Special Assistance SA-3340 HEARINGS

II. APPLICANT’S/RECIPIENT’S RIGHTS

A. The a/r has the right to appeal any action taken, including but not limited to the following:

1. When the county department denies an applicant the opportunity to make an application on the day he first appears at the agency and wishes to apply.

2. When a substitute payee is appointed and the a/r disagrees with this action.

3. When the individual alleges he/she improperly withdrew his/her application.

4. When a replacement check is denied.

5. When assistance has been approved, denied, modified, or terminated.

NOTE: It is not necessary to conduct a hearing when either state or federal law requires automatic adjustments for classes of recipients unless the reason for the hearing is incorrect computation or there is a factual issue regarding whether the change applies.

6. When the county DSS fails to act within the required time standards.

7. When the county department fails to act promptly on a request for a review of the case situation.

B. The a/r may request the hearing verbally or in writing.

C. The a/r must request a hearing within 60 calendar days from the date notice of action is mailed or given, unless he can show good cause for a later request. If good cause exists, the request must be no later than 90 days from the date of the notice of action.

1. For appeals based on allegation of discouragement, improper withdrawal, or improper denial, the time limit for requesting a hearing shall be 60 days (or 90 days with good cause) from the date the applicant became aware or should have known that incorrect or incomplete information given by the county DSS caused the applicant not to apply, caused the applicant to withdraw his/her application, or that the denial was improper.

2. Good cause is defined as:

a. Failure of the a/r to receive the notice of action,

b. Extended hospitalisation of the a/r or the spouse, child, or parent of the a/r,

c. Failure of a representative acting on the a/r’s behalf to meet required time frames, or

d. Illness resulting in incapacity, incompetence, or unconsciousness of the a/r and there is no representative acting on the a/r's behalf, or

e. Death of the a/r or his/her representative, or

f. Failure of the county DSS to provide sufficient or correct information regarding appeal rights.

3. Evidence of good cause, which must be provided by the a/r, includes but is not limited to:

a. Physician’s written statement,

b. Hospital bill, or

c. Written statement of a/r, his/her representative, or other individual knowledgeable of situation.

D. The a/r has the right to be represented at hearings by the person of his/her choice, including an attorney obtained at the a/r's expense.

E. In cases involving issues other than disability, an a/r has the right to request a state hearing only after a local hearing has been held and a decision has been rendered.

F. The a/r must request a state hearing within 15 calendar days of the mailing of the local hearing decision unless he can show good cause for a later request as defined in II.C.3., above.

G. In cases involving a question of disability, an a/r has the right to request a state hearing. Do not conduct a local hearing.

H. If, at any point, the a/r does not exercise his/her right to a hearing or the right to continued assistance, the a/r still has the right to reapply.

I. Right to Continued Benefits

A recipient whose benefits are changed or reduced may be entitled to continued benefits while awaiting a hearing decision. Continuation of benefits applies only to recipients. It does not apply to applicants who are denied assistance because there are no benefits to continue.

1. Recipients Who Receive Timely Notice

a. If a recipient appeals a reduction or termination of benefits on or before the effective date of the change (10 workdays after the notice is mailed or given to the recipient), he has the right to continued benefits until the end of the month in which the local hearing decision is rendered, except when the reduction or termination involves a disability determination by DDS or the recipient waives his right to continued benefits.

If the reduction or termination involves a disability decision by DDS, the recipient has the right to continued benefits until the end of the month in which a State hearing decision is rendered.

b. The recipient is not entitled to continued benefits if the appeal is not requested within the 10 workday period.

c. When the recipient requests the hearing, advise him that:

(1) If the reduction or termination of benefits is affirmed by the local or state hearings officer, he may be required to repay the benefits he received while awaiting a decision, and

(2) He has the right to choose not to continue to receive benefits.

d. In some cases, a hearing decision upholding the county’s action will be rendered prior to the termination of benefits. In these situations, no additional action is necessary. If benefits must continue for an additional period, administratively reopen the case for one month at a time until a decision is rendered. Complete any required case actions during the extended period.

2. Recipients Who Receive Adequate Notice

Recipients who receive adequate notice and appeal do not have the right to continued benefits.