GN 03940: Fee Authorization Under the Fee Agreement Process
TN 17 (03-05)
A. Policy - Notice of Determination on the Fee Agreement
When SSA makes a favorable decision on a claim involving a fee agreement, SSA will notify the claimant and the representative about the determination on the agreement.
If the decision maker disapproves the fee agreement, the notice also must advise the parties of the right to request administrative review of the determination.
B. Policy - Notice of the Authorized Fee Amount
SSA will authorize the amount of the fee that results from the approved fee agreement and notify the recipients identified in GN 03940.008A. of the following:
the past-due benefits amount (see GN 03940.007, Fee Agreements – Title XVI Past-Due Benefits);
the amount of the past-due benefits payable to the claimant, any auxiliary beneficiary(ies), and/or an eligible spouse;
the amount of the fee resulting from the fee agreement; and
the right to request administrative review of the amount of the fee within 15 days of receiving the notice.
C. Policy - Notice Recipients
The Act requires SSA to send the notice in GN 03940.008B. to the:
claimant,
any affected auxiliary beneficiary(ies) or eligible spouse, and
the appointed representative.
See GN 03910.040D for policy on notices in multiple representative situations.
If the claimant is mentally incapable of managing his/her funds, SSA issues the above notice to the representative payee, thereby protecting the claimant's right to request administrative review. See GN 03940.037 and GN 03940.051 for further instructions regarding processing claims involving mental capability.
Where the claimant dies before SSA issues a favorable decision, the claimant or representative had submitted a valid fee agreement, and the decision maker approves that fee agreement, SSA will send the notice described in GN 03940.008A. and GN 03940.008B. to the parties, including the survivors or estate of the deceased. Refer to GN 03940.009B. for fee payment policy. When there is a title XVI underpayment, refer to SI 02101.003, SSI Underpayment Due - Individual Deceased – General.
When a claimant or representative dies after SSA issues a favorable decision, refer to GN 03940.009B.
The decision maker may request a copy of the notice or ask that the field office (FO) or processing center (PC) notify him/her by e-mail when the FO/PC processes the favorable decision and authorizes the fee amount, if he/she believes a request for administrative review may be appropriate. An Office of Disability Adjudication and Review decision maker will put a flag on the claim file to request that the FO/PC notify him/her by e-mail when the fee is authorized.
NOTE: Although a representative who was discharged by the claimant may file a fee petition to receive payment for his/her services on the claim, SSA may not release a copy of the claimant's notice of favorable decision to a discharged representative without the claimant's written consent.