TN 8 (02-05)

A. Procedure - case decided below hearing level

The benefit authorizer (BA), benefit technical examiner (BTE), senior claims processing specialist (SCPS), or other position designated in the processing center (PC) in a title II or concurrent title II and title XVI claims, or the claims representative (CR) in a title XVI only claim is responsible for taking these actions.

1. Determine if SSA has received petition

When the 60-day diary matures:

• review the file to determine if a petition, authorization, or request for extension of filing has been received; and

• review PCACS (Processing Center Action Control System), the MBR (Master Beneficiary Record), the PHUS (Payment History Update System), the SSR (Supplemental Security Record) and/or the SPS (Single Payment System) for any information regarding the petition and authorization (possible payment to the representative). On SPS, PICS SA – SZ identify payments made to representatives from title II; direct fee payments paid from title XVI past-due benefits do not have a PIC.

If SSA has not received a fee petition from the representative, proceed to GN 03930.090A.2.

2. Consider whether services have ended

• Verify that the full 60-day period has elapsed since all adjudicative actions were completed.

• Consider whether there are outstanding issues that indicate the representative’s services in the case have not ended. If the representative’s services are not ended, diary the case (PCACS diary in the PC) for the time you estimate resolution will require. Continue withholding and do not proceed to GN 03930.090B.1. (See GN 03910.060, When a Representative’s Authority Expires.)

NOTE 1: Extend the diary period (PCACS diary in the PC) if an eligible title XVI spouse’s benefits or protected auxiliary awards are processed subsequent to the number holder/eligible individual’s claim (allow 60 days from the date of notice on the spouse or auxiliary claim). (See GN 03920.030, Representative’s Fee – Title II Past-Due Benefits, and GN 03920.031, Representative’s Fee – Title XVI Past-Due Benefits.)

NOTE 2: For claims processed in the PC, the position assigned to perform specific functions may vary among the PCs.

B. Procedure - case decided below hearing level and SSA has not received fee petition

The BA, BTE, SCPS, or other position designated in the PC in a title II or concurrent title II and title XVI claims, or the claims representative (CR) in a title XVI only claim is responsible for taking these actions.

1. Send 20-day notice

If there are no outstanding issues, take the following actions:

1. Prepare a letter to the representative and send a copy to the claimant. (You may use E3808, found in NL 00703.808. For title XVI cases, use TSM103 in the Distributed Online Correspondence System.) Ask the representative to file, within 20 days, a fee petition or a written request for an extension of time if he/she intends to charge a fee, or to notify us if he/she is waiving the fee.

   Also, advise the representative that:

   • SSA will release any withheld past-due benefits to the claimant if no petition or request for extension is received within the 20-day period;

   • the release of withheld benefits does not relieve the representative of the responsibility to petition if he/she later decides to charge a fee; and

   • attempting to collect a fee without obtaining SSA’s authorization could place him/her in violation of section 206(a) and/or section 1631(d)(2) of the Social Security Act (42 U.S.C. 406(a) and/or 1383) and the regulations.

     NOTE: In concurrent title II and title XVI claims on which SSA has withheld title XVI past-due benefits, revise E3808 to include the reference to 1631(d)(2) and 1383, as given in the bullet above. See TSM103 in DPS for a title XVI notice.

2. Unless the representative is known to maintain a supply of Form SSA-1560-U4 or to obtain the form via the internet, enclose a Form SSA-1560 (Petition For Authorization To Charge And Collect A Fee For Services Before The Social Security Administration) with the representative’s letter.

3. Diary for 30 days for return to a CA or CR. In the Office of Central Operations (OCO), the BTE prepares a 30-day PCACS dairy related to the existing “ATFEE FEEPAY” action control record (ACR) and routes the claims file to the development holding file (DHF PAY) for return to a CTE.

4. In the PC, refer the matter to the Special Case Review Analyst (SCRA) in the Security and Integrity section (or other employee position designated by your PC) to develop any possible violation of section 206(a) or 1631(d)(2) of the Act if, during this development, information reveals that the representative charged a fee without authorization. In the FO, refer to GN 03970.017, Referrals of Suspected Fee Violations, Possible Fee Violations, and Non-Fee Violations by the Field Office, the Program Service Center and the Disability Determination Services.

2. Diary matures or reply received

When the reply is received or the diary matures, take the following action(s):

• If the representative filed a fee petition, and the petition is received in the FO, forward the petition to the PC. (In the PC, the CA/CTE follows GN 03930.095 through GN 03930.105 to evaluate services and determine a reasonable fee.)

• If the representative filed a request for an extension of time, proceed to GN 03930.090B.3.

• If the representative filed a waiver of the fee or direct payment, refer the title II case to the BA/BTE to release the withheld title II past-due benefits via MACADE (special entry EA). Refer the title XVI case to the CR to close out the FEE PETITION issue and remove the U TAC.

• If the representative has not filed a fee petition or otherwise complied with SSA’s instructions, refer the title II case to the BA/BTE to release the withheld past-due benefits via MACADE (special entry EA). Refer the title XVI case to the CR to close out the FEE PETITION issue on the MSSICS DW01 and remove the U TAC from the SSR. In title II cases, provide instructions to send the representative a copy of the beneficiary notice. (You may use E3818, found in NL 00703.818.) In title XVI cases, the system automatically issues a notice to the claimant with a copy to the representative.

3. Representative requests extension

If the representative filed a request for an extension of time within which to petition, take the following actions:

a. Consider the reasons given

Consider the reasons given, remembering that:

• the representative should not petition for a fee until he/she has completed providing services for the claimant and any auxiliary beneficiary(ies) or spouse;

• the representative may request and receive more than one extension of time; and

• whether you grant an extension depends on the particular circumstances.

b. Provide written notice to the representative

Provide written notice to the representative, explaining the decision and rationale. If you decide not to grant the time the representative requested, state that he/she must file within 20 days of the date of your notice. In title II or concurrent claims, send copies to the claimant and the servicing FO.

c. Prepare a diary

In the PC, prepare a PCACS diary based on your decision. In the FO, change the follow-up date on the FEE PETITION ISSUE on the MSSICS DW01 screen.

d. Reply received or diary matures

When you receive the reply or when the diary matures, follow GN 03930.090B.2.

C. Procedure - OHO case resolved by ALJ

If the 60-day diary matures and the PC or FO has not received an Administrative Law Judge’s (ALJ’s) fee authorization, the position assigned these functions in the PC or the CR in the FO takes the following actions:

1. Obtain query

a. MBR or SSR and CPMS

Obtain a Master Beneficiary Record (MBR) query in a title II, an MBR and a Supplemental Security Income Display (SSID) query in a concurrent claim, an SSID in a title XVI claim, and an OHAQ and/or Case Processing and Management System (CPMS) information to determine whether:

• there are outstanding issues (e.g., workers’ compensation offset, a delayed auxiliary claim, or a delayed spouse’s claim ) that indicate the representative’s services in the case have not ended;

• the claimant appealed a partially favorable decision; or

• the representative has filed a fee petition, and if so, the status on that request.

b. Accessing CPMS

To access CPMS, go to http://cpms.ba.ssa.gov/cpms. (CPMS is also accessible through the “SSA Web Index Page” or the big red “I” icon on the desk top.)

• Click on “OHO - Case Processing and Management System.”

• Input the number holder’s SSN and press “Search.” If the response is “NO SSN FOUND,” then no information is available on the claim. Refer to GN 03930.090C.2.

• If the SSN is found, click on “View” to the right of the claimant’s name (select the name associated with the pertinent hearing request date) to view the General Information Summary.

• On the left side of the General Information Summary screen, click on “Representative Information” to view representative and waiver information.

• Click on “Back” and select “Representative Fee” to view the fee document summary.

For more information on how to use CPMS, see the CPMS Desk Aid for FOs, PCs & Teleservice Centers.

2. Evaluate query information

a. Petition received

If a petition has been received but a fee has not been authorized, prepare a PCACS or FO diary for an additional 30 days. In OCO, prepare a PCACS diary related to the existing ACR and route the case to the DHF PAY.

If a fee has not been authorized at the end of the 30-day period, refer to GN 03930.090C.3.

b. Fee authorized

If CPMS indicates that a fee has been authorized, request that the designated hearing office (HO) contact fax the fee authorization. Refer to the OHO Fee Contacts to determine the HO contact.

After the authorization is verified, take action to pay the fee and withhold the assessment as necessary.

• Title II – Pay the fee through the Single Payment System (SPS) and release any excess withholding to the claimant(s) via MACADE (special entry EA). Refer to SM 00834.405.

• Title XVI – Pay the fee through the SSR. See GN 03930.032 for procedures.

c. Outstanding issues

If there are any outstanding issues or an appeal is pending, diary the case for the time you estimate it will require to complete the action(s). Continue withholding, and do not proceed to GN 03930.090C.3.

3. Send an e-mail message

If the fee has not been authorized and there is no outstanding issue or appeal pending, take the following actions:

a. Send message to hearing office contact

Send an e-mail message to the designated hearing office HO contact asking whether the representative has filed a fee petition, a statement of intent to petition, or a waiver.

If you do not receive a fee authorization within 14 days, contact the OHO regional fee liaison by e-mail to resolve the fee petition issue. For the regional fee liaison contact, refer to the OHO Fee Contacts.

b. Include case specific information

Include the following information in the e-mail message.

• SUBJECT

In the SUBJECT line: DELAYED FEE AUTHORIZATION

• TEXT

In the TEXT:

• Name and Social Security number (SSN) of the wage earner;

• Date of the favorable decision;

• ALJ’s name;

• PC Paperless fax number or FO fax number to which the HO should send the fee authorization;

• Statement: “Please provide either a fee authorization or status within 14 days;” and

• Requestor’s name, job title, phone number, and component.

NOTE: In the PC, send a cc: to the module manager on all e-mails. Scan a copy of the e-mail on paperless actions. Print a copy of the e-mail and associate if the folder or paper ACR is controlling the action.

c. Send to holding file

In the PC, send the folder/Action Control Record (ACR)/paperless action to the holding file. In OCO, prepare a PCACS diary related to the existing ACR and route the case to the DHF PAY.

d. Diary

Diary the action for 14 days.

In the FO, to diary the case and document the request process, the CR takes these actions:

• Change the follow-up date for the FEE PETITION issue on the DW01 (or MDW) each time a contact is made.

• Set up a DROC in MSSICS and record and explain each follow-up action taken to get the authorized fee amount.

4. Act on HO reply - fee petition or statement of intent filed

When the reply from the HO shows that the representative filed a fee petition or statement of intent to petition, take the following actions:

a. Diary based on HO response

Do one of the following, depending on the reply:

• If the HO received a fee petition, diary the case for 30 days for receipt of the fee authorization. In OCO, prepare a PCACS diary related to the existing ACR and route the case to the DHF PAY.

• If the HO received a statement of intent to petition, diary the case for the time estimated for resolution (generally no more than 60 days).

b. Send another e-mail message if authorization not received

If the HO did not forward the fee authorization within the expected time period, send another e-mail message to the HO contact. Provide the same information listed in GN 03930.090C.3., but add “SECOND REQUEST” to the remarks. Diary the action for 14 days. In the PC, return the folder/ACR/paperless action to the holding file.

c. Contact regional fee liaison if authorization still not received

If you do not receive a fee authorization within 14 days, contact the OHO regional fee liaison by e-mail to resolve the fee petition issue. For the regional fee liaison contact, refer to the OHO Fee Contacts.

Diary the action for an additional 14 days. In the PC, return the folder/ACR/paperless action to the holding file. In OCO, prepare a PCACS diary related to the existing ACR and route the case to the DHF PAY.

d. Refer to OCALJ if regional liaison unable to resolve issue

If the OHO regional fee liaison is unable to resolve the issue, refer the matter to the Office of the Chief Administrative Law Judge (OCALJ). To do so, forward the earlier e-mail (GN 03930.090C.3.b.) to ^OHO OCALJ Delayed Atty Fee Petitions, and request status of the fee petition.

e. Diary for OCALJ response

Diary the claim for an additional 14 days. In the PC, return the folder/ACR/paperless action to the holding file. In OCO, prepare a PCACS diary related to the existing ACR and route the case to the DHF PAY. In the FO, follow the procedures in GN 03930.090C.3.d.

5. Act on HO reply - fee or direct payment waived

When the HO reply shows that the representative has waived a fee or direct payment:

• In a title II claim or concurrent title II and title XVI claims, refer the case to the BA/BTE for release of the past-due benefits withheld via MACADE (special entry EA). In concurrent claims, notify the servicing FO to release of any title XVI withheld past-due benefits.

• In a title XVI claim, release the past-due benefits to the claimant by closing out the FEE PETITION issue on the MSSICS DW01 and removing the U TAC from the SSR.

6. Act on HO reply - neither fee petition nor statement of intent filed

When the HO reply shows that the HO did not receive either a fee petition or a statement of intent to petition, take the following actions:

a. Send notice to representative

Send the representative the notice described in GN 03930.090B.1., advising that SSA will release the benefits withheld to the claimant unless the representative files either a fee petition or a written request for an extension of time within 20 days. Direct the representative to:

• File the fee petition or written request with the ALJ who decided the case. (If you use paragraph E3808 in NL 00703.808, in the #6 fill-in, insert the ALJ’s name and HO address. In title XVI only claims, advise the representative to send the petition to the FO.)

• Mail or fax a copy of his/her request to you to prevent premature release of the benefits withheld. Provide the specific component’s (paperless) fax number and address or a self-addressed envelope.

b. Diary

Diary the action for 30 days. In OCO, prepare a PCACS diary related to the existing ACR and route the case to the DHF PAY. In the FO, follow the procedures in GN 03930.090C.3.d

7. Act on HO reply - NO reply from HO

NOTE: When the procedure is to diary the case, the specific procedure for OCO is to prepare a PCACS diary related to the existing ACR and route the case to the DHF PAY.

a. Send follow-up e-mail to HO

If the HO does not reply to the e-mail request:

• Send a follow-up e-mail request to the HO. Diary the claim for an additional 7 days. In the PC, return the folder/ACR/paperless action to the holding file. In the FO, follow the procedures in GN 03930.090C.3.d.

• Refer to GN 03930.090C.4., GN 03930.090C.5. or GN 03930.090C.6 when a response is received.

b. Send e-mail to regional contact if no response received

If the HO contact does not respond to the follow-up e-mail:

• Send an e-mail request to the regional contact (as shown on the OHO Fee Petition Contact List). In the e-mail, include the HO, the HO contact’s name, and the dates of the original and follow-up e-mail requests.

• Diary the action for an additional 14 days. In the PC, return the folder/ACR/paperless action to the holding file. In the FO, follow the procedures in GN 03930.090C.3.d.

• Refer to GN 03930.090C.4., GN 03930.090C.5. or GN 03930.090C.6. when the HO or RO responds.

• Forward the e-mail request to the OCALJ at ^OHO OCALJ Delayed Atty Fee Petitions, if neither the HO nor RO responds within the 14-day period.

• Diary the action for an additional 14 days. In the PC, return the folder/ACR/paperless action to the holding file.

8. Act on representative’s response to 20-day notice sent

If you receive a response from the representative within 30 days, act based on the representative’s response:

a. Representative sends copy of fee petition

When you receive a copy of the representative’s fee petition in the PC, set a new diary for 30 days for receipt of the fee authorization. In the FO, forward the fee petition to the fee authorizer and follow the procedures in GN 03930.090C.3.d.

If you do not receive it within that time, follow GN 03930.090C.4.b.

b. Representative sends copy of request for extension of time

• When you receive a copy of the representative’s request for an extension of time, send an e-mail message to the HO fee contact asking whether the ALJ granted an extension and, if so, until what date.

• Diary for 14 days for the reply. In the PC, return the folder/ACR/paperless action to the holding file. In OCO, prepare a PCACS diary related to the existing ACR and route the case to the DHF PAY. In the FO, follow the procedures in GN 03930.090C.3.d. after forwarding the request to the fee authorizer.

• When you receive the reply, diary for the time estimated for the additional time the ALJ granted the representative, plus 30 days for receipt of the fee authorization. In the FO, follow the procedures in GN 03930.090C.3.d.

• If you do not receive it within that time, follow GN 03930.090C.4.b.

9. Act on representative’s failure to respond to 20-day notice

NOTE: When the procedure is to diary the case, the specific procedure for OCO is to prepare a PCACS diary related to the existing ACR and route the case to the DHF PAY.

If you do not receive a copy of the representative’s fee petition or request for an extension of time within 30 days, take the following actions:

a. Send e-mail to HO contact person

Send an e-mail message to the HO fee petition contact person similar to that in GN 03930.090C.3. However, modify the TEXT entry to include the following:

“(PC name) sent the 20-day notice about the need to file a fee petition to (representative’s name and address) on (date of notice). Please advise whether the representative has filed a fee petition. If the representative requested an extension of time instead, advise whether the ALJ granted an extension and, if so, until what date. If you do not confirm within 14 days that the representative responded, we will release the past-due benefits to the claimant.”

b. Diary

Diary the action for 20 days. In the FO, follow the procedures in GN 03930.090C.3.d.

c. Return to holding file

In the PC, return the folder/ACR/paperless action to the holding file.

d. Act based on reply or diary expiration

Take one or more of the following actions when you receive the reply or when the diary matures.

• If the HO reply shows that the representative did not file a fee petition or request an extension of time, in the PC, refer the case to the BA/BTE for release of the past-due benefits withheld via MACADE (special entry EA). In the FO, refer the case to the CR for release of the past-due benefits by closing out the FEE PETITION issue on the DW01 in MSSICS and removing the U TAC from the SSR.

• If the HO reply shows that the representative filed a fee petition, diary for 30 days for receipt of the fee authorization. In the PC, return the folder/ACR/paperless action to the holding file. In the FO, follow the procedures in GN 03930.090C.3.d.

• If you do not receive it within that time, follow GN 03930.090C.4.b.

• If the HO reply shows that the representative requested and the ALJ granted an extension of time, diary for the time estimated for resolution (i.e., the additional time the ALJ granted the representative), plus 30 days for receipt of the fee authorization. In the PC, return the folder/ACR/paperless action to the holding file. In the FO, follow the procedures in GN 03930.090C.3.d.

• If you do not receive it within that time, follow GN 03930.090C.4.b.

• If the HO does not reply, contact the regional office (RO) liaison listed on the OHO Fee Petition Contact List. If the RO does not respond in 14 days, send an e-mail to the OCALJ, at ^OHO OCALJ Delayed Atty Fee Petitions, and request status. Note the issuance of the 20-day letter and no response from the HO or RO.

• Following OCALJ’s confirmation of status, take the appropriate action of either referring the case to the BA/BTE in the PC or CR in the FO for release of the withheld past-due benefits or setting a diary for an appropriate follow-up. Release title II past-due benefits withheld via MACADE (special entry EA) and title XVI by closing out the FEE PETITION issue on the MSSICS DW01 and removing the U TAC from the SSR.

D. Procedure - OHO case decided by appeals council

If the 60-day diary matures and the PC or FO has not received a fee authorization, take the following actions:

NOTE 1: Each PC designates the employees/position (e.g., reconsideration reviewer) responsible for this task.

NOTE 2: When the procedure is to diary the case, the specific procedure for OCO is to prepare a PCACS diary related to the existing ACR and route the case to the DHF PAY.

1. Obtain query

Obtain an MBR query, SSID, CPMS information and/or an OHO summary query (select function 17 on the SSA Menu) to determine whether:

• there are outstanding issues (e.g., workers’ compensation offset or a delayed auxiliary or spouse claim) that indicate the representative’s services in the case have not ended; or

• the claimant appealed a partially favorable decision.

To access CPMS, refer to GN 03930.090C.1.b.

If there is an outstanding issue or an appeal is pending, diary for the time you estimate it will take to complete the action. Continue withholding, and do not proceed to GN 03930.090D.2.

2. Contact the AFB for status

a. Determine representative’s response

Contact the Attorney Fee Branch (AFB) to determine whether the representative filed a fee petition, a statement of intent to petition, or a waiver.

• Call the AFB at 703-605-7900; send a fax to 703-605-7901; or send an e-mail message to: ^DCARO OAO ATTY FEE BR

• Provide your name, specific component location, and telephone number.

Also provide the name of the claimant, the Social Security Number (SSN) and claim number, the date of the award notice, the amount of past-due benefits withheld for possible direct payment, your return address, and your (paperless) fax number.

Follow-up if the AFB has not replied within 14 days.

b. Act based on AFB’s reply

Do one of the following, depending on the reply:

• If the AFB received a fee petition, diary for 30 days for receipt of the fee authorization. In the PC, return the folder/ACR/paperless action to the holding file. In the FO, follow the procedures in GN 03930.090C.3.d.

• If the AFB received a waiver, ask the AFB to fax a copy to you and mail the original. When you receive the facsimile, refer the case to a BA/BTE or CR for release of the past-due benefits.

• If the AFB received a statement of intent to petition, diary for the time estimated for resolution. In the PC, return the folder/ACR/paperless action to the holding file. In the FO, follow the procedures in GN 03930.090C.3.d.

c. Follow-up if authorization not received

If you have not received a fee authorization when the diary matures, call the AFB for status.

3. Ask the AFB to send the 20-day notice

If the AFB did not receive a fee petition, take the following actions:

1. Ask the AFB to send the representative the 20-day notice described in GN 03930.090B.1.

2. Diary for 45 days. In the PC, return the folder/ACR/paperless action to the holding file. In the FO, follow the procedures in GN 03930.090C.3.d.

3. Call the AFB for status if, when the diary matures, you have not received a fee authorization or notice from the AFB to release the past-due benefits.