Administrative Hearings
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Administrative Hearings


Revised March 25, 2011



What is an Administrative Hearing?

 

How are clients notified of their right to an Administrative Hearing?

 

What are continued benefits?

 

How do I process continued benefits?

 

How do I process continued benefits when the system will not allow a change?

 

How do I process continued benefits if the client must be active in two AUs?

 



What is an Administrative Hearing?

 

·         An Administrative Hearing is a process that can be initiated any time a client disagrees with an action taken by the Department.  Some examples of hearing issues include but are not limited to; terminations, reductions in benefits, assignment of a protective payee, overpayments or denial of benefits.

 

·         See EAZ Manual – Fair Hearing - Overview.

 

How are clients notified of their right to an Administrative Hearing?

 

·         Administrative Hearing rights are included on all letters generated to clients.

 

What are continued benefits?

 

·         Clients are eligible to continue receiving benefits at the same level they received before the action was taken which resulted in the hearing request if requested prior to the effective date of the change occurring.  This is called continued benefits.

 

·         See EAZ Manual – Fair Hearing – Pending Continued Benefits.

 

How do I process continued benefits?

 

·         If an AU has been closed, follow the steps in the Reinstatement chapter to return the AU to active status.

 

·         To process continued benefits, take the following steps:

 

1.    From the AMEN, select Option R – Interim/Hist Change.

 

2.    Make the appropriate changes to the AU to return to its original status prior to the hearing request.

 

3.    Call DONE and commit the data.


NOTE:

The Appeal Ind on the STAT screen currently does not affect processing.


How do I process continued benefits when the system will not allow a change?

 

·         In some situations reinstating a case will not work as the client is no longer program eligible and the AU will not remain active. 


EXAMPLE

Client is active on F06 Children’s Medical.  Child turns 19 years old on 1/12/09.  ACES will terminate the AU effective 1/31/09 due to child’s age.  Client requests an administrative hearing with continued benefits.  Once the AU is reinstated, the system will continue to close the AU due to the child’s age.


·         In these instances, users can contact Customer Support at (360) 664-4560 for assistance processing these cases.

 

How do I process continued benefits if the client must remain active in two AUs?

 

·         While the administrative hearing process is pending, it may be necessary to issue benefits for a client in the same month on two separate AUs.  To process these situations, take the following steps:

 

1.    Issue benefits to the client in the first AU.

 

2.    Close the client in the first AU by entering [a 500 level reason code] on the STAT screen.

 

3.    When opening the client on the second AU enter [the appropriate code] in the Concurrent Receipt field on the DEM1 screen to avoid dual participation edits.

 

4.    Call DONE and commit the data.

 

·         This process must be completed for each month pending an administrative hearing decision as long as the client is receiving continued benefits.


EXAMPLE

Client is active on FS with her 20 year old son.  The son moves out of the home and applies for his own FS benefits on 2/15/09.  The son is removed from Mom’s FS AU reducing her FS benefits effective 3/1/09.  Mom files a hearing on 2/23/09 disputing the reduction in benefits.  The 20 year old is eligible for FS in his own right so benefits must be issued on his AU.  However, Mom is eligible for continued benefits so the 20 year old son must remain on her FS AU as well.

Modification Date: March 25, 2011