soon as possible.

Suspect Social Security Fraud?

If you suspect Social Security fraud, please visit http://oig.ssa.gov/r or call the Inspector General's Fraud Hotline at 1-800-269-0271 (TTY 1-866-501-2101).

If You Have Questions

Please visit our Representing Claimants website at www.socialsecurity.gov/representation for general information.

If you have questions, please call us at 1-800-772-6270. If you are hearing impaired, you may call the TTY number, 1-800-325-0778 between 7:00 a.m. and 7:00 p.m. Eastern Standard time, Monday through Friday. We can answer most of your questions over the phone. When you call, please have this letter with you to help us answer your questions.

4. RSR107 - Appointment withdrawal to claimant

We no longer recognize [representative’s name] as your representative, because we received a withdrawal request on [date]. This change will not affect how we decide your claim(s) or any other matter that you have before us.

What Happens Next

You may choose to appoint someone else to represent you. Until you decide whether to appoint another representative, we will deal directly with you. We will help you with your claim(s).

[representative’s name] may ask for a fee for services up to the withdrawal date. If the representative who has withdrawn asks for a fee from you, we will let you review the request before we decide the fee amount. The representative may collect the authorized fee directly from you.

Suspect Social Security Fraud?

If you suspect Social Security fraud, please visit http://oig.ssa.gov/r or call the Inspector General's Fraud Hotline at 1-800-269-0271 (TTY 1-866-501-2101).

If You Have Questions

For general information about Social Security, we invite you to visit our website at www.socialsecurity.gov on the Internet. For general questions and specific questions about your case, you may call us toll-free at 1-800-772-1213. You can also call your local Social Security office at 866-708-3210. We can answer most questions over the phone. If you are deaf or hard of hearing, you may call our TTY number 1-800-325-0778. If you do call or visit an office, please have this letter with you. It will help us answer your questions.

5. RSR108 - Appointment withdrawal to claimant - replacement principal

We no longer recognize [representative’s name] as your representative, because we received a withdrawal request on December 5, 2017. This change will not affect how we decide your claim(s) or any other matter that you have before us.

What Happens Next

You have appointed other representatives on your claim(s). We have selected [representative’s name] to be your principal representative. However, you may choose to select one of your other representatives to be your principal representative. Until you decide, we will deal directly with [representative’s name].

[Representative’s name] may ask for a fee for his or her services through [date]. If the representative who has withdrawn asks for a fee, we will let you review the request before we decide the fee amount. The representative may collect the approved fee directly from you.

Suspect Social Security Fraud?

If you suspect Social Security fraud, please visit http://oig.ssa.gov/r or call the Inspector General's Fraud Hotline at 1-800-269-0271 (TTY 1-866-501-2101).

If You Have Questions

For general information about Social Security, we invite you to visit our website at www.socialsecurity.gov on the Internet. For general questions and specific questions about your case, you may call us toll-free at 1-800-772-1213. You can also call your local Social Security office at 866-708-3210. We can answer most questions over the phone. If you are deaf or hard of hearing, you may call our TTY number 1-800-325-0778. If you do call or visit an office, please have this letter with you. It will help us answer your questions.


GN 03905 TN 4 - Forms, Exhibits and Notices for Representatives - 2/04/2020