Appeals for Nutrition, Cash, and Medical Assistance Benefits

Often, you can resolve matters without legal action by talking to your Local DES Office.

You have a right to ask for a legal review of your case if you disagree with a decision or action taken by DES.  This review is called an Appeal.  You can ask for an Appeal on DES decisions, actions, or inaction on all of the following programs:

• AHCCCS Health Insurance (Medical Assistance) (MA)
• Cash Assistance (CA)
• Nutrition Assistance (NA)
• Two-Parent Employment Program (T-PEP)
• Tuberculosis Control (TC)

In an Appeal, an impartial Administrative Law Judge reviews DES’s decision to make sure Arizona law and DES policy is correct. For Cash Assistance you must request an Appeal within 30 days of the mailing date of the decision notice by completing and returning the following form:

• Fair Hearing Request Form - English (FAA-0098A)
• Fair Hearing Request Form - Spanish (FAA-0098A-S)

For Nutrition Assistance, you must request an Appeal within 90 days of the mailing date of the decision notice.

Your Appeal Rights

DES must send you a notice when a decision is made on your case. An Appeal is your chance to explain your case to a judge who will decide if DES made the right decision.

You have the right to:

• Ask for an Appeal if you do not agree with a decision we made.
• Ask for an Appeal if we have not made a timely decision.
• Ask for a pre-hearing meeting with DES to discuss your case.
• Review your DES case file.
• Get a copy of the law, rule or policy that we used in your decision.
• Present testimony and evidence at the Appeal to support your case.
• Bring a representative or lawyer to the Appeal.

What happens after you ask for an Appeal?

You will receive a notice asking you to contact us for a pre-hearing meeting with DES.  You do not have to come to the pre-hearing meeting.  If you do, we may be able to fix the problem.
If the problem cannot be fixed, the DES Office of Appeals will send you a notice telling you the date and time of the Appeal.

How do you request an Appeal?

Any of the following may be used to request an appeal hearing:

• Through Health-e-Arizona PLUS (HEAplus) when a participant is signed into their account
• Fair Hearing Request Form FAA-0098A or request a form at your local office.
• Hearing form included with any decision notice
• Written statement from the appellant or representative
• Verbal request

Give the local DES office your completed Fair Hearing Request form, or a written statement in person, by mail, or by fax. Find your Local Office at the DES Office Locator.

The statement asking for an Appeal should include your address, date of the notice you do not agree with, and a reason why you do not agree with the decision.

What is the deadline to request an Appeal?

You must request an Appeal within:

• 30 days from the date on the decision notice for: AHCCCS Health Insurance (Medical Assistance), Cash Assistance, Two-Parent Employment Program and Tuberculosis Control
• 90 days from the date on the decision notice for Nutrition Assistance

How can you keep getting benefits while you wait for an Appeal?

You may keep getting benefits if you ask for an Appeal within 10 days from the date on the decision notice. For Cash Assistance you may keep getting benefits if you ask for an Appeal any time prior to the effective date of the adverse action on your case. But, you cannot keep getting benefits while you wait for an Appeal if:

• Your application was denied.
• Your benefits were stopped because the approval period ended.
• You received the maximum benefits under the program.
• The law changed.

Caution: If you do not go to your Appeal, withdraw your Appeal request, or the judge decides that DES was correct, you may have to Refund any type of Cash Assistance benefits or Nutrition Assistance benefits received while waiting for the Appeal.