Pennsylvania Code › Title 55 - HUMAN SERVICES › Part II - Public Assistance Manual › Subpart H - Appeal and Fair Hearing › Chapter 275 - APPEAL AND FAIR HEARING AND ADMINISTRATIVE DISQUALIFICATION HEARINGS › Subchapter A - APPEAL AND FAIR HEARING › GENERAL PROVISIONS › Section 275.1 - Policy

Current through Register Vol. 54, No. 28, July 13, 2024
(a)
Right
						to appeal and have a fair hearing.
The policy with regard to the right
						to appeal and have a fair hearing will be as follows:
(1) The freedom of the applicant or recipient
						to request a hearing is a fundamental right and is not to be limited or
						interfered with in any way.
(2) The
						regulations contained in this chapter, in accordance with the law, afford every
						person applying for or receiving a money payment, medical assistance, food
						stamps or services the right to appeal from a Departmental action or failure to
						act and to have a hearing if he is dissatisfied with a decision refusing or
						discontinuing assistance in whole or in part.
(3) As used in this chapter, the term
						departmental includes, in addition to County Assistance Offices, agencies which
						administer or provide social services under contractual arrangements with the
						Department.
(4) The term assistance
						as used in this chapter means a money payment, medical assistance, food stamps
						and services.
(i)
Right of
						appeal.
Therefore, the opportunity for a hearing will include the
						right of appeal from the following:
(A) A
						denial, suspension or discontinuance in whole or in part.
(B) A change in the amount of
						payment.
(C) A denial,
						discontinuance, reduction or exclusion from a Departmental service program
						including the failure to take into account the client's choice of a service or
						a determination that he must participate in a service program.
(D) The manner or form of payments, including
						restricted or protective payments. Exception: When the Department denies or
						discontinues a protective or vendor payment the right of appeal in this clause
						will not apply.
(E) Undue delay in
						making a payment adjustment or acting upon a request or application.
(F) Overpayment and reimbursement claims,
						including the computation of the amount of the claim and collection
						procedures.
(G) An action taken
						under the Child Support Enforcement Program (IV-D), that is, assignment or
						reassignment of support orders, reimbursement of delayed support payments,
						arrearages and the like.
(H) A
						denial of a request for a correction or a deletion in the case file.
(ii)
No right of
						appeal.
An appeal will be dismissed by the Office of Hearings and
						Appeals under the following circumstances:
(A)
						A person will not have the right to appeal from the following:
(I) A decision by the Department to initiate
						prosecution proceedings under §
																255.4 (relating to
						procedures).
(II) When the decision
						does not involve food stamps and the sole issue is one of State or Federal law
						requiring automatic grant adjustments for classes of recipients, unless there
						is an error in the mathematical computation of the grant. There is always a
						right to appeal a food stamp decision.
(III) Where a decision has been rendered
						after a WIN hearing before the manpower agency that a participant has, without
						good cause, refused to accept employment or participate in the WIN Program, or
						has failed to request such a hearing after notice of intended action for the
						refusal.
(IV) When a reimbursement
						claim has been collected by the Bureau of Claims Settlement, a client who
						desires to have money returned to him which has been reimbursed to the
						Department must petition the Department of Treasury, Board of Finance and
						Revenue.
(B) A client
						will be notified in writing of his right to request a hearing when a decision
						is made on eligibility and when a change in eligibility occurs. The written
						notices of this right appear on the Form PA 5-M, Form PA 162, Form PA 162-A,
						and Form PA 162-C.