1. (a) Rights of the appellant. An appellant has the right to appear in person at the hearing and he may represent himself, or he may be represented. For food stamps, the appellant may also bring friends or relatives to the hearing; however the hearing examiner may limit the number of persons in attendance at the hearing if space limitations exist. The appellant or his representative, if any, have the following rights:

   1. (1) To present evidence on his own behalf, to bring witnesses or documents he deems necessary, and to confront and cross-examine witnesses the county office, administering agency or social service provider will produce to support its decision or action.
   2. (2) To request a subpoena from the hearing officer for the production of evidence or witnesses that he feels will be essential in obtaining necessary facts.

   3. (3) To examine prior to the hearing, as well as during the hearing, documents which the county office, administering agency or social service provider will introduce as evidence in the hearing as well as the contents of the case files as provided for in § 105.5 (relating to access by an individual to his case file) or appropriate confidentiality regulations for the service program.

      1. (i) If the appellant requests material from the case file, other than narrative material dated prior to January 1, 1980 which the County Assistance Office, administering agency, or service provider believes is within one of the exceptions of § 105.5(b) or appropriate confidentiality regulations for the service program, a hearing officer will determine prior to the date of the hearing, whether the material is relevant and whether it tends to support the position of the appellant. However, under no circumstances may the same hearing officer conduct the hearing.
      2. (ii) The hearing officer will refuse access to irrelevant material, but will allow access with appropriate safeguards to relevant, confidential information which supports the position of the appellant. If the office, agency, or provider wishes to protect the confidentiality of such relevant information, in spite of the decision of the hearing officer, it must provide the relief requested. The case record material will be made available on as early a date as possible prior to the hearing so that the appellant and his representative shall have ample opportunity to review the evidence of the county or that of the administering agency or social service provider and prepare their case.

      3. (iii) To obtain a hearing officer’s determination of whether the appellant may examine the material in question, the County Assistance Office, administering agency or social service provider will promptly provide the Office of Hearings and Appeals a summary of the situation which will include the following:

         1. (A) The decision or action which precipitated the appeal and the reasons for it.
         2. (B) The specific document or subject matter the appellant wants to examine.
         3. (C) The reasons for withholding the material.
      4. (iv) A copy of the summary will also be promptly provided to the appellant, who shall have the right, on a timely basis, to submit to the hearing officer the reasons for requesting the specific matter which the appellant wishes to examine. The Hearing Officer will notify the County Assistance Office, administering agency or social service provider of his determination as to what materials are required to be disclosed with a copy sent to the appellant and his representative, if any. The determination will be made on a timely basis in advance of the date of the hearing. No administrative appeal will be permitted from the determination of the hearing officer.
   4. (4) To be provided with the names of the County Assistance Office, administering agency or social service provider staff members and witnesses who will be present at the hearing.
   5. (5) To request reconsideration of the reversal of a hearing decision by the Secretary within 15 days from the date of reversal.
   6. (6) To appeal the final administrative action of the Department within 30 days from the date of its order.

2. (b) Time limitations on right to appeal. An applicant or recipient must exercise his right of appeal within the following time limits. Appeals which do not meet the following time limitations will be dismissed without a hearing:

   1. (1) Thirty days from the date of written notice of a decision or action by a County Assistance Office, administering agency or service provider except for food stamps which time limits are indicated in paragraph (4).
   2. (2) Sixty days from the date of a decision or action by a County Assistance Office, administering agency or service provider when they did not send written notice because the notice was not required or 60 days from their failure to act except for food stamps which time limits are indicated in paragraph (4).

   3. (3) When the county office, administering agency or service provider fails to send written notice which was required of the action and of the right of appeal or because of administrative error, ongoing delay or failure to take corrective action that should have been taken, the time limit in paragraphs (2) or (4) will not apply. For a period of 6 months from the date of the action or failure to act, the client shall have the right of appeal and shall exercise that right in writing. After 6 months from the date of the county office, administering agency or service provider action or failure to act, a written appeal may be filed with the agency provided that the client signs an affidavit stating the following:

      1. (i) The client did not know of his right of appeal or believed the problem was being resolved administratively.
      2. (ii) The client actually believes the county office erred in its actions.
      3. (iii) The appeal is being made in good faith. Appeals which do not meet the time limitations and requirements set forth in this paragraph and in paragraphs (1) and (2) will be dismissed without a hearing.
      4. (iv) An appeal request received by the agency prior to March 1, 1979 will be controlled by the regulation in effect at the time the request was received by the agency.
   4. (4) For food stamps, the time limits in paragraphs (1) and (2) will not apply. A household may request a hearing within 90 days from the date of an action by the County Assistance Office or loss of benefits. Action by the County Assistance Office shall include a denial of a request for restoration of benefits lost more than 90 days but less than 1 year prior to the request. Additionally, a household may request a hearing to dispute its current level of benefits at any time within a certification period.

Source

The provisions of this § 275.3 amended through December 5, 1980, effective December 6, 1980, 10 Pa.B. 4594. Immediately preceding text appears at serial pages (54068) and (54069).

Notes of Decisions

Failure to appeal the CAO’s proposed action within 30 days made the decision final and may not be collaterally attacked under § 227.24(d)(ii)(B)(II). Otero v. Department of Public Welfare, 517 A.2d 213 (Pa. Cmwlth. 1986).

Public assistance recipients must appeal within 30 days from date of county assistance officers written denial notice or the decision becomes final and immune to collateral attack. Otero v. Department of Public Welfare, 517 A.2d 213 (Pa. Cmwlth. 1986).

A remand was required to determine if any grounds existed to grant an appeal nunc pro tunc, hearing officer should have made findings on the factual arguments advanced by Medical Assistance applicant to support acceptance of appeal nunc pro tunc on equitable grounds. Martin v. Department of Public Welfare, 514 A.2d 204 (Pa. Cmwlth. 1986).

Where notice of denial of benefits stated only: ‘‘client failed to supply essential information . . .’’, cited irrelevant regulation, failed to indicate the essential information and failed to state the basis for denying after only 2 weeks from date of request, the notice was invalid on due process grounds and the 30 day appeal period set forth in § 275.3(b) was inapplicable. Martin v. Department of Public Welfare, 514 A.2d 204 (Pa. Cmwlth. 1986).

The good faith requirement for filing an appeal, as stated in 55 Pa. Code § 275.3(b)(3)(iii) modifies all elements of 55 Pa. Code § 275.3(b). Trant v. Department of Public Welfare, 452 A.2d 590 (Pa. Cmwlth. 1982).

Even where notice of action has been given, an extension of the time limit for appeal from 30 days to 6 months is allowed under 55 Pa. Code § 275.3(b)(3) because of an administrative error in supplying misinformation which causes a claimant to forego an appeal. Trant v. Department of Public Welfare, 452 A.2d 590 (Pa. Cmwlth. 1982).

The six month appeal period provided for in 55 Pa. Code § 275.3(b)(3) is inapplicable when written notice, though sent to an address other than that on the application for benefits, is actually received by the applicant. Clark v. Department of Public Welfare, 427 A.2d 712 (Pa. Cmwlth. 1981).

Even though a rejection notice may be deficient because sent to an address other than that on the application for benefits, the inadequacy is cured when the applicant actually receives the notice, and from the time of receipt the applicant has at best 30 days in which to appeal. Clark v. Department of Public Welfare, 427 A.2d 712 (Pa. Cmwlth. 1981).

A CBA error indicating the incorrect year in the deadline for an application for medical assistance is not a substantial enough error to deprive the applicant of notice of his right to appeal. Crail v. Department of Public Welfare, 416 A.2d 633 (Pa. Cmwlth. 1980).

The denial notices to applicants need not state the appeal period, since the appeal period was stated in published regulations. Zani v. Department of Public Welfare, 400 A.2d 247 (Pa. Cmwlth. 1979).

Cross References

This section cited in 55 Pa. Code § 105.5 (relating to access by an individual to his case file); 55 Pa. Code § 275.4 (relating to procedures); 55 Pa. Code § 1181.564 (relating to when an appeal is required to be filed); and 55 Pa. Code § 3041.166 (relating to hearing procedures).