WHAT YOU NEED TO KNOW ABOUT FAIR HEARINGS
(Article published in HWW July-Aug 2008)
by Diane Wenzler, Director of Publications and Benefit Research Services, Community Service Society
Your rights under public benefit programs, such as Public Assistance, are protected through the Fair Hearing process, which protects individuals from wrong decisions by the government.
If your application has been denied or your benefits are going to be stopped, reduced, or suspended, you can appeal the determination through a Fair Hearing. Fair Hearings are conducted by New York State’s Office of Temporary Disability Assistance (OTDA), and not by the local agency. OTDA monitors NYC to ensure that they follow correct policy and procedures.
In NYC, the local agency that decides about eligibility for benefits is the Human Resources Administration (HRA). If HRA mails you a Notice of Intent to deny, reduce, suspend your benefits or close your case, the Notice should indicate their reasons. A Notice of Intent must provide enough data to enable you to mount a defense or to raise meaningful objections if you disagree with the decision. In legal parlance this means the notice must be “adequate.” You can ask the following questions to determine whether the notice is adequate.
Is the reason for the proposed action clear, detailed and specific?
Is the stated reason a valid basis for the proposed action?
Is the relevant regulation cited for the proposed action?
If the proposed action is financial determination, is a budget computation attached?
Are the current and proposed amounts of Public Assistance and/or Food Stamps listed?
If the proposed action is a recoupment, does it state the amount of the recoupment?
Is there an explanation of your right to a Fair Hearing and a right to “aid continuing,” if appropriate?
In addition, HRA must provide a timely notice when it intends to discontinue, reduce, restrict or suspend a recipient’s benefits. A notice is “timely” if it mailed at least 10 days before the date the proposed action is to become effective.
If you request a Fair Hearing, you should request it according to the instructions on the Notice of Intent. A Fair Hearing must be requested within 60 days of the date on the Notice of Intent. If you miss the deadline, reexamine the notice. If the notice is inadequate, then the time to request the Fair Hearing cannot start until you receive the proper notice.
You should request a Fair Hearing immediately. Don’t wait until the day before the effective date of action on the notice. You have the right to have your benefits continue unchanged until OTDA issues a decision. This is known as “aid continuing.” You have a right to aid continuing if you request the Fair Hearing 10 days before the date of the proposed action indicated on the Notice of Intent. You should request aid continuing at the same time you request the Fair Hearing.
You can request a hearing by contacting the New York State Office of Temporary and Disability Assistance/Office of Administrative Hearings as follows:
By Telephone:
(800) 342-3334
(518) 474-8781 (easier to get through)
By Fax:
(518) 473-6735
In Person:
14 Boerum Place
Brooklyn, NY
In Person for Medicaid only:
330 West 34th Street, 3rd floor
New York, NY
By Mail:
New York State Office of Temporary and Disability Assistance
Office of Administrative Hearings
P.O. Box 1930
Albany, NY 12201-1930
Online:
Use the OTDA online hearing request form at: http://www.otda.state.ny.us/oah/forms.asp.
Hearings are limited to the issue(s) requested. Be sure to list all your reasons when you first make the request. A photocopy of the notice should be included with the request, so there will be no misunderstanding of what the issue(s) is. If the issue(s) for the denial is not included in the notice, contact HRA to verify the reason(s) for the intended action. If HRA cannot provide one, state this in the request. If you want to add additional issue(s) to the Fair Hearing request, you should call OTDA at the above number immediately and try to have the issue(s) added. If you are unsuccessful, you may have to request a second Fair Hearing.
It usually takes about two weeks before you receive a notice (Acknowledgment of Fair Hearing Request) that OTDA has received the request. The notice will indicate the issue(s) identified in the Fair Hearing request and whether the State is issuing aid-continuing. If the acknowledgment does not include all of the issues or misidentifies them, call OTDA at (800) 342-3334 and ask the State to correct the list of issues.
If this notice is not received within two weeks, call OTDA at the above number or visit OTDA at 14 Boerum Place in Brooklyn to inquire about the status of your request.
About three to four weeks after requesting a Fair Hearing, you will receive a Notice of the Fair Hearing identifying the place, date and time of the hearing. The notice must be mailed at least ten calendar days prior to the hearing date, except for emergency Fair Hearings. If you do not receive the notice within four weeks, you should call OTDA at the number above.
At the Fair Hearing, HRA will submit a "Fair Hearing evidence packet,” which is the documentation that supports the action HRA intends to take against you. Evidence packets must contain a detailed history, copies of relevant WMS screen printouts, other documentation relevant to the action taken, and copies of NYCWAY Case Notes. HRA must provide you and/or your representative with a copy of the packet. If you want a copy, contact HRA, Division of Fair Hearings, 14 Boerum Place, Brooklyn, NY 11201, (718) 722-5012 (for Public Assistance or Food Stamps cases). For a Medicaid evidence packet contact HRA, Division of Fair Hearings, 330 W. 34th Street, New York, NY 10001, ( 212) 630-0996.
However, you may want to examine your entire case record, not just the evidence packet, to prepare for the Fair Hearing. A case record includes all written material concerning your application, case history, budget, medical, and financial records. You or your representative has the right to examine the contents of your Public Assistance case record at any time, even if a Fair Hearing has not been requested. You can request access to your case record by contacting the Fair Hearing and Conciliation (FH&C) Unit at your Job Center.
State law requires the State to issue a Fair Hearing decision and the City to comply with the decision within 90 days of your request for the Fair Hearing. OTDA will send a copy of the Fair Hearing decision to you, your representative, and HRA. If you do not receive a decision from the State within the time frame above, you should call the OTDA Office of Administrative Hearings at (800) 342-3334 or (518) 474-8781. These time frames hold as long as you have not delayed the process through an adjournment.
If you receive a decision that states, "the determination of the HRA is reversed,” you have won the hearing. If you have won, your Job Center should comply with the decision within 30 days of receiving it. If no action is taken within these time frames, take the following steps:
Public Assistance/Food Stamps: Take a copy of the decision to the FH&C unit of the Job Center. Or call OTDA Office of Administrative Hearings at (800) 342-3334 or (518) 474-8781 to register a compliance complaint and to ask that direct assistance be restored.
If you receive a decision that states, "the local agency is correct," you have lost the case. You can appeal adverse decisions in New York State Supreme Court with an Article 78. Appeals for “Article 78 Proceedings,” must be filed within four months of the date of the unfavorable decision. It is advisable, at this level, to obtain an attorney. Contact Legal Aid Society at (800) 649-9125 or Legal Services at (212) 431-7200.
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HOW TO NAVIGATE THE HRA SYSTEM AND AVOID SANCTIONS
“HRA is one of the biggest problems homeless people face — Just getting a newborn child on the case is crazy,” says Sandra Garces, Family Services Coordinator at Settlement Housing Fund’s new “semi perm” apartment complex in Manhattan. Families can stay there two to five years while they finish their education and get their careers on track.
Sandra spends much of her time solving the problem of welfare cases that HRA (Human Resources Administration) has sanctioned. Clients miss appointments because HRA sends mail to the wrong address. Often, she says, it’s not her clients’ fault. Families will put their new address into the record at lease signing but “someone” doesn’t put that information into the system.
So Sandra and her colleague Tricia Blanchard, Community Program Coordinator, offer their TOP TEN TIPS for navigating the HRA system and avoiding sanctions:
1. Stay compliant with all HRA requirements.
2. When updating your personal information with an HRA worker (such as change of address, or adding a new family member to your case), ask to see and confirm the changes in HRA’s computer system.
3. Anytime you meet with an HRA worker, be sure to write down his or her name and job title and what you discussed. This extra work can help clear up confusion later on.
4. As soon as you see any changes in your HRA income, contact your center and request a budget letter explaining and verifying the changes.
5. Learn how to read your budget letter. Ask the worker to explain the codes so you fully understand what each of them means.
6. Request a budget letter every two months and review it for changes.
7. Always notify your HRA worker immediately if there are any changes in your general income (SSI, employment, unemployment, etc.).
8. To keep your case fully open and active, you must be employed and/or in school for 35 hours a week.
9. If the person working on your case is not making the correct changes, ask to speak with a supervisor.
10. Know your rights and advocate for them.
