Identification Number:
GN 03920 TN 58
Intended Audience:See Transmittal Sheet
Originating Office:ORDP ODP
Title:Administering Representatives Fees Provisions
Type:POMS Full Transmittals
Program:All Programs
Link To Reference:
 

PROGRAM OPERATIONS MANUAL SYSTEM

Part GN – General

Chapter 039 – Representation and Representative's Fee

Subchapter 20 – Administering Representatives Fees Provisions

Transmittal No. 58, 12/06/2024

Audience

PSC: BA, CA, CS, DE, DEC, DS, ES, ICDS, IES, PETE, RECOVR, SCPS, TSA, TST;
OCO-OEIO: BIES, CAQCR, CR, PETL, RECONR;
OCO-ODO: BTE, CR, CST, CTE, DS, PETE, PETL, RECOVR;
FO/TSC: CS, CS TII, CS TXVI, CSR, CTE, FR, OA, OS, RR, TA, TSC-CSR;

Originating Component

ODP

Effective Date

12/09/2024

Background

On August 21, 2024, we published the final rule Changes to the Administrative Rules for Claimants Representation and Provisions for Direct Payment to Entities, which introduces significant changes to our sub-regulatory guidance following the First Circuit Court’s decision in Marasco and Nesslebush, LLP v. Collins and Social Security. These updates are part of broader efforts to modernize our processes and enhance clarity. In preparation for the second phase this final rule, we revised tour instructions, which allows us to collect user fee directly from entities assigned direct payment of authorized fees. These changes will be effective on December 9, 2024.

Summary of Changes

GN 03920.051 Excess Representative Fee Payments

  • The section title changed to "Excess Fee Payments Made to Representatives and Entities".

  • The section revised to combine and cover excess fee payment issued to representatives and affiliate entities.

  • Wording changes throughout to enhance clarity, improve accuracy, and ensure consistency with the final rule.

 

GN 03920.052 Pursuing Recovery of Excess Fees Paid to Representatives and Entities, and Referrals for Ineligible for Direct Payment Entity (IDPE) List

A new section created to provide guidance on recovering excess fees and the referral process for fees paid to entities. This policy was added as a direct result of the final rule concerning the direct payment of authorized fees to entities. The section includes processing instructions for field office and payment center technicians, and submitting referrals to the IDPE Coordinator Group to pursue recovery of excess fees paid to the entity.

 

GN 03920.051 Excess Fee Payments Made to Representatives and Entities

A. Introduction to excess representative fee payments made to a representative and entities

Excess fee payments are fee payments made to a representative or an entity that exceed the authorized fee amount. Excess fee payments can be the result of processing errors, adjustments, or revised fee authorizations.

An excess fee payment is a debt owed to us, not to the claimant; remittance of the fee must be made to us. If the relevant instructions in GN 03920.051B in this section direct us to issue a refund to the claimant, the technician refunds to the claimant any funds erroneously withheld or paid. For information on issuing the refund, see SM 01901.005 and SM 01901.015 for Title XVI claims and SM 00848.330 for Title II claims.

Payments made by claimants to a representative above the fee amount we authorize are not excess fee payments. These payments are potentially fee violations and must be referred to the Office of the General Counsel (OGC) for further investigation. For more information on fee violations, see GN 03970.010D and GN 03970.017.

NOTE 1: The claimant is not due a refund if we did not withhold past-due benefits for the fee payment. Also, the claimant may not be due a refund if the revised past-due benefits and fee resulted in an overpayment to the claimant.

If a representative has assigned direct payment of their authorized fee to an entity, and the conditions for honoring that assignment continue to be met at the time we certify direct payment of the fee, we directly pay the authorized fee to the designated entity. If an excess fee payment is made to an entity, the entity is responsible for repaying this debt to us.

NOTE 2: If a representative assigned direct payment of their authorized fee to an entity but we incorrectly issued the payment to the representative, we will not treat the payment as an excess fee or take any action to correct the error. The representative and the entity are responsible for resolving the misdirected payment between themselves.

For more information on the process of recovering excess fee payments made to representatives or entities, see GN 03920.052.

IMPORTANT: An excess fee payment to a representative or an entity is not an overpayment of benefits, as defined in section 204(a) of the Social Security Act and 1631(b)(1)(A). Therefore, waiver and appeal rights do not apply to our determination that an excess fee payment has been made to a representative or entity. We refer representatives who fail to refund excess fees to the Office of the General Counsel (OGC) for possible sanctions. We refer entities who fail to refund excess fees to the Ineligible for Direct Payment Entities (IDPE) coordinators.

For more information on sanction referrals for fee violations, see GN 03970.017.

For more information on the IDPE referral process for entities, see GN 03920.052C.6.

B. When we will pursue recovery of an excess fee payment

We will pursue recovery of an excess or incorrectly paid fee when:

1. We paid an amount above the authorized fee amount

We will recover an excess fee if the amount we directly paid a representative or entity exceeds the amount authorized. We refund the amount to the claimant, if appropriate, and will recover the excess amount from the representative or entity.

IMPORTANT: We do not delay the refund to the claimant while we wait for the representative or entity to refund the excess fee payment.

2. We directly paid a fee when the determination or decision did not result in past-due benefits

We would recover an excess fee if we directly paid a fee to a representative or entity when no past-due benefits were available (e.g., we paid a fee under the fee agreement process, but the case did not result in past-due benefits). Under these circumstances, we will:

  • Request that the representative or entity refund the excess fee payment to us;

  • Establish an overpayment on the claimant’s record for any past-due benefits calculated and awarded; and

  • Inform the claimant and the representative(s) that because there are no past-due benefits payment of the authorized fee(s) is a matter between them.

NOTE: If we erroneously failed to withhold past-due benefits for direct fee payment in a case where past-due benefits were available, follow the instructions in GN 03920.055.

3. The claimant protested after we erroneously withheld past-due benefits to directly pay a fee

a. Representative received the fee

We will recover an excess fee if we erroneously withhold past-due benefits for the purposes of directly paying a representative’s authorized fee, the claimant has objected to the amount withheld or direct payment of the fee, and:

  • The representative was not eligible for direct payment GN 03920.051.C.1.; or

  • The representative waived direct payment of the fee GN 03920.051.C.2.

We will explain to the claimant that they will continue to owe the authorized fee amount to the representative.

If the claimant continues to protest the fee withholding, we will:

  • Inform the claimant and the representative that payment of the authorized fee is now a matter between them; and

  • Refund the excess fee payment to the claimant and pursue recovery of the excess amount paid to the representative. The erroneous fee payment is a debt the representative owes to us, not to the claimant.

If the claimant withdraws the protest after the explanation, refer to GN 03920.051C.1.-C.2. to determine whether we will continue to pursue recovery of the excess payment.

b. Entity received the fee

We will recover an excess fee if we erroneously withhold past-due benefits for the purposes of directly paying a representative’s authorized fee to an entity, the claimant has objected to the amount withheld or direct payment of the fee, and:

  • The representative was not eligible for direct payment GN 03920.051.C.1.;

  • The representative waived direct payment of the fee GN 03920.051.C.2.; or

  • The entity was not eligible for direct payment at the time we certified payment.

We will explain to the claimant that, if they wish to continue protesting, we will refund the excess fee payment to them, but they will owe the authorized fee amount to the representative and that payment of the authorized fee will be a matter between the claimant and the representative.

If the claimant continues to protest the fee withholding, we will:

  • Inform the claimant and the representative that payment of the authorized fee is now a matter between them; and

  • Refund the excess fee payment to the claimant and pursue recovery of the excess amount paid to the entity. The erroneous fee payment is a debt the entity owes to us, not to the claimant.

If the claimant withdraws the protest after the explanation, refer to GN 03920.051C.1.-C.2. to determine whether we will continue to pursue recovery of the excess payment.

4. The claimant protested after we directly paid an authorized fee that exceeded 25% of past-due benefits

We will recover an excess fee if we authorize a fee that exceeded the 25 percent withholding limit and:

  • We withheld the authorized fee from the claimant’s past-due benefits;

  • We paid the representative or entity no more than the authorized fee; and

  • The claimant has protested the withholding of the past-due benefits or direct payment of the authorized fee in excess of 25 percent of past-due benefits to the representative or entity.

We will explain to the claimant that, if they wish to continue protesting, we will refund the amount of the authorized fee we paid that exceeded 25 percent of past-due-benefits. However, we will also explain that the fee authorization itself is still in effect, that the amount of the fee we refund will be owed to the representative, and that payment of the remainder of the authorized fee will be a matter between the claimant and the representative.

If the claimant withdraws the protest after the explanation, follow instructions below in GN 03920.051C.3. If the claimant continues to protest the fee withholding, we will:

  • Refund the excess fee payment to the claimant and pursue recovery from the representative or entity. The excess fee payment is a debt owed to SSA, not to the claimant.

  • Inform the claimant and the representative that payment of the authorized fee is now a matter between them.

NOTE: The excess fee payment refers to the portion of the fee that exceeds 25 percent of past-due benefits, which is the amount to be refunded by the representative or entity in the event of a claimant’s protest. Although the excess fee payment refunded by the representative or entity is an authorized fee, the amount we can directly pay is limited to 25 percent of the past due benefits. The claimant is still responsible for paying the remaining portion to the representative.

5. A representative protests an unequally distributed fee payment under the fee agreement process

We will recover an excess fee if we unequally distributed shares of a fee under the fee agreement process and any of the affected representatives objects to the payments as described GN 03920.051C.4. In this situation, we will:

  • If errors are identified in the fee authorization notices, send corrected fee authorization notices specifying the individual fee amounts;

  • Pay the representatives or entities who received less than their respective portions of the authorized fee the difference between their correct fee portions and the amounts we already paid them, adjusting for any increase in their portion of the user fee; and

  • Notify the representatives or entities who received more than their portions of the authorized fee that they must refund the excess portion of their fee payment (adjusting for a decrease in their portion of the user fee). Inform representatives that failure to return the excess portion could result in a referral for sanctions. Inform entities that failure to return the excess portion could result in a referral for placement on the IDPE list.

6. The representative misrepresented their eligibility for direct payment

We will recover an excess fee if there is indication that the representative misrepresented their eligibility for direct payment and the factors listed in 03920.051C1 in this section do not apply. We will:

  • Require that the representative or entity refund the fee to us;

  • Refund the erroneously withheld fee to the claimant (including a refund of the user fee);

  • Document the situation as instructed in GN 03920.051D;

  • Refer the matter to OGC for possible sanctions, as explained in GN 03970.017; and

  • Inform the claimant and the representative that payment of any authorized fee balance is a matter between them.

7. We issued duplicate fee payments

a. Duplicate payment issued to a representative

We will recover an excess fee if we issue a duplicate payment to a representative. In this circumstance, we will:

  • Inform the representative that we issued a duplicate fee payment;

  • Request that the representative refund the excess fee payment to us; and

  • Document the situation as instructed in GN 03920.051B.2.

b. Duplicate payment issued to an entity

We will recover an excess fee if we issue a duplicate payment to an entity. In this circumstance we will:

  • Inform the entity’s POC that we issued a duplicate fee payment;

  • Request that the entity refund the excess fee payment to us; and

  • Document the situation as instructed in GN 03920.052B.

For more information involving recovery of excess fees paid to an entity, see GN 03920.052C.

8. We reduced the authorized fee on administrative review

We will recover an excess fee if we directly pay an authorized fee to a representative or entity, but the amount of the fee is later reduced following administrative review. Under this circumstance, we will:

  • Confirm that the parties were notified of the administrative review determination. If not, contact the decision maker and inform them of the issue. (see GN 03950.040 and GN 03960.070).

  • Notify the parties (and entity, if applicable) of the issue;

  • Use the revised fee amount and appropriate user fee to determine the representative’s excess fee payment;

  • Require that the representative or entity refund the excess fee payment to us; and

  • Pay the claimant the difference between the prior fee amount and the revised fee amount (before the user fee withholding).

For more information on the administrative review process, see GN 03950.000 Fee Petitions and GN 03960.000 Fee Agreements.

9. We reduced the authorized fee after discovering that the original fee was authorized based on an incorrect computation of past-due benefits

We will recover an excess fee if we reduce a representative’s authorized fee after discovering that, due to a processing or input coding error, we incorrectly calculated the claimant’s past-due benefits. Under this circumstance, we will:

  • Notify the claimant and representative (and entity, if applicable) that we have reduced the past-due benefit amount and authorized fee;

  • Use the revised authorized fee amount to calculate the overpayment to the claimant;

  • Use the revised authorized fee amount to determine the excess fee payment to the representative or entity (after applying the appropriate user fee); and

  • Request that the representative or entity, if applicable, refund the excess fee payment to us.

For more information on adjustments to the past-due benefits amount, see GN 03920.040.

10. We authorized a fee to a representative who was not appointed to the claim or who was appointed but waived the right to charge and collect a fee

a. The representative received the fee

We will recover an excess fee if we pay it to a representative who was never appointed to the claim or who was appointed but waived the right to a fee. Under these circumstances, we will:

  • Require the representative to refund the fee (the representative owes the debt to us and not to any other appointed representative(s) or to the claimant); and

  • Pay the fee to any appointed representative(s) who is eligible for direct payment and requested it. If there is no appointed representative who requested and is eligible for direct payment, release the funds to the claimant.

For more information on Direct Payment Errors, see GN 03970.025.

IMPORTANT: We do not delay the release of a payment to another eligible representative or the claimant while awaiting the refund of the excess payment.

b. An entity received the fee

We will recover an excess fee directly paid to an entity if the fee was authorized to a representative who was never appointed to the claim or who was appointed but waived the right to a fee. Under these circumstances, we will

  • Require that the entity refund the fee (the entity owes the debt to us and not to any other appointed representative(s) or to the claimant); and

  • Pay the fee to any appointed representative(s) to whom we authorized a fee and who is eligible for and requested direct payment. If there is no appointed representative who requested and is eligible for direct payment, release the funds to the claimant.

IMPORTANT: We do not delay the release of a payment to an eligible representative or the claimant while awaiting the refund of the excess payment.

11. We issued an incorrect fee notice and the claimant paid or may pay an excess fee to the representative

We will recover an excess fee if:

  • We did not directly pay a fee;

  • We issued a notice authorizing an incorrect fee amount; and

  • The claimant paid or may pay a representative an excess fee based on the notice.

In this situation, we will notify the claimant and the representative of:

  • The corrected fee amount, and

  • The amount the representative must refund to the claimant if the claimant already paid the fee.

For processing instructions, see GN 03920.052B.

C. When we will not pursue recovery for an excess fee payment

Although we generally require representatives to refund excess fees, in some situations it is not administratively practical to request a refund. When a fee payment error results in no monetary loss to the claimant and the monetary loss to us is negligible (e.g., less than or equal to the user fee), we will not pursue recovery from the representative. For additional information regarding the user fee, see GN 03920.019.

IMPORTANT: This subsection is not intended to set a minimum amount for recovery of an excess fee. Nothing in this subsection will prevent recovery in cases where the user fee was misapplied in a series of cases for a representative even if the error equals the user fee, e.g., a class action suit where we deducted a lower or incorrect user fee across many or all cases, even if individual errors are less than or equal to the user fee.

We will not pursue recovery of an excess or incorrectly paid fee in the following situations:

1. We directly paid an authorized fee to a representative who is, or was at the time, ineligible for direct payment

We will not pursue recovery when we directly paid a fee to a representative who is, or was at the time we certified payment, ineligible for direct payment if:

  • The representative has not intentionally misrepresented their eligibility for direct payment;

  • We withheld the authorized fee from the claimant’s past-due benefits;

  • We paid the representative no more than the authorized fee;

  • The claimant did not protest the withholding of the past-due benefits or direct payment of the authorized fee to the representative;

  • The claimant was physically and mentally capable of filing a timely protest but did not file a protest of the withholding of the past-due benefits or direct payment of the authorized fee to the representative;

  • The representative did not protest the fee payment; and

  • The incorrect fee payment does not adversely affect any other representative.

Technicians must ensure that the representative’s status is correctly coded in our systems to prevent similar administrative errors.

2. We paid an authorized fee to a representative who is eligible for direct payment but who waived direct payment on the case

We will not pursue recovery when we withheld from the claimant’s past-due benefits and directly paid an authorized fee to a representative who is (1) eligible and registered for direct payment and (2) did not waive the fee but waived their right to direct fee payment, if:

  • We withheld the authorized fee from the claimant’s past-due benefits;

  • We paid the representative no more than the authorized fee;

  • The claimant did not protest the withholding of the past-due benefits or direct payment of the authorized fee to the representative;

  • The claimant was physically and mentally capable of filing a timely protest but did not file a protest of the withholding of the past-due benefits or direct payment of the authorized fee to the representative;

  • The representative did not protest the fee payment; and

  • The incorrect fee payment does not adversely affect any other representative.

3. We paid an authorized fee that exceeded the 25% withholding limit

We will not pursue recovery when we directly paid an authorized fee to a representative that exceeded 25 percent of past-due benefits, if:

  • We withheld the authorized fee from the claimant’s past-due benefits;

  • We paid the representative no more than the authorized fee; and

  • The claimant did not protest the withholding of the past-due benefits or direct payment of the authorized fee in excess of 25 percent of past-due benefits to the representative.

4. We did not distribute the payments equally among multiple appointed representatives who signed the fee agreement

We will not pursue recovery when we directly paid different fee amounts to two or more appointed representatives who signed a single, approved fee agreement, if:

  • We withheld the authorized fee from the claimant’s past-due benefits;

  • The total we paid the representatives did not exceed the authorized fee; and

  • The representatives did not protest our unequal distribution of the authorized fee.

5. We deducted an incorrect user fee

We will not pursue recovery if we directly paid the authorized fee to a representative eligible for direct payment (or an entity, if the representative had assigned direct payment of the fee to it), but we did not deduct the correct user fee.

However, we will subsequently collect the user fee if, in the same claim, matter, or issue, an additional fee is authorized to a representative and directly paid to a representative (or entity) . For example, if we failed to deduct the user fee from the primary claimant’s portion of the representative’s fee, we will collect the user fee from the portion of the representative’s fee that may be due from an auxiliary beneficiary’s benefits.

If we revised the authorized fee amount, recalculate or adjust for the required user fee. The amount of the fee payment error equals the difference between the amount paid and the amount due after withholding the appropriate user fee. If no payment was due, the fee payment error equals the amount paid.

IMPORTANT: This subsection is not intended to set a minimum amount for recovery of an excess fee. Nothing in this subsection will prevent recovery in cases where the user fee was misapplied in a series of cases for a representative even if the error equals the user fee, e.g., a class action suit where we deducted a lower or incorrect user fee across many or all cases, even if individual errors are less than or equal to the user fee.

If we revised the fee authorization amount, technicians will recalculate or adjust for the required user fee. The amount of the fee payment error equals the difference between the amount paid and the amount due after withholding the appropriate user fee. If no payment was due, the fee payment error equals the amount paid.

Notify the representative of the amount they must refund to SSA within 30 days. For sample language, see GN 03970.025.

GN 03920.052 Pursuing Recovery of Excess Fees Paid to Representatives or Entities and Referrals for Ineligible for Direct Payment Entity (IDPE) List

CITATIONS:

20 CFR 404.1703, 404.1720, 404.1730, 404.1735, 416.1503, 416.1520, 416.1530, and 416.1535

A. Introduction

We use a different process to recover excess fee payments from representatives than we use to recover excess fee payments from entities.

Recovery of excess fees paid to a representative is performed directly by the field office (FO) or processing center (PC) that identifies the issue, following the instructions in GN 03920.052B. If the representative fails to remit the excess fee, the representative may be subject to referral to the Office of General Counsel (OGC) for possible sanctions, as explained in GN 03970.017.

Recovery of excess fees paid to an entity is first attempted by the FO or PC technician who identifies the issue. However, if the entity fails to remit the excess fee, the respective FO or PC will refer the issue to the IDPE Coordinator Group as explained in GN 03920.052C.6. in this section. The IDPE Coordinator group is comprised of designated staff from each PC and Regional Office with experience in processing representative fees, and they maintain a list of Ineligible for Direct Payment Entities (IDPE). Once an entity is placed on the IDPE list, we will not issue direct fee payments to the entity until the entity resolves all outstanding issues affecting eligibility.

Entities are required to name a registered representative as their Point of Contact (POC) to help us resolve any fee-related matters that may arise. We will work with these entity POCs to resolve any fee-related matters and, if necessary, pursue recovery of excess fees from the entity. For additional information on the roles and responsibilities of POCs, see GN 03920.021D.

B. Pursuing recovery of excess fee payments made to representatives

When a technician identifies an excess fee payment made to a representative, follow these steps:

1. Confirm the excess fee meets the conditions for pursuing recovery from a representative

When a technician identifies a potential excess fee issue, the technician must first ensure that the excess fee is one for which we will pursue recovery and that the excess fee was paid to the representative.

For more information on the circumstances under which we will pursue recovery of an excess fee, see GN 03920.051B.

2. Document the situation

If the excess fee issue meets the criteria for pursuing recovery and the fee in question was paid to a representative, the technician will document the situation in a Report of contact (ROC) in the Registration, Appointment and Services for Representatives (RASR) report of contact screen.

The ROC should include the following information:

  • The representative(s) involved (identify representative(s) and date(s) of appointment);

  • The fee process involved (fee petition or fee agreement);

  • The past-due benefit period and amount (include amounts for claimant and any affected auxiliaries);

  • The date of fee authorization (for fee agreements use date of fee setting notice);

  • The date fee authorization was amended or reversed by decision maker or person with fee setting authority, if applicable;

  • An explanation of the incorrect fee payment, including the amount; and

  • An indication of whether we correctly paid the claimant and any affected auxiliaries.

3. Verify that the claimant and representative have been notified of the correct authorized fee

Before requesting a refund of an incorrect fee payment, verify that the decision maker or person with fee setting authority sent the correct fee authorization or rescission notice. We must notify both the claimant and the representative of the correct fee.

For information on the proper authorities for authorizing fees or reviewing requests for administrative review, see

GN 03930.015 and GN 03950.005 fee petition, and

GN 03940.002 and GN 03960.015 fee agreements.

If the excess fee resulted from a reduction in the fee we authorized, ensure that notice of the revised fee action was sent to the claimant and representative.

For a fee petition case, the decision maker will have issued a corrected or revised fee authorization notice.

For a fee agreement case, the processing center (PC) (for Title II claims) or field office (FO) (for Title XVI claims) will have sent notice of the revised fee amount which includes the fee authorization language specified in GN 03940.008B.

4.  Issue a refund to the claimant, if necessary

If the relevant instructions in GN 03920.051B direct us to issue a refund to the claimant, the technician will refund any erroneously withheld benefits to the claimant.

For information on refunding the excess fee withholding, see

SM 01901.005 and SM 01901.015 for Title XVI claims, and

SM 00848.330 for Title II claims.

NOTE: The claimant is not due a refund if we did not withhold past-due benefits for the fee payment. Also, the claimant may not be due a refund if the revised past-due benefits and fee resulted in an overpayment to the claimant.

5. Issue any required notices

Notify the representative of the amount they must refund to us within 30 days. For sample language, see GN 03970.025.

6. Establish the excess fee in the appropriate systems

Technicians annotate the incorrect fee payment or debt owed to us in the Debt Management System (DMS) for T2 claims, per SM 00610.772B.7.

Manually control debts for T16 claims and debts owed to claimants, see GN 03920.052C.7 GN 03920.051D.8. in this section. For information on debts owed to the claimant, see GN 03920.051D.9. in this section.

Annotate a special message or remark regarding the incorrect payment to the Master Beneficiary Record (MBR) or Consolidated Claims Experience.

For more information regarding special messages and remarks, see SM 00510.075 for T2 and SM 01301.841 for T16.

7. Establish a diary

Technicians will establish a 45-day diary to follow up on the refund request. PCs may establish an ATFEE EXCESS diary through the Processing Center Action Control System (PCACS). For additional information on establishing PCACS diaries, see MS 04909.002 Diary Request Menu (DRMN). FOs may establish an issue on the Development Worksheet page or on the MDW screen.

For additional information on establishing FO follow-ups, see

MS 08122.004 Development Worksheet, and

MS 03901.002 Modernized Development Menu (MMEN).

8. Follow-up actions

a. The representative refunds the excess fee

If the representative refunds the excess fee payment to us, the technician will:

  1. 1. 

    Verify receipt (and clearance) of remittance. See the references below for remittance and returned fee payment processing instructions.

  2. 2. 

    Document recovery of the representative’s debt in the claimant’s electronic or paper file. If the FO or PC received the remittance but the Mid-Atlantic Program Service Center (MATPSC) Remittance and Accounting Unit (RAU) has not processed it, document the pending status of the remittance.

  3. 3. 

    After the MATPSC RAU processes the remittance for T2 claims, the remittance may require manual DMS and Payment History Update System (PHUS) annotation if an automated interface does not occur.

  4. 4. 

    After the MATPSC RAU processes the remittance for T16 claims, clear any manual controls for the representative’s debt.

For more information on remittance and returned fee payment processing, see:

GN 02403.006 Processing Remittances Received in the Field Office (FO)

GN 02405.010 How to Process Unendorsed Title II Returned Benefit Checks Received in the FO (Including Unendorsed Claimant Representative/Attorney Fee Checks)

GN 02405.100 How to Process Unendorsed Title XVI Returned Benefit Checks and Unendorsed Claimant Representative Attorney Fee Checks Received in the Field Office

MS DMS 003.003 PC Remittance Input (REMI)

MS DMS 003.008 Verif/Corr of FO Remittances (RFOV)

SM 01311.634 How to Resolve a B4 Diary

SM 00610.291 Completion of SSA-124-U3 for Misrouted Remittances

SM 00610.296 Allegation of Remittance

b. The representative did not refund the excess fee

If, after the 45-day diary expires, the representative has not refunded the full excess fee payment or if the representative intentionally misrepresented their direct payment eligibility (e.g., non-attorney claimed EDPNA status), we:

  1. 1. 

    Refer the matter to OGC for possible sanctions action, following the instructions in GN 03970.017 or GN 03970.025, along with any documentation (i.e., copy of the incorrect fee check(s), proof of direct deposit with the referral, copy of the remittance receipt.)

  2. 2. 

    If a response or remittance is received by the representative, update (if not locked) or add a new RPOC and send to OGC.

  3. 3. 

    Forward the new or updated report of contact to OGC, along with any new documentation (i.e., copy of the incorrect fee check(s), proof of direct deposit with the referral, copy of the remittance receipt) within 2 business days.

C. FO and PC instructions for recovering excess fee payments made to an entity

1. Confirm that the excess fee meets the conditions for pursuing recovery from an entity

When FO or PC technicians identify a potential excess fee issue, they must first ensure that the excess fee is one for which we will pursue recovery and that the excess fee was paid to the entity.

For more information on the circumstances under which we will pursue recovery of an excess fee, see GN 03920.051B.

2. Issue a notification of collection action to the entity’s POC and document the situation

If the excess fee issue meets the criteria for pursuing recovery and the fee in question was paid to an entity, the technician issues a Notification of Collection Action to Entity (MAO104). This notice can be created using the Document Processing System (DPS) or AURORA, and it should be addressed to the entity’s POC.

The technician then establishes an ATFEE issue through the Processing Center Action Control System (PCACS) and establishes a 30-day diary to follow-up on the refund request.

When establishing the ATFEE issue in PCACS, technicians should include the following information in the additional remarks section:

  • The amount of the excess fee payment;

  • The name and Employer Identification Number (EIN) of the entity involved;

  • The name and Rep ID of the entity’s POC;

  • The fee process involved (fee petition or fee agreement);

  • The date of the fee authorization;

  • The past-due benefit period and amount (include amounts for the claimant and any affected auxiliaries);

  • The names and Rep IDs of any representatives involved, their dates of appointment, and the date(s) they assigned the right to direct payment of their fee to the entity, if applicable;

  • A brief description of the excess fee issue; and

  • An indication of whether we correctly paid the claimant and any affected auxiliaries.

3. Follow-up after the initial diary expires

Once the initial 30-day diary has expired, the technician queries DMS and PCACS to determine whether the entity has refunded the entire excess fee.

  • If the entity has refunded the entire excess fee payment, the technician updates PCACS to reflect that full payment of the excess fee has been received. Clear any pending diaries in PCACS.

  • If the entity has not refunded the entire excess fee payment, the technician proceeds to step 4.

4. Issue a final notification of collection action to the entity’s POC and establish a second diary

If the entity has not refunded the full excess fee payment by the expiration of the first 30-day diary, the technician issues a second, final recovery notice, Final Notification of Collection Action to Entity (MAO105). This notice can be created using DPS or AURORA, and it should be addressed to the entity’s POC.

The technician will then update the ATFEE issue previously established in PCACS and set a new 30-day diary to follow-up on the refund request.

When updating the ATFEE issue in PCACS, the technician should ensure that the information listed in GN 03920.052C.2. has been input in the remarks section. If any information is absent, the technician will include it.

In addition, the technician adds the following information:

  • The amount of the excess fee payment that has been refunded, if applicable;

  • The amount that has not yet been remitted.

  • The date the initial notification of collection action was issued; and

  • Any other relevant information related to the fee recovery process, including whether the entity’s POC has contacted us.

5. Follow-up after the second diary expires

Once the final 30-day diary has expired, the technician queries DMS and PCACS to determine whether the entity has refunded the entire excess fee.

  • If the entity’s POC has refunded the entire excess fee payment, the technician updates PCACS to reflect that full payment of the excess fee has been received. Clear any pending diaries in PCACS.

  • If the entity has not refunded the entire excess fee payment, or has refunded only part of it, the technician proceeds to step 6.

6. Refer the Entity-related Fee Issue to the IDPE Coordinator Group

If the entity does not refund the full excess fee by the expiration of the second diary, the FO or PC technician seeks management approval to refer the issue to the IDPE Coordinator Group.

If management approves, the technician:

  • Refers the entity to the DCO Central IDPE coordinator’s mailbox for immediate action by sending an email to IDPEcoordinatorgroup@ssa.gov. See the example email.

  • Update PCACS with the following message “IDPE Referral made on [insert date].”

  • Close any open diaries in PCACS.

The subject line of the referral email should be “IDPE Referral for [Entity name and EIN].

The body of the email may be formatted as follows:

Re: [Claimant Name and SSN]

Good [Morning/Afternoon],

We are referring [Entity Name, EIN] for potential action by the IDPE Coordinator Group. An excess fee of [Full Excess Fee] was paid to this entity on [Fee Payment Date]. Based on the criteria in [Cite the applicable recoverable excess fee provision in GN 03920.052B], we identified this payment as an excess fee requiring recovery.

We sent collection notices to the entity’s POC on [Date of First Collection Notice] and [Date of Final Collection Notice], but as of today, [Remaining Excess Fee] remains unremitted. Please see the information below for more details.

[Include any information that is relevant to recovering the excess fee. This includes but is not limited to:

  • The claimant’s SSN and name.

  • The name and EIN of the entity involved;

  • The name and Rep ID of the entity’s POC;

  • The names and Rep IDs of any representatives involved, their dates of appointment, and the date they assigned the right to direct payment of their fee to the entity, if applicable;

  • The fee process involved (fee petition or fee agreement);

  • The past-due benefit period and amount (include amounts for the claimant and any affected auxiliaries);

  • The date of the fee authorization;

  • The date the fee authorization was amended or reversed by decision maker or person with fee setting authority, if applicable;

  • An explanation of the excess fee payment;

  • The dates of the first and final notice collections notice; and

  • An indication of whether we correctly paid the claimant and any affected auxiliaries.

Once the referral has been submitted, no further action is required of the FO or PC technician. The IDPE Coordinator Group will not generally provide updates to the referring technician.

7. Responding to excess fee-related inquiries received after the issue has been referred to the IDPE Coordinator Group

If an FO or PC technician receives an inquiry from an entity’s POC about an issue that relates to the IDPE list or other excess fee-related matters, the technician may access the IDPE list in RASR for information on an entity’s status and any unresolved fee issues.

Technicians may provide any necessary information needed to resolve the excess fee matter, including but not limited to:

  • Claimants’ SSN,

  • IDPE status,

  • Ineligibility Start or End Date, and

  • Amount Owed.

D. Processing remittances by an entity’s point of contact

If an FO or PC technician receives a remittance from an entity’s POC, the technician:

  • Checks the PCACS record to verify the full excess fee amount that we assessed and the amount that has been refunded.

  • Processes the remittance. See the references below for remittance and returned fee payment processing instructions.

  • Documents the pending status of the remittance in PCACS, if the Mid-Atlantic Program Service Center (MATPSC) Remittance and Accounting Unit (RAU) has not processed it.

  • After MATPSC RAU processes the remittance for Title II claims, query the remittance for manual DMS and PHUS annotation if an automated interface does not occur.

  • Checks the IDPE list in RASR to determine whether there is an IDPE entry related to this excess fee. If the excess fee appears on the IDPE list, email the IDPE Coordinator Group at the IDPECoordinatorgroup@ssa.gov mailbox and notify them of the amount remitted. Include a copy of the payment receipt as an email attachment.

For more information on remittance and returned fee payment processing, see:

GN 02403.006 Processing Remittances Received in the Field Office (FO)

GN 02405.010 How to Process Unendorsed Title II Returned Benefit Treasury Checks and Unendorsed Claimant Representative Attorney Fee Checks Received in the Field Office

GN 02405.100 How to Process Unendorsed Title XVI Returned Benefit Checks and Unendorsed Claimant Representative Attorney Fee Checks Received in the Field Office

MS DMS 003.003 PC Remittance Input (REMI)

MS DMS 003.008 Verif/Corr of FO Remittances (RFOV)

E. IDPE Coordinator Group instructions for maintaining the IDPE list

When the IDPE Coordinator Group receives a referral from the FO or PC the IDPE group will:

  • Verify there is still an excess fee amount due after accounting for any remittances.

  • Ensure that the notices in GN 03920.052C.2 and 03920.052C.4 in this section have been issued.

  • Use the RASR IDPE screen to create a record with the entity’s EIN and the claimant’s SSN to document the specific fee issue and excess fee amount owed.

  • Document in the comments the attempts to recover, any contacts with the entity POC, and other relevant information.

  • After generating a record, RASR send the entity a Notification of Action to Terminate Eligibility for Direct Payment to Entity (RSR-122).

Once a record has been established on the IDPE list, the entity will be ineligible for direct payment until this and all other fee issues documented on the IDPE list are resolved. The IDPE Coordinator Group updates the IDPE records when warranted, such as when a fee remittance is received.

NOTE 1: Each instance of an erroneous or excess fee payment creates a new record for the specific EIN. All excess fee issues documented on the IDPE list must be resolved for the entity to be removed from the IDPE list.

NOTE 2: RASR will not automatically generate a notice if the entity is already ineligible for direct payment at the time a new IDPE record is generated. However, the entity will remain ineligible for direct payment until all excess fee issues documented in the IDPE list are resolved.

 



GN 03920 TN 58 - Administering Representatives Fees Provisions - 12/09/2024