Page 11

NYS Office of Temporary and Disability Assistance- TA and SNAP Employment Policy Manual

Appendix C – Page 11 Rev. 3/2022

The second check box (Part 2 - Medical Work Limited) applies to individuals whose personal health status has been evaluated and who have been determined to be nonexempt and work limited. It explains to the individual the effective date of the determination and that they have ten days from the notice date to request a fair hearing. Please note: the “effective date” of the determination and the “notice date” should be the same date. The district must identify in this section of the notice the individual’s limitations as determined by a licensed physician or other medical professional.

The third check box (Part 3 - Nonexempt-Other Than Medical) is used to notify an individual that they have been determined to be nonexempt from work requirements for reasons other than a personal health related issue. It explains to the individual the effective date of the determination and the reason for the determination. It also notifies the individual that they have 60 days from the notice date to request a fair hearing. Please note: the “effective date” of the determination and the “notice date” should be the same date.

The notice also includes a description of the duties of a nonexempt person related to finding and keeping a job, including the requirement to participate in work activities. Fair Hearing Rights

This section of the notice informs applicants and recipients of the right to request a Fair Hearing within 10 or 60 days of the notice date depending on which section is completed and includes instructions describing how to request a Fair Hearing.