GN 03930.034:
Title XVI Only – Fee Petitions - Notifying the Representative, the Claimant and Spouse
Effective Dates: 07/16/2012 - Present- Effective Dates: 04/04/2018 - Present
- TN 8 (02-05)
- GN 03930.034 Title XVI Only – Fee Petitions - Notifying the Representative, the Claimant and Spouse
- A. Introduction
- The claims representative (CR) uses a Document Processing System (DPS) notice when paying representative fees authorized based on a fee petition. Fee notices are in the “General” notices section of DPS, under “Fee Petitions.” They have a TSMXXX identifying code.
- B. Process - Petition Before Award
- The claims representative (CR), claims authorizer (CA), claims technical examiner (CTE), or processing center (PC) fee reviewer designates appropriate paragraphs.
- C. Process - Fee Authorized After Award
- The responsibility for notifying the claimant and the representative of the amount of the fee SSA authorizes the representative to charge depends on who authorizes the fee. The field office is responsible for paying a fee to a representative who is eligible for direct payment and for notifying the claimant and representative about the direct payment.
- 1. Services Below the Hearing Level
- The PC authorizes fees based on fee petitions for cases decided at the initial and reconsideration levels. When the PC authorizes the fee or proposes (consistent with GN 03920.015B.) to authorize a fee of more than $10,000:
- * The fee reviewer instructs the BA/BTE on notice language for initial fee awards.
- * The Senior Claims Processing Specialist in the program service centers, the Disability Specialist in the Office of Disability Operations and the fee reviewer in the Office of International Operations explain in the notice administrative review and how the representative should collect the fee or fee increase.
- * When SSA makes direct payment to the representative, the CR notifies the claimant and the representative of the amount paid to the representative from past-due benefits and about the assessment made for direct payment. Use TSM104 in DPS to notify the claimant and the representative when SSA makes direct payment to the representative.
- 2. Services at or Above the Hearing Level
The Office of Disability Adjudication and Review (ODAR) authorizes the fee for cases decided at the hearing or request for review levels. The court authorizes the fee for services the claimant’s attorney provided before the court.- Office of Hearings Operations (OHO) or the Office of Appelate Operation (OAO) authorizes the fee for cases decided at the hearing or request for review levels. The court authorizes the fee for services the claimant’s attorney provided before the court.
- a. Notice to Representative
* ODAR notifies the representative of the authorized fee and the method of payment using Form SSA-1560A-U5.- * The fee decision maker notifies the representative of the authorized fee and the method of payment using Form SSA-1560A-U5.
- * The court order provides the representative with the necessary notice.
- b. Notice to Claimant and Eligible Spouse
- SSA notifies the claimant, the claimant’s eligible spouse if SSA uses his/her past-due benefits to pay the representative, and the representative when releasing the claimant’s withheld title XVI past-due benefits. The CR prepares the notice(s) when SSA makes direct fee payment. Use TSM104 in DPS to notify the claimant and the representative when SSA makes direct payment to the representative.
- After SSA makes direct fee payment, notification to the claimant and representative about the disposition of any additional withheld past-due benefits (e.g., SSA releases balance of withheld past-due benefits to claimant) is generally done by an automated notice.
- 3. SSA Failed to Withhold Benefits
- Additional notice language is required if SSA failed to withhold or prematurely released past-due benefits.
- * Refer to the instructions in GN 03920.055.
- * In court cases, the CR contacts the Office of the General Counsel (OGC) to resolve the situation (see GN 03930.180 for the OGC contact list).
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