1614.4 Completion of Agency Summary

Within 15 days after the appellant has filed a request for a fair hearing, the agency shall furnish the appellant and the Office of Administrative Hearings (OAH) with a summary. One copy of the summary shall be sent electronically to the OAH. Another copy shall be mailed to the appellant or representative. The summary shall include the following information:

Name and address of the appellant;

A summary statement concerning why the appellant is filing a request for a fair hearing;

A brief chronological summary of the agency action which led to the appeal and the agency's action after receiving the request for fair hearing;

A statement of the basis for the agency's decision;

A citation of the applicable policies relied upon by the agency;

A copy of the notice which notified the appellant of the decision in question;

Applicable correspondence; and

The name and title of the person or persons who will represent the agency at the hearing.

When the request for fair hearing involves a Disability Determination Services (DDS) disability determination, the process described in 1614.6(1)(c) shall be followed.

If through an agency contract as discussed in 1614.2 , the appellant has withdrawn the appeal (see 1614.3 ), completion of the summary is not necessary. The Request for Administrative Hearing form should then be submitted, along with the Notice of Withdrawal of Appeal, to OAH within 7 days of the date of the request for a fair hearing.