Jim, age 65, and Jim's spouse Mary, a disabled spouse, age 60, file for SSI on 01/10/08.
Jim already receives title II benefits of $605.00 per month. Jim's title II benefit
increases to $623.00 per month in 2009.
Mary is not insured or entitled to any title II benefits. Jim will not be eligible
for SSI unless Mary's SSI claim is approved. Mary appoints a representative to assist
with the title XVI claim, and the representative submits a fee agreement. On 09/10/09,
the ALJ finds Mary disabled as of 01/10/08 and approves the representative’s fee agreement.
Both Mary and Jim are now eligible for SSI and their retroactive SSI payments are
issued on 10/25/09.
Determine the representative's fee based on Mary's fee agreement with the representative
by following steps GN 03940.052.C.1.a. through GN 03940.052.C.1.d.:
The couple's maximum potential benefits are $8,161.00 ($4,080.50 for Jim and $4,080.50
for Mary) in SSI benefits for 02/08 - 10/09, computed on the SSR as follows.
$956.00 Couple Federal Benefit Rate (FBR) for 2008
-585.00 Countable Income (Jim's title II of $605.00 - $20.00)
$371.00 Couple Payment Amount for 02/08 - 12/08 ($371 x 11 = $4,081.00)
$1,011.00 Couple FBR for 2009
-603.00 Countable Income (Jim's title II of $623.00 - $20.00)
$408.00 Couple Payment Amount for 01/09 -10/09 ($408 x 10 = $4,081.00)
Therefore, the past-due benefits are $4,081.00 + $4,080.00 = $8,161.00.
All retroactive benefits are past-due benefits for representative fee purposes.
Jim was not previously eligible for SSI benefits; therefore, there is nothing to subtract
from the past-due benefits amount.
Because there are past-due benefits and the fee agreement provided for a fee of the
lesser of 25 percent of past-due benefits or the specified dollar amount of the fee
cap indicated in GN 03940.003B.3, the fee in this case is $2,040.25 , or 25 percent of $8,161.00.
Mary's eligibility results in Jim's eligibility for SSI; therefore SSA uses the couple's
past-due benefits to calculate Mary's representative's fee.