Sam and Charlotte filed for SSI on 05/30/08. Charlotte also filed for title II benefits.
Charlotte appointed a representative, who submitted a fee agreement. The fee agreement
called for a fee of the lesser of 25% of past-due benefits, or the specified dollar
cap of $6,000.00. Sam's SSI claim was approved and he began receiving SSI payments
in 06/08. He was paid the full FBR for an individual for 06/08 - 08/09 because Charlotte's
initial claim was denied.
In July 2009, the ALJ issued a favorable title II and title XVI decision finding Charlotte
disabled as of 02/10/08, and approved the fee agreement. Charlotte received her retroactive
SSI payment of $5,886.00 in August 2009 (the difference between the couple's FBR and
the individual's FBR). Charlotte's title II waiting period was 03/08 - 07/08. She
received her first monthly title II check in September 2009, a CMA of $509.00. SSA
withheld title II retroactive benefits of $6,064.00 for the months of 08/08 - 07/09
(benefits that would have been paid in 09/08 - 08/09) pending windfall offset and
attorney fee adjustment. Charlotte's title II MBA rates are shown on the MBR as $498.00
for 08/08-11/08, and $509.00 for 12/08 and continuing.
Determine the representative's fee based on Charlotte's fee agreement with her representative
by following with steps a. through e. in GN 03940.052C.2.:
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•
The representative fee based on title II past-due benefits is $1,516.00 according
to the amount on the APPREP data line on the MBR. Based on the fee agreement between
Charlotte and her representative, and on the statutory limits outlined in GN 03940.003B.3., SSA may authorize total representative fees (based on title II and title XVI past
due benefits) in an amount not to exceed the lesser of 25% of past due benefits or
$6,000.00.
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•
Determine Charlotte's SSI past-due benefits for the fee computation. Per GN 03940.052C.2.c., determine the amount the couple would have received for each month included in Charlotte's
retroactive payment, if Charlotte's retroactive title II benefits had been paid first
and when due.
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•
Subtract the actual amount of SSI that Sam has already been paid for the same months.
See summary calculation in the table below.
MMYY
|
Amount Couple Due If Charlotte's T2 Was Paid on Time
|
SSI Paid to Sam
|
Past Due Benefits
|
06/08
|
956.00* (see explanation below)
|
637.00
|
319.00
|
07/08
|
956.00
|
637.00
|
319.00
|
08/08
|
956.00
|
637.00
|
319.00
|
09/08
|
956.00
|
637.00
|
319.00
|
10/08
|
956.00
|
637.00
|
319.00
|
11/08
|
478.00** (see explanation below)
|
637.00
|
-159
|
12/08
|
478.00
|
637.00
|
-159
|
01/09
|
522.00*** (see explanation below)
|
674.00
|
-152
|
02/09
|
522.00
|
674.00
|
-152
|
03/09
|
522.00
|
674.00
|
-152
|
04/09
|
522.00
|
674.00
|
-152
|
05/09
|
522.00
|
674.00
|
-152
|
06/09
|
522.00
|
674.00
|
-152
|
07/09
|
522.00
|
674.00
|
-152
|
08/09
|
522.00
|
674.00
|
-152
|
Total Past-Due Benefits
|
|
|
$61.00
|
$956.00 Couple FBR for 2008
- 0.00 No title II retro due for 06/08 - 10/08; no countable income
*$956.00 Amount couple due for 6/08 - 10/08
$956.00 Couple FBR for 2008
- 478.00 Charlotte's title II rate of $498.00 - $20.00
**$478.00 Amount couple would have been due for 11/08 - 12/08
$1011.00 Couple FBR for 2009
- 489.00 Charlotte's title II rate of $509.00 - $20.00
***$522.00 Amount couple would have been due for 01/09 - 08/09
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•
If the “Amount Couple Due” for a month is MORE than what Sam received for that month,
the difference is the SSI past-due benefit for that month. If the “Amount Couple Due”
for a month is LESS than what Sam received for that month, then there are no past-due
benefits for that month. Offset any negative amount for a month against any additional
amounts due for other months in the withholding period to arrive at the past-due benefits.
In this case, there are past-due benefits of $61.00.
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•
Authorize a fee that is the lesser of:
-
–
25 percent of the SSI past-due benefits (25 percent of $61.00 is $15.25)
OR
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–
The dollar cap of $6,000.00. To calculate the remaining representative fee SSA could
authorize from title XVI past-due benefits based on the dollar cap of $6,000.00, subtract
the title II fee already authorized from the dollar cap of $6,000.00 ($6,000.00 -
$1,516.00= $4,484.00);
Since $15.25 is less than $4,484.00, SSA will authorize a fee of $15.25 based on title
XVI past-due benefits.
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•
Prepare and issue the SSI Fee Agreement Notice authorizing a title XVI fee of $15.25.