Appendix B Fair Hearings

Georgia State Seal

Georgia Division of Family and Children Services
TANF Policy Manual

Policy Title:

Fair Hearings

Effective Date:

February 2022

Chapter:

Appendix B

Policy Number:

N/A

Previous Policy Number(s):

MT 61

Updated or Reviewed in MT:

MT-65

Requirements

An applicant or recipient of cash assistance has a right to appeal an agency action and receive a hearing regarding such action. The hearing process entitles an applicant or recipient to an impartial hearing, upon his/her request. Applicant and recipient include individuals in the assistance unit (AU).

Basic Considerations

A request for a hearing is a clear expression, made verbally or in writing by an applicant, recipient, or his/her protective payee to the effect that he or she wants the opportunity to present their case to a higher authority.

TANF cases involving an alleged intentional program violation (IPV) or suspected fraud are referred to the Office of Inspector General’s Benefit Integrity and Recovery Unit (BIRU) for investigation. OIG is responsible for ensuring the appropriate adjudication of these cases either through administrative disqualification hearings or referrals for prosecution. Administrative Hearings involving IPVs are held in accordance with the Office of State Administrative Hearings (OSAH) Administrative Rules of Procedure. See Ga. Comp. R. & Regs. r. 616-1-2-.01 et seq. See also OIG policies 1850, 1853, 1855.

Notification of the Right to a Fair Hearing

Every applicant or recipient must be informed in writing of his/her right to a hearing, the methods of requesting a hearing and that he or she may be represented by a protective payee or other representative (designated in writing by the AU) such as legal counsel, relative, friend, other spokesperson, or he/she may represent himself/herself. If requested, assistance with the completion of the required forms will be provided. Client notices include hearing information.

The applicant or recipient must be informed of the right to a hearing at the following times:

  • Application

  • When any action is taken that affects benefits,

  • When the applicant or recipient requests a restoration of lost benefits.

Request for a Fair Hearing

DFCS must receive the applicant’s or recipient’s fair hearing request (orally or in writing) within 30 days of the date of a decision notice. When an oral request is made, Form 118, Request for Hearing, is completed by the staff who received the request. Upon receipt, workers must scan all Fair Hearing requests into WEC.

The Fair Hearing Coordinator team will complete an OSAH Form 1 for all hearing requests submitted by an applicant, recipient, or protective payee or other representative (designated in writing by the AU) for all timely and untimely requests. If at any time DFCS receives a Fair Hearing request that is based on the agency’s failure to act, the Fair Hearing Coordinator team will complete an OSAH Form 1. If DFCS fails to forward a hearing request to OSAH within 30 days after DFCS receives such request, the applicant, recipient, or protective payee can file a petition for a direct appeal with OSAH.

For untimely requests received, the Fair Hearing Specialist supervisors are responsible for uploading completed Motions to Dismiss and all corresponding exhibits to the OneDrive folder that is designated by the Fair Hearing Coordinator team. For complete procedures for drafting and submitting motions to dismiss due to untimeliness, refer to, “Procedures for Submission of Motions to Dismiss due to Untimeliness” which are available on the TANF share-point site.

DFCS is prohibited from disclosing Personally Identifiable Information (PII) or Protected Health Information (PHI) to unauthorized individuals. Therefore, DFCS will not disclose, discuss, or allow access to the applicant’s or recipient’s PII or PHI without authorization. DFCS processes hearing requests that are submitted on behalf of an applicant or recipient when DFCS is provided valid legal authorization.

If requested, the county DFCS office must assist the applicant or recipient in completing the hearing request.

A qualified interpreter must be provided to assist customers who have limited English proficiency or who request an interpreter as a form of communication assistance due to a disability. Hearing procedures must be explained in the customer’s preferred language.

A hearing request can be expedited for an applicant/recipient if the court deems it necessary to protect the interests of the parties or the public health, safety, or welfare.

OSAH is responsible for scheduling hearings and notifying the parties (the Petitioner and DHS/DFCS) of the date, time, and location of the hearing. An Administrative Law Judge (ALJ) from OSAH conducts hearings.

Continuation of Benefits

The applicant or recipient may request that cash assistance continue at the level at which it was received prior to the action under appeal. Cash assistance is continued if the request is made within 14 days from the date of the decision notice.

Cash assistance is not continued or reinstated if the request for a hearing is received more than 14 days after the date of the decision notice unless good cause exists for making the late request. Refer to Chart B.1.

If the applicant or recipient requested benefits to be continued and the OSAH decision is in the agency’s favor, the applicant or recipient must repay any overpayment of cash assistance received as a result of the continuing benefits.

When a fair hearing request is pending, with a continuation of TANF benefits, and a change occurs to an applicant’s or recipient’s case that affects the TANF benefit amount, the reported change must be processed in accordance with policy (the “Subsequent Change”). If a fair hearing is requested on the Subsequent Change and continuation of TANF benefits are requested again, the agency must continue TANF cash assistance to the amount prior to the Subsequent Change.

Processing a Fair Hearing Request

Follow the steps below when an applicant, recipient, or his/her representative requests a fair hearing:

  1. Within three (3) business days of agency’s receipt of a fair hearing request, review the record to determine the following:

    • Was the correct action taken? If not, correct the case and notify the applicant or recipient. S/he may choose to withdraw the request for a hearing.

    • Is the AU eligible on all points of eligibility other than the one at issue?

    • Is there enough information in the record to determine the correct amount of issuance? If not, the case worker will request the needed information and/or verification.

  2. Within three (3) business days of agency’s receipt of a fair hearing request, DFCS will attempt to discuss and resolve the complaint with the AU or the representative.

    • If a mutually satisfactory decision can be reached, the AU may withdraw the hearing request, in writing. Update the case based on the changes agreed upon during client contact.

    • If during client contact, a mutually satisfactory solution cannot be obtained or if unable to contact the AU to discuss the complaint, electronically submit the following documents to OSAH within five working days:

      • original Form 118, Request for Hearing, or any written request for hearing presented by the applicant or recipient

      • Decision notice to the applicant or recipient of the action in dispute.

      • Original OSAH Form 1 - TANF.

        Make sure that any available contact information, including phone numbers and an email address for the applicant or recipient are included on the OSAH Form 1 – TANF.

    • It is the responsibility of the case manager to present the following documents at the hearing:

      • the application or renewal for assistance related to the matter(s) in dispute.

      • all records documenting or verifying facts, including records of telephone conversations, interviews, etc., which pertain to the action in dispute and any other materials that were made part of the case file in the normal course of business and on which the agency relied for the action taken, including budgets;

      • copy of all policy and regulation(s) relied upon in reaching the action in dispute. subpoenas for individuals and/or documents prepared for the ALJs. If subpoenas are required for documents, include the type of document, and the document custodian’s name and address.

        A subpoena form must be completed. It must explain the relevance of the testimony and/or documents that are sought. The subpoena form must be issued and properly served in accordance with OSAH rules. A copy of a subpoena form is available on OSAH’s website. Refer to OSAH’s rules regarding the proper procedures for issuing and serving subpoenas.

  3. Copy all documents submitted to OSAH and scan into the WebCenter Enterprise Capture (WEC).

  4. Determine if the assistance unit (AU) is entitled to continued or reinstated cash assistance.

  5. Allow the applicant, recipient, or protective payee the opportunity to examine documents and records that will be used in the hearing. If the applicant or recipient has named a representative other than a protective payee, allow the AU’s representative the opportunity to examine these documents if the Form 5459, Authorization for Release of Information, is signed. The AU’s representative may also review such records if legal authority is otherwise established (e.g., through a valid power of attorney).

  6. Report any changes in the circumstances related to the hearing, including address changes, to OSAH.

    Forward any subsequent documents received concerning the hearing to OSAH.

The following chart is used to determine whether to continue, reinstate or change cash assistance pending a hearing decision:

Chart B.1 – Continuation of Cash Assistance Pending a Fair Hearing Decision
IF THEN

the applicant or recipient requests a hearing prior to the expiration of the date of the timely notice and requests continuation of benefits, or does not waive the right to continued benefits

while the fair hearing decision is pending, cash assistance may be continued in an amount equivalent to that received by the AU prior to the change specified on the timely notice.

the applicant or recipient requests a hearing within 14 days of the date of the adequate notice and requests continuation of benefits

while the fair hearing decision is pending, cash assistance may be reinstated to the amount equal to what the AU received prior to the date of the adequate notice.

the applicant or recipient requests a hearing and claims good cause for not appealing during the 14-day timely notice period

while the fair hearing decision is pending, cash assistance may be reinstated only upon approval by the ALJ.

the applicant or recipient requests a hearing and a change, other than a mass change, affecting eligibility occurs

while the fair hearing decision is pending, the benefits are changed appropriately unless the applicant or recipient requests a hearing on the subsequent change and requests continuation of benefits.

Notify the ALJ.

the applicant or recipient requests a hearing and a mass change is required

while the fair hearing decision is pending, the benefits are changed appropriately and the ALJ is notified.

Continuation or reinstatement following a mass change is appropriate only if the ALJ determines that the mass change was incorrectly applied.

the applicant or recipient requests a hearing for an IPV disqualification

Benefits are not reinstated at the level prior to the disqualification.

The outstanding claim is pended, and benefits reinstated to the level prior to recoupment at the applicant’s or recipient’s request.

Withdrawal, Cancellation or Postponement of the Fair Hearing

Prior to DFCS’s submission of the OSAH Form 1, any withdrawal of a fair hearing request must be made in writing. After DFCS’s submission of the OSAH Form 1, any requests for a withdrawal, cancellation, or postponement of a hearing must be made in writing, by DFCS or the petitioner, and must be forwarded to OSAH immediately. Upon receiving a petitioner’s written request for a withdrawal, cancellation, or postponement of a fair hearing from the Fair Hearing Specialist, the Fair Hearing Coordinator will forward the written request to OSAH and copy the petitioner to all related correspondence.