WAG 01-07-07-b: Appeal of "Not Disabled" Determination

PM 01-07-07-b

(Client) Files appeal of "Not Disabled" determination.

(FCRC) If necessary, contact other Department staff involved in the determination of "Not Disabled".

(Client or Representative) May provide medical or other information, evidence, or testimony relevant to appellant's condition.

(FCRC) Complete the original and one copy of Notice to Persons Appealing a Determination of Failure to Meet Disability Eligibility Requirements (Form 2397). Send the original Form 2397 to the appellant within 48 hours of receipt of appeal request. File a copy of Form 2397 in the case record.

(FCRC) Following the pre-hearing meeting, submit to CAU for reconsideration: medical or any other information, evidence, or testimony related to disability on which CAU based the finding (all medical reports; Medical Evaluation [Forms 183A, 183B, and 183C]) If Mail-In Application for Medical Benefits (Form HFS 2378H) is completed, Form G may be used in place of Form 183B; and any new medical or other information, evidence, or testimony related to disability submitted by the appellant/or their representative during the pre-hearing meeting.

(FCRC) Submit information to CAU, even if there's no new information. At the top of the covering memo to CAU, indicate that this is an "APPEAL". Also, indicate either "ADDITIONAL MEDICAL ATTACHED" or "NO ADDITIONAL MEDICAL ATTACHED", as applicable.

(CAU) Before the appeal hearing, reports the results of a reconsideration to the FCRC on Form 183C.

(FCRC) For AABD cases , contact CAU to determine the status of the case if the FCRC hasn't received Form 183C by 2 workdays before the date of the scheduled hearing. If CAU has again determined that the appellant is not disabled or has not made a decision in the case, contact the Assistance Hearings Section (AHS) and the appellant or appellant's representative to postpone the hearing until you receive the CAU decision. If CAU has determined that the appellant is disabled, immediately authorize benefits. Send the appropriate notice to the appellant with a copy to their representative. Include a letter and Form 65 asking the appellant and their representative to withdraw the appeal.

(FCRC) If the appeal is not withdrawn, present CAU completed Form 183C and all other reports, information, and medical information, evidence, or testimony related to the disability used by the Department at the hearing.