The fee authorizer must consider the purpose of the program. For Title II, the purpose is to provide a measure of economic security for program beneficiaries. For Title XVI, the purpose is to assure a minimum level of income for supplemental security income recipients who otherwise do not have sufficient income and resources to maintain a standard of living at the established Federal minimum income level.

Depending on the circumstances in the case, the fee authorizer will consider the extent and type of the representative's services, including whether the representative:

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  Researched relevant law or rulings.

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  Was diligent in obtaining the necessary medical evidence, such as searching old records to obtain the evidence.

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  Arranged a medical examination.

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  Submitted medical or lay evidence of disability or other factors of entitlement or eligibility.

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  Contacted the Social Security Administration (SSA) as needed about the status of the claim.

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  Prepared for and participated at the hearing.

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  Promoted timely decision making or acted in a way that delayed the issuance of the decision without justification.

Examples:

1. 1) 

   A representative submitted a copy of a hospital report that served as the primary basis for the administrative law judge (ALJ) finding the claimant disabled.

2. 2) 

   A representative submitted a copy of medical evidence the representative had used successfully in a recent workers' compensation claim to support the claim for a period of disability and disability insurance benefits. The representative provided SSA with readily available evidence we may not have had. However, the submission of new medical evidence relating to the period before insured status expired would have been a far more valuable service.

The fee authorizer will evaluate the complexity of the case based on the work or documentation needed to resolve the issues. The fee authorizer should not underestimate complexity because of the representative's presumed knowledge or experience as a representative.

Example: A representative contacted numerous sources for information used to establish the claimant's date of birth, a task of some complexity.

The fee authorizer will consider the issues involved and the actions the representative took to resolve them. The fee authorizer will consider whether the representative supported each contention with evidence, whether the representative complied with SSA's rules and policies and applied them correctly and effectively during representation. The fee authorizer should not base the assessment on what the fee authorizer would have done or on what the representative could have theoretically done.

Example: One representative submitted a copy of the evidence the representative used in the claimant's workers' compensation claim but did not submit a brief. A representative in another case scheduled a medical examination and submitted the results for evaluation, along with other new evidence showing the claimant's condition and a brief explaining how the results of the evaluation show the severity of the claimant's impairments. The representative's actions in the second case demonstrate greater skill and competence.

The fee authorizer will credit only the time spent on representation services before SSA (e.g., one hour to arrange a medical appointment), unless the time seems exaggerated or excessive (e.g., 20 hours to research a routine issue when the fee authorizer knows the representative regularly handles social security claims).

Refer to HALLEX HA 01120.057 B. below for time to exclude.

The fee authorizer will consider the results achieved along with all the other factors.

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  The fee authorizer will not permit this factor to completely override the others. For example, if SSA made a favorable determination on one claim and an unfavorable determination on another claim, but the representative provided similar services on both claims, the fee authorizer must not disregard the other factors and authorize the fee amount the representative requests in the first, but authorize no fee in the second, simply because of the outcome.

  EXCEPTION: 

  If the representative and claimant entered into a contingency contract, which provided that there will be no fee if the claim is not favorably decided, SSA will honor that provision. In such a case, SSA will not authorize any fee for services if the representative submits a petition.

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  The fee authorizer will not authorize the fee primarily on the basis of the amount of benefits awarded (or lack thereof); the benefit amount payable is unrelated to the extent or caliber of services the representative provided.

Example An assessment of the client's description of symptoms prompted the representative to develop evidence of a medical condition the field office and Disability Determination Services had overlooked. This established the claimant's entitlement to disability insurance benefits. When evaluating, the fee authorizer will credit the favorable results the representative achieved. The fee authorizer will also credit the representative's demonstrated skill and competence in a case complicated by the claimant stressing the symptoms of a medical condition that alone was not disabling.

The fee authorizer will consider the level in the administrative process at which the representation began, as well as the level to which the representative pursued the case.

The fee authorizer will consider the amount the representative requested, including any amount previously authorized and apply all of the factors listed above in conjunction with the excluded items identified in HALLEX HA 01120.057 B. below. After considering these factors, if the fee the representative requested is reasonable for the services provided, the fee authorizer will authorize a fee in the amount requested. The fee authorizer may authorize a fee in a greater or lesser amount than that requested, providing it is reasonable. When a claimant or any auxiliary beneficiary is liable for the fee or part of the fee for representational services, the fee authorizer must authorize the total fee, so the fee authorizer must consider any amounts previously authorized in their authorization of the total fee.

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  The fee authorizer will complete the Form SSA-1178 fields (Evaluation of Fee Petition for Representation) (refer to POMS GN 03905.080) to document the rationale for setting the fee. The fee authorizer will use this form to show the amount of the fee that is found to be reasonable, and to explain and document the rationale. The rationale must reflect how the fee was set using the factors in HALLEX HA 01120.057 A.1. through A.8. above.

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  If the amount of the fee the fee authorizer believes is reasonable is $15,000 or less, file the SSA-1178 in the hearing office file when the SSA-1560A or other fee authorization document is distributed. (See HALLEX for procedures on processing the SSA-1560A.)

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  If the amount of the fee the fee authorizer believes is reasonable exceeds $15,000, the fee authorizer will send the recommendation to the authorizing official with the SSA-1560A or other fee authorization document. Refer to HA 01120.006 B.2 to determine the designated authorizing official.

OHO staff will complete the Fee Petition Screen in HACPS to document the rationale for setting the fee. The Fee Petition Screen replaces Form SSA-1178 (Evaluation of Fee Petition for Representation). OHO staff will use the Fee Petition Screen to show the amount of the fee you find reasonable and to explain and document your rationale. OAO staff will complete this information using the SSA-1178 template in OAOCPS. The rationale must reflect how staff set the fee using the factors in A.1. through A.8.

OHO staff will follow the additional instructions below for hearing level cases:

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  If the amount of the fee believed reasonable is $15,000 or less, OHO staff will create the Authorization to Charge and Collect a Fee (e.g., SSA-1560A) based on the selections made on the Fee Petition Screen.

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  If the amount of the fee the fee authorizer believes is reasonable exceeds $15,000, OHO staff will alert the authorizing official that the recommendation is pending in the HACPS Fee Petition Screen. OHO staff will refer to HA 01120.006 B.2. to determine the designated authorizing official.