Take the following actions if you receive a request for administrative review under the fee agreement process. (See 2. below for handling telephone inquiries.)

1. a. 

   Date stamp the request.

2. b. 

   Obtain a written explanation for untimely filing, if the party requests administrative review in person more than 15 days after the date he/she received notice of either a disapproved agreement or a determination of the amount of the fee. (This applies in a face-to-face interview or a telephone interview preceding receipt of the written request for administrative review.)

3. c. 

   If SSA is withholding title II past-due benefits for possible direct payment to an attorney representative, call the PC module to prevent premature release. (The PC takes the actions in GN 03960.020.)

4. d. 

   Acknowledge receipt. (See model notices in GN 03960.075.)

5. e. 

   Route the request directly to the reviewing component with a copy of your acknowledgment and the claim(s) file, if available. Also, send a copy of the request to the AFB (for reporting purposes).

6. f. 

   For title II purposes, enter a special message to the master beneficiary record (MBR) data, following the procedure in MSOM T2PE 007.008: “[Date - mm/yy] -Request for administrative review of fee agreement [disapproval or amount] filed by [claimant, affected auxiliary beneficiary, representative, or decision maker] .” For title XVI purposes, enter a remark to the Supplemental Security Record (SSR), following the procedure in SM 01301.841: “[Date - mm/yy ]- Request for administrative review of fee agreement [ disapproval or amount]filed by [claimant, representative, or decision maker].”

If the Teleservice Center (TSC) or other SSA office receives an oral inquiry, take the following action once you determine the caller is requesting administrative review of the disapproval of a fee agreement or fee amount determination:

1. a. 

   Ask the caller his/her reason(s) for requesting administrative review and complete a Form SSA-795 (Statement by Claimant or Other Person) with the explanation (see sample at GN 03960.095).

2. b. 

   Tell the caller that you will send him/her a statement to review and sign.

3. c. 

   Advise the caller that the request for administrative review must be in writing and to immediately sign and return the statement in the envelope provided.

4. d. 

   Explain to the caller that he/she must include a late filing explanation on the SSA-795 statement, if he/she does not request review timely, i.e., the caller requests review more than 15-days after receiving notice of the fee agreement disapproval or notice of the fee amount determination.

5. e. 

   Place the TSC or other office code and the date of the call in the upper right corner of the SSA-795.

6. f. 

   Send the SSA-795 to the caller with a courtesy return envelope addressed to:

   SSA, Office of Appellate Operations
   
   Attn: Attorney Fee Branch
   
   Suite 805, Skyline
   
   5107 Leesburg Pike
   
   Falls Church, Virginia 22041-3255

If you receive a request for administrative review under the fee agreement process and your office is not responsible for conducting the review, follow 1. a., c., d., e. and, if possible, f. above. If you are in a PC and your PC has jurisdiction for the claim(s) file, also take the actions in GN 03960.020.