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West Virginia Income Maintenance Manual Chapter 1

West Virginia Income Maintenance Manual Page 9 Chapter 1 Application/Redetermination Process

The individual or his authorized representative can file the complaint using the Civil Rights Discrimination Complaint form (IG-CR-3) by phone or in person to the Civil Rights Compliance Officer, within 180 days of the incident to the following address: West Virginia Department of Human Services Office of Human Resource Management EEO/Civil Rights Officer One Davis Square, Suite 400 Charleston, West Virginia 25301 The individual may also report concerns for federal review within 180 days of the date of the incident to the following address: Centralized Case Management Operations U.S. Department of Health & Human Services Room 509F HHH Bldg 200 Independence Avenue, SW Washington, D.C. 20201 Or call (202) 619-0403 (voice) or (800) 537-7697 (TTY) A written complaint should include the following information: • The name of the person(s) felt to have been treated unfairly; • The date and description of the alleged discriminatory action; • The name(s) of other persons, if any, who were present when this action occurred; • The date the complaint is made; and, • The signature of the person or representative making the complaint. ➢ SNAP Only For SNAP benefits only, a copy of the IG-CR-3 must be sent to the following address, or the individual may file a direct complaint to: United States Department of Agriculture (USDA) Office of the Assistant Secretary for Civil Rights 1400 Independence Ave., SW Washington, D.C. 20250-9410 (866) 632-9992