UPM 1570.20 - Eligibility Pending Fair Hearing

CONNECTICUT DEPARTMENT OF SOCIAL SERVICESPRIVATE UNIFORM POLICY MANUAL _____________________________________________________________________________ Date: 06-01-10 Transmittal: UP-10-12 1570.20 ______________________________________________________________________________ Section: Type: The Eligibility Process POLICY ______________________________________________________________________________ Chapter: Program: AFDC Fair Hearings AABD _______________________________________________________________ MA Subject: SNAP Eligibility Pending Fair Hearing ______________________________________________________________________________

1570.20 A. Maintaining Benefits Pending Hearing Decision

Except in situations described below, the Department does not terminate or reduce the assistance unit's benefits until the Fair Hearing decision is reached if the unit requests a Fair Hearing within the 10‑day notice period, as described in this chapter.

Unless the assistance unit specifically waives its right to a continuation of benefits, the Department assumes that the unit's request for a Fair Hearing within the 10‑day period includes a request that the unit's benefits remain the same pending the Fair Hearing decision.

B. Exceptions to Maintenance of Benefits

The Department reduces or terminates the assistance units benefits prior to the Fair Hearing decision even if the unit requests a Fair Hearing within the 10 day notice period if it determines at the Fair Hearing that the sole issue is one of federal or state law or departmental policy, and not one of incorrect grant computation.

In respect to benefits issued under the Emergency Housing policy (Cross Reference: 4515 and 4525), the benefits are not continued beyond a specific date if the Department notified the assistance unit in writing at the time of grant that:

the benefits are being authorized for a specific period of time; and

the benefits will automatically terminate when the specific period ends.

In the AFDC program and the Supplemental Nutrition Assistance Program, the Department reduces or terminates the assistance unit's benefits prior to the Fair Hearing decision, in addition to the situation described in paragraph 1, if:

a change affecting the assistance unit's grant occurs while the Fair Hearing decision is pending and the unit fails to request a Fair Hearing based on this notice; or

a mass change affecting the unit’s eligibility or grant occurs while the Fair Hearing decision is pending.

CONNECTICUT DEPARTMENT OF SOCIAL SERVICES UNIFORM POLICY MANUAL _____________________________________________________________________________ Date: 06-01-10 Transmittal: UP-10-12 1570.20 page 2 ______________________________________________________________________________ Section: Type: The Eligibility Process POLICY ______________________________________________________________________________ Chapter: Program: AFDC Fair Hearings AABD _______________________________________________________________ MA Subject: SNAP Eligibility Pending Fair Hearing ______________________________________________________________________________

1570.20 B. Exceptions to Maintenance of Benefits (continued)

In the Supplemental Nutrition Assistance Program, the Department reduces or terminates the assistance unit's benefits prior to the Fair Hearing decision, in addition to the situations described in paragraphs 1 and 3, if the unit's certification period expires. In this case, the unit must reapply for benefits.

C. Notification of Assistance Unit

The Department promptly notifies the assistance unit in writing if benefits are reduced or terminated pending the Fair Hearing decision, as described in paragraph B.

D. Reinstatement of Benefits

1. Under the conditions described below, the Department reinstates the assistance unit's benefits if such benefits have been reduced or terminated pending a Fair Hearing decision.

a. In the AFDC and Medicaid programs, the Department reinstates the assistance unit's benefits if:

(1) the Department takes an action without sending timely notice; and

(2) the assistance unit requests a Fair Hearing within 10 days of the mailing date of the notice; and

(3) the Department determines that federal or state law or departmental policy is not the sole issue involved in the Fair Hearing.

b. In the Supplemental Nutrition Assistance Program, the Department reinstates the assistance unit's benefits if:

the unit establishes to the satisfaction of the Department that it had good cause for not requesting a Fair Hearing within the 10 day notice period. Good cause includes, but is not limited to the following:

CONNECTICUT DEPARTMENT OF SOCIAL SERVICES UNIFORM POLICY MANUAL _____________________________________________________________________________ Date: 06-01-10 Transmittal: UP-10-12 1570.20 page 3 ______________________________________________________________________________ Section: Type: The Eligibility Process POLICY ______________________________________________________________________________ Chapter: Program: AFDC Fair Hearings AABD _______________________________________________________________ MA Subject: SNAP Eligibility Pending Fair Hearing ______________________________________________________________________________

1570.20 D. Reinstatement of Benefits (continued)

an onset of serious illness or injury; or

a catastrophic event such as fire, flood or eviction; or

(c) non‑receipt of the notice; or

(2) the issue involves a reduction or termination of benefits caused by a mass change, and the assistance unit claims either that the Department made a computation error or that the Department misapplied federal law or regulation.

2. If the Department reinstates the assistance unit's benefits pending the Fair Hearing decision, the unit continues to receive such benefits until the decision is rendered, except under conditions described in paragraph B.

E. Corrective Action

1. If the Department does not reduce or terminate the assistance unit's benefits pending the Fair Hearing decision, and the decision upholds the Department, the Department recoups the overpayment which the unit received during this period.

2. If the Department reduces or terminates the assistance unit's benefits pending the Fair Hearing decision, and the decision favors the unit, the Department makes a prompt corrective payment to the unit to correct the underpayment which occurred during this period.