Paper claims |
Step 1. Affix the Form SSA-1128 (Representative Involved) to the front lower right
corner of the paper claim folder and indicate whether:
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•
the representative is an attorney, EDPNA, or a non-attorney who is not eligible for
direct pay;
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•
the representative waives a fee;
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•
the representative waives only direct payment of the fee from withheld past-due benefits;
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•
the claim is Title II, Title XVI, or concurrent;
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•
a third party has paid or will pay the representative's fee. See GN 03920.005B and GN 03920.010B for information on our authorization of fees when paid by a third-party entity; and
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•
the representative submits a fee agreement, but you are not the decision maker. Check
the block on the Form SSA-1128 labeled “Fee Agreement in File,” but do not check either
the “Approved” or “Disapproved” block. See GN 03940.002 for information on the fee agreement decision maker.
Step 2. Enter information in RASR and file the written notice of appointment in the
claim file.
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a.
Representative is in RASR.
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1.
Enter the information in RASR, which will send the necessary notices and acknowledgments
to the appointed representative.
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2.
The FO will also enter the information in MCS and MSSICS to ensure the representative's
information propagates into all claims systems.
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3.
When an affected auxiliary beneficiary's information becomes available, the FO will
enter this information and ensure that the system has created a link to the claimant.
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b.
Representative is not in RASR.
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1.
When the representative is an attorney or EDPNA and is eligible for and seeking direct
payment of a fee but is not in RASR, the FO will process the written notice of appointment
outside of RASR as explained in 2a below. Explain to the representative that we require
that representatives who are eligible for and seek direct payment of their fees to register with us. Once the representative is registered for direct
payment, enter the representative's information in RASR. Refer to 71 FR 58043 and GN 03913.000 for information on individual registration for appointed representative
services and direct payment of fees. If the representative (attorney or EDPNA) is
eligible for but not seeking direct payment, process the appointment as explained
in step 2a below.
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2.
If the representative is a non-attorney who is not eligible for direct pay, contact
the representative and ask if the representative would like to register in RASR for
access to electronic services as explained in GN 03913.005C.
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a.
If the non-attorney declines to register, for concurrent claims, the FO will file
the written notice of appointment in the Title II claim file and a copy in the Title
XVI claim file and process the appointment outside of RASR as follows: (1) send manual
notices from Document Processing System (DPS) to acknowledge the appointment; and
(2) annotate the required downstream applications (e.g., MCS and MSSICS) with the
representative's name, address, and phone number (in multiple representative situations,
enter the principal's representative's name, address, and phone number); and, if applicable,
note information about a fee agreement or waiver of fee, if any.
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b.
If the non-attorney representative agrees to register, the FO will secure a Form SSA-1699
and process it as explained in GN 03913.005. Unless other reasons prevent recognition of the appointment, process the appointment
as you would for unregistered representatives. Once the non-attorney is registered,
enter the appointment data in RASR. This process is a one-time
registration process done for non-attorney representatives who want access to electronic
services.
Step 3.
Update
other
systems.
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a.
In pending Title II and Title XVI claims, the FO will:
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1.
In pending Title II and Title XVI claims, the FO will: 1. Add a “1696” issue to the
MCS DW01 screen (MS
03508.004) and the CCE Development Worksheet page (MS
08122.004).
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2.
Annotate the NOT2 screen in a Title II MCS claim, as explained in MS 03509.009.
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3.
In a Title II non-MCS claim, annotate the Special Message field of the Master Beneficiary
Record (MBR) (after MBR is established) as explained in MS 06307.008 and obtain an
Inquiry Response Identification (QRID) query as explained in MS 05206.002 and MS 05206.022.
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4.
In Title XVI claims, annotate the UATH and UFEE screens, if any fee information is
applicable and available (i.e., appointed representative is eligible for and requesting
direct payment).
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b.
In reconsideration requests and hearing requests on MCS, annotate the system, as explained
in MS 03510.004 or MS 03510.006, as applicable.
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c.
In post-entitlement situations, to answer questions about the record posed by a claimant
or an appointed representative, query the system as explained in MS 05206.002, MS
05206.022, and MS 05206.023. This query accesses representative identification information
gathered from the MBR, Supplemental Security Record (SSR), and the Authorized Representative
File on the Modernized Data Input.
Step 4.
Document
Payment Center
(PC)
systems.
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a.
To send an action request for the PC, the FO will use “Paperless” to fax items and
create an action item in the Payment Center Action Control System (PCACS).
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b.
The FO will use the Evidence Portal to store Title II and Title XVI documents and
material for claims that do not have an electronic folder.
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c.
The FO will annotate the system if the OHO or OAO notifies the FO that it has received
an appointment of representative.
NOTE: When the claimant revokes the representative's appointment or the representative
withdraws before we make a determination or decision and the claimant does not appoint another representative,
remove the Form SSA-1128 from the paper claim file, the appointed representative’s
information from the NOT2 screen in MCS and UATH screen in MSSICS, and terminate the
appointment in RASR. The revoked or withdrawn representative is not entitled to direct
payment. Terminating the appointment in RASR will break the link between the representative
and the pending claim, matter, or issue and prevent direct payment of a fee, if any.
See the NOTE in GN 03920.017A for information on when we do not withhold the claimant's past due benefits for direct
payment of an authorized fee to a representative.
When the claimant revokes the representative's appointment or the representative withdraws
after we make a determination or decision, remove the Form SSA-1128 from the paper claim
and process direct payment of the authorized fee as explained in SM 00834.001 for
Title II claims or SM 01901.000 for Title XVI claims. Representatives who are revoked
or withdraw after we make a determination or decision are entitled to direct payment from us. If necessary,
develop for the date of revocation or withdrawal if the date is not shown on the statement
of revocation or withdrawal.
Step 5. Label evidence.
For paper claims, label any evidence submitted by a representative without a cover
letter or other identifier by annotating the evidence in the upper right corner “Submitted
by [Representative's Name] on [Date]."
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Electronic claims |
Step 1. Enter information in
RASR,
and the FO
will enter the information in downstream applications
at the FO
(e.g., MCS, MSSICS, and EDCS) as explained in Step 2 above. If processing the written notice of appointment outside of RASR:
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•
Upload the written notice of appointment into the electronic folder;
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•
The FO will send manual notices from DPS to acknowledge the appointment;
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•
The FO will annotate the required downstream applications (e.g., MCS and MSSICS) with
the representative’s name, address, and phone number. If the claimant appoints multiple
representatives, enter the principal representative’s name, address, and phone number;
and
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•
If applicable, enter information about a fee agreement or waiver of a fee, if any.
Step 2. Add the
"Representative
Involved"
flag
to the claim(s)
file.
If a representative enters the case before you send the medical file to the Disability
Determination Services (DDS), OHO, or OAO, add the "Representative Involved" flag
for an electronic folder in disability claims. See DI 81020.085 for information on certified electronic folder flags.
If the case is at the reconsideration or hearing level and jurisdiction has changed,
activate the flag and send an update after transfer (UAT) in EDCS.
Step 3.
The FO will
enter
information in other systems as explained in Step 3 above and annotate the EDCS transfer
screen.
See DI 81010.085 for information on transferring cases in EDCS.
Step 4.
The FO
enters
information in PC systems as explained in Step 4
above.
NOTE: When the claimant revokes the representative's appointment or the representative
withdraws before we make a determination or decision and the claimant does not appoint another representative,
remove the "Representative Involved" flag from EDCS, the appointed representative’s
information from the NOT2 screen in MCS and UATH screen in MSSICS, and terminate the
appointment in RASR. The revoked or withdrawn representative is not entitled to direct
payment. If the pending claim, matter, or issue is at the initial, reconsideration,
or hearing level, send an UAT in EDCS. Terminating the appointment in RASR will break
the link between the representative and the pending claim, matter, or issue and prevent
direct payment of a fee, if any. See the NOTE in GN 03920.017A for information on when we do not withhold the claimant's past due benefits for direct
payment of an authorized fee to a representative.
When the claimant revokes the representative's appointment or the representative withdraws
after we make a determination or decision, process direct payment of the authorized fee
as explained in SM 00834.001 for Title II claims or SM 01901.000 for Title XVI claims
and terminate the appointment in RASR. Representatives who are revoked or who withdraw
after we make a determination or decision are entitled to direct payment from us. If necessary,
develop for the date of revocation or withdrawal if the date is not shown on the statement
of revocation or withdrawal.
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