When the Family Community Resource Center becomes aware of an appeal related to the 60-month limit or exception decision, take the following actions:
- (FCRC) Verify appeal status by using Family Community Resource Center records and the Appeal Hearing System. Contact the Bureau of Assistance Hearings (BAH), if necessary.
- (FCRC) For active cases, if the appeal was filed on or before the date of change, authorize continued benefits unless the client states they do not want to receive them. Use TA 31/TAR 61 to:
- Enter code A for the exception reason. This reason code does not require central office approval.
- Enter Item 80 code 683 EXCPT with a date 4 months after the month in which the appeal was filed. For example, if the client appeals on 07/10/02, enter 11/02 as the code 683 date.
- (FCRC) Notify the RA of the appeal within one workday after you receive or become aware of the appeal.
- (FCRC) Contact the Bureau of Policy Development (BPD) by telephone, fax, or e-mail to expedite scheduling of the appeal hearing.
- (BPD) Logs the appeal.
- (BPD) Ensures BAH is aware of the need to prioritize scheduling of the appeal hearing.
- (BAH) Schedules the appeal hearing as soon as possible. Sends copies of scheduling notices and other appeal correspondence to FCRC, RA, and BPD.
- (FCRC) Conduct a pre-hearing review within 7 days after appeal is filed (see WAG 01-07-06). Schedule a pre-hearing meeting within
10 days after appeal is filed (see WAG 01-07-07). Involve the RA or designee in the review and meeting.
- If it appears the Department's action is correct, inform BPD that the appeal is proceeding.
- If the review indicates there may be a reason to change the Department's decision or additional evidence is presented at the pre-hearing meeting, fax the information to BPD at (217) 557-5850.
- (BPD) Presents the information to the Exception Committee, which considers it and makes a new decision.
- (BPD) Informs the FCRC and RA of the committee's decision.
- (FCRC) Take appropriate action.
- If the committee approves an exception, enter the exception coding on Form 552 through ACM, IPACS, or AIS. Issue benefits as appropriate. Tell the client and ask them to sign a Request to Withdraw Appeal (Form 65).
If client withdraws, see WAG 01-07-09 for how to tell BAH. Fax Form 65 to BPD and RA. No further action is needed. If client does not withdraw, continue
with the appeal process.
- If the committee denies an exception, continue with the appeal process.
- (FCRC) Notify the RA or designee that their participation will be needed in the appeal hearing.
- (FCRC) Present the Department's case during the appeal hearing.
- (FCRC) If new or additional information is presented that might change the Department's decision, request a continuance to consider it.
- If the continuance is denied, proceed with the hearing as planned.
- If the continuance is granted, immediately fax the information to BPD. Repeat steps 9 - 13.
- (FCRC) When the hearing reconvenes, present all available information.
- (BAH) Issues appeal decision. Sends copies to the FCRC, RA, and BPD.
- (FCRC) Take action based on the appeal decision.
- If the decision grants an exception that was not already approved by the Exception Committee, enter the exception coding and issue benefits as appropriate. If a client coded A is approved for an exception, change the A to the appropriate exception
code and update Item 80 code 683 with the exception review date.
- If the appeal is dismissed or the Department's action to reduce or cancel cash benefits is affirmed, take the appropriate case action and withhold the central notice. Delete code A and code 683. Determine and file an overpayment if the client
received benefits for which they were not eligible.
NOTE: The system does not authorize a 3-month extension after code A and code 683 are deleted.
- (FCRC) Report implementation of the appeal decision to BAH within 10 days if an action is required. Complete Implementation of Appeal Decision (Form 1456) showing all steps taken and the dates actions were taken
(see WAG 01-07-11). Send copies to the RA and BPD.