I-1-2-63.Fee Petition Administrative Review — Related Issues

A. Proper Party Filed the Request

Only the parties to a fee authorization, or certain individuals authorized to act on the parties' behalf, such as a minor claimant's parent or legal guardian, have a right to request administrative review. The claimant, any affected auxiliary beneficiary or eligible spouse have the right to request administrative review of the initial fee authorization. See 20 CFR 404.1720(d) and 416.1520(d).

An entity's POC or the executor or legal representative of a deceased representative's estate has the right to request administrative review when they are a party to the initial fee authorization, which is only in the limited circumstances described in Hearings, Appeals, and Litigation Law (HALLEX) manual I-1-2-53 A and I-1-2-61 A (see also POMS GN 03930.020A).

If it is unclear whether the person who filed the request was authorized to act on a proper party's behalf, send the acknowledgment letter and any request for more information to the proper party. However, in the letter, explain to the party that:

• The Social Security Administration (SSA) has received a request for administrative review from (the name of the person) on their behalf; and

• They 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 their behalf, deny administrative review. Notify the individual who protested the fee that they are not a proper party. Send a copy of the notice to the proper parties.

If a representative whom SSA did not authorize an initial fee protests the fee, determine whether SSA paid the fee to the correct individual or entity, particularly when multiple representatives from the same entity worked on the claim(s).

B. Timely Filing

If the request for administrative review is filed more than 30 days after the date of SSA's initial fee authorization notice, the requester must state, in writing, why it was not filed on time. In such cases, the reviewing official will conduct an administrative review only if they determine that there was good cause for not filing the request on time. Examples of good cause are provided at 20 CFR 404.1720(d)(2)(ii) and 416.1520(d)(2)(ii).

C. Acknowledging Receipt of Request

The reviewing official must acknowledge receipt of the request for administrative review. They must also notify all other parties of the request for administrative review and afford them 15 days to submit written information responding to the request. (See HALLEX I-1-2-64 for guidance on issuing the acknowledgment letter.)

If the request is untimely and good cause is not found, notify the claimant, any affected auxiliary beneficiary and the representative that the prior fee authorization is final and not subject to further review.

D. Additional Development

Based on the review of the documents listed in HALLEX I-1-2-62, the reviewing official will:

• Determine if more information is needed to make the administrative review determination; and

• Identify issues, if any, that SSA did not resolve when it initially authorized the fee.

Situations in which additional actions must be undertaken before acting on the request for administrative review include, but are not limited to the following.

1. If the claimant discharged one representative and another representative accepted an appointment to represent the claimant, the prior representative retains the right to request a fee. This situation also applies when both representatives have assigned direct payment of their fee to the same entity because each individual representative must generally file their own petition, and should they choose, their own request for administrative review. For more information about the assignment of direct payment of fees to an entity, see POMS GN 03920.021. If the prior representative files a fee petition:

   • Send the fee petition to the office that authorized the fee that is the subject of the protest (so that it can process the second fee request.) Advise that office of the pending request for administrative review and ask them to send you a copy of the fee authorization.

   • Do not conduct the administrative review until the time limit for requesting administrative review has expired on the second fee authorization.

2. If there are multiple representatives involved in the claim, SSA authorized more than one fee, and one party filed a request for administrative review:

   • Review the services of all the representatives, and

   • Recognize that the services of the representatives are generally interrelated, particularly when all or some of the representative assigned direct payment of their authorized fees to the same entity or entities.

   However, do not:

   • Conduct administrative review of any unprotested fee authorization, or

   • Consider modifying any fee except the one being protested.

3. If the contents of the original fee petition are insufficient, the reviewing official should contact the representative or the party to the petition who filed the petition in place of the representative (see HALLEX I-1-2-61 A), for clarification. Information most frequently omitted, but essential to the evaluation of the services pertain to:

   • The date the services ended, and

   • The itemization of the representative's services.

E. Money Collected from the Claimant as a Fee

If there is an indication that the representative charged, received or collected money from the claimant, as a fee, in excess of the amount SSA authorized, then:

• Ask the representative for more information about the money collected from the claimant (do not ask for a refund until the issue is resolved);

• Resolve the issue in the administrative review determination;

• Notify the representative that they must immediately refund to the claimant any funds collected as fees exceeding the amount SSA finally authorized (refer to HALLEX I-1-1-40 for rules governing the conduct of representatives); and

• Notify the claimant that they should inform SSA if the representative does not refund the excess funds.

F. Review of the Fee Amount Determination

After receipt of any additional information or comments in response to the acknowledgment or interim letters, and following resolution of any issues(s) that may have been identified, the reviewer must review the initial fee authorization in light of all the information in the file. The reviewing official will determine whether the fee initially authorized is a reasonable fee for the services provided to the claimant based on the factors outlined in HALLEX I-1-2-57. The reviewing official will increase, decrease, or affirm the fee initially authorized.

During this evaluation, the reviewing official will:

• Examine the authorization to identify the factual elements (e.g., the time spent and services performed by the representative, the results achieved by the representative, and the level at which the representative entered the case), rationale and conclusions reached;

• Identify what issues, if any, pertinent to the representative's services, had a bearing on the conclusion and decide if these issues have been resolved fully; and

• Obtain further clarification from the parties if the factual elements critical to the authorization are based on assumptions not supported by evidence in the claim file.