If the claimant discharged one representative and appointed another, the prior representative retains the right to request a fee. If both representatives have assigned direct payment of their fee to the same entity, each individual representative still files their own fee petition and, if applicable, their own request for administrative review. For more information about assigning direct payment of fees to an entity, see GN 03920.021.

If there are multiple representatives involved in the claim, we authorized more than one fee, and one party filed a request for administrative review:

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  Review the services of all the representatives; and

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  Be mindful that the services of the representatives are generally interrelated, particularly when all or some of the representatives assigned direct payment of their authorized fees to the same entity or entities.

Do not, however:

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  Conduct administrative review of any unprotested fee authorization; or

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  Consider modifying any fee other than the one being protested.

1. a. 

   If the claim(s) file indicates that all parties did not receive a copy of the fee petition, then:

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     Send an interim letter similar to the one discussed in GN 03930.095B.4.;

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     Delete the portion of that letter saying we will not work on the request for 20 days;

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     Provide the parties with the opportunity to comment (See GN 03950.030B.2.); and

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     Because of Privacy Act considerations, ensure that the personal information (e.g., mailing address or Social Security number (SSN)) of the claimant, any auxiliary beneficiary, or eligible spouse is redacted from the copy of the notice sent to any other party except the representative.

2. b. 

   If the claim(s) file indicates that all parties did not receive a copy of the initial fee authorization, then:

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     Send a copy of the initial fee authorization with the acknowledgment letter explaining that it appears we did not previously send a copy;

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     Provide the parties with the opportunity to comment. (See GN 03950.030B.2.); and

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     Because of Privacy Act considerations, ensure that the personal information (e.g., mailing address or SSN) of the claimant, any auxiliary beneficiary, or eligible spouse is redacted from the copy of the notice sent to any other party except the representative.

If there is an indication that the representative charged, received, or collected money from the claimant in excess of the amount we authorized, then:

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  Ask the representative for more information about the disposition of the funds in the acknowledgment or interim letter (do not ask for a refund until the issue is resolved);

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  Resolve the issue in the administrative review determination;

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  Notify the representative that the representative must immediately refund to the claimant any funds collected. If the representative collected the excess funds personally, notify them that failure to refund the excess fee may result in a referral to the Office of the General Counsel for administrative sanctions (see GN 03970.017); and

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  Notify the claimant that they should inform us if the representative does not refund the excess funds.

If you receive a request for administrative review in a case where we did not withhold a portion of the claimant's past-due benefits for the eligible representative’s fee, or prematurely released the withheld benefits without certifying direct payment to the eligible representative or eligible entity based on a valid assignment, the representative may also report that they have been unable to collect the authorized fee from the claimant. In these circumstances, the representative is both requesting administrative review of the fee authorized and notifying us that they have been unable to collect the initially authorized fee.

In such situations:

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  Use additional language when sending the acknowledgment letters to the representative and the claimant. (See Model Acknowledgment Letters AF-2 and AF-3 at GN 03950.055B.);

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  Conduct the administrative review;

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  Direct the benefit authorizer (BA) to certify direct payment of the fee decided on administrative review to the representative or entity if there is a valid assignment as per GN 03920.021 (limited to the amount of the past-due benefits that should have been withheld or the amount of the authorized and unpaid fee, whichever is smaller); and

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  Ask the BA to establish an overpayment in the amount that should have been withheld or the amount of the authorized and unpaid fee, whichever is smaller, and initiate recovery, following the instructions in GN 03920.055C.

For more information on failure to withhold policy, see GN 03920.055.

1. a. 

   Because we usually release the remaining withheld past-due benefits to the claimant and any auxiliary beneficiary or eligible spouse after paying the eligible representative or entity the initial authorized fee, you must add special instructions to the decision letter if you increase a fee on administrative review.

   EXCEPTION: We continue to withhold past-due benefits if there may be additional fees awarded by a Federal court under§206(b) of the Act. For additional information about fees authorized by a Federal court, see GN 03920.060.  

2. b. 

   When we properly released the remaining past-due benefits after paying the initial authorized fee, tell the claimant, any auxiliary beneficiary or eligible spouse, and the eligible representative or other authorized individual (see GN 03930.020A) in the decision letter that:

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     The increase in the fee is a matter between the parties; but

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     The eligible representative should contact us if they are unable to collect the authorized fee from the claimant, any auxiliary beneficiary, or eligible spouse. We will certify direct payment of the fee to the extent of the remaining past-due benefits or the amount of the authorized and unpaid fee, whichever is smaller.

   Because of Privacy Act considerations, ensure that the personal information (e.g., mailing address or SSN) of the claimant, any auxiliary beneficiary, or eligible spouse is redacted from the copy of the notice sent to any other party except the representative.

3. c. 

   If the eligible representative reports that they are unable to collect the authorized fee from the claimant:

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     Direct the BA to certify direct payment of the increased fee to the eligible representative or entity if there is a valid assignment as per GN 03920.021 (in the amount of remaining past-due benefits released after the initial fee payment or the amount of the authorized and unpaid fee, whichever is smaller, subject to the 25 percent direct pay limitation); and

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     Ask the BA to establish an overpayment corresponding to the amount directly paid (up to 25 percent) and initiate recovery, following the instructions in GN 03920.055C.

   EXCEPTION: Do not certify direct payment of the increased fee to the eligible representative, or entity if there is a valid assignment, if the request for administrative review was untimely filed (even if good cause was established as described in GN 03950.025).

1. a. 

   Examine the authorization to identify the regulatory factors (e.g., the time spent and services performed by the representative; the results achieved by the representative; and the level at which the representative entered the case), rationale, and conclusions reached.

   NOTE: We use Form SSA-1178 (Evaluation of Fee Petition for Representation) to document the initial fee authorization and reflect how the fee authorizer arrived at the authorized fee in cases decided below the hearing level.

2. b. 

   Identify what issues, if any, pertinent to the representative's services had a bearing on the conclusion and decide if these issues have been resolved fully.

3. c. 

   Obtain further clarification from the parties if the prior conclusions critical to the authorization are based on assumptions not supported by evidence in the claim(s) file.