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Appeals Process
A request for an administrative appeal can be submitted verbally or in writing to the appropriate DHHS program or service. There are limited time frames to appeal an action or decision. The Notice of Rights and Responsibilities and Notice of Decision provide time limits in which an appeal or fair hearing can be requested for specific programs or services. In some cases if the request for an appeal is received within 10 days of a decision, services may continue at the before-notice level until a decision is issued on the appeal.

The Administrative Appeals Brochure Adobe Acrobat Reader Symbol provides more general information about the appeals process.

  • What are my rights as the party who asked for a hearing (Appellant)?
    • As an Appellant, you have the following rights:
      • You may represent yourself, be represented by a friend, relative, or other person, or may be represented by an attorney at your own expense
      • You, or your authorized representative, may examine the case file prior to or during the hearing, including any and all documents or records to be introduced by the other party at the hearing. (Note: Prior arrangements must be made in order to examine the case file, and the material to be examined will not include any confidential material, or other material protected from disclosure by law.)
      • You will be given an opportunity to testify.
      • You may bring witnesses and have them testify.
      • You may introduce evidence to establish all pertinent facts and circumstances.
      • You may present any relevant arguments without undue interference.
      • You may cross-examine the other party's witnesses.
      • You may question or refute any testimony or evidence.
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  • Do I need an attorney?
    • You do not need an attorney, however, you may want one to protect your interests and rights. The laws and rules are complicated, but do remain the same whether or not you have an attorney.
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  • What are the "mandatory pre-hearing disclosure requirements" mentioned in the Notice of Hearing?
    • The following items must be mailed and received by the Administrative Appeals Unit and other party(ies) at least 5 days before the hearing:
      • If you plan to call any witnesses, you must provide a list of witnesses with a brief summary of what they will say;
      • If you have any exhibits (documents such as medical records, written opinions, letters or other evidence) that you want the presiding officer to consider, you must provide a list of the exhibits and provide a copy of each exhibit.
      • This requirement does not apply to pre-hearing conferences.
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  • How should my exhibits (documents) be identified?
    • Each exhibit must be labeled "Appellant" and numbered. For example, your first exhibit will be labeled "Appellant 1", the second will be "Appellant 2" and so on. The DHHS exhibits shall be labeled using "DHHS".
  • Am I allowed to contact the presiding officer about questions or concerns that I have?
    • Any communication with the presiding officer that does not include all parties is prohibited. An example of prohibited communication is sending a letter or exhibit to the presiding officer, without sending a copy to the other parties. Communication between the parties, however, does not violate any rule and is encouraged.
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  • What should I do if I will not be able to make it to the hearing?
    • As soon as you know that you cannot attend the hearing, you should call the other parties and ask if they will agree to have the hearing continued (rescheduled). Next you should write to the Administrative Appeals Unit to ask that the hearing be continued. You must explain why the hearing needs to be continued, and whether the other parties agree to reschedule the hearing. If it is too late to ask for a continuance in writing, you may call the AAU with your request. You must contact the AAU, by letter or phone, before the date of the hearing. Do not assume that your request for a continuance has been granted. The hearing will not be continued unless your request is granted.
  • What happens if I do not attend a scheduled hearing?
    • If you do not attend the hearing and you have not been granted a continuance, your appeal will be dismissed automatically. Several people must prepare for the hearing and if a party does not attend, resources and time that could be spent on other cases are wasted. If you want to withdraw your appeal, you must notify the other parties and the Administrative Appeals Unit prior to the hearing. This notification should be in writing, but may be done by telephone if time is a factor.
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  • What time should I arrive for the hearing?
    • You should arrive at least 15 minutes before the start of the hearing. This will allow you a few minutes to get settled, and discuss any last minute issues with the other parties.
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  • Does the document provided to me contain all of the rules, regulations and laws that I need to know for the hearing?
    • No. The purpose of the document is to present some of the frequently asked questions and the answers in general terms. DHHS Rules of Practice and Procedure and Hearings govern the hearing process.
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  • What is meant by burden of proof at a hearing?
    • Burden of proof is the duty that is placed on one of the parties to initially produce evidence and testimony and to persuade the presiding officer to find in their favor.

      The general rule is that the party who appealed has the burden of proof. Each case is different, however, and you will be notified at the time of the hearing which party has the burden of proof.

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  • What opportunity will I have to present my case at the hearing?
    • Once the hearing begins, the presiding officer may ask for opening statements. You are not required to make an opening statement. If you do, it should be brief, no more than a minute or two. The opening statement is your opportunity to provide a brief overview of your position in the matter being addressed at the hearing.

      Next, the parties will take turns presenting evidence and testimony. Usually, the party with the burden of proof goes first. Whether you go first or not, the basic process will be the same. When it is your turn, you may call your witnesses one at a time. The presiding officer will swear them in, and you may ask them questions. When you are finished questioning each witness, the other parties will have a chance to question or cross-examine your witness. If you have no witnesses, you will be sworn in and may tell the presiding officer your side of the story. If you do this, other parties may question you when you are finished making your statement. All parties will be given the same opportunity to call witnesses, make statements, and cross-examine the other party's witnesses. The presiding officer may ask questions of any witness or party at any time during the hearing.

      When all testimony has been given, each party may make a closing argument. A closing argument should be brief (no more than 3 to 5 minutes) and should highlight and summarize the evidence that supports your position. You are not required to give a closing argument, and there is no penalty for not giving one.

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  • Are there any additional rules to follow during the hearing?
    • Yes. Be courteous to all individuals, even if you disagree with them. You should not interrupt others when they are talking. The only time you are allowed to interrupt is to make an objection. If you object to any testimony or evidence, you must state the reason for your objection. The presiding officer may refuse to accept the evidence or testimony if it repeats something already presented or is not related to the issue.
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  • When will a decision be made in my case?
    • The presiding officer will issue a written decision sometime after the hearing concludes and the record is closed.
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  • Can I submit additional evidence after the hearing?
    • In general, evidence sent to the presiding officer after the hearing will not be considered in the decision. There are some exceptions to the general rule, and you will be told at the hearing if any exception applies. You should make every effort to submit all of your exhibits at least five days before the hearing.
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