DHHR Fair Hearings: What you need to know about the process

Last Updated On: 2/5/2018 4:37:46 PM

What is a DHHR Fair Hearing?

A Fair Hearing is a hearing that is held to settle disagreements between DHHR and individuals or families about some kind of DHHR benefit, such as SNAP (Food Stamps), WV WORKS (welfare ), a medical card, Emergency Assistance, or a School Clothing Voucher. The “judge” at the Fair Hearing is a State Administrative Hearing Officer who is a neutral decision maker in the case.

The most common disagreements that people take to Fair Hearings involve situations where one or more of the family’s benefits has been cut down they have been cut off of one or more benefits. The other situation where people need a Fair Hearing comes up when they apply for a benefit and DHHR sends them notice that DHHR does not think that they are eligible.

When Does It Make Sense to File for a Fair Hearing?

Before you file for a Fair Hearing, you may want to contact your DHHR caseworker just to make sure that there has not been a computer mistake or a misunderstanding.

If there has not been a misunderstanding or a computerized letter sent out by mistake, and you believe that DHHR has not treated you fairly, you should file for a Fair Hearing. You can always cancel the Fair Hearing if you are able to work things out with DHHR before the Fair Hearing date.

In some cases, for example, if you have been cut off Medicaid Waiver, DHHR may send a staff lawyer to the Fair Hearing to represent DHHR. At other times, for example in most WV WORKS and SNAP disputes, DHHR will send a caseworker or caseworker supervisor to represent DHHR.

How Do I File For a Fair Hearing?

To file for a Fair Hearing, you should contact your local DHHR office and ask for a Fair Hearing. If you were getting a benefit that DHHR cut down or cut off, you should have gotten a Fair Hearing Request form that you can fill out and mail in or drop off at DHHR. Be careful to check the right box, and ask for a Fair Hearing, not just a case conference.

If you did not get a Hearing Request Form, you can get one here. You should fill out the Hearing Request form and send the hearing request form to your local DHHR office. It can also helpful to include a cover letter that briefly describes the problem you are having with DHHR. You should keep a copy of your Hearing Request Form and note the date that it was sent.  

A Hearing Officer should notify you once a hearing date is set.

How do I ask for a Hearing if DHHR told me I was not eligible for benefits?

 

If you are turned down for benefits you think you should be able to get, you should ask DHHR to provide you with written proof that they turned you down, so you can ask for a Fair Hearing about whether you are eligible for the benefits. If you applied for benefits and were turned down, you will not get any benefits while you are waiting for the hearing.

Can I Keep My Benefits From Being Cut While I am Waiting for a Hearing?

If you have been getting benefits and they are cut down or cut off, if you respond to the DHHR “Adverse Action” notice within 13 days, you may be able to keep your benefits while you wait for the hearing. (Some benefits should give you a little more time to respond and keep your benefits, but it is safest to make your request within 13 days). If you do not ask to keep your benefits before the date your notice says your benefits will be cut down or cut off, that change will take place, but you can still ask for a Fair Hearing for up to 90 days after you get the notice.

DHHR will not continue your benefits if your benefits were cut down or cut off due to a SNAP review where DHHR says you now have too much in income or assets to qualify or where DHHR says that you did not cooperate and timely give them proof of your income and assets. DHHR will also not continue your benefits if you lost benefits due to an annual Social Security increase. Finally, if you signed a form that gave up your right to get advance notice of a change in your benefits, DHHR will not continue your benefits. However, you can still ask for a Fair Hearing if any of these things led to your losing benefits and you do not think DHHR acted correctly.

How Should I Prepare for my Fair Hearing?

You should try to find out the following things in order to prepare for the Hearing:

  1. You should try to find out from DHHR why they have taken action against you.
  2. You should ask DHHR to send the you a copy of the policy DHHR says that it applied to the your case
  3. You should try to figure out if those policies were correctly applied. It may be that DHHR made a mistake about the policy. You can find DHHR policies on the internet here. If you have questions about the DHHR policy that DHHR applied to your case, you can contact Legal Aid of West Virginia to apply for help.
  4. You should find out if there are facts that you and DHHR disagree about.
  5. You will need proof of the facts you believe to be correct: make a list of any documents or witnesses that support your side of things. Collect those documents and ask those witnesses to come to the hearing, or see if they are available to take part by telephone (and notify the Hearing Officer that you plan to offer a witness by phone).
  6. You may want go to DHHR to review your file. Be sure to ask for both written materials and computer print outs of case comments.

What if We Are Able to Work Things Out With DHHR Before the Hearing?

You can always cancel the Fair Hearing if you are able to work things out with DHHR before the Hearing date. You will need to contact the Hearing Officer by letter or by telephone to let them know that the hearing is no longer necessary because you have worked things out.

Can the Family Bring Anyone to the Hearing Besides Their Witnesses?

You can certainly go to a hearing on your own, or can bring anyone you want (it need not be an attorney). Community agency staff from such organizations as Head Start, and the domestic violence programs will sometimes attend a Fair Hearing if you ask them to go with you. Also, you can bring other family members who are not on your DHHR case. This can be useful for support if you are worried you will be nervous.

What Will Happen If We Have to Go To the Fair Hearing?

1. What is the Pre-hearing conference?

When you arrive at DHHR, the Hearing Officer is likely to send you to meet with the case worker or caseworker supervisor to try to work things out. Some times you will be able to work things out at this time. However, if both sides are set on their positions, then you will need to have the Hearing.

2. Where is the hearing held?

The Fair Hearing is held in a conference room or in the hearing officer’s office at DHHR. The hearing is not a formal as a court hearing in family court or circuit court. Both sides get the chance to tell their “story,” and any DHHR policy, witnesses, or evidence that support their arguments. State Hearing Officers vary in style – some are more or less formal than others. You may need to get advance permission from the Hearing Examiner to have a witness take part by phone.

3. What happens at the Hearing?

Generally, the DHHR worker or attorney goes first and explains DHHR’s side of the story. They must give information on all policies DHHR relied on to make its decision, the paper case record and any paper evidence they used to make their decision, and any witness or expert testimony that they used to make the decision.

Then, you will have the chance to respond, to tell your side of the story, the policy you think is relevant, and any evidence that you have or any fact witnesses or expert witnesses you have. You will also have the chance to present short closing arguments summing up why you feel you should keep your benefits or should be allowed to start getting benefits.

The hearing officer probably will not decide the outcome of the hearing on the hearing date. They will rule on the case and send out a written decision within a couple of weeks of the hearing.

4. What happens if you do not agree with the Hearing Officer’s decision?

Once Hearing examiner has issued the Order, if you disagree with the result, the remedy is to appeal is to the Circuit Court. If you feel that this is something that you want to pursue, you should get in touch right away with Legal Aid of West Virginia to apply for help. You only have a limited time after the DHHR hearing decision to appeal, and if you wait, Legal Aid may not be able to help you with your case even if you have a good one.  

This is general legal information. For guidance about your situation, talk to a lawyer.