I-1-2-44.Administrative Review of the Fee Amount Authorized Under the Fee Agreement Process — Overview
Last Update: 12/9/24 (Transmittal I-1-108)
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, they may request administrative review of the amount of the fee. See HALLEX I-1-2-41 B for more information on who may file administrative review.
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 Hearings, Appeals, and Litigation Law (HALLEX) manual I-1-2-44 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 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 (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 over the decision maker's hearing office or a designee OR for National Hearing Center (NHC) cases, the National Service Delivery Associate Chief ALJ (NSD ACALJ) or a designee. |
|
RCALJ |
Deputy Chief Administrative Law Judge or a designated ACALJ in the Office of the Chief Administrative Law Judge (OCALJ) |
|
Claimant, affected auxiliary beneficiary, eligible spouse, or representative AND Decision maker |
RCALJ with jurisdiction over the decision maker's hearing office or a designee OR for NHC cases, the NSD ACALJ or a designee |
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 |
Office of Appellate Operation (OAO) Deputy Executive Director or designee |
|
Administrative appeals judge (AAJ) |
OAO Deputy Executive Director or designee |
|
OAO Deputy Executive Director or designee |
OAO Executive Director or Designee |
The individual conducting review (i.e., the designee) cannot be the same AAJ who was the initial decisionmaker. If more than one of these persons requests review, the OAO Deputy Executive Director 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 (an entity is never a party; see HALLEX I-1-2-41 B), including the decision maker if they are 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 and concurrent 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 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 is a proper party and filed a timely request (or filed late with good cause), 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 (except those who reside with the claimant), or eligible spouse;
The representative; and
The decision maker, when they 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.