DO NOT EDIT THE RED BUTTONS UNLESS YOU ARE AN OCTO EDITOR
For many types of issues, OAH has standard forms to help you file a hearing request. Using a form is preferred, but if you are unable to use a form, you can write or type your hearing request on a blank sheet of paper. Your hearing request should have the following information:
- a short description of your dispute
- a description of what you want the judge to do
- any key dates involved
- your name, address, phone number, and email address (if you have one)
- if known, the name, address, phone number, and email address of the other party involved in the dispute
Hearing Request Forms for Employment-Related Issues
Use this form to appeal a decision by the Department of Employment Services (DOES) regarding Unemployment Benefits.
Use this form to appeal a decision by the Office of Risk Management (ORM) regarding Public Sector Workers Compensation Benefits.
Use this form to appeal a decision by the Office of Paid Family Leave (OPFL) Regarding Paid Family Leave Benefits.
Hearing Request Forms for Public Benefits Issues
For a public benefits case, you can request a hearing by phone. If you want to make your request by phone, call OAH at (202) 442-9094, press “3” from the main menu for a case filing, and then press “3” again from the next menu for Public Benefits.
You can also request a hearing in writing using one of these forms.
Use this form to appeal a decision or action by the Department of Human Services (DHS) regarding the Supplemental Nutrition Assistance Program (SNAP, also known as Food Stamps), Temporary Assistance for Needy Families (TANF), General Assistance for Children (GAC), Interim Disability Assistance (IDA), or another benefit program administered by DHS.
Use this form to appeal a decision or action by the Department of Human Services (DHS) or a DHS Provider regarding a Rental Assistance Program, such as the Family Re-Housing and Stabilization Program (FRSP), the Emergency Rental Assistance Program (ERAP), or Permanent Supportive Housing (PSH).
Use this form to appeal a Shelter Decision or Action.
Use this form to appeal a decision or action by the Department of Human Services (DHS) regarding financial eligibility for Medicaid, the Elderly and Persons with Physical Disabilities (EPD) Waiver Program, DC Healthcare Alliance, or the Health Benefit Exchange.
Use this form to appeal a decision or action by the Department of Health Care Finance (DHCF) or DHCF’s contractor regarding healthcare coverage under Medicaid, the Elderly and Persons with Physical Disabilities (EPD) Waiver Program, or DC Healthcare Alliance.
Use this form if you are or applied to be a Medicaid provider and you want to appeal a decision from the Department of Health Care Finance regarding you provider status or payments.
Use this form to appeal a decision or action by the Department of Behavioral Health (DBH) regarding the Home First Subsidy, a Mental Health Community Residence Facility, or DBH’s complaint review process.
Use this form to appeal a decision or action by the Department on Disability Services (DDS) regarding a disability program or service.
Use this form to appeal a decision or action by the Department of Energy and Environment (DOEE) regarding the Low Income Home Energy Assistance Program (LIHEAP).
Use this form if you believe your public benefit situation requires an emergency hearing.
Hearing Request Forms to Contest Enforcement Agency Notices
Use this form to answer a taxicab or for-hire vehicle ticket for the violation of a Department of For-Hire Vehicle (DFHV) regulation. This will be listed on the ticket as a "Title 31" violation.
Use this form to answer a Notice of Violation (NOV) from the Department of Public Works (DPW) or a Notice of Infraction (NOI) from the Department of Consumer and Regulatory Affairs (DCRA), Department of Health (DOH), Department of Energy and Environment (DOEE), the Department of Transportation (DDOT), or another enforcement agency.
Use this form to appeal a decision about a Stop Work Order from the Department of Consumer and Regulatory Affairs (DCRA).
If you received a Final Order from OAH saying you owe a fine and penalties because you did not respond to a NOV or NOI, you should not use one of these forms. Instead, visit the Closed Case Forms page and follow the instructions for appealing an OAH Final Order.
Hearing Request Forms for Other Case Types
Use this form to appeal a decision or action from Child Support Services Division (CSSD) regarding child support enforcement.
Use this form to appeal a decision by the Metropolitan Police Department (MPD) regarding a Security Officer Certification.
Use this form to appeal a decision by the Metropolitan Police Department (MPD) regarding a Firearm Registration Certificate.
Use this form to protest of a Proposed Assessment of Deficiency, Interests and/or Penalty by the Office of Tax and Revenue (OTR).
If you do not see a standard form for the type of case you want to file, you may use the General Hearing Request Form. However, it is ultimately your responsibility to know whether OAH is the right place to request a hearing for your legal issue. If OAH does not have authority over an issue, your OAH hearing request will be dismissed.
Also, some types of hearing requests require a form provided by another agency. And some cases that come to OAH are initially filed with another agency. Pay close attention to instructions in any notice you received to see if any special circumstances apply. You should also look at the OAH Rules for further clarification. You can find the OAH Rules on the Rules & Laws page.
If you still have questions, you may contact the OAH Resource Center by calling (202) 442-9094 and pressing “4” from the main menu, or by emailing [email protected].
When you are ready to file your completed form, go to the Filings & Forms homepage for instructions on how to file your form with OAH.