A Hearing Packets

Program	Manual Section
All programs	MA1701

Procedures

The items that must be included in a hearing packet are generally the same, but since there are some differences in what must be included and the responsible staff, this process is split into two separate processes.

1) DES Hearing Packets

The Appellate Services Administration (ASA), Office of Appeals receives all requests for a fair hearing and prepares the fair hearing packet.

When applicable, documents provided by AHCCCS or any other outside agency will be included in the fair hearing packet.

The following is a general list of the documents required for the fair hearing packet:

Case Summary screens;
Decision letters for the actions being appealed;

NOTE Letters that were sent in Spanish must be provided in English for the Hearing Packet.

Screen prints of any case notes in the eligibility system about the action;
Application for the issue being appealed;
Fair Hearing Request form or written request; if applicable;
Pre-Hearing Summary, noting the Appeal number, with the policy or legal citations that support the action taken;
All other forms and documents related to the hearing process such as Request to Vacate and Remand form (FAA-1389A) and Voluntary Withdrawal.

The following table provides some common hearing issues and the kinds of items to include in the packet in addition to the general list above.

NOTE The table does not cover all possible hearing types. If the issue is not listed in the table, include all documents and information that support the agency’s determination.

Hearing Issue	Documents
Income calculation or Amount of benefits	Income and expense screens; Budget worksheets screens; A copy of all proof related to the income that was used, such as hub verification screens, check stubs, verification statements, and documents that support self-employment; Hand budgets for the decision being appealed, if needed.
Failure to provide proof	All requests for information related to the adverse action, including requests that were sent by e-mail; A copy of any proof that was provided.
Qualified noncitizen status	A copy of any immigration documentation; Printout of the SAVE verification showing the current immigration status from USCIS.
Resource calculation	If the action is because of excess resources, include all resource verification documents and worksheets A copy of all proof related to the resources that were counted, such as account statements, county assessor and county recorder records, vehicle value documents, statements showing principle owed on loans against the resource value
Drug conviction	A copy of court records
Sanction hearings	Documents submitted from the appropriate agency regarding the sanction; Any disqualification screens
Overpayments	The notice from OARC regarding the overpayment; The complete overpayment packet

2) AHCCCS Hearing Packets

The following is a list of the documents required for the minimum hearing packet:

Case Summary screens;
Decision letters for the actions being appealed;

NOTE Letters that were sent in Spanish must be provided in English for the Fair Hearing Packet.

Screen prints of any case notes in the eligibility system about the action;
Application for the issue being appealed;
Fair Hearing Request form or written request; if applicable;
Pre-Hearing Summary, noting the Appeal number, with the policy or legal citations that support the action taken;
All other forms and documents related to the hearing process, such as the Authorization to Represent at Hearing form (DE-169), Request to Vacate and Remand form (FAA-1389A) and Voluntary Withdrawal.

If the issue for hearing has not been resolved within two weeks of receiving the hearing request or does not seem likely to be resolved informally, update the packet with the additional information needed for the hearing. The following table provides some common hearing issues and the kinds of items to include in the packet.

NOTE The table does not cover all possible hearing types. If the issue is not listed in the table, include all documents and information that support the agency’s determination.

Hearing Issue	Documents
Income calculation	Income and expense screens; Budget worksheets screens; A copy of all proof related to the income that was used, such as hub verification screens, check stubs, verification statements, and documents that support self-employment; If the action involves a trust, include a copy of the trust and all related documents; Hand budgets for the decision being appealed, if needed.
Failure to provide proof	All requests for information related to the adverse action, including requests that were sent by e-mail; A copy of any proof that was provided.
Qualified noncitizen status	A copy of any immigration documentation; Printout of the SAVE verification showing the current immigration status from USCIS.
Resource calculation	If the action is because of excess resources, include all resource verification documents and worksheets A copy of all proof related to the resources that were counted, such as account statements, county assessor and county recorder records, vehicle value documents, statements showing principle owed on loans against the resource value; If the action involves a trust, include a copy of the trust and all related documents;
Medical eligibility	PAS tool and score sheet; PAS thresholds for ALTCS and ALTCS Transitional; Physician review; All related medical records.