GN 03950.010: Requesting Administrative Review and Preliminary Actions - Fee Petition Process

changes
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~~Effective Dates: 07/16/2012 - Present~~
Effective Dates: 04/06/2018 - Present
BASIC (03-95)
GN 03950.010 Requesting Administrative Review and Preliminary Actions - Fee Petition Process
A. Policy
SSA sends notice of an initial fee authorization to the parties on Form SSA-1560A-U5 (Authorization to Charge and Collect a Fee). The notice tells the parties that if they disagree with the fee authorization they may file a written request for administrative review within 30 days after the date of the notice.
SSA reviews the fee authorization if a proper party files a written request with one of SSA's offices within 30 calendar days after the date of the notice of an initial fee authorization.
1. Inquiry or Request for Administrative Review
An individual may write to SSA and ask questions about the fee that was authorized. SSA must not confuse a request for more information with a request for administrative review. For example, an inquiry from a representative may challenge the amount authorized but clearly shows that the representative does not understand the fee authorization process. When there is doubt whether the correspondence constitutes a request for administrative review, the office charged with responsibility for conducting the administrative review must contact the author of the correspondence and obtain a clarification (see GN 03950.015B.1.).
2. Proper Party to File Request
Only a proper party, i.e., a party who is affected by SSA's initial fee authorization, may request an administrative review.
Parties to a fee authorization are:
* a representative(s);
* a claimant(s); and
* an auxiliary beneficiary(ies) who is responsible for paying the representative's authorized fee.
A party who files a request for administrative review must mail a copy of the request to the other parties to the initial fee authorization.
3. Elements of a Request
A request for administrative review must:
* be in writing; and
* clearly express an intent to request review of an initial fee authorization.
4. Time Limit for Filing a Request
A party must file a request for administrative review within 30 days after the date of the notice of SSA's initial fee authorization.
If the party files a request for administrative review more than 30 days after the date of the notice, the party must explain in writing why the review was not filed on time.
In those cases, SSA will conduct an administrative review only if it determines that there was good cause for not filing the request on time. The reviewing office will determine whether there was good cause for late filing (see GN 03950.020).
5. Where a Request Is Filed
A party may send a request for administrative review to:
* the PC or ODAR office whose address is shown on the SSA-1560A-U5; or
* the PC or OHO office whose address is shown on the SSA-1560A-U5; or
* any SSA office.
B. Procedure - Other than the Reviewing Office
If an office other than a reviewing office receives a request for administrative review:
* date stamp the request;
* acknowledge receipt and advise the requester that his/her request was sent to the office with jurisdiction; and
* send the request to the PC or ODAR office with jurisdiction to conduct the administrative review with a copy of the acknowledgment letter and the claim(s) file, if available.
* send the request to the PC or OHO office with jurisdiction to conduct the administrative review with a copy of the acknowledgment letter and the claim(s) file, if available.
C. PROCEDURE - WHO RECEIVES REQUEST
1. Field Office (FO) Receives Request
Take the following actions if the FO receives a request for administrative review under the fee petition process:
* Date stamp the request.
* Obtain a written explanation for untimely filing if the party requests administrative review in person more than 30 days after the date of the notice of the fee authorization. (See GN 03950.020 for examples of good cause.) Make the request in face-to-face interviews, or a telephone interview preceding receipt of the written request for administrative review. (See 2. below for handling telephone inquiries.)
* Acknowledge receipt. (See GN 03950.055 for model letters.)
* Send the request directly to the reviewing office with a copy of the acknowledgment letter and the claim(s) file, if available.
2. SSA Receives Oral Request
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 under the fee petition process:
* Ask the caller for his/her reason(s) for requesting administrative review and complete a Form SSA-795 with the explanation. (See Exhibit at GN 03950.070.)
* Tell the caller that you will send him/her a statement to review and sign.
* 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.
* Additionally, if the caller does not request review timely, i.e., requests review more than 30 days after the date of the notice of the initial fee authorization, tell the caller to include a late filing explanation on the SSA-795 statement.
* Place the TSC or other office code and the date of the call in the upper right corner of the SSA-795.
* Send the SSA-795 to the caller with a courtesy return envelope addressed to the reviewing office. (See GN 03950.005 for PC jurisdiction cases and below for ODAR jurisdiction cases.)
* Send the SSA-795 to the caller with a courtesy return envelope addressed to the reviewing office. (See GN 03950.005 for PC jurisdiction cases and below for OHO jurisdiction cases.)
~~3. Determining Address of ODAR Reviewing Official~~
3. Determining Address of OAO Reviewing Official
~~To determine the address of the ODAR reviewing official, proceed as follows:~~
To determine the address of the OAO reviewing official, proceed as follows:
* ask the caller to read the name and address of the reviewing official listed on the fee authorization document.
If unavailable, ask the caller who issued the most recent final favorable determination or decision or took the last unfavorable action on his/her claim.
If unavailable, obtain an ODAR case control query (OHAQ) summary and determine who issued the most recent final favorable determination or decision or took the last unfavorable action in the caller's claim.
If unavailable, obtain an OAO case control query (OHAQ) summary and determine who issued the most recent final favorable determination or decision or took the last unfavorable action in the caller's claim.
* if an ALJ issued the most recent final favorable decision or took the last unfavorable action use the "HO1" field to determine the claimant's servicing HO;
* refer to the chart in GN 03950.075 to determine the address of the RCALJ with jurisdiction over this HO and place this address on the courtesy envelope;
* if an Administrative Appeals Judge issued the most recent final favorable decision or took the last unfavorable action, place the following address on the courtesy envelope:
* Deputy Chair, Appeals Council THROUGH: Attorney Fee Branch Suite 805 Skyline 5107 Leesburg Pike Falls Church, Virginia 22041-3255
4. PC or Other SSA Office Receives Request
If you receive a request for administrative review under the fee petition process and your office is not responsible for conducting the review, follow 1. above. If you are in a PC and your PC has jurisdiction for the claim(s) file also follow 1. above and take the actions described in GN 03950.015.
D. REFERENCES
* Jurisdiction when a PC issued the initial fee authorization, GN 03950.005B.1.
* Jurisdiction when ODAR issued the initial fee authorization, GN 03950.005B.3.
* Jurisdiction when OHO issued the initial fee authorization, GN 03950.005B.3.
* PC Jurisdiction, GN 01050.055 ff.

POMS Reference

GN 03950.010: Requesting Administrative Review and Preliminary Actions - Fee Petition Process