ASH Hearing Process
Appeals Process Overview
- Claimant files an appeal for a County inaction or action.
- The Appeals Hearing Specialist reviews the correctness of the action and contacts the claimant to discuss it.
- If the County acted incorrectly, the Appeals Hearing Specialist resolves the appeal with the claimant.
- If the County acted properly and met all procedural requirements, the Appeals Hearing Specialist prepares the appeal for the hearing phase.
Aid Paid Pending (APP)
- If an adequate hearing request is filed before the effective date of the County's action, aid can be continued at the same level. The ALJ may order continuation of APP until the hearing decision is rendered.
- APP must be initiated within 5 days from the filing date of the appeal and issued within the claimant's normal benefit issuance date.
Withdrawal of a Hearing Request
- The claimant can agree to withdrawal his/her hearing request before the official State Hearing.
- A "Conditional Withdrawal" is where the claimant agrees to withdraw the hearing request and the County agrees to take corrective action.
- A "Straight Withdrawal" is where the claimant cancels the hearing request because his/her issues are resolved and the claimant is satisfied with the County's action.
Reasons for "Conditional Withdrawals"
- Unavailability of case record or suitable documents.
- Inadequate Notice of Action (i.e., untimely, missing).
- Unsubstantiated County actions.
- Conflicting or discrepant information in the case record.
- Lack of corroborating evidence in the case record.
- Misapplication of regulations by the County.
Request for Case Correction for Conditional Withdrawals
- The Appeals Hearing Specialist contacts the district offices to discuss the Conditional Withdrawals before making a final agreement with the claimant; however, ASH has final authority to enter into a Conditional Withdrawal.
- The Appeals Hearing Specialist forwards the case correction to the district office within 2 working days of the claimant's agreement with the Conditional Withdrawal.
- Districts offices must comply with case correction instructions within 30 days of the agreement.
- Failure to comply with a Conditional Withdrawal may result in the claimant requesting a reopening of his/her State Hearing request.
- The Appeals Hearing Specialist prepares a "Statement of Position" with supporting documentation.
- The Appeals Hearing Specialist and required witnesses appear at the hearing before the ALJ; all hearings are taped. Proper court demeanor includes formal oath of all participants and witnesses.
- The Appeals Hearing Specialist does the oral presentation of the County's position, the claimant/or an AR presents their position and the ALJ asks questions as needed.
- The hearing ends and the ALJ must deliver a decision within 90 days from the initial filing date of the appeals request.
- Granted Decision: The appeal was decided in favor of the claimant; County will comply with the decision even if a rehearing is being requested by the County.
- Denied Decision: The claimant's appeal was denied.
- Granted in Part, Denied in Part: Part of the claimant's appeal was decided in his/her favor and part was denied.
- Dismissal of Decision: The issue appealed was outside the CDSS State Hearings Division's jurisdiction or the hearing request was untimely.
- Remanded Decision: The ALJ instructed the County to take specific action about the appeal but did not make a decision on the merits of the case.
- Stipulated Decision: An agreement by the County and the claimant was made at the hearing, whereby the County granted some or all of the claimant's allegations.
- Rehearing: The claimant or the County can contest the hearing decision within 20 days from receipt of the decision. CDSS' State Hearings Division's Legal Section reviews the rehearing request and grants or denies the requests. If a rehearing is granted, a new hearing is held or it might be limited to a review of the record where a new binding decision is rendered.
- Judicial Review: The claimant or County may file a petition in the Superior Court to review a hearing decision or a rehearing decision. The petition must be filed within one year of receipt of the final decision. The Los Angeles County Counsel is responsible for processing any judicial review requests.
Compliance with Hearing Decisions (CDSS Manual of Policy and Procedures, Section 22-078)
- District offices must comply with a hearing decision within 20 days from receipt of the decision and also submit evidence substantiating compliance to the ASH Compliance Unit within this timeframe.
- The ASH Compliance Unit must report the County's compliance with a hearing decision to CDSS' State Hearing Division within 30 days from receipt of a decision.
- If the action taken by the County is correct, CDSS' State Hearing Division notifies the claimant and the County that they approve the action taken. If the action taken is not correct, they notify the claimant and County and provide instructions on the pending necessary action.
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