We are writing to tell you that you are entitled to (1) benefits from Social Security beginning (2) . However, we cannot pay you all your back benefits now because we may have to pay
your lawyer for work on your claim. The following information explains what this means
to you.
What We Will Pay And When
-
•
You will soon receive a check for $ (3) .
-
•
This is money you are due for (4) , minus the money withheld to pay for your legal expenses.
-
•
We withheld $ (5) , or 25 percent of your back benefits, in case we have to pay your lawyer.
-
•
We will write to you later about your regular monthly check when we finish working
on your claim.
What We Will Pay Your Lawyer
Your lawyer has to ask us to approve any fee for work done. Your lawyer has 60 days
to let us know that a fee will be charged. If we approve the fee:
-
•
We will pay your lawyer directly, using the $ (6) we withheld from your benefits.
-
•
If the fee is less than the money we withheld, we will pay you any extra money that
is left.
-
•
If the fee is more than the money we withheld, you will need to arrange to pay your
lawyer the difference.
We are sending a copy of this letter to your lawyer.
If You Have Any Questions
3901C - Domestic
3901D - Foreign