Important Information for FoodShare and Health Care
Fair Hearings
Anytime your benefits are denied, reduced or ended, and you think the agency made a mistake, contact the agency. If the agency does not agree, you can ask the agency worker to help you in asking for a prehearing conference and a fair hearing.
You may be able to come to an agreement with the agency through a prehearing conference without having to wait for a fair hearing to take place. At a conference you get to tell your side of the story, and the agency will explain to you why s/he feels that the action was taken. If the agency finds that it has made a mistake, it will change its decision and will take corrective action. If the agency decides that its initial decision is correct, and you feel that the agency is still wrong, you have the right to go through the fair hearing process.
Please Note: The fact that you agreed to have a prehearing conference does not affect your right to have a fair hearing. You can ask for a fair hearing and if you are satisfied with the action of the prehearing conference you can then cancel your fair hearing.
A fair hearing gives you the chance to tell a hearing officer why you think the decision about your application or benefits was wrong. At the hearing, a hearing officer will hear from you and the agency to find out if the decision was right or wrong. You may bring a friend or family member with you to the hearing. You may also be able to get free legal help.
(See Legal Help to learn more.)
If you believe that the agency made a wrong decision on your case, the fair hearing process may be used to have the decision reviewed. Examples include:
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You believe your application was denied unfairly or
in error.
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Your benefits were suspended, reduced or ended and
you think it was a mistake.
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You do not agree with the amount of benefits you are
getting.
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Your application was not acted on within 30 days.
Read each letter you get carefully to help you under-stand the action taken. If the reason for the change in your benefits is a federal or state rule change, the Division of Hearings and Appeals is not required to give you a fair hearing.
Ask your agency to help you file for a fair hearing, or write directly to:
Department of Administration
Division of Hearings and Appeals
PO Box 7875
Madison WI 53707-7875
You can get the Fair Hearing Request form online at
dhs.wi.gov/em/customerhelp or by calling (608) 266-3096.
If you chose to write a letter in place of the form, you must include the following:
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Your name,
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Your mailing address,
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A brief description of the problem,
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The name of the agency that took the action or denied the service,
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Your social security number, and
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Your signature.
For FoodShare, your agency can take your request verbally.
Note: A request must be made no later than 45 days for health care or 90 days for FoodShare after the date of the action being appealed. You can request a hearing at any time while you are getting FoodShare benefits if you do not agree with the benefit amount. Your latest Enrollment Letter will have the date by which you must request a hearing.
You, your chosen representative (if you have one), and the agency will all get written notice at least 10 days before the fair hearing with the time, date and place of the hearing.
You have the right to bring witnesses, your own lawyer or other advisor to the fair hearing. The Department of Health Services will not pay for legal help to represent you, but, they may be able to help you find free legal help for questions or fair hearing representation.
You have the right to review any information in your case file that was used to determine your enrollment. You, or your representative, have the right to:
If the fair hearing is about whether or not you are disabled or unable to work due to illness or injury, you have the right to present medical evidence for proof. The agency will pay these costs.
If you cannot speak English, you have the right to have an interpreter present at the hearing. The Division of Hearings and Appeals may pay for translation or interpreters, if you ask.
If you are getting benefits and you ask for a hearing before your benefits change, you can keep getting the same benefits until the hearing officer makes a decision. If the hearing officer decides that the agency was right, you may need to return or repay the extra benefits that you get between the time you asked for your hearing and the time that the hearing officer decides about your case.
If you have asked for a hearing, you will still need to complete any scheduled renewals. If the agency tells you, before the fair hearing has taken place, that your enrollment period has ended, you must reapply and be found eligible for your benefits to be continued. If the renewal shows that there have been changes in your circumstances, your benefits may change or end because of these changes.
If the fair hearing decision is in your favor:
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No action will be taken against you by the agency.
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If your benefits have been ended, you will start receiving them again (the date you will start getting benefits will be listed in the letter of the Fair Hearing decision you get).
If the Fair Hearing is decided against you:
Ask the agency about any limitations on the recovery of overpayments.
No other action will be taken against you for filing a fair hearing request.
If you do not agree with the fair hearing decision, you have the right to ask for a “Rehearing”, if:
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You have important new evidence that was not known or available to you before the hearing that could change the decision, or
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You feel that there was a mistake in the facts of the decision, or
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You feel that there was a mistake in the legal basis of the decision.
A written request for a rehearing must be received within 20 days after the date of the written decision about the fair hearing. The Division of Hearings and Appeals will then decide within 30 days of getting the written request if you will get a rehearing. If the agency does not issue a written response to your request within 30 days, your request is denied.
If you do not agree with the fair hearing or rehearing decision, it is still possible for you to appeal this decision to the Circuit Court in your county. This must be done within 30 days after you get the written decision about the fair hearing or within 30 days of the denial of the rehearing request. An appeal to the Circuit Court must be done by filing a petition with the Clerk of Courts in your county. It is best to have legal help if you decide to appeal a fair hearing decision in Circuit Court.
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Last Revised:
September 07, 2012 |
