GN 03940.003 Fee Agreement Evaluation

NOTE: To identify the appropriate fee agreement decision maker, see GN 03940.002.

B. Statutory conditions for fee agreement approval

When a representative utilizes a fee agreement to obtain our approval to charge and collect a fee for services, the fee agreement must meet the following five statutory conditions:

1. Filed timely

The claimant or representative must submit the fee agreement to us before the date of the first favorable decision that the representative worked toward achieving, as explained in GN 03940.001B.

We use the date of the award or decision notice, not the date of adjudication or effectuation. The date of the first favorable decision under one title is controlling in concurrent claims.

If we receive more than one fee agreement, we act on the latest fee agreement received before the favorable decision date. We cannot consider a fee agreement filed after the favorable decision, even when signed prior to the favorable decision.

NOTE: Parties cannot submit a new fee agreement in lieu of a request for appointment, withdrawal, or revocation. The claimant must submit a separate writing to appoint a new representative or revoke an appointment, and a representative must separately withdraw the representative's own appointment.

2. Submitted in writing

The claimant, the claimant's legal guardian, or the parent of a child under the age of 18 and the appointed representative must submit a fee agreement in writing. To validate the agreement, we also require that all parties sign the same agreement:

Either a court appointed representative, a parent of a child under age 18, or the legal guardian of legally incompetent claimant, refer to GN 00502.139 may sign the fee agreement.

If we determined that a claimant under age 18 can be a payee, the claimant may sign the fee agreement. For developing capability for children, see GN 00502.070.

We can accept a representative’s stamped signature on a fee agreement unless we have reason to doubt the representative’s intent to sign the fee agreement. However, we must not accept a fee agreement with only the stamp or name of an entity. We only recognize individuals as representatives, not firms, corporations or other entities. The fee agreement must show the name(s) of each representative(s) who is party to the fee agreement.

We accept the claimant’s signature in pen and ink. While we cannot currently accept electronic signatures on fee agreements, we will as they become available through future systems enhancements.

We may contact the parties for clarification if the signatures are illegible or questionable. The parties may submit a photocopy or fax of the original fee agreement.

We accept a fee agreement signed by multiple individuals as long as the claimant appointed at least one of them; however, we must only recognize and authorize a fee to the individuals who are properly appointed representative(s). We must not include in our fee considerations individuals who signed the fee agreement but were not appointed.

3. Meet the statutory fee limits

The fee requested in the fee agreement cannot exceed the lesser of 25 percent of the past-due benefits or the fee limit set by the Commissioner under the authority provided by section of the Act 206(a)(2)(A)(ii)(II). The current limit is $7,200.

The fee limit also applies to concurrent claims with a common issue. We cannot approve a fee greater than 25 percent of the combined Titles II and XVI past-due benefit amounts or $7,200 (or other statutory fee limit in effect).

We accept language in a fee agreement that permits an adjustment for the statutory fee limit in effect as of the day we approve the fee agreement. We also accept language that sets the percent or fee limit at an amount lower than the statutory limit. We must not accept language that establishes a specific minimum fee amount that may result in a fee of more than 25 percent of the past-due benefits.

4. Result in a favorably decided claim

To approve a fee agreement, the claim or action must result in a fully or partially favorable decision. This can be an initial favorable decision or a post-entitlement decision that leads to new past due benefits.

We still approve a fee agreement even if our decision is favorable to the claimant under only one title in a concurrent claim, so long as the agreement meets all other statutory conditions and no exceptions apply.

5. Yield past-due benefits

We must only approve a fee agreement when the claim or post-entitlement or post-eligibility (PE) favorable decision results in past-due benefits for a single claim or at least one title in concurrent claims. If we initially approved a fee agreement on the condition that there are past due benefits, but, at the time we effectuate the favorable decision, we find that there are no past-due benefits, we cannot process the fee agreement approval. In these situations, we must notify the representative(s) and the claimant that the representative(s) must file a fee petition in order to charge and collect a fee. For notice language, refer to NL 00720.050.

The fee agreement process applies to claims for initial entitlement, as well as PE actions that involve new entitlement for additional benefits or reopening after termination.

We must disapprove fee agreements received in connection with processing PE actions that only adjust benefit amounts or remove payment suspensions from benefits for which we have already established entitlement (e.g., changes in workers’ compensation offset, resolution of earnings discrepancies, increased payments from work ending while disabled), even though the decisions may result in past-due benefits.

NOTE: Other actions may result in past-due benefits; however, the fee agreement process applies only to claims for entitlement.

C. Factors immaterial to the fee agreement evaluation process

We do not require a standard fee agreement format. We accept various forms and language choices, so long as: