Effective Dates: 12/19/2024 - Present Previous | Next

TN 13 (12-24)

GN 03960.005 Responsibility for Conducting Administrative Review Under the Fee Agreement Process - Jurisdiction

A. Policy - Favorable Determination Below the Hearing Level

In all cases favorably decided below the hearing level, responsibility for conducting administrative review is the same under both the fee agreement and the fee petition processes. See GN 03930.015A.2; GN 03950.005B.1.; and, if necessary, GN 01050.055 for Processing Center (PC) jurisdiction. PCs include the Program Service Centers (PSCs) and the Office of Central Operations (OCO).

The chart below shows those employees delegated authority to conduct administrative review in all cases decided below the hearing level, including Title XVI only cases.

COMPONENT REVIEWER
PSC Claims Technical Expert (CTE), Senior Case Processing Specialist (SCPS), or other individual in an equivalent position designated by the PSC
ODO Disability Specialist in the Special Appeals and Class Action Section
OIO Reconsideration Reviewer

The Assistant Regional Commissioners for Processing Center Operations (ARC-PCO) in the PSCs and the Director of the OCO may delegate authority to others in equivalent positions, as necessary.

B. Policy - Favorable Decision at or Above the Hearing Level

In cases favorably decided at or above the hearing level, responsibility for conducting administrative review varies depending on the issue for review.

1. Review of the Fee Agreement Determination

When conducting administrative review of an approval or disapproval of the fee agreement, the identity of the initial decision maker controls who has authority to conduct the administrative review. The chart below shows those delegated authority to conduct administrative review in cases decided at or above the hearing level, including Title XVI only cases.

 

NOTE: The reviewer must not be the same individual who made the initial decision.  

DECISION MAKER REVIEWER
Attorney adviser, administrative law judge (ALJ), or hearing office chief administrative law judge (HOCALJ) Regional Chief (RCALJ) or assistant RCALJ
RCALJ or assistant RCALJ Deputy Chief ALJ (DCALJ)
Deputy Chief ALJ, administrative appeals judge (AAJ) Chief ALJ
Administrative appeals judge (AAJ) Office of Appellate Operations (OAO) Deputy Executive Director or designee
OAO Deputy Executive Director or designee OAO Executive Director or designee

2. Review of the Fee Amount

When the issue for administrative review is the amount of the fee under the fee agreement process, the identity of the requester controls who has authority to conduct the review.

  1. a. 

    Hearing Level

    Individual Requesting Review of the Fee Amount

    Reviewing Official

    Claimant, affected auxiliary beneficiary, eligible spouse, or representative

    Decision maker (Hearing Office Chief Administrative Law Judge (HOCALJ), ALJ, or attorney advisor) who issued the favorable decision

    Decision maker

    RCALJ or assistant RCALJ with jurisdiction over the decision maker's hearing office

    RCALJ or assistant RCALJ

    Deputy Chief ALJ or Chief ALJ

    Claimant, affected auxiliary beneficiary, eligible spouse, or representative AND Decision maker

    RCALJ or assistant RCALJ with jurisdiction over the decision maker's hearing office OR in National Hearing Center (NHC) cases, the RCALJ or assistant RCALJ with jurisdiction over the hearing office that transferred the case to the NHC

  2. b. 

    Appeals Council Level

    Individual Requesting Review of the Fee Amount

    Reviewing Official

    Claimant, affected auxiliary beneficiary, eligible spouse, or representative

    OAO Deputy Executive Director or designee

    AAJ

    OAO Deputy Executive Director or designee

    OAO Deputy Executive Director or designee

    OAO Executive Director or designee

 

To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0203960005
GN 03960.005 - Responsibility for Conducting Administrative Review Under the Fee Agreement Process - Jurisdiction - 12/19/2024
Batch run: 12/19/2024
Rev:12/19/2024