Virginia Law

A. Every applicant or recipient shall have the right to request a hearing before a hearing officer. An opportunity for a hearing shall be granted to any applicant who requests a hearing because his claim for financial assistance is denied, or is not acted upon with reasonable promptness, and to any recipient who is aggrieved by any agency action resulting in suspension, reduction, discontinuance, or termination of assistance, or determination that a protective, vendor, or two-party payment should be made or continued. A hearing need not be granted when either state or federal law required automatic grant adjustments for classes of recipients unless the reason for an individual appeal is incorrect grant computation. A hearing may be requested by a clear expression, oral or written, by any member of an assistance unit or its authorized representative to the effect that it wishes to appeal a decision or that an opportunity to present its case to a higher authority is desired.

B. An applicant or recipient shall be allowed to request a hearing on any agency action or loss of assistance for up to 30 days after receipt of the notice of adverse action if the proposed action is effective within the next 30 days. If the proposed action is effective more than 30 days following receipt of this notice, an appeal may be filed until the effective date. In addition, an assistance unit may at any time request a hearing to dispute its current level of assistance. Within 90 days of the receipt of a request for a hearing, the hearing shall be conducted, a decision reached, and the applicant or recipient shall be notified of the decision.

C. The applicant or recipient shall be afforded all rights as specified in this section.

D. Every applicant or recipient shall be informed in writing at the time of application and at the time of any action affecting his claim:

1. Of his right to a hearing,

2. Of the method by which he may obtain a hearing;

3. That he may be represented by an authorized representative, such as legal counsel, relative, friend, or other spokesman, or he may represent himself.

E. The hearing shall be conducted at a reasonable time, date, and place, and adequate preliminary written notice shall be given.

F. When the hearing involves medical issues such as those concerning a diagnosis, an examining physician's report, or a medical review team's decision, a medical assessment other than that of the person or persons involved in making the original decision shall be obtained at agency expense and made part of the record if the hearing officer considers it necessary.

G. The hearing shall include consideration of:

1. An agency action, or failure to act with reasonable promptness, on a claim for financial assistance, which includes undue delay in reaching a decision on eligibility or in making a payment, refusal to consider a request for or undue delay in making an adjustment in payment, and discontinuance, termination or reduction of such assistance;

2. An agency decision regarding:

a. Eligibility for financial assistance in both initial and subsequent determinations;

b. Amount of financial assistance or change in payments; or

c. The manner or form of payment, including restricted or protective payments.

H. The claimant, or his representative, shall have adequate opportunity to:

1. Examine the contents of his case file and all documents and records to be used by the agency at the hearing at a reasonable time before the date of the hearing as well as during the hearing;

2. At his option, present his case himself or with the aid of an authorized representative;

3. Bring witnesses;

4. Establish all pertinent facts and circumstances;

5. Advance any arguments without undue interference;

6. Question or refute any testimony or evidence, including opportunity to confront and cross-examine adverse witnesses.

I. Decisions of the hearing officer shall be based exclusively on evidence and other material introduced at the hearing. The transcript or recording of testimony and exhibits, or an official report containing the substance of what transpired at the hearing, together with all papers and requests filed in the proceeding, and the decision of the hearing officer shall constitute the exclusive record and shall be available to the claimant at a place accessible to him or his representative at a reasonable time.

J. Decisions by the hearing officer shall:

1. In the event of an evidentiary hearing, consist of a memorandum decision summarizing the facts and identifying the regulations supporting the decision;

2. In the event of a de novo hearing, specify the reasons for the decision and identify the supporting evidence and regulations.

K. The claimant shall be notified of the decision in writing.

L. When the hearing decision is favorable to the claimant, or when the agency decides in favor of the claimant prior to the hearing, the Department of Social Services shall promptly make corrective payments retroactively to the date the incorrect action was taken.