Department of Human Services

Food Stamp OnlinePolicy Manual

Complaints, Appeals and Fair Hearings - Procedures

Revised:

40.4

APPEALS

Food Stamp Table of Contents

1240-1-30

(1)   Right to Appeal and Fair Hearing

 

Any person dissatisfied with an action of the county office on his claim for benefits has a right to appeal to the State Office for a fair hearing.

 

The same circumstances which may precipitate a complaint (Refer to Circumstances Which May Precipitate Complaints) may be the basis of an appeal, if the grievance has not been resolved through the conference procedure outlined above, or if the applicant/recipient does not wish to discuss his grievance with local staff.The individual may also question the Departmentís interpretations of the law and the validity and applicability of the policies promulgated under the law, if he is aggrieved by their application to his situation.Group hearings may be conducted where the sole issue is one of State or Federal law, regulations or policy.

 

If the client requests a fair hearing, it cannot be delayed or cancelled without the consent of the client or his representative because of a review by the county office or the Conciliation Unit.

 

(2)   Information to be Provided Regarding Right of Fair Hearing

 

Every applicant or recipient must be informed of his right of appeal if he is aggrieved by an action taken by DHS.††

 

The right to appeal should be discussed with each applicant and recipient at each interview for application or recertification of eligibility and the Fair Hearings information sheet must be given to the applicant/recipient at the same time.In addition, the information sheet will be included with each notice of approval, denial, increase or decrease.The telephone number for free legal assistance is also printed on each notice generated by the ACCENT system.

 

(3)   Time Limit for Filing an Appeal

 

A food stamp household shall be allowed to request a hearing on any action by the Department, including loss of benefits, which occurred in the previous ninety (90) days.Action by the State agency shall include a denial of a request for restoration of any benefits lost more than ninety (90) days but less than a year prior to the request.In addition, at any time within a food stamp certification period, a household may request a fair hearing to dispute its current level of benefits.The Division of Appeals and Hearings will make the decision upon receipt of the Appeal for Fair Hearing as to whether the request for a hearing will be accepted or denied.DHS staff must allow a household to complete an Appeal for Fair Hearing form at any time.

 

Appeals will be accepted only if they are filed within these time limits unless good cause can be shown as to why the appeal could not be filed within the prescribed limits.

 

In order for the recipient to continue receiving assistance during the current certification period pending the outcome of the final decision by the Commissionerís office, the appeal must be filed within ten (10) days of the mailing date of the notice.However, if it can be established that there was good cause for the clientís failure to request a hearing and continuation of assistance during the ten-day advance notice period, assistance may be reinstated at the same prior level.

 

The time limits shall be computed by excluding the first day and including the last, unless the last day is a Saturday, a Sunday, or a legal holiday, and then it shall also be excluded.If the 10th day or the 90th day falls on a legal holiday or weekend, the next working day may be considered as filing within the time limit.Good cause for delay will be considered on a case-by-case basis when a request for continued benefits mailed by the appellant or his/her representative is received in a DHS office following the 10th day after the notice of adverse action is mailed.

 

The Commissioner or his/her designee will approve any extension of time under this section after a showing of good cause by the appellant that he/she could not file within the prescribed time limits.

 

(4)   Persons Who May Appeal

 

Fair Hearings shall be provided to any person aggrieved by any action of the Department.

 

Households may request a fair hearing if they disagree with a denial, termination and/or reduction of food stamp benefits.

 

The applicant/recipient or his representative may request a hearing by any clear expression, oral or written.The request should be in writing, if possible.It is mandatory that DHS staff assist the client in every possible way in filing the appeal.When an individual makes an oral request for an appeal, the Department shall complete the procedures necessary to start the hearing process.

 

If the applicant/recipient is infirm or incompetent, his legally appointed guardian or conservator, his spouse or another close relative or a non-relative who has previously represented him in his claim for assistance or would normally do so, may be accepted as his representative in filing an appeal.Otherwise, any person who asks to appeal in behalf of the individual will be asked to obtain the applicantís/recipientís written statement that he wishes to designate him/her as his representative, unless that person is an attorney licensed to practice law in Tennessee, who has been asked by the client to be represent him/her.

 

If the individual making the request speaks a language other than English the agency shall ensure that the hearing procedures are verbally explained in that language.

 

An employee of the Department, as a representative of the Department, is not in a position to legally represent the appellant in filing an appeal.The household shall be advised of legal services that are available to provide representation at the hearing.

 

(5)   Procedure for Filing an Appeal

 

(a)   Request Made to County Office

 

A hearing may be requested by a clear expression of dissatisfaction, oral or written, from the applicant/recipient or his representative.The freedom to make a request for a fair hearing should not be limited or interfered with in any way.The county office must assist the individual in anyway necessary in filing the appeal.Applicants/Recipients making an oral request for an appeal may be assisted in putting the request in writing but an oral request will be accepted.The applicant/recipient or his designated representative shall be asked to complete and sign the Appeal for Fair Hearing (found in Default Library).If it is unclear what action the household wishes to appeal, the state agency may ask the household to clarify its grievances.The Appeal for Fair Hearing will be given or mailed to the household, as requested.

 

The date a hearing is first requested, orally or in writing, shall be considered the filing date of the appeal.If the request was received by telephone or the appellant refuses to sign the Appeal for Fair Hearing even though he has clearly asked to appeal, the Department shall, without waiting for the clientís signature, initiate the processing of the appeal.Copies of the Appeal for the Fair Hearing form shall be distributed on the date the hearing is requested or the next working day thereafter.

 

(b)   Request First Made to the State Office

 

If the request for a hearing is first made to the State Office, either orally or in writing, staff shall complete the Appeal for Fair Hearing.

 

Staff will then fax a copy of the Appeal for Fair Hearing to the county office to inform them of the request for a fair hearing, and will transmit the original copy of the Appeal for Fair Hearing to Appeals and Hearings in the State Office.

 

(c)    Request First Made to a Service Center

 

If the request for a hearing is first made to a Service Center, Service Center staff will enter the appropriate information directly into ARTS.

 

(6)   Agency Conferences

 

Once an appeal has been filed, the Department shall offer agency conferences to households who wish to contest a denial of expedited service.The conference shall be scheduled within two working days, unless the household requests that it be scheduled later.Such agency conference shall be attended by a supervisor and/or area manager, and by the household and/or its representative.An agency conference may lead to an informal resolution of the dispute.However, a fair hearing must still be held unless the household submits a written withdrawal of its request for a fair hearing.The individual shall be advised that the use of an agency conference is optional and that it shall in no way delay or replace the fair hearing process.

 

If the conference results in a satisfactory agreement between the appellant and the Department that benefits can be adjusted, or that the applicant/recipient will reapply, or if the individual accepts the explanation of the reason for the action or delay in action, the appeal may be withdrawn provided the household makes a written withdrawal.When the county office makes an adjustment, corrective action must be authorized retroactive to the date of entitlement.

 

(7)   Information and Referral for Legal Counsel

 

The county office will advise the appellant of his right to legal counsel as may be available in the community to represent him in his appeal.

 

(8)   Continuation or Discontinuation of Assistance or Services During Appeal

 

If a proposed action to reduce or terminate assistance is appealed within ten (10) days, assistance shall be continued pending the hearing decision if the householdís certification period has not expired, unless the household specifically waives continuation of benefits.Good cause for delay will be considered on a case-by-case basis when a request for continued benefits mailed by the appellant or his/her representative is received in a DHS office following the 10th day after the notice of adverse action is mailed.††

 

When benefits are reduced or terminated due to a mass change, benefits at the prior level will be continued only if the issue being contested is that eligibility or benefits were improperly computed or that Federal law or policy is being misapplied or misinterpreted by the agency.

 

Once continued or reinstated, benefits shall not be reduced or terminated prior to the receipt of the official hearing decision unless:

 

(a)   A change affecting the appellantís eligibility or benefit level occurs while the hearing decision is pending and the appellant fails to request a hearing on that issue within 10 days of the mailing of the notice of adverse action.Action on that change will not be delayed pending the hearing decision.Good cause for delay will be considered on a case-by-case basis when a request for continued benefits mailed by the appellant or his/her representative is received in a DHS office following the 10th day after the notice of adverse action is mailed.

 

(b)   A mass change affecting the householdís eligibility or benefit level occurs while the hearing decision is pending.†††††† †††

 

(c)    The certification period expires.[The household may reapply and may be determined eligible for a new certification period, with a new benefit amount determined on the basis of current eligibility.]

 

(d)   The Administrative Law Judge/Hearing Officer makes a preliminary determination at the hearing, followed by written confirmation, that the sole issue is one of federal law or regulation and that the householdís claim that the Department improperly computed the benefits or misinterpreted or misapplied the law or regulation is invalid.

 

If a hearing request is not made within the period provided by the notice of adverse action, benefits shall be reduced or terminated as provided in the notice.However, if the household established that its failure to make the request within the advance notice period was for good cause, the county shall reinstate the benefits to the prior level.

 

(9)   Recovery When Decision Upholds the County Office

 

When the hearing decision upholds the county office, any benefits issued due to continuation of assistance pending the hearing decision will be subject to recovery and a claim shall be prepared according to the usual procedures for recovering such benefits.

 

Glossary of Terms

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