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Page 184 of 202 § 10:90-14.5 Reimbursement of assistance for cases pending SSI entitlement

i. The county/municipality will be provided with an automated billing form, SSA- L8125-F6 (9/96) "IAR Payment Pending Case-State Due Payment." This billing form will contain a monthly breakdown of the client's payments for the retroactive period and will identify the case as an IAR-Payment Pending Case. The county/municipality shall complete the section entitled, "Amount of reimbursement claimed by the State" using the information provided by SSA in the section entitled, "Retroactive Amount Due Summary." The county/municipality shall be responsible for returning the completed billing form to the SSA field office (FO) servicing the SSI recipient within 10 working days from the date of receipt. The address of the servicing FO will be included on the cover page of the Form SSA-L8125-F6. After the SSA FO receives the completed billing form from the county/municipality, a check shall be issued to the county/municipality in the amount of the reimbursement claimed. The SSA will distribute the remaining SSI installment payments to the recipient. (g) Rules concerning payment of fees to attorneys or legal entities for successful appeals of claims for SSI benefits are: 1. In order for an attorney or legal entity to be eligible for legal fee payments, the appeal must have been filed on or after September 10, 1996. 2. The funding for the payment of the legal fees will be disbursed from the State's share of the Interim Assistance Reimbursement (IAR) checks. Legal fees shall be paid by DFD and shall be 25 percent of the total retroactive SSI award, provided it does not exceed the amount of the State's share. 3. In order for an attorney/legal entity to receive payment for a successful appeal, the represented individual must have been an active GA recipient sometime during the period covered by the retroactive SSI benefit check. 4. In order for disbursement of fees to be made, legal services providers shall submit the following information to DFD: i. A petition and copy of the favorable decision within 60 days of the date of receipt of the favorable appeal decision; ii. An invoice specifying legal services provided; iii. Proof of the initial and subsequent (if applicable) denial of SSI benefits; iv. The date of the filing of the appeal; v. Form WFNJ/GA-31, Repayment of IAR that is provided to the client by the county or municipal agency; and vi. Form WFNJ/GA-25, Proof of Representation by the Attorney or Legal Entity. 5. If the legal services entity is not an established vendor with the State, then a New Jersey W-9 Form, Request for Taxpayer Identification Number and Certification, should be included with the legal entity's first submittal of an appeal. 6. DFD is required to disburse payment to the legal services provider within 30 days of the date of the submission of the required information.