I-1-2-44.Administrative Review of the Fee Amount Authorized Under the Fee Agreement Process — Overview
Last Update: 4/12/21 (Transmittal I-1-101)
A. Who May File a Request for Administrative Review of the Fee Amount Authorized Under the Fee Agreement Process
When a claimant, affected auxiliary beneficiary (title II), eligible spouse (title XVI), representative, or decision maker disagrees with the fee the Social Security Administration (SSA) authorized based on an approved fee agreement, he or she may request administrative review of the amount of the fee.
1. Claimant, Affected Auxiliary Beneficiary, Eligible Spouse, or Representative Requests Review
The claimant, affected auxiliary beneficiary, eligible spouse, and representative have the right to request administrative review of the amount of the fee authorized under the fee agreement process, provided they timely file the request. For more information on timeliness, see subsection B, below.
2. Decision Maker Requests Review
The decision maker may request administrative review of the amount of the fee authorized under the fee agreement process only when there is evidence showing that:
The representative did not represent the claimant's interest adequately, or
The fee is clearly excessive in light of the services provided.
For more information about the review criteria when a decision maker is the requesting party, see Hearings, Appeals and Litigation Law (HALLEX) manual I-1-2-46 A.3.
B. Time Limit for Filing a Request for Administrative Review
Sections 206(a)(3)(A) and 1631(d)(2)(A) of the Social Security Act require that the person requesting administrative review do so in writing within 15 days after receiving the notice of the fee amount authorized under the fee agreement process.
For questions regarding calculation of the 15-day period or regarding untimely filed requests for administrative review, see HALLEX I-1-2-41 C.
C. Designated Reviewing Official
The Commissioner has delegated authority to the following officials to conduct administrative review of the fee amount authorized under the fee agreement process:
1. Hearing Level
|
Individual Requesting Review of the Fee Amount |
Reviewing Official |
|---|---|
|
Claimant, affected auxiliary beneficiary, eligible spouse, or representative |
Decision maker (Hearing Office Chief Administrative Law Judge (HOCALJ), administrative law judge (ALJ), or attorney advisor) who issued the favorable decision |
|
Decision maker |
Regional Chief ALJ (RCALJ) who has jurisdiction |
|
RCALJ |
Deputy Chief ALJ or Chief ALJ |
|
Claimant, affected auxiliary beneficiary, eligible spouse, or representative AND Decision maker |
RCALJ with jurisdiction over the decision maker's hearing office OR for National Hearing Center (NHC) cases, the RCALJ with jurisdiction over the hearing office that transferred the case to the NHC |
For more information about the NHC, see HALLEX I-2-1-58.
NOTE:
To avoid inordinate delays, if the ALJ or attorney advisor with jurisdiction over a request for administrative review is unavailable for 30 days or more, the HOCALJ will review the request and either act on the request or delegate that responsibility to another ALJ or attorney advisor.
2. Appeals Council Level
|
Individual Requesting Review of the Fee Amount |
Reviewing Official |
|---|---|
|
Claimant, affected auxiliary beneficiary, eligible spouse, or representative |
Deputy Chair of the Appeals Council (AC) or designee |
|
Administrative appeals judge (AAJ) |
Deputy Chair of the AC or designee |
|
Deputy Chair of the AC or designee |
Chair of the AC |
If more than one of these persons requests review, the Deputy Chair of the AC or designee takes a single action resolving all the issues raised in the requests for administrative review. This applies even if an AAJ requested administrative review and the request was untimely.
D. Preliminary Actions by the Reviewing Official
1. Informing the Parties
The reviewing official must:
Acknowledge receipt of the request for administrative review
Notify all other parties of the request, including the decision maker if he or she is not the party who requested administrative review; and
Afford the other parties 15 days to submit a written response to the request for administrative review.
See HALLEX I-1-2-46 C for guidance on the notice content.
2. Notifying Effectuating Components
The reviewing official must notify the effectuating component(s) that SSA has received a request for administrative review of the fee agreement.
For title II claims, the effectuating component is the processing center (PC) as defined in HALLEX I-1-2-2 D. For PC jurisdictions, see Program Operations Manual System GN 01070.245.
For title XVI claims, the effectuating component is the field office.
3. Notifying a Representative Who Filed a Fee Petition After SSA Authorized a Fee Under the Fee Agreement Process
If a representative files a fee petition within 15 days after receiving SSA's notice of the fee amount authorized based on an approved fee agreement and asks for a higher fee than that shown in the notice, the reviewing official must notify the representative that:
The request cannot be processed as a fee petition because SSA has already authorized a fee based on the fee agreement and, as provided in section 206(a) of the Social Security Act, the two fee processes are mutually exclusive; and
The fee petition will be deemed a request for administrative review of the fee amount based on an approved fee agreement and processed in accordance with this section and not as a request for a fee under the fee petition process.
E. Reviewing Official's Action on Review of the Fee Amount
1. Authorize a Fee
If the party requesting review filed a timely request and the reviewing official determines the fee agreement meets the statutory requirements for approval (and no exceptions apply), the reviewing official generally will review the amount of the fee authorized under the fee agreement process and either affirm or modify the fee. See HALLEX I-1-2-47 for guidance on determining the fee amount on review.
2. Issue Notice of Administrative Review Determination
The reviewing official must mail a written notice of the action taken on administrative review to:
The claimant, any affected auxiliary beneficiary(ies) (except those who reside with the claimant), or eligible spouse;
The representative; and
The decision maker, when he or she requested review or commented on the review.
The reviewing official will send notices to the last known addresses of the parties. The notice will inform the parties that the determination is not subject to further review. See HALLEX I-1-2-48 for more information about the notice.