The decision maker's approval of a fee agreement can remain in effect for any subsequent
favorable decision SSA may issue on the same issue or issues, if there has been no
change in pertinent circumstances and if the approval was proper. Accordingly, if
a fee agreement was approved in connection with a favorable initial or reconsideration
determination or a hearing decision, and on appeal SSA issues a subsequent favorable
decision on the same issue or issues, no further action is required on the fee agreement
unless the initial fee agreement approval was improper or there has been a change
in the pertinent circumstances.
EXAMPLE: If a claims authorizer (CA) or claims technical examiner (CTE) has properly approved
a fee agreement and on reconsideration a subsequent decision is issued that is either
more or less favorable than the initial determination, the fee agreement will not
require a second approval by a CA/CTE. However, if the CA's/CTE's approval was improper
under the statute and the exceptions listed in GN 03940.003, or if there was a change in circumstances subsequent to the approval such that an
exception applies, the PC reviewing official should rescind approval of the fee agreement.
(Refer to GN 03940.020G. for procedures on processing incorrectly approved fee agreements.)
If on appeal, SSA makes a more favorable decision yielding additional benefits, SSA
will use the additional benefits when recalculating the past-due benefits, and may
authorize an additional fee under the fee agreement process, subject to the limits
established by the fee agreement, but not to exceed the statutory maximum as indicated
in GN 03940.003B.3., unless a higher amount is awarded on administrative review.
If on appeal, SSA makes a more favorable decision which yields past-due benefits in
a case in which there were previously no past-due benefits, the decision maker evaluates
the fee agreement in accordance with GN 03940.003.