Last Update: 1/28/03 (Transmittal I-1-44)
Only the claimant's duly appointed representative(s) may charge or collect a fee. Under the fee petition process, each representative who wants to charge and collect a fee for his/her services, must file a fee petition. However, if the representative has submitted a contingency fee contract (i.e., agreed to charge and collect a fee only if the Social Security Administration (SSA) favorably decides the claim), and SSA's decision is unfavorable, the representative may not then file a fee petition.
A representative must file a fee petition to obtain SSA's authorization to charge and collect a fee for services performed on behalf of an individual filing a claim under titles II, XVI or XVIII of the Act, if one or more of the following apply:
The representative and the claimant have no written fee agreement.
The representative filed a fee agreement, which the decision maker did not approve, and if the representative or claimant requested administrative review, the reviewing official affirmed the disapproval determination.
The representative filed a fee agreement, which the decision maker approved, and subsequently, a reviewing official reversed the approval determination.
The representative filed a fee agreement, which the decision maker approved, and subsequently, SSA disapproved because no past-due benefits resulted from the favorable determination or decision.
The representative filed a fee agreement that included a provision limiting the agreement's application to services through a specific level of the administrative appeals process (i.e., a two-tiered fee agreement), and the decision maker disapproved the fee agreement because the claim was first favorably decided after the level specified (see I-1-2-15).
Social Security Ruling SSR 85-3 provides that a representative does not need to petition for approval to charge and collect a fee if a nonprofit organization or government agency will pay the fee and the claimant has no liability to pay any part of the fee. See I-1-2-5, Representative's Fees Not Subject to SSA's Authorization.
Refer to I-1-2-1(C.) for policy on informing representatives about fee regulations.
If the representative of a Medicare beneficiary submits a fee petition for approval, ODAR follows the same procedures and regulations as in a Social Security case.