Effective Dates: 12/09/2024 - Present

Identification Number:
GN 03930 TN 31
Intended Audience:See Transmittal Sheet
Originating Office:OARO OAO
Title:Fee Authorization Under the Fee Petition Process
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 30 – Fee Authorization Under the Fee Petition Process

Transmittal No. 31, 12/09/2024

Audience

PSC: BA, CA, DS, ICDS, IES, ILPDS, IPDS, ISRA, PETE, RECONR, SCPS;
OCO-OEIO: BIES, BTE, CIES, CR, CTE, PETL, RECONR, RECOVR;
OCO-ODO: BTE, CR, CST, CTE, CTE TE, DS, PETE, PETL, RCOVTA, RECOVR;
FO/TSC: CS, CS TII, CS TXVI, CSR, CTE, FR, OA, OS, RR, TA, TSC-CSR;

Originating Component

OAO

Effective Date

Upon Receipt

Background

On July 16, 2021, the United States Court of Appeals for the First Circuit issued a decision in Marasco & Nesselbush, LLP v. Collins , instructing the Social Security Administration (SSA) to find a reasonably reliable means for law firms or other entities to receive direct payment of the fees the agency authorizes to their salaried employees. On August 4, 2023, SSA published a Notice of Proposed Rulemaking (NPRM), entitled Changes to the Administrative Rules for Claimant Representation and Provisions for Direct Payment to Entities. The NPRM announced SSA’s framework for ensuring law firms and other entities could receive direct payment of the fees the agency authorizes to their salaried employees. SSA will soon publish a final rule and regulations implementing this framework.

We are preparing POMS for consistency with the framework announced in the NPRM and finalized in the Final Rule and updated regulations. The regulations provide updated definitions, updated requirements for appointing a representative and for representative and entity registration, and establish a process for representatives to assign direct payment of fees to entities. Furthermore, the regulations provide that in limited circumstances an entity’s point of contact can file a fee petition on behalf of the entity. GN 03930.020 explain those circumstances and the remaining sections include references to GN 03930.020 where appropriate. The changes to subchapter GN 03930 implement the regulatory changes and provide guidance that aligns with the changes.

This is part 1, of a larger 3-part package.

Summary of Changes

GN 03930.001 Fee Petition Process - Introduction and Preview

We updated language throughout to enhance clarity, improve accuracy, and ensure consistency with post-Marasco regulatory changes. We also made minor changes throughout to remove gendered language.

GN 03930.005 Selection of the Fee Petition Process

We updated language throughout to enhance clarity, improve accuracy, and ensure consistency with post-Marasco regulatory changes. We also made minor changes throughout to remove gendered language.

GN 03930.010 Determining a Reasonable Fee Under the Fee Petition Process

We updated language throughout to enhance clarity, improve accuracy, and ensure consistency with post-Marasco regulatory changes. We also made minor changes throughout to remove gendered language.

GN 03930.020 Petitioning for Approval of a Fee for Services Provided in Proceedings Before SSA

We updated language throughout to enhance clarity, improve accuracy, and ensure consistency with post-Marasco regulatory changes. We also made minor changes throughout to remove gendered language.

GN 03930.025 Receipt and Routing of Fee Petitions

We updated language throughout to enhance clarity, improve accuracy, and ensure consistency with post-Marasco regulatory changes. We also made minor changes throughout to remove gendered language.

GN 03930.030 Title XVI - Adjudicating Claims and Posteligibility Actions Involving Representatives Who May Petition

We updated language throughout to enhance clarity, improve accuracy, and ensure consistency with post-Marasco regulatory changes. We also made minor changes throughout to remove gendered language.

GN 03930.032 Direct Payment to the Appointed Representative Under the Fee Petition process for Title XVI and Certain Title II Concurrent Cases and Windfall Offset Calculation

We updated language throughout to enhance clarity, improve accuracy, and ensure consistency with post-Marasco regulatory changes. We also made minor changes throughout to remove gendered language.

GN 03930.033 Fee Petitions – Processing the Assessment in Title XVI Cases

We updated language throughout to enhance clarity, improve accuracy, and ensure consistency with post-Marasco regulatory changes. We also made minor changes throughout to remove gendered language.

GN 03930.034 Title XVI Only – Fee Petitions - Notifying the Representative, the Claimant and Spouse

We updated language throughout to enhance clarity, improve accuracy, and ensure consistency with post-Marasco regulatory changes. We also made minor changes throughout to remove gendered language.

GN 03930.035 Title II - Adjudicating Claims Involving Representatives Who May Petition - Overview

We updated language throughout to enhance clarity, improve accuracy, and ensure consistency with post-Marasco regulatory changes. We also made minor changes throughout to remove gendered language.

GN 03930.001 Fee Petition Process - Introduction and Preview

A. Introduction

This subchapter describes the policies and procedures for authorizing representatives’ fees under the fee petition process. For information on administrative review of fees authorized under the fee petition process, see GN 03950.000. The policies and procedures for authorizing fees under the fee agreement process are described in GN 03940.000.

The sections in this subchapter follow the organization of GN 03930.025 covering actions taken in the field offices (FOs) and processing centers (PCs), and are grouped into topics based on the position of the employee who generally performs the task(s) identified. However, an individual PC may designate employees in another position as responsible for a given task within that component.

B. Definitions

When used in this subchapter, the following definitions apply:

1. Entity

Entity is any business, firm, or other association, including but not limited to partnerships, corporations, for-profit organizations, and not-for-profit organizations. See 20 CFR 404.1703 and 416.1503. A representative can assign their right to receive direct payment of an authorized fee to an eligible entity per GN 03920.021.

2. Fee Agreement

A fee agreement is a written statement signed by the claimant and their representative(s) specifying the fee the representative(s) expects to charge and collect, and the claimant expects to pay, for services the representative(s) provides in pursuing the claimant's benefit rights in proceedings before us.

3. Fee Authorization

Fee authorization is our approval of the amount of fee a claimant's representative may charge and collect for services provided.

4. Fee Authorization Documents

a. Fee Petition Process Authorization Documents

Fee authorization documents in the fee petition process include the following:

  • •

    Form SSA-1560A (Authorization to Charge and Collect a Fee), see GN 03905.085, or

  • •

    Fee-Authorization to Charge/Collect Fee (AUTHFEE) (available to fee authorizers in the Office of Hearings Operations (OHO) and the Office of Appellate Operations (OAO) only).

NOTE: 

The policies and procedures in GN 03930 and GN 03950 apply only to fee petitions and administrative review of fees authorized under the fee petition process for representational services provided before us. We do not have jurisdiction to authorize or review any fees a court authorizes for services provided before the court. For information about court-authorized fees, refer to GN 03920.060.

b. OHO/OAO Denying Fee Authorization

A fee authorizer at the hearing level and Appeals Council levels of review uses one of the documents listed in GN 03930.001B.4.a. and inserts zero dollars ($0.00) for the amount authorized when deciding not to authorize a fee (see HALLEX I-1-2-59).

5. Fee Petition

A fee petition is a written statement signed by the claimant's representative, requesting the fee the representative wants to charge and collect for services they provided in pursuing the claimant's benefit rights in proceedings before us. Refer to GN 03930.020 for additional information about the requirements for filing a fee petition.

6. Point of Contact (POC)

A POC is an individual who registers as a representative in the manner we prescribe and is selected by an entity to speak and act on the entity's behalf and who assumes the affirmative duties and obligations we prescribe. See GN 03920.021D for more information on the role of a POC. In the limited circumstances described in GN 03930.020, a POC may file a fee petition and submit a request for administrative review for the services provided by a representative before us.

7. Processing Centers (PCs)

The PCs are the six Program Service Centers (PSCs) and the Office of Central Operations (OCO). OCO is comprised of the Office of Disability Operations (ODO) and the Office of Earnings and International Operations (OEIO).

8. Representative

A representative is an individual whom the claimant appoints to represent them in the claimant's dealings with us (i.e., to act on the claimant's behalf and pursue the claimant's interests). For purposes of our rules of conduct and standards of responsibility for representatives, representative also includes any individual who provides representational services, regardless of whether they have been formally appointed, and an individual who is listed as a POC for an entity, as applicable to their identified role (see GN 03970.010). For information on the appointment of a representative, see GN 03910.040.

9. Representative Eligible for Direct Payment

A representative who is eligible to receive direct payment of the fee is either:

  • •

    an attorney, or

  • •

    a non-attorney whom we determine meets the prerequisites for direct payment of the fee as outlined in GN 03920.018.

For general policy on payment of representative fees, see GN 03920.016.

C. References

  • •

    GN 03920.000 Policies and general procedures that pertain to both the fee petition and fee agreement processes.

  • •

    GN 03940.000 Policies and procedures that pertain primarily to authorization of representatives’ fees under the fee agreement process.

  • •

    GN 03920.016 For general policy on payment of representative fees.

 

GN 03930.005 Selection of the Fee Petition Process

A. Policy - General

A representative who wants to charge and collect a fee for services provided in any proceeding before us under the Social Security Act (Act) generally must first obtain our authorization. Refer to GN 03920.010 for information about exceptions to our fee authorization requirement. The representative must use one of two mutually exclusive fee authorization processes: the fee petition process that this subchapter describes or the fee agreement process described in GN 03940.000.

NOTE: A representative may waive their right to charge and collect a fee from a claimant but still collect a fee from a third party entity (see GN 03920.020B.3.b.). In situations involving a third party individual, we must authorize the representative's fee petition (see GN 03920.020B.3.a.) using the instructions in GN 03930.100 or GN 03930.105 and GN 03930.110.

For hearing and Appeals Council level instructions on processing fee petition documents and authorizing a fee under the fee petition process, refer to HALLEX I-1-2-56, I-1-2-57, and I-1-2-58.

B. Policy - Selection of Process

1. General Information

The representative generally selects which fee authorization process to use. The two fee authorization processes are not interchangeable. When a representative who was a party to an approved fee agreement also files a fee petition, we generally treat the fee petition as the representative's request for review of the fee authorized under the fee agreement process (see GN 03960.010). We will never authorize a fee(s) under both processes for the same case.

EXAMPLE: After receiving a notice of favorable decision in a claim, the representative filed a Form SSA-1560 (Petition For Authorization To Charge And Collect A Fee For Services Before The Social Security Administration). The representative answered “yes” to item 2, indicating that they and the claimant had entered into a fee agreement as described in GN 03930.001B.2., and they attached a copy of the fee agreement they had with the claimant to the SSA-1560. In this example, do not process the “agreement” attached to the fee petition document as described in GN 03940.001, as the representative did not qualify for the fee agreement process by timely submitting a fee agreement (see GN 03930.005B.3.).

2. Two-Tiered Agreement

The representative and the claimant may submit a fee agreement in which they have agreed to a two-tiered agreement where the representative has specified that the parties will use:

  • •

    The fee agreement process if we favorably decide the claim at a certain level (e.g., at or below the first administrative law judge (ALJ) hearing); and

  • •

    The fee petition process if the claim progresses beyond the level specified in the agreement (e.g., at the OAO level or following a remand from OAO or a Federal court).

3. Presumption

Unless the representative or claimant files a fee agreement before the date we make the first favorable determination or decision the representative worked toward achieving, we presume that the representative will either file a fee petition or waive the fee.

4. Court Case

When a court makes the final decision regarding the claimant’s entitlement to or eligibility for benefits (also called a "true court case"), and the representative has not waived the fee, the representative must submit a fee petition to charge and collect a fee for the services the representative provided before us. The filing of a fee petition is required even if the representative previously submitted a fee agreement which was approved at the administrative level, because the fee agreement process applies only in a case favorably decided by us and any previously approved fee agreement will be vacated. The representative must have our authorization to retain any fee previously authorized under the fee agreement and must explain such previously authorized fees in the fee petition. Any fee for services provided before the court must be authorized by the court (see GN 03920.060).

NOTE: After the court remands a case to the agency, if an ALJ or administrative appeals judge (AAJ) issues a favorable decision and the claimant and representative had submitted a fee agreement, the ALJ or the AAJ must approve or disapprove the fee agreement. The representative is only required to file a fee petition if the fee agreement is disapproved and they want to charge and collect a fee.

C. References

  • •

    GN 03920.001C SSAs Fee Authorization Processes

  • •

    GN 03920.001C.4 For a list of when the representative must file a fee petition to obtain our authorization,

see . see

GN 03930.010 Determining a Reasonable Fee Under the Fee Petition Process

A. Criteria for Fee Authorization under the Fee Petition Process

A representative may file a fee petition once the representative’s services have ended (even when the proceedings continue). We will assume that a representative’s services have ended if they file a fee petition.

Generally, only the representative who performed the services can request a fee, and we will not accept a fee petition filed by someone other than the representative who performed the services. Each representative must file a separate fee petition. In limited circumstances, an entity's point of contact (POC) or the individual administering a deceased representative's estate may file a fee petition to request a fee authorization for the services performed by the representative. For information about these circumstances and the individuals who may submit a fee petition for a deceased representative, see GN 03930.020A. For more information about the assignment of direct payment of fees, including the roles and responsibilities of POCs, see GN 03920.021.

To evaluate a fee petition and determine a reasonable fee, the fee authorizer must consider the purpose of the program(s) as well as regulatory factors under 20 CFR 404.1725 and 416.1525 .

1. Program Purpose

The fee authorizer must consider the purpose of the programs:

  • •

    Under Title II, the purpose of the program is to provide a measure of economic security for program beneficiaries; and

  • •

    Under Title XVI, the purpose of the program is to assure a minimum level of income for the recipients who otherwise do not have sufficient income and resources to maintain a standard of living at the established Federal minimum income level.

2. Regulatory Factors

The fee authorizer must also consider each of the regulatory factors described in subsection B. to determine a “reasonable” fee.

B. Analyzing Regulatory Factors

We must consider all the regulatory factors listed in this subsection to determine the fee we authorize. The benefits payable in any claim are determined by specific provisions of law and may be unrelated to the efforts of the representative. We may authorize a fee even if no benefits are payable and we cannot directly pay any part of the authorized fee. In evaluating the factors, the fee authorizer will consider statements from the representative and any statement from the claimant and compare such statements to the materials in the claim(s) file.

1. The Extent and Type of Services Provided

The fee authorizer will consider the extent of the representative’s services, such as the representative’s diligence in obtaining the necessary medical evidence, the type of services provided by the representative, and whether the representative researched or applied relevant law or rulings in a manner that promoted the expeditious processing of the case. Other considerations include whether and how timely the representative:

  • •

    arranged any required medical examinations,

  • •

    submitted relevant medical or other evidence related to the question of disability or other factors of entitlement or eligibility,

  • •

    contacted us, as needed, about the status of the claim,

  • •

    prepared for and participated at the hearing, and

  • •

    furthered the timely determination or decision of the claim.

The fee authorizer will also consider whether the representative, without justification:

  • •

    acted in a manner that delayed the determination or decision, or

  • •

    did not provide or was delayed in providing information we requested or required.

NOTE: Fee authorizers must be mindful that there is no standard value for each type of service, there are many activities performed by a representative during the administrative proceedings, and the same activity may be more challenging in one situation than in another situation. Additionally, decision makers may also need to consider locality or the geographical area when evaluating fee rates for services.

For additional detail and examples on evaluating services, refer to GN 03930.015A.1. and HALLEX I-1-2-57 A.

2. The Complexity of the Case

When considering the services performed by the representative, the fee authorizer will examine the complexity of the case, which might have affected the documentation that was necessary to move the case forward, the research that was required, and the various legal issues presented and argued.

3. The Level of Skill and Competence Required

The fee authorizer will consider the issues related to the case, whether and how the representative assisted in properly resolving them, and whether the representative supported each contention with evidence. The fee authorizer also will consider the representative’s familiarity with our rules and policies, and whether the representative complied with or applied them correctly and effectively during representation.

4. The Time Spent on the Case

The fee authorizer will consider the amount of time the representative spent on services they performed before us on the case. In evaluating the amount of time spent on a case, the fee authorizer must exclude any time spent preparing any fee documents, such as the fee petition or relevant agency forms, and services the representative did not provide before the agency (e.g., preparing a complaint and briefs for a federal court).

5. The Results the Representative Achieved

The fee authorizer will consider the results achieved, but will not authorize or deny a fee simply because of a favorable or unfavorable outcome. While a favorably decided case will typically warrant a higher fee, the results achieved will not override other factors. For concurrent claims, a favorable result for one title is sufficient for this factor (i.e., an unfavorable result for one title or action will not discount a favorable result for the other).

NOTE: The authorized fee does not depend on the amount of the past-due benefits. However, our ability to directly pay the authorized fee is subject to the limitation of 25 percent of past-due benefits. Any amount we authorize beyond the 25 percent limitation is a matter between the claimant and the representative. For Title XVI, the calculation of past-due benefits for representative fee purposes must consider the Title II benefits as if they had been paid timely.

6. The Level of Administrative Review to which the Claim was Taken and the Level at which the Representation Began

The fee authorizer will consider the level of the administrative review process when the representative began providing services to the claimant, as well as the level to which the representative pursued the case. For more details, refer to GN 03930.015B.6. and HALLEX I-1-2-57A.

7. The Amount Requested for Services Provided

The fee authorizer will evaluate the amount the representative is requesting, including any amount previously authorized or requested (e.g., any fee authorized and paid under a fee agreement that we subsequently disapproved), or previously paid or will be paid by another source (e.g., third-party entity). Even though we are not responsible for directly paying any portion of an authorized fee that may be paid by another source, we must authorize the total fee the representative may charge whenever a claimant or any auxiliary beneficiary is financially liable for paying part of the fee (see GN 03920.005B.). The fee authorizer will also consider any agreement the representative made with the claimant to only collect a fee if there is a favorable outcome. This evaluation will not include the amount of any expenses incurred.

NOTE: For the policy on out-of-pocket expenses, refer to GN 03920.010C., and for services not provided in proceedings before us, refer to GN 03920.010D. and GN 03920.010F.2. For the policy on when representatives’ fees are not subject to our authorization, refer to GN 03920.010.

C. Other Considerations

In cases where the representative’s services are provided in connection with both Title II and Title XVI programs, the fee authorizer will determine one reasonable fee for both titles when:

  • •

    The concurrent Title II and XVI claims, or post-entitlement or post-eligibility (PE) actions, involved a common substantive issue (e.g., disability or overpayment); and

  • •

    Some of the services provided may have been unique to the Title II or XVI claim or PE action, but most of the representative's services focused on resolving the common issue, and the representative generally did not perform different services for each claim.

D. Documenting the Fee Authorization

The fee authorizer will complete Form SSA-1178 (Evaluation of Fee Petition for Representation) or equivalent document at the hearing and Appeals Council levels.

On the Form SSA-1178, or equivalent, the fee authorizer will record the amount of the authorized fee and provide a detailed explanation of how they arrived at the fee amount. The explanation will reflect their decision based on each of the factors described in GN 03930.010B. in this section.

GN 03930.020 Petitioning for a Fee for Services Provided in Proceedings Before Us

A. Who May File?

The representative may file a fee petition unless:

  • •

    the representative was previously authorized to receive a fee for services on that claim, matter, or issue based on an approved fee agreement, and we did not subsequently reverse or disapprove that fee agreement, or

  • •

    the representative submitted a contingency fee contract (i.e., agreed to charge and collect a fee only if we favorably decided the claim, matter, or issue) and the decision is unfavorable.

However, a representative cannot submit multiple fee petitions for the same services on a single case, even if additional past-due benefits become payable. Former representatives may file fee petitions only when they did not waive their fees.

In limited circumstances, we will accept a fee petition from an individual other than the representative. If a representative dies before filing the fee petition, and there was no valid assignment, the executor or other legal representative of the estate may file the fee petition. However, if a representative dies before filing a fee petition but after assigning their right to receive direct payment to an entity, only the entity’s point of contact (POC) (and not the executor or other legal representative of the estate) may file a fee petition for the services performed by the representative. For more information, see GN 03930.020D.5. in this section. See GN 03920.021 for further information about the assignment of direct payment of authorized fees to an entity, including the roles and responsibilities of POCs. In these situations, the executor or other legal representative of the estate or the POC must follow the same rules that apply to individual representatives filing fee petitions.

IMPORTANT: Except in the limited circumstances explained in this subsection, the representative must file the fee petition personally and we will not authorize fees based on fee petitions submitted by any other individual or entity on behalf of the representative, including submitters with a power of attorney. We will return those fee petitions to the representative(s), and we will inform the representative(s) that we will not take any action until they submit a fee petition personally.

B. Multiple Individuals Provided Services

1. Representative's Unappointed Associate Provided Services

A representative may delegate certain tasks to an unappointed associate whom the representative supervises and directs, as explained in GN 03910.025B. The representative files a single fee petition that may include the services of the unappointed associate. Refer to GN 03910.025B and GN 03305.025 for instructions about disclosing a claimant's record to such associates.

2. Co-Representation

A claimant may appoint multiple representatives (refer to GN 03910.040). An agreement between the representatives about the fee does not control our fee authorization under the fee petition process. Each representative must file a separate fee petition to obtain our approval of any fee for services performed.

C. Services Provided to Multiple Individuals

A representative who provided services for multiple parties in the same case may file a single fee petition for all the representational services they provided in the case. For example, in a Title II claim, the representative may file a single fee petition for the primary claimant and any auxiliary beneficiary. We require a separate fee petition for any auxiliary beneficiary only when that individual was independently represented. In a Title XVI claim, the representative may file a single fee petition for the claimant and the eligible spouse. We require a separate fee petition for the claimant’s eligible spouse only when the spouse was independently represented.

D. Filing the Fee Petition

1. Format of Petition

a. Form SSA-1560

A representative may petition for fee approval using Form SSA-1560, "Petition For Authorization To Charge And Collect A Fee For Services Before The Social Security Administration." Currently, the Form SSA-1560 is formatted only for use by individual representatives. Other individuals, in the limited circumstances described in GN 03930.020A in this section, must use another writing when filing a fee petition for an individual representative.

b. Another Written Form

A representative, or other individual in the limited circumstances explained in GN 03930.020A, may also petition for fee approval by providing the required information in writing, as detailed in GN 03930.020D.3. and GN 03930.020D.4.

2. Fee Petition for Concurrent Case

A representative files one fee petition covering all services they provided party in connection with both the Title II and XVI programs when all of the following circumstances apply:

  • •

    The concurrent Titles II and XVI claims, or post-entitlement or post-eligibility (PE) actions, involved a common substantive issue (e.g., disability);

  • •

    Although some services may have been unique to the Title II claim, the Title XVI claim, or the PE action, most of the representative's services focused on resolving the common issue, and the representative did not perform different sets of services; and

  • •

    The services the representative provided led to favorable determinations or decisions under both titles.

3. Information Required for Fee Petition

The representative or other individual listed in GN 03930.020A in this section, in the event of the representative's death, must furnish all of the following information in the petition:

  • •

    The dates services began and ended;

  • •

    The services provided (e.g., preparation of correspondence, research, travel, and attendance at the hearing);

  • •

    The amount of time spent on each type of service;

    EXAMPLE:

    Date

    Service Provided

    1/3/18

    Meeting with client (.5 hr.)

    1/7/18

    Telephone calls with client and claims representative (.25 hr.)

    1/8/18

    Preparation of brief (1.75 hr.)
  • •

    The amount of the fee the representative wants to charge for the services;

  • •

    The amount of the fee the representative has received or wants to request or charge for services provided in the same matter before any State or Federal court;

    NOTE 1: To facilitate the fee petition process and ensure compliance with agency rules and regulations, we encourage representatives to provide the amount of money, if any, the representative received, or expects to receive, toward payment of the fee from a third party, or from the claimant, and whether any money received from a third party or from the claimant is held in a trust or escrow account.

  • •

    The amount(s), and a list, of any expenses the representative incurred for which they have been paid or expect to be paid; and

  • •

    A statement affirming that the representative sent a copy of the petition and any attachment(s) to the claimant.

    NOTE 2: In the limited circumstances when an individual other than the representative files the fee petition (see subsection A), this requirement is especially important because the individual alleging services provided and expenses incurred may not have direct knowledge of the representational services provided in the case.

    NOTE 3: For non-attorney representatives, we may request a description of the special qualifications that enabled the representative to provide the claimant with valuable help with their claim.

  • •

    If the representative has died, the POC or other individual listed in GN 03930.020A must submit proof of the representative's death with the fee petition.

4. Fee Request from a Legal Guardian Representative

As GN 03920.010 explains, a representative who is also a legal guardian, committee, conservator, or other State court-appointed representative also must furnish copies of:

  • •

    the fee request to the State court;

  • •

    the accounting to the State court; and

  • •

    either the State court's declination to order a fee, or the State court's order(s) of fees for their services as legal guardian during the same period in which the representative provided services in proceedings before us.

We will require this information whether the representative used Form SSA-1560 or another written form.

5. The Death of a Representative

If a representative, who was eligible for and requested direct payment, filed their fee petition but died before we make direct payment to the representative, we will issue the payment to the deceased representative’s estate. If the representative validly assigned their right to receive direct payment to an entity before their death, we will issue the payment to the assigned entity. If the deceased representative was ineligible for, or waived their right to, direct payment, we will notify the executor of the deceased representative's estate, or the individual recognized by the State as the representative of the estate, that they must look to the claimant for payment of any authorized fee.

If the representative dies before filing a fee petition and did not validly assign the right to receive direct payment of their fee to an entity as per GN 03920.021, only the executor of the representative's estate, or the individual recognized by the State as the representative of the estate, may file the fee petition to request authorization of a fee for services the deceased representative provided to the claimant in proceedings before us. We will authorize the fee and certify payment to the deceased representative's estate.

If the deceased representative validly assigned their right to receive direct payment of an authorized fee to an entity before their death, the entity's POC may file a fee petition to request a fee authorization for the services performed by the representative. We will authorize the fee and certify payment to the entity.

6. When to File

a. General

The representative files the fee petition only after completion of services for the claimant and any auxiliary beneficiaries in a Title II claim or the claimant and the claimant’s eligible spouse in a Title XVI or XVI couples claim. If the representative assisted a claimant in both obtaining a partially favorable determination or decision and in appealing the unfavorable aspects of that determination or decision, the representative's services do not end until the appealed issues are resolved, or the representative's appointment terminates for another reason (see GN 03910.060). A representative whose services have ended may file the petition before we effectuate a determination or decision (GN 03910.060 discusses when a representative's appointment ends).

b. Direct Payment Consideration

While representatives are encouraged to file fee petitions as soon as their services have ended, there is no time limit for filing a fee petition. However, to obtain direct payment of all or part of an authorized fee from withheld past-due benefits, the representative who is eligible for direct payment must file the petition, or a written notice of the intent to petition, within 60 days of the date we mail the notice of the first favorable determination or decision. The same time limit applies if the POC or other individual listed in GN 03930.020A is filing in the event of a representative's death. This requirement ensures that we do not erroneously release past-due benefits withheld to pay the representative's fee. Refer to GN 03920.016 and 03930.001C.7. for more information.

EXAMPLE: There are multiple claims on one account, but the representative does not expect to complete their services and petition for a fee within 60 days of the date we mail the notice of the first favorable determination. To obtain direct payment of an authorized fee, the representative should file (within the 60-day period) a written notice of intent to petition for a fee when their services have ended.

If a representative filed their fee petition or intent to file before the determination or decision was issued (i.e., because their services ended before the favorable determination or decision was issued), we will consider their fee petition timely but fee authorizers will delay their evaluation of the fee petition and authorization of any fee until the administrative proceedings on the claimant’s case are complete (e.g., we issue a fully favorable decision or the time limit for appealing an unfavorable determination expires).

7. How to File

The representative must give the claimant a copy of the petition and any attachment(s) before filing the original with the appropriate office listed in GN 03930.020D.8.

The representative may use Form SSA-1560 or another writing as described earlier in GN 03930.020D1. After completing the document, the representative will:

  • •

    send the claimant a copy,

  • •

    file the original with us by mail by following the instructions provided in GN 03930.020D.8., and

  • •

    retain a copy for their records.

8. Where to File

  • •

    If a Federal court issues a favorable judgement, the claim is resolved by the Appeals Council, or the claim is pending at the Office of Appellate Operations (OAO) when the representative's services end, the representative must send the petition for fees for services performed before us to:

    Social Security Administration

    Office of Appellate Operations

    ATTN: Attorney Fee Branch

    6401 Security Blvd

    Baltimore, MD 21235-6401
  • •

    If an administrative law judge (ALJ) resolves the claim, the representative must send the petition to the ALJ, using the hearing office address on the decision. If the claim is pending at the Office of Hearings Operations when the representative's services end, the representative must send the petition to the hearing office where the request for hearing was pending at the time the representative's services ended.

  • •

    If we resolve a Title II only or concurrent Titles II and XVI claim at the initial or reconsideration level, the representative must send the petition to the mailing address of the processing center (PC) that appears on the claimant's Title II notice (e.g., the notice of award or notice of disapproved claim). If one of these claims is pending at the initial or reconsideration level when the representative's services end, the representative must send the petition to the servicing PC. For information about the claims routing and PC jurisdiction, see GN 01050.075.

  • •

    If we resolve a Title XVI only claim at the initial or reconsideration level, or if the claim is pending at the initial or reconsideration level when the representative’s services end, the representative must send the petition to the servicing field office (FO).

    NOTE: 

    The servicing FO will forward the fee petition and the Title XVI claim(s) file (if there is a paper file) to the servicing PC. For authorization of the fee and routing, refer to:

    • •

      GN 03930.015 - Responsibility for Authorizing Fees Under the Fee Petition Process for Services Provided in Proceedings Before SSA - Jurisdiction

GN 03930.025 Receipt and Routing of Fee Petitions

A. Introduction

A representative can file a fee petition only after completion of representational services, which may be before or after we make a determination or decision.

EXAMPLE: A claimant discharged a representative before we made a final determination on their claim. The representative may file a fee petition before we make a final determination.

The field office (FO) or processing center (PC) action varies depending on whether the claim, or post-entitlement or post-eligibility (PE) action has been decided and, if so, who decided the case.

B. Procedure - Case Not Decided

When you receive the fee petition, take one of the action(s) shown depending on where the claim(s) of PE action is pending:

1. Pending at Initial or Reconsideration Level

a. You have the claim(s) file or pertinent electronic records

  • •

    Process the claim(s) or PE action. See GN 03930.030 through GN 03930.045, about claims specialist (CS) responsibilities.

  • •

    Upload the fee petition to the electronic folder (eView) and Evidence Portal (EP) and notify the fee reviewer in the PC having jurisdiction (see GN 03930.015A). If the case is not electronic, load a copy of the fee petition into EP, place the original in the claim(s) file, and forward the folder to the fee reviewer in the PC. If you are in an FO or another PC, use the routing instructions shown below in GN 03930.025D. For Title XVI only fee petitions, annotate the envelope with “SSI fee petition.”

NOTE: 

If this is a paper claim, the FO will forward the Title XVI file with the fee petition when possible, to aid the PC fee authorizer in evaluating the petition.

b. You do not have the claim file and electronic records are not available

Forward the fee petition to the fee reviewer in the PC having jurisdiction (see GN 03930.015A). If you are in an FO or another PC, use the routing instructions shown below in GN 03930.025D.

The fee reviewer in the PC will not evaluate the fee petition or authorize a fee until they know the final determination or decision on the claim(s) or PE action. The reviewer or other appropriate staff designated by the PC will set regular diaries to check on the status of the case following local PC practices. The fee reviewer will evaluate the fee petition, and authorize a fee if warranted, either when they learn that the case was decided unfavorably and the time limit for appealing has expired or the favorable determination or decision is effectuated.

2. Pending at Hearing or Appeals Council Level

Upload the fee petition to the electronic folder (eView) and Evidence Portal (EP) and notify by email the appropriate hearing office (HO) using the OHO Fee Contacts list, or the Office of Appellate Operations (OAO) at ^DCARO OAO ATTY FEE BR. If the case is paper, load the fee petition into EP only and forward the claim(s) file with the fee petition to the HO if the case is pending at the hearing level. Email the fee petition to OAO if the case is pending with the Appeals Council and in the email, alert OAO of the paper case. Do not forward the claim(s) file to OAO until OAO responds with further instructions.

C. Procedure - Case Decided

When you receive the fee petition, take the action(s) shown:

1. Decided at Initial or Reconsideration Level

Upload the fee petition to the electronic folder (eView) and EP and notify the fee reviewer in the PC having jurisdiction (see GN 03930.015A). If the case is paper, load the fee petition into EP only and forward the fee petition, with the file if you have it, to the fee reviewer in the PC having jurisdiction (see GN 03930.015A). If you are in an FO or another PC, use the routing instructions shown in GN 03930.025D.

NOTE: 

If there is a paper file, the FO must forward the Title XVI file with the fee petition because the PC fee authorizer cannot evaluate the petition without it.

2. Decided Hearing Level

Upload the fee petition to the electronic folder (eView) and EP and notify by email the appropriate HO using the OHO Fee Contacts list. If there is a paper file, load the fee petition into EP only and forward the fee petition to the HO. Use the Detailed Office/Organization Resource System (DOORS) to determine the HO address (see MS 01302.013). (See GN 03930.015B about jurisdiction.)

3. Decided at Appeals Council Level

Upload the fee petition to the electronic folder (eView) and EP and notify OAO by email at ^DCARO OAO ATTY FEE BR. If there is a paper file, load the fee petition into EP only and forward the fee petition to OAO by email and in the email, aalert OAO of the paper case. Do not forward the claim(s) file to OAO until OAO responds with further instructions.

D. Procedure - Routing instructions

For paper files, follow these routing instructions: 

PC

Route To:

PC-1
Social Security Administration

Northeastern Program Service Center

P.O. Box 314800

Jamaica, NY 11431-4092

PC-2
Mid-Atlantic Program Service Center, SSA

ATTN: Reconsideration Review Section

     (DO NOT OPEN IN MAILROOM)

 300 Spring Garden Street

Philadelphia, PA 19123

PC-3
Social Security Administration

Southeastern PSC

Birmingham Social Security Center

1200 Rev. Abraham Woods, Jr. Blvd.

Birmingham, AL 35285-0001

PC-4
Social Security Administration

Great Lakes Program Service Center

600 W Madison St

Chicago, IL 60661

PC-5
Western Program Service Center, SSA

ATTN: Reconsideration Review Section

     (DO NOT OPEN IN MAILROOM)

 P. O. Box 2152

Richmond, CA 94802

PC-6
Mid-America Program Service Center, SSA

P. O. Box 15487

Kansas City, MO 64106

PC-7
Office of Disability Operations, SSA

P.O. Box 1075

Baltimore, MD 21241

PC-8
Office of International Operations, SSA

P.O. Box 1075

Baltimore, MD 21241
​ ​

GN 03930.030 Title XVI – Adjudicating Claims and Post-Eligibility (PE) Actions Involving Representatives Who May Petition for Fees

A. Introduction

The claims specialist (CS) in the field office (FO) adjudicates Title XVI claims and PE actions involving representatives who may petition to obtain our approval of fees for their services. The procedures below highlight the key CS responsibilities. The CS must refer to POMS and/or MSOM sections shown for complete processing instructions.

For those cases in which the representative is eligible for direct fee payment and did not waive a fee or the right to direct payment of a fee, including cases in which the eligible representative validly assigned their right to receive direct payment of the fee to an eligible entity (see GN 03920.021), the CS withholds 25% of the claimant's past-due benefits for direct payment of the representative's authorized fees.

For general policy on direct payment to representatives, see GN 03920.016. For specific policy on direct payment to non-attorney representatives, see GN 03920.018.

B. Policy – CS Responsibilities

Although the CS does not review fee petitions or authorize fees under the fee petition process for services provided in proceedings before us, the CS is involved in the fee petition process in connection with Title XVI claims and PE actions because the CS must do the following:

  • •

    If there are past-due benefits, as defined in GN 03920.031, Representative's Fee – Title XVI Past-Due Benefits, determine if the representative and entity, if there is a valid assignment (see GN 0392.0.021), are eligible for direct fee payment.

  • •

    When we issue a favorable determination or decision and the representative is eligible for direct fee payment and has not waived the fee or direct payment of the fee, ensure that 25% of the claimant's past-due benefits, or the remaining past-due benefits if that amount is less than 25% after we make any interim assistance reimbursement (IAR) are withheld for direct payment of the authorized fee. In addition, ensure that the claimant is issued an underpayment and paid ongoing benefits.

    NOTE: The system automatically withholds 25% of the Title XVI past-due benefits or the remaining past-due benefits if that amount is less than 25% after we make any IAR. This amount is withheld for direct payment of representative’s fees in a Title XVI only claim or the Title XVI claim in a concurrent claim situation. Please note that the Title XVI past-due benefits withheld in a concurrent claim situation are calculated prior to offset of the Title XVI past-due benefits. To ensure that direct payment of an authorized fee does not exceed 25% of past-due benefits in a concurrent claim situation, offset the Title XVI past-due benefits using the instructions in GN 03920.031B.2. prior to direct payment of an authorized fee.

    In addition, the system automatically releases the remaining Title XVI past-due benefits to the claimant after repaying IAR, withholding for representative’s fees, and collecting overpayments. This payment is subject to dedicated account and installment payment provisions – see SI 02101.010 and SI 02101.020.

  • •

    Provide correct notice to the claimant and the claimant's representative. In addition, if the claimant's spouse's past-due benefits are included in the past-due benefits for representative fee purposes, provide correct notice to the eligible spouse when taking actions that affect the spouse's benefits.

    NOTE 1: When sending notices, include only the information the party is entitled to receive. Claimants are entitled to only certain information about auxiliary beneficiaries. See GN 03316.105. Likewise, auxiliary beneficiaries should only receive certain information about the claimant. Notices sent to auxiliary beneficiaries must adhere to the policies articulated in GN 03316.110.

    NOTE 2: We will only provide a copy of the SSA-1560 or other fee authorization document to the POC if the POC filed the fee petition in the limited circumstances described in GN 03920.020.

  • •

    In a Title XVI only claim, if we are withholding the claimant's past-due benefits for possible direct fee payment, diary an administratively decided case for 60 days for receipt of the fee petition, and follow-up if no fee petition has been submitted within 60 days from the date we mailed notice of the claimant's favorable determination or decision. Diary a claim decided by a Federal court for 120 days. See GN 03930.045 for further information about these diaries.

    NOTE 3: In favorably decided concurrent Titles II and XVI claims, the processing center (PC) sets the diary for receipt of the fee petition and performs necessary follow-ups when we are withholding the claimant's past-due benefits.

  • •

    If the file is paper, decide whether the FO has alerted the Office of Appellate Operations (OAO), or forwarded to the Hearing Office (HO) or the PC the Title XVI claim(s) file for necessary action on a fee petition.

  • •

    When the fee authorization is received from OAO, the HO, or the PC, if the representative and the entity, if there is a valid assignment, are eligible for direct payment, manually release the fee payment or the balance of the fee payment, if any, in concurrent Titles II and XVI claims to the representative (or entity, if there is a valid assignment) to the extent that the withheld Title XVI benefits permit; recover any outstanding overpayment; and release any excess withheld past-due benefits to the claimant unless there is court involvement. Refer to SM 01901.950 for instructions on manually processing representative fee payments.

  • •

    In concurrent claims situations, make any necessary adjustments to the Title II income as described in SI 00830.100 and SI 02006.200.

C. Procedure

1. Reviewing the Representative Information on the Supplemental Security Record (SSR)

Review the electronic file (eView), paper claim(s) file if available, and the Registration, Appointment and Services for Representatives (RASR) application to identify all appointed representatives. Determine the status of prior representatives, if applicable. Determine which representatives, if any, are eligible for fees and for direct payment. Ensure that the SSR reflects the identity of the claimant's principal representative and the representative's eligibility for direct payment. If the representative is eligible for direct payment, review RASR to determine whether the representative has waived their right to direct payment. To determine if a representative is eligible for direct payment, take the actions in GN 03930.030C.2. If the representative has validly assigned their right to receive direct payment of authorized fees to an entity, review GN 03920.021 for the requirements for an entity to be eligible for direct payment.

If a representative is not on the SSR, take the following actions:

  • •

    Determine if the representative is eligible for direct payment using the instructions in GN 03930.030C.2. If the representative has validly assigned their right to receive direct payment of their authorized fees to an entity, review GN 03920.021 for the requirements for an entity to be eligible for direct payment.

  • •

    Initial Claims: Complete the UMEN, UATH and UFEE screens using the instructions in MS 00302.012 - Appointed Representative Processing, MS 00302.013 - Authorized Representative (UATH), and MS 00302.014 - Representative Fee Update Data (UFEE).

  • •

    Posteligibility Actions: Complete the UMEN, UATH and UFEE screens using the instructions in MS 00302.012 - Appointed Representative Processing, MS 00302.013 - Authorized Representative (UATH), and MS 00302.014 - Representative Fee Update Data (UFEE).

After ensuring that the SSR is correctly coded:

  • •

    Go to GN 03930.030C.3. if the representative and entity, if there is a valid assignment, are eligible for direct payment.

  • •

    Continue effectuating the determination or decision without withholding past-due benefits if no representative is eligible for direct payment and there is no court involvement.

2. Determining Representative's Eligibility for Direct Fee Payment

These procedures apply to favorable determinations or decisions we effectuate.

  1. a. 

    Attorneys: To determine an attorney's eligibility to receive direct payment, review the criteria in GN 03920.016B.1. Return to GN 03930.030C.1.

  2. b. 

    Non-attorney representatives: To determine a non-attorney's eligibility to receive direct payment, follow the instructions in GN 03920.016B.1. and GN 03920.018.

    Check the RASR EDPNA Query to determine if the non-attorney is eligible for direct payment at the time of effectuation.

    • –

      If the representative is listed, go to GN 03930.030C.2.c.

    • –

      If the representative states that they are eligible for direct payment, but are not listed on that date, take the action in GN 03930.030C.2.d. and then return to GN 03930.030C.1.

    • –

      If the representative did not state that they are eligible for direct payment and are not listed, continue effectuating the determination or decision without withholding past-due benefits if no representative is eligible for direct payment and there is no court involvement.

  3. c. 

    If RASR indicates the non-attorney representative is eligible to receive direct payment and has not waived direct payment, verify that there is a valid appointment in the file. For information that is required for a valid appointment, see GN 03910.040.

  4. d. 

    If the non-attorney stated that they are eligible for direct payment but they are not, notify the representative that we cannot make direct payment and send a copy to the claimant (see model language below). Continue effectuating the determination or decision without withholding past-due benefits if no representative is eligible for direct payment and there is no court involvement.

Model language to use in these situations follows:

You advised your client, (Recipient's name), and indicated on (the Form SSA-1696 (Claimant's Appointment of a Representative) OR notice of appointment Use only for an appointment signed by the claimant before December 9, 2024 where the representative did not submit a Form SSA-1696]) that you are a non-attorney who is eligible to have authorized representatives' fees withheld and paid directly from a claimant's past-due benefits. However, [Select the conclusion that describes the status]:

  • •

    you are not eligible to receive direct payment of the authorized fee,

  • •

    you did not become eligible to receive direct payment of the authorized fee until after we effectuated the favorable decision on your client's claim, or

  • •

    you failed to maintain your eligibility to receive direct payment of the authorized fee and were no longer eligible on the date we effectuated the favorable decision on your client's claim.

Accordingly, we will not pay any authorized fee directly to you. You should look to the claimant for payment of the fee authorized in this case.

3. Determine Entity's Eligibility for Direct Payment

If the eligible representative validly assigned their right to receive direct payment of the fee to an entity, determine if the entity is eligible to receive direct payment. Verify that the entity is registered and has not been placed on the Ineligible for Direct Payment Entity (IDPE) list in RASR. See GN 03920.021B.2. for further information on determining an entity's eligibility to receive direct payment and actions to take if the entity is ineligible.

4. Adjudicating a Claim and Withholding Past-Due Benefits

If we issued a favorable Title XVI only or concurrent favorable Titles II and XVI determination or decision, there are Title XVI past-due benefits, and the representative is eligible for direct payment and did not waive a fee or direct payment:

  • •

    Annotate the UFEE screen to show that the Fee Situation is unresolved (see MS 00302.014, Representative Fee Update Data (UFEE));

  • •

    Ensure that Direct Payment Waived is answered “N” on the UFEE screen; and

  • •

    Go to GN 03930.030C.3.a. through GN 03930.030C.3.d. as the claim warrants.

See GN 03920.031 for guidance in calculating a claimant's past-due benefits for representative fee purposes.

a. No Interim Assistance Reimbursement (IAR) Involvement – No Prior Overpayment

  • •

    Input a U TAC to the SSR to withhold 100 percent (%) of past-due benefits. See MS 00304.018, Underpayment Processing (UOUP).

  • •

    Adjudicate the claim (i.e., calculate benefits, net past-due benefits for a current overpayment, and pay ongoing benefits).

  • •

    Establish for resolution a FEE PETITION issue on the Development Worksheet (or the MDW on a non-MSSICS claim) and set a follow-up date. Counting from the date of the FO action, set a 60-day follow-up in a case resolved by us or a 120-day diary for a case resolved in Federal court proceedings.

  • •

    Input an automated one-time payment (A-OTP) to pay claimant 75% of past-due benefits or the first installment of that amount, if required. See SM 01901.000, One-Time Payments Process; SI 02101.010, Past-Due Benefits Payable – Individual Alive Under Age 18 with Representative Payee – Dedicated Account Required; and SI 02101.020 Large Past-Due Supplemental Security Income (SSI) Payments by Installment – Individual Alive.

    NOTE: In Title XVI only claims, the withheld amount is 25% of the Title XVI retroactive benefits (i.e., past-due benefits) and the amount payable to the claimant is 75% of past-due benefits. In concurrent claims, we reduce the Title XVI past-due benefits amount by the Title XVI offset amount for the same period, regardless of whether the actual offset, as provided under §1127 of the Act, reduces the Title II or Title XVI benefits. Therefore, in concurrent claims, 25% of the Title XVI past-due benefits for fee purposes will usually be less than 25% of the total SSI retroactive payments. After determining the amount of past-due benefits for representative fee purposes, there may be more than 75% of the actual retroactive benefits available to pay to the claimant.

  • •

    Send a manual notice to the claimant and representative. Refer to GN 03930.030C.4.

  • •

    If the FEE PETITION issue follow-up date arrives before the fee petition is received, go to GN 03930.030C.6. When the fee authorization is received, go to GN 03930.032.

b. No IAR Involvement – Prior Overpayment

  • •

    Delete overpayment collect decisions in the Overpayment Decision Data (OPDD) segment of the existing SSR that relate to an overpayment from a period not adjudicated by the favorable determination or decision (i.e., a prior overpayment). When the overpayment collect decision is deleted, a diary will be established. The diary will serve as a reminder to re-post the overpayment collect decision. See MS 00304.007, Add/Change/Delete Overpayment Decisions (UODC).

  • •

    Input a U TAC to the SSR to withhold 100% of past-due benefits.

  • •

    Adjudicate the claim (i.e., calculate benefits, net past-due benefits for a current overpayment, and pay ongoing benefits).

  • •

    Establish for resolution a FEE PETITION issue on the Development Worksheet (or the MDW in a non-MSSICS claim) and set a follow-up date. Counting from the date of the FO action, set a 60-day follow-up in a case resolved by us or a 120-day diary for a case resolved in Federal court proceedings. See GN 03930.045 for further information about these diaries.

  • •

    If the overpayment is less than 75% of past-due benefits, input an A-OTP to pay the claimant the difference between 75% of past-due benefits and the overpayment amount, or the first installment of that amount, if required. If the overpayment is more than 75% of past-due benefits, make no payment to the claimant. See SI 02101.010, Past-Due Benefits Payable – Individual Alive Under Age 18 with Representative Payee – Dedicated Account Required; and SI 02101.020 Large Past-Due Supplemental Security Income (SSI) Payments by Installment – Individual Alive.

    NOTE: In a concurrent claim, refer to the Note in GN 03930.030C.3.a.

  • •

    Send a manual fee notice to the claimant and representative. Refer to GN 03930.030C.4.

    NOTE: Even if there is a valid assignment, do not send a copy of this notice to the POC without the claimant's express written consent. We will only provide a copy of the 20-day closeout notice (see GN 03930.060A.3.) to the POC or other individual listed in GN 03930.020A when we have information confirming that the representative has died. We will only provide a POC or other individual listed in GN 03930.020A with a copy of the SSA-1560 or other fee authorization document when that individual filed the fee petition.

  • •

    If the FEE PETITION issue follow-up date arrives before the fee petition is received, go to GN 03930.030C.6. When fee authorization is received, go to GN 03930.032.

c. IAR Involved – No Prior Overpayment Pending

Past-due benefits equal to or greater than $5,000 - If the underpayment or past-due benefits due to the claimant are equal to or greater than $5,000, the CS must complete the underpayment review and enter the appropriate code on the Underpayment Processing (UOUP) screen (see MS 00304.018, Underpayment Processing (UOUP)) to show that the prepayment review is complete. The system will generate an online build transaction SSR alert message: I9 ALERT – REQUIRES IAR TO BE PAID BY OTP. When the CS receives the message, the CS continues with the transaction. The system will set the underpayment verification code to “V” (UPV:V), withhold 100% of past-due benefits, and send an automated notice to the State to request the IAR amount. In these cases, when the response is received from the State, take the actions in the bullets below.

Past-due benefits less than $5,000 - If the underpayment is less than $5,000, the system will set the underpayment verification code to “V” (UPV:V), withhold 100% of past-due benefits, and send an automated notice to the State to request the IAR amount. (See SI 02003.025, IAR Payment Processing for Exception Cases and Proration Cases.) In these cases, when the response is received from the State, take the actions in the bullets below.

  • •

    If the IAR is less than 75% of the past-due benefits:

    • –

      Input a U TAC into the SSR to continue withholding 100% of past-due benefits (U TAC replaces UPV:V).

    • –

      Input an A-OTP to pay the State the IAR amount. This also produces an automated notice to the State.

    • –

      On the next workday, add an A-OTP to pay the claimant the difference between 75% of past-due benefits and the IAR amount, or the first installment payment if required. (Past-due benefits that are being withheld by U TAC minus IAR minus 25% of past-due benefits [if concurrent case, as defined in GN 03920.031B.2. = benefits due claimant in one payment or installments.)

    • –

      Establish for resolution the FEE PETITION issue on the appropriate claims Development Worksheet and set a follow-up date. Counting from the date of the FO action, set a 60-day follow-up in a case resolved by us or a 120-day diary for a case resolved in Federal court proceedings.

  • •

    If the IAR is equal to or greater than 75% of the past-due benefits, there are no benefits due claimant at this time.

    • –

      Input a U TAC to the SSR to continue withholding 100% of past-due benefits (U TAC replaces UPV:V).

    • –

      Input an A-OTP to pay the State the IAR amount. This also produces an automated notice to the State.

    • –

      Establish the FEE PETITION issue on the claims Development Worksheet for resolution and set a follow-up date. Counting from the date of the FO action, set a 60-day follow-up for a case resolved by us or a 120-day diary for a case resolved in Federal court proceedings.

  • •

    If past-due benefits minus IAR equals zero, there are no benefits for direct fee payment and no past-due benefits due to the claimant.

    • –

      Input an A-OTP to pay the State the IAR amount. This also produces an automated notice to the State.

    • –

      Send a manual notice to the claimant and representative to advise that payment of any fee we authorize is between the claimant and the representative.

      NOTE: In a concurrent claim, refer to the NOTE in GN 03930.030C.3.a.

    • –

      If the FEE PETITION issue follow-up date arrives before the fee petition or authorization is received, go to GN 03930.030C.6. When fee authorization is received, go to GN 03930.032.

d. IAR Involved – Prior Overpayment Pending

  • •

    Delete the overpayment collect decision for any overpayment with a collect decision in the OPDD segment of the existing Title XVI record. This removes an overpayment decision for an overpayment from a period not adjudicated by the favorable determination or decision (i.e., a prior overpayment). When the overpayment decision is removed, a diary will be established. The diary will serve as a reminder to re-post the overpayment collect decision. UPV:V (for IAR) withholds 100% of past-due benefits and sends an automated notice to the State for the IAR amount (see SI 0311.030 and SM 01311.045).

  • •

    Adjudicate the claim (i.e., calculate benefits, net past-due benefits for a current overpayment, and pay ongoing benefits.)

  • •

    When the response is received from the State, input a U TAC to continue withholding 100% of past-due benefits.

  • •

    Input an A-OTP to pay the State the IAR amount. This produces an automated notice to the State.

  • •

    If past-due benefits minus IAR is greater than zero, establish for resolution a FEE PETITION issue on the Development Worksheet (or MDW in a non-MSSICS claim) and set a follow-up date. Counting from the date of the FO action, set a 60-day follow-up for a case resolved by us or a 120-day diary for a case resolved in Federal court proceedings.

    If past-due benefits minus IAR is zero, there is no withholding for fee payment. Send a manual fee notice to advise the claimant accordingly.

  • •

    If there are remaining past-due benefits, send a manual fee notice to the claimant and representative. Refer to GN 03930.030C.4.

  • •

    If the FEE PETITION issue follow-up date arrives before the fee petition is received, go to GN 03930.030C.6. When the fee authorization is received, go to GN 03930.032.

5. Preparing Fee Notice

If the initial or reconsideration determination on a Title XVI only claim was favorable, there are past-due benefits, and the representative is eligible for direct fee payment, send a manual fee notice to the claimant with a copy to the representative to advise that we are withholding the claimant's past-due benefits for possible fee payment and that the representative must file a fee petition or a statement of intent to file a fee petition within 60 days of the date of the favorable determination in order to receive direct payment from the claimant's withheld past-due benefits.

If we include the claimant's eligible spouse's past-due benefits in the claimant's past-due benefits for representative fee purposes, send a fee notice to the spouse with a copy to the representative whenever we take an action that affects the spouse's benefits.

NOTE: When sending notices, include only the information the party is entitled to receive. Claimants are entitled to only certain information about auxiliary beneficiaries. See GN 03316.105. Likewise, auxiliary beneficiaries should only receive certain information about the claimant. Notices sent to auxiliary beneficiaries must adhere to the policies articulated in GN 03316.110.

If we are withholding past-due benefits on a Title XVI only claim favorably resolved by a Federal court, refer to GN 03930.040G. for sample language to include in the fee notice to the court attorney.

6. Sending Copies of Notices

Send a copy of the claimant's notice and the spouse's notice, if pertinent, to the representative. Also send a copy to the representative payee and/or legal guardian, if applicable.

NOTE 1: Although a representative who withdrew their appointment or was discharged by the claimant may file a fee petition, do not send a copy of the award notice or other protected information (e.g., the claimant’s information) unless it is the minimum amount necessary for the former representative to review it to resolve fee-related issues. For information that is not relevant or necessary to resolve fee-related issues, only disclose it if the claimant has expressly consented in writing on a Form SSA-3288 or other written consent that meets the requirements of GN 03305.003. We may still provide a copy of the 20-day closetout notice (see GN 03930.090A.3.) to the terminated representative.

NOTE 2: Even if there is a valid assignment of the right to receive direct payment to an entity, do not send a copy of the award notice or other protected information (e.g., the claimant’s information) to the entity’s POC unless it is the minimum amount necessary for the POC to review it to resolve fee-related issues. For information that is not relevant or necessary to resolve fee-related issues, only disclose it if the claimant has expressly consented in writing on a Form SSA-3288 or other written consent that meets the requirements of GN 03305.003. We will only provide a copy of the 20-day closeout notice (see GN 03930.090A.3.) to the POC or other individual listed in GN 03930.020A when we have information confirming that the representative has died, and we will send the SSA-1560A or other fee authorization document to the POC or other individual listed in GN 03930.020A when that individual filed the fee petition.

NOTE 3: Representative payees are entitled to only certain information about the claimant in order to perform their duties. Notices to representative payees must adhere to these limitations (see GN 03316.120). Do not send a copy of the spouse’s notice to the claimant’s representative payee.

7. Responding to a Matured FEE PETITION Issue Follow-up Date

a. Title XVI Only Claim

For a Title XVI only claim, if within 60 days, the FO does not receive a fee authorization from the PC, the HO, or OAO, and the representative, or other individual listed in GN 03930.020A when the representative is deceased, does not submit a fee petition, an intent to file a fee petition, or a statement that the representative waives the fee or waives direct payment, follow the procedures in GN 03930.090.

If within 120 days the FO does not receive a fee authorization from the court, follow the procedures in GN 03930.091.

For additional guidance on diaries, see GN 03930.045.

When the fee petition is received, go to GN 03930.030C.7.

b. Concurrent Titles II and XVI Claims

The PC diaries receipt of the fee petition and fee authorization. If within 60 or 120 days, the FO does not receive a fee authorization from the PC, the HO, or OAO, reestablish for resolution a FEE PETITION issue on the Development Worksheet and set a follow-up date for 60 days.

If the fee petition is received in the FO, go to GN 03930.030C.7.

8. Notifying OAO, the HO, or the PC after Petition Received that the Title XVI Claim is Ready for Processing

For Title XVI only and concurrent Titles II and XVI claims, before notifying OAO, the HO, or the PC that the Title XVI claim is ready for necessary action on a fee petition filed by the representative, or other individual described in GN 03930.020A when the representative is deceased, fully adjudicate the Title XVI claim or resolve any existing post-entitlement issues (as GN 03930.025B. and GN 03930.025C. describe).

D. References

The following sections provide specific instructions for related CS functions:

 

GN 03930.032 Direct Payment to the Representative or Entity Under the Fee Petition Process for Title XVI and Certain Title II Concurrent Cases and Windfall Offset Calculation

A. Releasing Past-Due Benefits

For fee petitions, an official in the processing center (PC), the Office of Hearings Operations (OHO), or the Office of Appellate Operations (OAO) authorizes the representative’s fee and notifies the claimant and the representative of the authorized fee amount and the right to administrative review of the fee.

The PC technician (e.g., reconsideration reviewer, claims specialist (CS) or claims technical examiner (CTE)), Administrative Law Judge (ALJ), or OAO’s Attorney Fee Branch (AFB) sends the fee authorization to the field office (FO) instructing the claims specialist (CS) for each Title or to the claims technical expert (CTE) to release the past-due benefits.

B. FO Procedures for Releasing Past-Due Benefits

After receiving the fee authorization from the PC, OHO, or OAO, the CS reviews the authorization and the claim for issues that might preclude or delay payment of the authorized fee. For examples of these issues (e.g., another representative petitions for a fee and is due direct payment, or a party requests administrative review), see GN 03930.060C. In concurrent claim situations, if the CS identifies an issue that precludes direct payment from the Title II withheld benefits, the CS notifies the PC of the issue. If the representative and entity, if there is a valid assignment as per GN 03920.021, are eligible for direct payment and there is no issue, the CS must release the fee and past-due benefits payments per GN 03930.032B.1. and GN 03930.032B.2. in this subsection.

NOTE: If a court case or a court fee is pending, technicians must not recover any overpayment or release any remaining past-due benefits to the claimant until we process the court fee. For additional information about releasing withheld past-due benefits to the claimant see GN 03930.060 and SI 02101.002A.

1. Direct Payment of the Authorized Fee in Title XVI Only Claims

Under the fee petition process, all Title XVI representative fee payments are manual. Take the following actions when the authorized fee is for a Title XVI only claim:

  1. a. 

    Issue the representative or eligible entity, if there is a valid assignment (see GN 03920.021), an automated one-time payment (A-OTP) in the amount of the authorized fee (up to a maximum of 25 percent of the past due benefits) less the assessment and the amount that another source paid (e.g., EAJA, trust or escrow account), if applicable. For information about processing the A-OTP, see SM 01901.950. For instructions on processing the fee assessment, see GN 03930.033.

    NOTE: The Title XVI system forwards the record of the fee payment and fee assessment (user fee) to the Single Payment System (SPS).

    For examples of releasing the past-due benefits for direct payment of the authorized fee and to the claimant, see GN 03930.060D.1. through GN 03930.060D.4.

  2. b. 

    Prepare and send the appropriate manual fee notice to the representative and claimant using the Document Processing System (DPS). For Model Fee notice language, see GN 03905.090.

  3. c. 

    Close out the fee petition issue on the applicable Development Worksheet as appropriate.

  4. d. 

    When necessary, remove the U TAC or bypass if the UPV code in the Supplemental Security Record (SSR) is set to A or B. (For specific instructions on inputting the UTAC, refer to GN 03930.030 or Underpayment Processing per MS 00304.018). This action automatically recovers any applicable overpayment, releases the balance of withheld funds, if any, to the claimant, and sends notices to the claimant and the representative. Also, consider the following situations before releasing the underpayment to the claimant:

    • •

      Overpayment balance

      If you are processing a case that involves an overpayment balance, ensure that the overpayment decision posts to the SSR. If it does not, post it. For instructions on posting overpayment decisions, see MS 00304.001.

    • •

      Installment payment

      If you are processing a case that involves an installment payment, manually calculate the installment payment amount, pay the next installment if due, and send manual notice of the actions to the claimant and representative. For additional information about installment payments, see SI 02101.020.

    • •

      Dedicated account

      If you are processing a case that involves a dedicated account, see SI 02101.010.

    • •

      Large underpayment diaries

      For instructions on resolving large underpayment diaries, refer to SM 01311.661 and SM 01311.669.

2. Concurrent Claims: Fee Adjustment of Countable Retroactive Title II Windfall Offset

When a claim is a concurrent Title II and Title XVI claim, you may need to make a windfall-offset computation. For more information on windfall offset, refer to SM 03045.910 and SM 00815.001. In concurrent cases for fee petitions, you may need to compute the windfall offset computation twice when a PC adjudicates a Title II claim but we have not yet authorized the representative’s fee. The first windfall offset computation (prior to receiving the fee authorization document) allows the PC to release the Title II past-due benefits avoiding further delay. The FO does the second computation when it receives the fee authorization document from the PC, OHO, or OAO. The second computation accounts for the representative’s fee as an expense of obtaining income.

a. Fee Adjustment of Title II Countable Retroactive Income When the Authorized Fee is Known

If you have the fee authorization from the PC, OHO, or OAO:

  • •

    Complete the windfall offset, if necessary.

  • •

    Deduct the entire authorized fee from the retroactive Title II benefits beginning with the earliest months the Title II retroactive benefits are payable. We make no distinction between services performed for Title II or Title XVI. We use the total fee to adjust the Title II income.

    NOTE: Under the fee petition process, the authorized fee may exceed the amount that we withheld and directly paid to the representative or entity (we only withhold 25 percent of the past-due benefits). For instructions on deducting authorized fees from retroactive Title II income, see SI 02006.200 and SI 02006.202. For instructions regarding expenses of obtaining income, see SI 00830.100.

b. No Fee Adjustment of Title II Countable Retroactive Income When the Authorized Fee is Unknown

  1. 1. 

    Authorized Fee is Unknown

    Complete the windfall offset, if necessary, to avoid an unnecessary delay in release of any retroactive Title II benefits. For representative fee processing instructions, see MS 00302.014.

  2. 2. 

    Fee Authorization Received from the PC, OHO, or OAO After Windfall Offset is Completed

    Re-compute the windfall offset computation, if necessary. Deduct the entire authorized fee from the retroactive Title II benefits beginning with the earliest months the Title II retroactive benefits are payable. If the fee authorizer designated part of the fee to the Title XVI claim specifically, do not use it to decrease the Title II income.

c. Direct Payment of the Authorized Fee on Concurrent Title II and Title XVI Claims

When processing direct payments of authorized fees for concurrent claims, follow these steps:

  1. 1. 

    Determine the Portion of the Authorized Fee Paid from Title II Past-Due Benefits

    Query SPS (see APQY screen as the SPPT screen will not show if direct payment of the fee was assigned to an entity) to determine the amount of the fee paid to the representative, or eligible entity if there is a valid assignment, from the claimant's (and the claimant's auxiliaries) past-due benefits and the amount of the assessment collected from the direct fee payment. For instructions on obtaining an SPS query, see MS 05701.003.

    Usually, in fee petition cases, the fee authorizer sets one fee for the representative’s services in connection with both Title II and Title XVI claims and does not designate a portion of that fee for one of the two claims. However, if the fee authorizer designates part of the authorized fee to services provided in connection with the Title XVI claim, pay that part of the fee from the withheld Title XVI past-due benefits per GN 03930.032B.1. above.

  2. 2. 

    Directly Pay the Title XVI Portion of the Fee

    Query SPS (see APQY screen as the SPPT screen will not show if the fee was assigned to the entity) to determine if the payment to the representative or entity, if there is a valid assignment, from the Title II past-due benefits was less than the authorized fee. Issue an A-OTP to the representative or entity, if there a valid assignment, with the lesser of the balance of the authorized fee or the amount withheld less the assessment (if applicable). If we paid the entire fee from the Title II past-due benefits, release the Title XVI past-due benefits following the instructions in GN 03920.032B.1. in this subsection. We cannot issue any fee from Title XVI past-due benefits even if there is an UPX on the SSR.

C. Additional references

GN 03930.033 Fee Petitions – Processing the Assessment in Title XVI Cases

A. Introduction

We are required to charge an assessment, also called a “user fee” or “service charge,” when making a direct fee payment to an eligible representative, or an eligible entity if there is a valid assignment (see GN 03920.021). The Social Security Protection Act of 2004 provided for:

  • •

    capping the assessment at a flat-rate dollar amount or at 6.3 percent of the fee payment, whichever is lower; and

  • •

    adjusting the flat-rate cap based on annual cost-of-living adjustments rounded down to the next lower $1.

NOTE: Refer to GN 03920.019 for the current assessment and to GN 03920.016F for direct payment calculations.

For information on processing the assessment in Title II cases and for guidance on calculating an assessment in special situations, such as when there is more than one representative, see GN 03930.066.

B. Process - Title XVI Only Cases

The claims specialist (CS) is responsible for calculating the assessment and coding the assessment on the Supplemental Security Record (SSR) through the automated one-time payment (A-OTP) process. The assessment is a flat rate cap based on the cost-of-living adjustment or 6.3 percent of the fee payment, whichever is lower.

The procedures in GN 03930.032 identify when to apply the assessment. When we make direct payment from the claimant’s and the claimant’s eligible spouse’s past-due benefits to pay the claimant’s representative’s fee, the total assessment deducted from both cannot exceed the flat rate cap based on the cost-of-living adjustment .

C. Process - Concurrent Title II and Title XVI Cases

The maximum assessment we will deduct from fees paid directly from Title II and Title XVI past-due benefits is the flat rate cap based on the cost-of-living adjustment. When the CS makes direct payment from Title XVI withheld past-due benefits, the CS will query the Single Payment System (SPS) to determine the amount of the assessment deducted from the Title II direct payment amount.

  • •

    If we deducted the flat rate cap based on the cost-of-living adjustment, the CS will not deduct an assessment from the portion of the fee payable from the withheld Title XVI past-due benefits.

  • •

    If we deducted less than the flat rate cap based on the cost-of-living adjustment, the CS will deduct 6.3 percent of the amount payable, up to a maximum of the difference between the flat rate cap based on the cost-of-living adjustment and the assessment we have already collected.

D. Procedure - Concurrent Title II and Title XVI Cases

To determine the assessment deducted from the Title II direct payment amount:

  • •

    Select number 27 on the SSA Main menu in PCOM.

  • •

    Select number 1 – SPS, on the Payments Outside Title II System (POTS) screen.

  • •

    On the Single Payment System Menu (SPSM) screen enter the claimant's social security number and select #1-Attorney Fee Payment to access the screen with the direct fee payment and assessment deducted amounts.

(See SM 00834.000, Single Payment System.)

 

GN 03930.034 Title XVI Only – Fee Petitions - Notifying the Representative, the Claimant, and the Spouse

A. Introduction

The claims specialist (CS) uses a Document Processing System (DPS) notice when paying representative fees authorized based on a fee petition. Fee notices are in the “General” notices section of DPS, under “Fee Petitions.”

B. Process - Petition Before Award

The CS designates appropriate paragraphs in the fee notice. Fee notices are in the "General" notices section of DPS, under "Fee Petitions."

C. Process - Fee Authorized After Award

The responsibility for notifying the claimant and the representative, or other individual listed in GN 03930.020A when the representative is deceased, of the amount of the fee we authorize depends on who authorizes the fee. The field office is responsible for paying the fee and for notifying the relevant individuals about the direct payment.

1. Services at Initial or Reconsideration Level

The PC authorizes fees based on fee petitions for cases decided at the initial and reconsideration levels. When the PC authorizes the fee or proposes (consistent with GN 03920.015B.) to authorize a fee of more than $15,000:

  • •

    The Claims Technical Expert (CTE) in the program service centers, the Disability Specialist in the Office of Disability Operations, and the fee reviewer in the Office of International Operations explain in the notice the right to request administrative review and how the representative should collect the fee or fee increase.

  • •

    When we make direct payment to the representative or to the entity, if there is a valid assignment (see GN 03920.021), the CS notifies the claimant and the representative of the amount paid to the representative from past-due benefits and about the assessment made for direct payment. Use AURORA to notify the claimant and the representative when we make direct payment.

2. Services at Hearing or Appeals Council Level

The Office of Hearings Operations (OHO) or the Office of Appellate Operations (OAO) authorizes the fee for cases decided at the hearing or Appeals Council levels. If a case is appealed to federal court, the court authorizes the fee for services the claimant’s attorney provided before the court (see GN 03920.060).

a. Notice to Representative and Entity

  • •

    The fee decision maker notifies the representative of the authorized fee and the method of payment using Form SSA-1560 or another fee authorization document as described in GN 03930.001C.5. If there is a valid assignment, send a copy of the fee authorization to the entity's POC.

  • •

    For fees for services provided before a court, the court order provides the representative with the necessary notice.

b. Notice to Claimant and Eligible Spouse

We notify the claimant, the claimant’s eligible spouse if we use the spouse's past-due benefits to pay the representative, and the representative when releasing the claimant’s withheld Title XVI past-due benefits. The CS prepares the notice(s) when we make direct fee payment. Use DPS to notify the claimant and the representative when we make direct payment.

After we make direct fee payment, notification to the claimant and representative about the disposition of any additional withheld past-due benefits (e.g., we release the balance of withheld past-due benefits to claimant) is generally done by an automated notice. Do not send a copy of this notice to an entity's POC without the claimant's written consent.

3. We Failed to Withhold Benefits

Additional notice language is required if we failed to withhold, or prematurely released, past-due benefits.

  • •

    Refer to the instructions in GN 03920.055.

  • •

    In court cases, the CS contacts the Office of the General Counsel (OGC) to resolve the situation (see GN 03930.180 for the OGC contact list).

 

GN 03930.035 Title II - Adjudicating Claims Involving Representatives Who May File Fee Petitions - Overview

A. Introduction

The claims specialists (CS) in the field office (FO), the program service centers (PSC), and the Office of Central Operations adjudicate Title II claims involving representatives who petition to obtain our approval of fees for their services. The procedures below, and in the two next sections, highlight the key CS responsibilities based on the processing system: the Modernized Claims System (MCS) or the Manual Adjustment, Credit, and Award Processes (MADCAP). The instructions in this section apply to all cases where there was one or more appointed representatives eligible for direct payment, there is no approved fee agreement, and at least one eligible representative did not waive their fee or right to direct payment of their fee. Refer to GN 03930.015 for information about which office has jurisdiction to authorize a fee under the fee petition process.

For those cases in which the representative is eligible for direct fee payment and the representative did not waive a fee or the right to direct payment of a fee, including cases with a valid assignment (see GN 03920.021), MCS and MADCAP propagate representative information into the Single Payment System (SPS) for creation of a payment record. For fee petition cases, the action will hold (i.e., pend) payment in SPS until action is taken to release the representative fee (i.e., the fee is authorized and input). See GN 03920.017C., Direct Payment to Representatives – Title II Cases.

NOTE: For cases with a valid assignment, the SPPT screen in SPS will show the appointed representative's name. Select the iteration to get to the APQY screen to see if the fee was paid to the entity next to the "Fee Assigned To" line.

The CS must refer to Program Operations Manual System (POMS) or Modernized System Operations Manual (MSOM) sections for complete instructions about processing limitations or exclusions and coding required entries.

B. CS Responsibilities

The CS (or other processing center (PC) position designated to perform these functions) must:

  • •

    prepare any necessary forms and make data entry necessary to use the most expeditious processing system available;

  • •

    ensure that we withhold funds from past-due benefits for possible direct payment, when required;

  • •

    provide correct notice to the claimant and the claimant's representative; and

  • •

    set the diary for receipt of the fee petition or fee authorization when we are withholding past-due benefits for possible direct payment to a representative or to an entity if there is a valid assignment (see GN 03920.021). For information about setting this diary, refer to GN 03930.045.

NOTE : Although a representative who has withdrawn or whose representation was revoked by the claimant may file a fee petition, do not send a copy of the award notice or other protected information (e.g., the claimant’s information) unless it is the minimum amount necessary for the former representative to review it to resolve fee-related issues. For information that is not relevant or necessary to resolve fee-related issues, only disclose it if the claimant has expressly consented in writing on a Form SSAA-3288 or other written consent that meets the requirements of GN 03305.003. Similarly, even in the limited circumstances described in GN 039030.020A when a POC may file a fee petition, do not send a copy of the award notice or other protected information (e.g., the claimant's information) to the entity's POC unless it is the minimum amount necessary for the POC to review it to resolve fee-related issues. For information that is not relevant or necessary to resolve fee-related issues, only disclose it if the claimant has expressly consented in writing on a Form SSA-3288 or other written consent that meets the requirements of GN 03305.003. For more information about the assignment of direct payment of fees, including the roles and responsibilities of POCs, see GN 03920.021.

C. Identify MCS Processing Limitations

Some characteristics currently prevent final claims processing through MCS using its earnings computation (EC) screens. Refer to MS 03504.002, MS 03504.003, and SM 00834.900 for MCS processing limitations.

D. Determine Representative's and Entity's Eligibility for Direct Fee Payment

Determine a representative's and, if there is a valid assignment, the entity's eligibility for direct fee payment as follows:

  1. 1. 

    Review GN 03920.016 to determine if the representative is eligible to receive direct payment. If the representative is eligible and assigned their right to receive direct payment to an entity, review GN 03920.021 to determine if the entity is eligible to receive direct payment.

  2. 2. 

    If the representative is a non-attorney, check Registration, Appointment and Services for Representatives (RASR) to determine if the representative is eligible to receive direct payment.

    • •

      If the representative states that they are eligible for direct payment but is not listed on that date, take the action in GN 03930.035D.4.

    • •

      If the representative did not state they are eligible for direct payment and is not listed, go to GN 03930.035E.

    • •

      If the representative is listed, proceed to GN03930.035D.3.

  3. 3. 

    If RASR indicates the representative is eligible to receive direct payment and they have not waived direct payment, verify that the claimant and the representative both signed the Form SSA-1696 (Claimants Appointment of a Representative). If yes, go to GN 03930.035E. If not, request the representative submit a copy of the previously filed Form SSA-1696 signed by both the claimant and representative.

  4. 4. 

    If the representative is a non-attorney who states they are eligible for direct payment, but RASR shows the non-attorney representative is not eligible for direct payment, notify the representative that we cannot make direct payment (using the following model language), send a copy to the claimant and go to GN 03930.035E.

Model language to use in these situations follows:

You advised your client, (beneficiary's name), and indicated on the Form SSA-1696 (Claimant's Appointment of a Representative) that you are eligible to have your approved representatives' fees withheld and paid directly from the claimant's past-due benefits. However, [select the conclusion that describes the status]

  • •

    you are not eligible to receive direct payment of your fees from the claimant’s past-due benefits, or

  • •

    you did not become eligible to receive direct payment of your fees from the claimant’s past-due benefits until after we effectuated the favorable decision on your client's claim, or

  • •

    you failed to maintain your eligibility to receive direct payment of your fees from the claimant’s past-due benefits and were no longer eligible on the date we effectuated the favorable decision on your client's claim.

Accordingly, we will not pay any authorized fee directly to you. You should look to the claimant for payment of the fee authorized in this case.

See GN 03920.017C, Policy – Direct Payment to Representatives in Title II Cases.

E. Procedure - Claims Processing

1. MCS

a. MCS Check/Notice 2 Screen

Use the MCS Check/Notice 2 (NOT2) screen to provide the data to tell the system whether to withhold from past-due benefits. For complete coding of representative data on the MCS clearance screens, see MS 03509.009. Note that court cases and court remand cases where the administrative fee is paid based on an approved fee agreement are an MCS exclusion.

When the representative is eligible for direct fee payment and has not waived a fee or the right to receive direct payment, we must withhold past-due benefits for that purpose. To withhold from past-due benefits, complete the MCS NOT2 screen as follows:

  • •

    Authorized Representative Type: 1 or 4

    (Use “1” for an attorney or "4" for an eligible for direct payment non-attorney)

  • •

    Fee Waived: N

  • •

    Direct Payment Waived: N

  • •

    If there is a valid assignment, use the "PE" for entity payment indicator

  • •

    Last Withholding Date: Calendar month and year before the calendar month and year you are adjudicating the claim unless it is a closed period of disability.

NOTE 1: The last withholding date for auxiliaries is the same as that of the claimant if protective filing exists, regardless of when the auxiliaries' claims are adjudicated.

  • •

    Attorney/Rep Name: This information will propagate to the NOT2 screen from RASR. Make any changes or corrections in RASR.

  • •

    Pending Fee Agreement Amount: Do not complete.

  • •

    Fee Agreement Type: Do not complete this field on the NOT2 screen for fee petition cases.

Completing the MCS NOT2 screen as described above will result in fee withholding and establish the FEE AMT on the AAPFEE line on the Master Beneficiary Record (MBR). The ATY indicator on the DW01 will generate an SPS record. See MS 03508.004 E 17-C for a list of DW indicators. There is an additional indicator of ATYPE which will make the payment to the entity on the record.

NOTE 2: If a non-attorney alleges that they are eligible for direct payment, but RASR indicates they are not eligible. Refer to GN 03930.035E for language to include in a notice if we have not previously communicated with the representative about their status.

b. DW01 Screen

If the representative is an attorney or a non-attorney eligible for direct payment, include the Attorney Issue code ATY04, which means “Petition Awaiting Authorization,” on the MCS Development Worksheet (DW01) screen. The Attorney Issue Code ATY04 will “pend” the payment in SPS until the petition/authorization is complete.

c. DECI Screen and Diary

The system automates a diary in MCS on the DECI screen for the fee petition cases at the initial and reconsideration levels (diary code 098), and at the Office of Hearings Operations (OHO) and the Office of Appellate Operations (OAO) levels (diary code 099). See MS 03509.013 for additional information. If an ATFEE action control record (ACR) is already pending, the adjudicator will delete the systems generated diary (GN 01040.010A.).

NOTE: In the Office of Central Operations (OCO), when processing an OHO or OAO level case, the CTE prepares a 60-day Processing Center Action Control System (PCACS) diary related to the existing “ATFEE FEEPAY” ACR and routes the claims file to the development holding file (DHF PAY) pending receipt of the petition/authorization. In cases with Federal court involvement, the CTE prepares a 120-day diary related to the existing “ATFEE COURT” ACR.

2. Withholding With MADCAP

A101 or EF101

When completing the A101 or EF101, which MADCAP processing requires, take the actions shown if you are withholding past-due benefits for possible direct payment.

  • •

    Code the BCF fields on the BCRN screen following instructions in MS 03514.006.

  • •

    Show in the REMARKS field on the BCRN screen the following remarks: “FEE WITHHOLDING CASE - Fee Petition Expected”; and “Withhold 25 percent of (HA's, HB's, HC1's, or other appropriate entry) past-due benefits for possible direct payment to representative.”

  • •

    Enter the fee petition paragraph (ATY055, ATY056, ATY057, ATY058, or ATYPE as appropriate) and paragraph 160 in the NOTICE field on the BCRN screen per NL 00708.100 and NL 00720.050.

3. No Withholding With MADCAP

A101 or EF101

When completing the A101 or EF101, which MADCAP processing requires, take the actions shown if you are not withholding past-due benefits for possible direct payment.

  • •

    Add the remark to the BCRN screen. See MS 03514.006.

  • •

    Show the appropriate paragraph (981.1, 981.2, 981.3, or 983) to indicate whether the representative has waived a fee or just waived direct payment of the fee. If the fee itself has not been waived, include paragraph 160 per NL 00708.100.

4. Manual Adjustment Credit and Award Data Entry (MACADE) Cases

a. Coding to Withhold Past-Due Benefits When Representative Eligible for Direct Payment

Input direct data entry through MACADE. Enter the following special coding:

  • •

    In the HST screen “MR” column, the 25 percent withholding amount.

  • •

    In the HST screen “TO” column, the “AD” special entry. We use the special entry AD to withhold the legal payment and post the amount withheld to the PHUS.

    NOTE: See SM 00842.013 and SM 00848.360 for further instructions.

  • •

    Enter the Attorney Payment Indicator (API) of “04” on the MACADE ATT screen. The API of 04 will establish the payment in SPS in pending status until the petition/authorization is complete.

  • •

    On MACADE REM screen, show “Fee Petition Case.”

b. Diary

For MACADE processed claims, the benefit authorizer (BA) or CS must establish a Processing Center Action Control System (PCACS) ATFEE PETPAY diary. Begin the diary period when the notice is released, which is usually five days after the MACADE action. To determine the length of the diary for a specific case, refer to GN 03930.045.

NOTE: In OCO, in processing an OHO- or OAO-level case, the CS or other designated technician prepares a 60-day PCACS diary related to the existing “ATFEE FFEPAY” ACR and routes the claims file to the DHF PAY pending receipt of the petition/authorization. In cases with Federal court involvement, the BTE prepares a 120-day diary related to the existing “ATFEE COURT” ACR.

See GN 03930.090 for the follow up procedure when no fee petition or fee authorization is received before the diary matures.

c. Windfall

If possible windfall (Title II or Title XVI) offset is involved, refer to SM 00815.100 through SM 00815.500 for required MADCAP coding.

d. Notice Paragraphs

Designate necessary paragraphs for inclusion in the fee notice and instruct staff to prepare additional copies. Refer to GN 03930.040 for appropriate language. Or, if trained in AURORA, complete the necessary paragraphs in that system.

5. Prepare Special Message

Prepare a message for the MBR stating a fee petition/authorization is pending.

For cases involving appointed representatives below the court level:

  • •

    Access the Special Message screen through MONET (or MACADE) and select special message 52; and

  • •

    Process the standard special message 52 to the MBR.

Special Message 52 will display:

APPOINTED REPRESENTATIVE(S) INVOLVED – SEE RASR, APPREP, AND APPFEE DATA LINES FOR ADDITIONAL INFORMATION

For court cases with court attorney involvement (see GN 03920.060):

  • •

    Code the special message field to read: COURT CASE/REPINVOLVED/DO NOT RELEASE 25% WITHHELD PENDING COURT FEE AND ADMIN FEE; and

  • •

    If the case is a court remand for additional administrative proceedings, replace “COURT CASE” with “COURT REMAND.”

F. References

The following sections provide specific instructions for related CR or CA/CTE functions.


GN 03930 TN 31 - Fee Authorization Under the Fee Petition Process - 12/09/2024