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Revision 23-1; Effective July 31, 2023
1910 Implementing the Hearing Decision - 1 TAC Section 357.7
Revision 23-1; Effective July 31, 2023
1911 Responsibility of the Agency Representative for Implementing Decisions
Revision 23-1; Effective July 31, 2023
When the hearings officer reverses the agency action on appeal, the agency representative is required to implement the order and enter implementation data, or delays, in the TIERS, Hearings and Appeals, Decision Implementation module.
The agency representative has 10 calendar days from the date the decision was issued to implement the hearing decision. If additional information is needed, the agency representative will contact the appellant and pend the implementation process. Once the additional information is received, the agency representative has three business days to complete the implementation.
The agency has 10 calendar days to report compliance to the hearings officer, via e-mail, on a Sustained with Instructions decision. Hearings officers must monitor compliance with these orders.
1912 Delays in Implementing a Hearings Decision
Revision 23-1; Effective July 31, 2023
The following delay reasons are applicable in specific circumstances and can only be used by program staff after a hearing decision has been issued and the worker is delayed in responding to the directives of the hearings officer.
Beyond Agency Control: Circumstances beyond HHSC control, such as fire, flood or other acts of nature.
Pending Information Needed: Additional information or verification was needed from the appellant, and the appellant agreed to cooperate.
Client Refuses to Cooperate: The appellant refused to cooperate in providing additional information or verification.
Agency staff enter delays in the TIERS Hearings and Appeal Module under Decision Implementation/Delays.
1920 Requests to Reopen
Revision 23-1; Effective July 31, 2023
1921 Request to Reopen Following Dismissal for Failure to Appear
Revision 23-1; Effective July 31, 2023
1921.1 Determining Good Cause for Failure to Appear
Revision 23-1; Effective July 31, 2023
Requests to reopen must be in writing. If the hearings office receives a written reopen request within 30 calendar days of the dismissal decision date, date stamp the statement and immediately route it to the hearings officer for review. The hearings officer must determine, on a case-by-case basis, whether good cause is established for the appellant’s failure to appear at the scheduled hearing.
To constitute good cause for failure to appear, the appellant must demonstrate the failure was due to circumstances beyond their control. If the good cause statement shows the appellant could have appeared but failed to do so, good cause is not established.
1921.2 Action on Reopen Request
Revision 23-1; Effective July 31, 2023
The hearings officer must initiate one of the following actions within 10 business days of receipt of the appellant’s reopen request.
When Good Cause is Established: If the written statement establishes good cause for the appellant’s failure to appear at the scheduled hearing, reopen the appeal and schedule another hearing. The reopen date will be the date the hearings office received the good cause statement.
If the appellant appears for the hearing, the hearings officer includes, in the procedural history section of the hearing decision, the detailed actions taken and that the original dismissal decision is set aside.
If the appellant fails to appear at the new hearing, dismiss the appeal. The appellant may again submit a reopen request within 30 calendar days of the dismissal decision date. The hearings officer reviews the request and again initiates action within 10 business days of receipt. There is no limit on the number of times an appellant may submit a reopen request. If the hearings officer continues to find good cause, reopen the appeal, and schedule a hearing.
When the Reopen Request is Not Clear
If the reopen request does not contain sufficient or clear information that allows the hearings officer to determine if the appellant had good cause for failing to appear at the hearing, the hearings officer may schedule a pre-hearing conference or send a letter asking the appellant to provide the reason for missing the hearing within 10 business days. The hearings officer makes the decision on good cause based on the information obtained.
If a pre-hearing conference is held, the sole issue is whether the appellant’s reason(s) for failing to appear resulted from circumstances beyond their control. If the hearings officer finds the appellant’s failure to appear was not caused by such circumstances, the hearings officer closes the hearing record and dismisses the appeal. A pre-hearing conference may be rescheduled because of extenuating circumstances and considered on a case-by-case basis.
If good cause is established and a new hearing is conducted, the hearings officer details these actions in the procedural history section of the hearing decision and sets aside the original dismissal decision. The reopen date is the date the reopen request was received by the hearings office.
When Good Cause Does Not Exist
If the reopen request does not clearly establish the appellant had good cause for failing to appear at the scheduled hearing, the hearings officer will send the good cause request for an administrative review to an HHSC Administrative Law Judge (ALJ). The ALJ will either uphold the hearings officer’s decision to not grant good cause or overturn it. If the decision is overturned, the hearings officer will reopen the record and schedule a new hearing.
If the appellant submits a reopen request after the 30-day period, the hearings officer will send the appellant a decision letter within 10 business days of receipt by the Fair and Fraud Hearings Department. The decision informs the appellant that no further action will be taken on the appeal, because the reopen request was submitted after the 30-day period.
1922 Request to Reopen Following Sustained Decision - 1 TAC Section 357.23(f)
Revision 23-1; Effective July 31, 2023
The hearings officer may reopen an appeal and reconsider the decision if, within 12 months of the decision date, the appellant offers evidence that:
- the hearings officer decides would have affected the outcome of the original decision;
- shows the original decision was not valid; and
- the appellant did not offer at the hearing.
The hearings officer must decide whether to reopen the appeal within 10 business days from the date of the request. If the hearings officer decides to reopen the appeal, the decision-issuance time frames apply beginning with the date of the request to reopen. See 1820 Decision Issuance Time Frames.
If the appellant offers information after the hearings officer has issued the original decision and the hearings officer decides the information is new and would have affected the outcome of the decision, the hearings officer reopens the appeal and schedules a hearing with notice to both parties. After the hearing, the hearings officer issues a new decision.
If the hearings officer decides the information is not new, they notify the appellant in writing that they are denying the request to reopen, and that the original decision remains in effect.
If information was provided with an administrative review request, see Section 2240 New Information Received During the Administrative Review.
1930 Time Frames for Processing Requests to Reopen
Revision 23-1; Effective July 31, 2023
After the hearing decision is rendered, an appellant may request that the appeal be reopened. The request must be made in writing. The date the appellant contacts hearings staff, in writing, is considered the request date. The hearings officer has 10 business days from the date of the reopen request to determine whether to reopen the appeal.
If the hearings officer decides to reopen the appeal, all the time frames and delays for an initial appeal apply.
1940 Amended or Re-issued Decision - 1 TAC Section 357.23(g)
Revision 23-1; Effective July 31, 2023
The hearings officer has the authority to withdraw, revise and re-issue a decision within 20 calendar days following the original decision date if they become aware of an error of law or fact that would have affected the outcome of the decision for either side.
If program staff or the appellant feel that the hearings officer committed an error of law or fact, they may send a letter to the hearings officer and to the other parties within five business days of the date the decision was issued to allow the hearings officer sufficient time to re-issue a decision, if necessary.
Corrected Decision
The hearings officer has the authority to revise a decision to correct an error that does not affect the outcome of the decision. The correction may be made at any time by the request of either party, the attorney conducting an administrative review, or when a hearings officer discovers the error.
Issuance of a corrected decision does not extend any timelines for filing a request for Administrative Review or a petition for Judicial Review.
The decision that is rendered, be it revised, reissued, or corrected, must be identified as an amended decision on the cover letter and the order of the decision. The procedural history should indicate the date the first decision was mailed and possibly the date the hearings officer became aware of the need to reconsider the decision.
An amended decision should be submitted to the hearings manager for review before issuance.