BASIC (03-95)

A. Introduction

The first step in the administrative review process is to examine the request itself. SSA will consider whether the:

• inquiry is a request for administrative review under the fee petition process;

• request was filed by a proper party;

• request was filed on time;

• request was filed before the initial fee authorization; and

• request includes other issues, and who has jurisdiction to process the request.

B. Procedure

Follow the procedure below when examining the request for administrative review.

1. Is the Inquiry a Request for Administrative Review

1. Examine the party's inquiry to determine whether there is a clear request for administrative review. Do not confuse a request for more information with a request for administrative review.

   EXAMPLE:

   A non-attorney representative sends a letter questioning why SSA did not pay the authorized fee directly to him. This inquiry is not a request for administrative review. Send a letter to the representative explaining the withholding and certification provisions.

2. If you question whether an inquiry is a request for administrative review, contact the party who made the inquiry (preferably by telephone) and determine the party's intent.

   NOTE: If the party only wants more information or an explanation, the office that authorized the initial fee will respond to the inquiry in writing. If the inquiry was made within 30 days after the date of the initial fee authorization, give the party 30 days after the date of the new response to request administrative review.

2. Was Request Filed by Proper Party

If the spouse of a claimant or an individual in the office of the appointed representative protests a fee when neither is a party to the fee authorization, assume that the individual is acting at the request of the proper party.

NOTE: Only the parties to a fee authorization, or individuals appointed to act on the parties' behalf, have a right to request administrative review. (See GN 03950.001B.2. for an explanation of who may request review.)

Send the acknowledgment letter and any request for more information to the proper party. However, in the letter, explain to the party that:

• SSA has received a request for administrative review from (the name of the person) on his/her behalf; and

• he/she must let SSA know, within 15 days, whether to proceed with the review.

If the party does not verify that the request was filed on his/her behalf, deny administrative review. Send a notice to the individual who protested the fee that he/she is not a proper party. Send a copy of the notice to the proper parties.

If a representative who did not participate in the initial fee authorization protests the fee, determine whether SSA paid the fee to the correct person.

NOTE: If more than one individual from the same office is involved in a claim, SSA may have paid the wrong person.

EXAMPLE:

The claimant appointed a senior attorney in a law firm as her representative. An associate attorney in the same law firm handled the claim under the direction of the appointed representative. The associate submits the fee petition and SSA authorizes a fee and certifies direct payment to that individual. The associate files a request for administrative review of the amount of the fee.

If such a situation occurs, contact the authorized representative (the senior attorney in the above example) and obtain a statement from him/her acknowledging the receipt of the certified fee and verifying he/she requests administrative review of the fee authorization.

If the appointed representative states he/she did not receive the fee:

• ask the individual who received the erroneous payment (the associate in the above example) to refund the money to SSA; and

• advise this individual that failure to refund the money will violate the Social Security fee regulations and could result in his/her suspension or disqualification as a representative in Social Security proceedings.

3. Was the Request Filed on Time

Examine the request to see whether the party filed it with an SSA office within the 30-day time limit (see GN 03950.010A.4.).

4. Was the Request Filed Before the Initial Fee Authorization

If the claimant protested a representative's fee request when he/she received a copy of the Form SSA-1560-U4 (Petition to Obtain Approval of a Fee for Representing a Claimant Before the Social Security Administration) or equivalent statement, but SSA did not consider this protest when it authorized the fee because the protest had not been associated with the claim file, tell the claimant (by telephone, if possible) that:

• the protest was not placed in the claim file until after SSA authorized the fee, therefore SSA did not consider the protest in authorizing the fee; and

• SSA will treat the original protest as a timely request for administrative review of the amount of the fee SSA authorized.

EXCEPTION: If when contacted, the claimant states that he/she is now satisfied with the authorized fee, document the claim file. Inform the claimant that SSA will take no action on his/her protest and that the initial fee authorization is final, unless the claimant subsequently files a timely request for administrative review.

5. Does the Request Include Other Issues

If a request for administrative review includes other issues, such as:

• a request for post-adjudicative action or information; or

• a question concerning another claim a representative is handling.

Release the acknowledgment notice and request more information immediately, then work on the other issues.

NOTE: Generally, perform post-adjudicative actions before acting on the administrative review.

6. Who Has Jurisdiction to Process the Request for Administrative Review

1. If the PC receives the written request and has jurisdiction for review, refer the case to the reviewer (shown in GN 03950.005B.1.).

2. If OARO has jurisdiction for review:

   • Send a copy of the request for administrative review to the OARO office with jurisdiction, if it appears they did not receive the initial request.

   • Diary the case for 90 days to follow-up on the administrative review determination if SSA is withholding past-due benefits for a potential attorney's fee.