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Letter AF-1 |
Acknowledgment Letter - No Development (To Claimant)
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Letter AF-2 |
Acknowledgment Letter - No Development (To Representative)
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Letter AF-3 |
Acknowledgement Letter - No Development (To Nonrequester)
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Letter AF-4 |
Acknowledging Receipt of Request for Administrative Review Received by Wrong Office
- Forwarded to Correct Office
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AF-1 — Acknowledgment Letter - No Development (To Claimant)
James Smith
Street Address
City/State/ZIP Code
We are writing about your letter dated January 25, 1995. You asked us to lower the
fee amount we said your representative can charge for work on your claim.
Because you asked us to review the fee amount, we are giving you a list of rules we
use to decide a fee. When we approve a representative's fee, we consider the purpose
of the Social Security and Supplemental Security Income (SSI) programs. In all cases,
we also consider:
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the services provided (including the type of service);
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the difficulty of the case;
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the level of skill required to provide the services;
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the amount of time spent on the case;
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the level of administrative review to which the representative took the claim;
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the level of review at which the representative entered the proceedings; and
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the fee amount requested, not including any out-of-pocket expenses but including any
amount already approved or requested. An example of out-of-pocket expenses is the
cost to get copies of doctors' and hospitals' reports.
What Will Happen
Someone who did not decide the fee amount will review the decision and make a new
one. Based on that review we will raise, lower, or not change the fee amount your
representative can charge.
Because John Jones, Susy Smith, and Joey Smith can comment on your request for administrative
review, we are sending them a copy of your request. They also can provide more information
to the person reviewing your request.
If we need more information, we will contact you. We will send you, and the other
people listed above, a letter telling what we decide.
If You Have Any Questions
If you have questions about this letter, please write us at:
Address of Originating Component
If you have questions about other Social Security matters, call us toll free at 1-800-772-1213,
7 a.m. to 7 p.m. Monday through Friday. We can answer most questions over the phone.
Our busiest times are the first week of the month and Mondays. So, we may be able
to handle your call more quickly if you can call us at other times.
If you wish, you can call your local Social Security office at xxx-xxxx. You can also
write or visit a Social Security office. The office that serves your area is located
at:
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Street Address
City/State/Zip Code
If you do call or visit an office, please have this letter with you. It will help
us answer your questions. This will help us serve you more quickly.
AF-2 — Acknowledgment Letter - No Development (To Representative)
Jane Doe
[Attorney at Law]
Street Address
City/State/ZIP Code
We are writing about your letter dated January 25, 1995. You asked us to raise the
fee amount we said you can charge for your work on Sally Brown's claim. You also said
the claimant has not paid the fee.
What Will Happen
Someone who did not decide the fee amount will review the decision and make a new
one. Based on that review we will raise, lower, or not change the amount of the fee
you can charge. We will pay you as much of the fee as the law allows.
Because Sally Brown, Susy Brown, and Joey Brown can comment on your request for administrative
review, we are sending them a copy of this letter. They also can provide more information
to the person reviewing your request.
If we need more information, we will contact you. We will send you and the other people
listed above a letter telling what we decide.
If You Have Any Questions
See Referral Paragraphs in Model Acknowledgment Letter AF-1
AF-3 — Acknowledgment Letter - No Development (To Nonrequester)
Sally Brown
Street Address
City/State/ZIP Code
Jane Doe has asked us to raise the fee amount we said they can charge for work on
your claim.
What Will Happen
Someone who did not decide the fee amount will review the decision and make a new
one. Based on that review we will raise, lower, or not change the fee amount your
representative can charge.
Your representative also said that you had not paid the fee. Since you haven't paid,
we will pay your representative as much of the fee as the law allows. Then we plan
to take this amount out of your future benefits. You will get another letter about
this.
What You Can Do
We are sending you a copy of Jane Doe's letter. If you have comments about the letter
or want to give us more information, write us within 15 days. We will consider what
you tell us. You can write us at this address:
Address of Originating Component
If You Have Any Questions
If you have questions about this letter, please write us at the above address.
If you have questions about other Social Security matters, call us toll free at 1-800-772-1213,
7 a.m. to 7 p.m. Monday through Friday. We can answer most questions over the phone.
Our busiest times are the first week of the month and Mondays. So, we may be able
to handle your call more quickly if you can call us at other times.
If you wish, you can call your local Social Security office at xxx-xxxx. You can also
write or visit a Social Security office. The office that serves your area is located
at:
-
Street Address
City/State/Zip Code
If you do call or visit an office, please have this letter with you. It will help
us answer your questions. This will help us serve you more quickly.
AF-4 — Acknowledging Receipt of Request for Administrative Review Received by Wrong
Office - Forwarded to Correct Office
Abbey Rhodes
[Attorney at Law]
Street Address
City/State/ZIP Code
We are writing about your letter postmarked May 18, 1995. You asked us to raise the
fee amount we said you can charge for your work on George Harrison's claim.
What We Have Done
We have sent your letter to the Office of Central Operations, 6401 Secuirty Boulevard,
Baltimore, MD 21235. Someone in that office will review your request. If you want
more information or have questions about the review, please write to that office.