Background

This transmittal amends section I-1-2-5 in Hearings, Appeals and Litigation Law (HALLEX) manual to update and clarify instructions for when a representative's fees are not subject to the Social Security Administration's (SSA) authorization.

Explanation of Content and Changes

I-1-2-5 – We retitled the section from “Representative's Fees Not Subject to SSA's Authorization” to “Representative's Fees Not Subject to Authorization” for consistency with other HALLEX section titles that generally do not contain acronyms. We added an introductory paragraph, stating that a representative must obtain authorization from SSA to charge and collect a fee for services provided in proceedings before SSA, unless an exception applies. We retitled subsection A from “Payment by Non-Profit Organization or Government Agency” to “Payment by Third-Party Entity or Government Agency” to more accurately reflect current policy. We removed portions of subsection A regarding the rescinded Social Security Ruling 85-3 and added references regarding “entity.” We made editorial changes in subsections A through D. We retitled subsection D from “Legal Guardian or Other State Court Appointed Representatives” to “Legal Guardian or Other Court Appointed Representatives” to more accurately reflect the content of the subsection. We retitled subsection E from “Medicare Part A and Part B Cases” to “Entitlement Only to Hospital Insurance Benefits Under Sections 226(b)(2)(C), 226(e), and 226A of the Social Security Act” to more accurately reflect the content of the subsection. We also revised subsection E to remove outdated information and clarify exceptions that apply when a successful premium-free hospital insurance entitlement claim, under Medicare Part A, results only in entitlement to hospital insurance benefits without payment of (additional) cash benefits.

Date: October 9, 2019