Chapter 29: Rules for Public Benefits Cases

2970.1

Sections 2970 through 2979 shall govern hearings requested by individuals, other than service providers, concerning the following benefits:

(a) Medicaid, Healthcare Alliance, or other healthcare programs administered by the District of Columbia;

(b) Temporary Assistance for Needy Families (TANF);

(c) Supplemental Nutrition Assistance Program (SNAP) (formerly Food Stamps);

(d) Interim Disability Assistance;

(e) Shelter and services for homeless persons;

(f) Rental Assistance programs;

(g) General Assistance for Children;

(h) Child Care Subsidy;

(i) Program on Work, Employment, and Responsibility (POWER);

(j) Burial Assistance;

(k) Any other benefits provided by the District of Columbia Department of Human Services (DHS);

(l) Low Income Home Energy Assistance Program benefits provided by the District of Columbia Office of Energy and the Environment (DOEE);

(m) Vocational Rehabilitation Services;

(n) Randolph Sheppard Vending Facilities Program (RSVFP); and

(o) Benefits subject to a complaint made under the District of Columbia Department of Disability Services’ (DDS) Formal Complaint Process.

2970.2

Sections 2970 through 2979 also shall govern hearings requested by DHS when it seeks to disqualify someone from receiving SNAP (formerly Food Stamps) benefits due to an intentional program violation.

2970.3

The Rules in Chapter 28 shall apply for procedural issues not addressed in §§ 2970 through 2979.

2970.4

If there is a conflict between any federal law or regulation and anything in these Rules, the federal law or regulation shall control.

2970.5

If there is a conflict between any District of Columbia statute and these Rules, the District of Columbia statute shall control.

2970.6

If there is a conflict between any other agency’s procedural rules or regulations and these Rules, these Rules shall control.

2971.1

A person can request a hearing by e-mailing, filing via eFiling portal, mailing, or bringing a written request to OAH, or by making an oral request in person at OAH or by telephone to OAH. OAH’s email address is [email protected]; its telephone number is 202-442-9094; and its street and mailing address is Office of Administrative Hearings, One Judiciary Square, 441 4th Street, NW, Suite 450 North, Washington, DC 20001.

2971.2

Hearing request forms shall be available at OAH (including on its website), at all DHS service centers, at the District of Columbia Department of Health Care Finance (DHCF), at DOEE, at the Division of Early Childhood Education at OSSE, and at DDS, Rehabilitation Services Administration.

2971.3

(a) A hearing request shall describe:

(1) The type(s) of benefits involved;

(2) The action or inaction to which the person objects; and

(3) The name and, to the extent available, the telephone number, mailing address, and e-mail address of the person requesting a hearing.

(b) Persons who request a hearing under the Homeless Services Reform Act may provide only an e-mail address at which they can receive any papers in the case, including notices and orders, if they do not have a street address or post office box where they can receive mail.

(c) If available, a copy of the agency’s notice of its action or decision shall be attached to the hearing request. A hearing request that does not contain a copy of the notice shall not be rejected on that basis alone.

2971.4

To make a hearing request in writing, a person may email, file via eFiling portal, mail, or bring a written request to:

(a) A DHS;

(b) DHCF for a hearing concerning Medicaid, Healthcare Alliance, or other healthcare programs administered by the District of Columbia;

(c) DOEE for a hearing concerning Low Income Home Energy Assistance Program benefits (LIHEAP);

(d) A shelter or other service provider for a hearing under the Homeless Services Reform Act;

(e) The Division of Early Childhood Education at OSSE for a hearing concerning childcare benefits;

(f) DDS, Rehabilitation Services Administration, for a hearing concerning vocational rehabilitation services; or

(g) OAH.

2971.5

To make a hearing request in person, a person may visit:

(a) A DHS service center;

(b) DHCF, or the Office of the Health Care Ombudsman and Bill of Rights, for a hearing concerning Medicaid, Healthcare Alliance, or other healthcare programs administered by the District of Columbia, or the Aging and Disability Resource Center for a hearing concerning the Elderly and Persons with Physical Disabilities (EPD) waiver program;

(c) DOEE, for a hearing concerning Low Income Home Energy Assistance Program benefits (LIHEAP);

(d) The Division of Early Childhood Education at the OSSE, for a hearing concerning childcare benefits;

(e) DDS, Rehabilitation Services Administration, for a hearing concerning vocational rehabilitation services; or

(f) OAH.

2971.6

To make a hearing request by telephone, a person may call:

(a) DHS;

(b) DHCF, for a hearing concerning Medicaid, Healthcare Alliance, or other healthcare programs administered by the District of Columbia;

(c) The Division of Early Childhood Education at OSSE, for a hearing concerning child-care benefits; or

(d) DDS, Rehabilitation Services Administration, for a hearing concerning vocational rehabilitation services; or

(e) OAH.

2971.7

If the agency or service provider receives a written hearing request, it shall file the request with OAH within three (3) calendar days of receiving the request.

2971.8

If the agency or service provider receives an oral or telephone hearing request, it shall prepare and file a hearing request form with OAH within three (3) calendar days of receiving the request.

2971.9

If OAH receives a written hearing request from an individual, it shall send the request to any agency or service provider whose decision is being challenged.

2971.10

If OAH receives an oral or telephone hearing request from an individual, it shall complete a written summary of the request and send it to any agency or service provider whose decision is being challenged.

2971.11

If DHS requests a hearing concerning a claim that a SNAP (formerly Food Stamps) recipient should be disqualified from receiving benefits due to an intentional program violation, it shall do so by completing and filing a hearing request form approved by the Chief Administrative Law Judge.

2972.1

An attorney or a law student may represent an applicant for, or recipient of, public benefits pursuant to § 2808. An attorney entering an appearance under § 2808 may withdraw an appearance only as allowed under § 2809.

2972.2

An attorney who meets the qualifications to represent a party under § 2808 may limit the scope of representation in accordance with this Section. Scope of representation may be limited by date, time period, activity, or subject matter.

2972.3

A party shall agree to the scope of representation. A party and an attorney may provide notice of their agreement to limited scope representation and specify the scope of representation by filing and serving a Notice of Limited Scope Representation.

2972.4

If the scope of representation is limited by date or time period, the attorney’s appearance terminates at the end of the date or time period, without the necessity of leave of court. If the scope of representation is limited by activity or subject matter, the attorney’s appearance terminates upon the attorney filing a Notice of Completion, which shall be filed with OAH and served on each party, including the attorney’s client.

2972.5

Service on an attorney who has entered a limited appearance is required only for matters within the scope of the representation as stated in the notice. Service shall also be made on the party. Service on the attorney for matters outside the scope of the limited appearance does not extend the scope of the attorney’s representation.

2972.6

An attorney may extend a limited appearance only by filing and serving a new notice of limited appearance pursuant to this Section or by filing and serving a Notice of General Appearance pursuant to § 2808.

2973.1

An applicant for, or recipient of, public benefits may be represented by a relative, a friend, or any other representative who is not employed by the District of Columbia government.

2973.2

 Any person who is not a lawyer and who requests a hearing on behalf of another person shall file a statement, signed by that other person, authorizing the non-lawyer to be a representative. A hearing request is subject to dismissal if the required statement is not filed. Before dismissing a case under this subsection, an Administrative Law Judge shall notify the representative of this requirement.

2973.3

In accordance with the District of Columbia Public Assistance Act, D.C. Official Code § 4-210.10, if the public benefits applicant or recipient who requested the hearing is not represented by a lawyer, the District or a service provider may not be represented by a lawyer at any hearing involving the following public benefit programs:

(a) Medicaid, Healthcare Alliance or other healthcare programs administered by the District of Columbia;

(b) Temporary Assistance for Needy Families (TANF);

(c) SNAP (formerly Food Stamps);

(d) Interim Disability Assistance;

(e) General Assistance for Children;

(f) Shelter and services for homeless persons; and

(g) Program on Work Employment and Responsibility (POWER).

2973.4

The District or a service provider may be represented by a lawyer at a hearing involving any other public benefit program regardless of whether the person who requested a hearing is represented by a lawyer.

2973.5

Sections 2808 and 2810 shall govern the practice of non-attorney representatives.

2974.1

An administrative review is an informal meeting between the person who has requested a hearing at OAH and a representative of the agency or service provider whose action or inaction is being challenged by that person. The purpose of an administrative review is to determine whether the agency’s or service provider’s position is valid and, if possible, to achieve an informal solution.

2974.2

An agency or service provider shall offer each person who requests a hearing at OAH an opportunity for an administrative review, if required by law. At least five (5) calendar days before the hearing date, the agency or service provider shall file and send to all parties and their representatives a status report, which says whether an administrative review was held, and the results of any review.

2974.3

In cases involving shelter or other services for homeless persons, as required by the Homeless Services Reform Act, DHS shall conduct the administrative review.

2974.4

As required by law, the agency or service provider shall make the case file available to the person who requested the hearing.

2975.1

Any party may file a request in writing for an Administrative Law Judge to issue a subpoena to require a witness to attend a hearing.

2975.2

The Administrative Law Judge shall issue a subpoena under this Section if it is likely that the witness will be able to provide testimony that will be helpful in deciding the case, and if requiring the witness to appear will not be unduly burdensome or otherwise contrary to law.

2975.3

Any party also may request a subpoena to require a witness to bring documents, photographs, or other materials to present as evidence at the hearing. The Administrative Law Judge shall issue a subpoena if it is likely that the requested items will be helpful in deciding the case, and if requiring those items to be produced will not be unduly burdensome or otherwise contrary to law.

2975.4

A form to be used to request a subpoena is available from OAH.

2975.5

If an Administrative Law Judge issues a subpoena, the party requesting the subpoena shall deliver it pursuant to §§ 2824.6 through 2824.9 and 2824.11. Unless otherwise ordered by an Administrative Law Judge, delivery shall be made at least two (2) days before the hearing.

2976.1

After a hearing request is filed, an Administrative Law Judge ordinarily shall schedule a hearing. If any applicable law requires that an administrative review be completed before a hearing takes place, a hearing shall not take place until the administrative review has been completed; a statutory deadline for completing the administrative review has passed; or the party requesting a hearing has waived their right to the administrative review.

2976.2

An Administrative Law Judge may schedule a status conference or other preliminary hearing to simplify the issues in the case, identify the parties’ legal and factual positions, rule on any preliminary legal issues, or for any other purpose.

2976.3

Any party may ask an Administrative Law Judge for a different hearing date. Copies of a request form shall be sent with any hearing notice and are available from OAH.

2976.4

Only an Administrative Law Judge may change a hearing date.

2977.1

The Administrative Law Judge shall decide at each hearing the order in which the parties will present their cases.

2977.2

If a party who requests a hearing fails to attend the hearing or a status conference without good cause, the Administrative Law Judge may dismiss the case without prejudice. “Good cause” for failing to attend a hearing or status conference includes, but is not limited to: serious illness, an accident, an unexpected child-care issue, severe weather conditions, or other emergency.

2977.3

If the agency or service provider whose action or inaction is being challenged fails to attend the hearing, the Administrative Law Judge may rule in favor of the person who requested the hearing.

2977.4

In a SNAP (formerly Food Stamps) Intentional Program Violation case, the District shall prove its case even if the other party fails to attend the hearing.

2977.5

Parties shall have the following rights at a hearing:

(a) To testify and to have other witnesses testify for them;

(b) To cross-examine witnesses called by another party;

(c) To request that any prospective witness be excluded from the courtroom;

(d) To examine all exhibits offered into evidence by another party;

(e) To object to the admission of any testimony or other evidence;

(f) To subpoena witnesses, as provided in § 2975; and

(g) To appear with a representative, as provided in §§ 2972 and 2973.

2977.6

At a hearing, all parties may present evidence. “Evidence” includes testimony by the parties and any witnesses that a party may present. Evidence also includes documents, photographs, or any other items that a party believes may help the Administrative Law Judge decide the case. The Administrative Law Judge shall decide what evidence becomes part of the record.

2977.7

Unless otherwise ordered by the presiding Administrative Law Judge, at least five (5) calendar days before the hearing date, each party shall file with OAH, and send to the other parties, a list of witnesses’ names and addresses, if available; and copies of any documents, photographs, or other items that the party wants the Administrative Law Judge to consider at the hearing. If the party who requested a hearing needs assistance copying or scanning documents or photographs, the party may request assistance from OAH.

2977.8

If anything is not filed according to the requirements of § 2977.7, and the other party shows that it has been prejudiced, the Administrative Law Judge shall have the discretion to set a new hearing date to allow the other party to prepare.

2977.9

If any party demonstrates that it has been prejudiced by the unexpected appearance of a witness, the Administrative Law Judge shall have the discretion to set a new hearing date to allow the other party to prepare for the witness testimony. If a witness was named on the witness list in the manner provided in § 2977.7, the Administrative Law Judge shall find that there has been no prejudice.

2978.1

If a federal or District of Columbia law or regulation imposes any time limitation for issuing or serving the decision in a particular public benefits matter, that law or regulation shall govern.

2979.1

Motions for reconsideration, a new hearing, or relief from a final order shall be decided in accordance with § 2830.