Hearing Decision Implementation - Preparing and Submitting a Petition to Review
When there is disagreement with the
Office of Appeals hearing decision, the following have the right to appeal the decision:
●The Appellant
●The Appeals Processing Unit (APU)
●The Overpayment Unit
When either party (APU or Overpayment Unit (OPU)) is in disagreement they must notify the
Policy Support Team (PST) via email within three
workdays(g) from receipt of the hearing decision notice.
NOTE Decisions that are remanded by the Administrative Law Judge (ALJ) are not subject to a
petition for review(g) by APU or Overpayment Unit (OPU).
The notification must contain the following information:
●Be in writing and filed in person, by email or fax.
●The appellant’s name and Social Security number.
●AZTECS case number or HEAplus Customer ID number.
●The appeal number.
●The mail date shown on the hearing decision.
●A copy of the hearing decision notice that is being appealed.
●Written explanation as to why the Hearing Officer's decision should be reviewed by the Appeals Board. Include all CNAP Manual references and other evidence to support the explanation.
●All applicable audio files.
●Complete Appeals Packet.
●Describe why the Department disagrees with the ALJ’s decision.
●Be signed and dated by the Department’s representative.
NOTE Do not take negative action on the budgetary unit's benefits while an Appeals Board decision is pending. (See
Adjusting Benefits)
APU is responsible for assigning a contact person to handle
Appeals Board issues in a timely manner.
APU Completes all of the following:
●Sends the participant the Appeal of Hearing Decision (C837) notice. This notice allows the participant to choose not to continue their benefits during the appeal process.
●Allows the participant through the ninth
calendar day(g) from the decision date to respond.
●Follows the ALJ’s orders on the tenth calendar day when no response is received by the participant.
When the participant receives a notice of discontinuance and files an appeal before the effective date of closure, they are eligible for continued benefits.
When the ALJ remands the issue back to FAA for a new determination, the participant has the option to file an appeal on the new decision. When the participant files an appeal on the new decision, the participant is entitled to request continued benefits under the new timeframe.
PST is responsible for designating a PST staff member to review all requests for a Petition to Review. The designated PST staff member submits an Interoffice Memo (IOM) to the Attorney General’s office citing the appropriate legal references and a summary of why the decision should be appealed. This is submitted within 10 calendar days from the date of the decision that is being appealed. For NA, the IOM must be submitted withing 15 calendar days from the date of the decision that is being appealed.
NOTE When PST determines the ALJ’s decision is correct, PST sends an email containing all of the following to the APU or Overpayment Unit (OPU):
●The reason the request was denied.
●The supporting policy and procedures.
The Attorney General’s office submits a
Petition to Review to the Office of Appeals and represents the Department in the appeals board hearing.
When the Appeals Board rules in the Department’s favor, the participant could be responsible for an overpayment. When the Appeals Board does not rule in the Department’s favor, APU or Overpayment Unit (OPU) takes the necessary action on the case.