I-1-2-115.Sample — Acknowledge Receipt of Request for Administrative Review of Fee Petition Determination

Last Update: 2/25/05 (Transmittal I-1-48)

  1. To Claimant - No Development

  2. To Representative - No Development

  3. To Non-requester - No Development

A. To Claimant - No Development

I am writing about your letter dated (date). You asked me to lower the fee amount we said your (representative) can charge for (his/her) work on your claim.

Because you asked me to review the fee amount, I am giving you a list of factors we use to decide a fee. When we authorize a representative's fee, we consider the purpose of the Social Security and Supplemental Security Income (SSI) programs. In all cases, we also consider:

  • the services provided (including the type of service);

  • the difficulty of the case;

  • the level of skill required to provide the services;

  • the amount of time spent on the case;

  • the results achieved;

  • the level of administrative review to which the representative took the claim;

  • the level of review at which he or she entered the proceedings; and

  • the fee amount requested, not including any out-of-pocket expenses but including any amount already approved or requested. An example of out-of-pocket expenses is the cost to get a doctor and hospital report.

We do not authorize a representative's fee on a straight hourly basis or as a percentage of any past or future benefits.

What Will Happen

I will review the decision on the fee amount and make a new one. Based on that review I will raise, lower or not change the fee amount your (representative) can charge.

Because (name(s) of other party(ies)) may comment on your request for administrative review, I am sending them a copy of your request. They also may provide more information to me.

If I need more information, I will contact you. I will send you and the other people listed above, a letter telling what I decide.

B. To Representative - No Development

I am writing about your letter dated (date). You asked me to raise the fee amount we said you can charge for your work on (claimant's name)'s claim. (You also said the claimant has not paid the fee.)

Because you asked me to review the fee amount, I am giving you a list of factors we use to decide a fee. When we authorize a representative's fee, we consider the purpose of the Social Security and Supplemental Security Income (SSI) programs. In all cases, we also consider:

  • the services provided (including the type of service);

  • the difficulty of the case;

  • the level of skill required to provide the services;

  • the amount of time spent on the case;

  • the results achieved;

  • the level of administrative review to which the representative took the claim;

  • the level of review at which he or she entered the proceedings; and

  • the fee amount requested, not including any out-of-pocket expenses but including any amount already approved or requested. An example of out-of-pocket expenses is the cost to get a doctor and hospital report.

We do not authorize a representative's fee on a straight hourly basis or as a percentage of any past or future benefits.

What Will Happen

I will review the decision on the fee amount and make a new one. Based on that review, I will raise, lower or not change the fee amount you can charge. (We will pay you as much of the fee as the law allows.)

Because (Names of other parties) can comment on your request for administrative review, I am sending them a copy of your letter. They also may provide more information to me.

If I need more information, I will contact you. I will send you and the other people listed above a letter telling what I decide.

C. To Non-requester — No Development

(Representative's name) has asked me to raise the fee amount we said (he/she) can charge for (his/her) work on your claim.

What Will Happen

I am sending you a copy of (representative's name)'s letter. If you have comments about the letter or want to give me more information, write me within 15 days. I will consider what you tell me. You can write me at the return address on this letter.