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

TN 13 (12-24)

GN 03960.030 Administrative Review of the Fee Agreement Determination

A. Policy

1. Parties to the Determination

Parties to the fee agreement determination are the parties who signed the agreement. These parties include:

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    The claimant; and

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    The representative, as well as any co-representative who signed the fee agreement.

NOTE: An entity is not a party to a fee agreement even where an appointed representative validly assigned direct payment of a fee to that entity. As such, the entity and its point of contact (POC) generally do not have the right to file for administrative review under the fee agreement process and only the assigning representative may request administrative review. However, if a representative who has validly assigned direct payment of any authorized fees dies, and at least one other representative remains active on the claim (see GN 03940.003D6), or the representative died after the agreement was approved and an initial fee was authorized, the entity’s POC may request administrative review under the fee agreement process. The POC must provide proof of the representative’s death (e.g., a copy or screenshot of an obituary) when filing the request for review. For more information about the assignment of direct payment of fees, including the roles and responsibilities of a POC, see GN 03920.021. If the representative did not assign direct payment of their fee before dying, the executor or other legal representative of the deceased representative's estate may request administrative review.

2. Informing the Parties of the Request

When a proper party files a request for administrative review of the fee agreement determination, we must:

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    Notify each other party and the decision maker of the request; and

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    Give them the opportunity to respond to the request in writing within 15 days.

(See GN 03960.035B.4. for the procedure.)

3. Review of the Determination

When deciding whether to affirm or reverse the decision maker's determination on the fee agreement, we will consider the fee agreement, the fee agreement determination, the request for administrative review, and any additional information provided.

B. Procedure - Notice of Determination on Administrative Review

Handle the notice as follows:

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    Send written notice of the determination made on administrative review to the claimant and the representative at their addresses of record;

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    Advise the parties that the determination is not subject to further review; and

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    Send a copy of the notice, or an email notification that the notice is available in the Online Retrieval System (ORS), to the decision maker.

(See GN 03960.037B.2. for the procedure.)

If a PC has jurisdiction for review, have the notice of determination signed by the official listed in GN 03960.070A.2.

NOTE: When sending notices, include only the information the party is entitled to receive. Claimants are entitled to only certain information about auxiliary beneficiaries. See GN 03316.105. Likewise, auxiliary beneficiaries should only receive certain information about the claimant. Notices sent to auxiliary beneficiaries must adhere to the policies articulated in GN 03316.110.

 

To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0203960030
GN 03960.030 - Administrative Review of the Fee Agreement Determination - 12/19/2024
Batch run: 12/19/2024
Rev:12/19/2024