2100, Administrative Review – 1 TAC §357.701-703

Revision 11-4; Effective June 1, 2011

An administrative review is the review of a hearings officer’s decision on a Supplemental Nutrition Assistance Program (SNAP), Temporary Assistance for Needy Families (TANF) or Medicaid appeal or an administrative disqualification hearing by HHSC Regional Legal Services. The assigned attorney reviews the testimony and evidence available to the hearings officer when the decision was issued and issues a new decision. An appellant or appellant’s representative may request an administrative review when he does not agree with the hearings officer’s decision.

2110 Appellant’s Responsibility

Revision 11-4; Effective June 1, 2011

When an appellant or appellant’s representative does not agree with a hearings officer’s decision, he may request a review of the decision within 30 days of the date on the decision. The request must be in writing and postmarked no later than the 30th day. A request for administrative review will be considered timely if filed after 30 days, when the appellant demonstrates good cause for the filing delay.

The request for a review is sent to the hearings administrator at:

Hearings Administrator
Mail Code W-613
P.O. Box 149030
Austin, TX 78714

Exception: The 30 days does not begin until a new decision is issued if the appellant or appellant’s representative is working with the hearings officer to reopen or reschedule the hearing.

2120 Receipt of the Administrative Review Request

Revision 14-2; Effective August 6, 2014

Appellants submit administrative review requests by fax, mail and email.

Upon receipt of the request, the hearings administrator’s assistant:

  • enters the request into the appropriate database,
  • creates a tracking sheet with pertinent information,
  • scans the request, and
  • emails it to the appropriate hearings manager.

The hearings officer reviews the request to determine whether to reopen the appeal. If the original appeal was dismissed because the appellant failed to appear for the hearing, the hearings officer needs to determine if the appellant had good cause for failing to appear. If the hearings officer determines the appellant did have good cause, the hearings officer reopens the appeal. If the hearings officer determines the appellant did not have good cause, the appeal is sent to administrative review. If the appeal is being reopened, the hearings manager sends an email to the hearings administrator.

The database is updated to reflect the decision to reopen the appeal.

If the appeal is not reopened, the request is sent to Regional Legal Services.

The hearings administrator sends an acknowledgement letter to the appellant.

The appellant has the right to submit a brief. The brief should be no more than five pages. For the brief to be considered, the appellant must submit it with the request for administrative review filed with the hearings administrator. The brief must address only the issues that were addressed in the appeal hearing.

2130 Assigning the Administrative Review Request

Revision 11-4; Effective June 1, 2011

The scanned request and any other documents submitted by the appellant are e-mailed to the Health and Human Services Commission (HHSC) Regional Legal Services and a request is made that an attorney be assigned. The documents are also sent to the appropriate hearings manager.

The e-mail with the scanned documents will include the appeal ID, case name, case number, program, region, hearings officer, date of request and date of decision.

HHSC's Regional Legal Services responds to the e-mail and assigns an attorney.

Hearings staff scan the hearing record and post it to the public folder notifying the assigned attorney via e-mail when it is posted and the file name. The hearing record must be received by the assigned attorney within 10 days from the date of the request.

The assigned attorney will access the hearing record from the public folder and the AVAYA recording from the FairHearAudio folder.

2140 Completing the Administrative Review

Revision 10-4; Effective July 16, 2010

 

2141 Attorney’s Responsibility

Revision 11-1; Effective June 1, 2011

Within 15 business days of receipt of the hearing record, the assigned attorney will review the hearing record and issue a new decision.

The decision format will be similar to the one used by the hearings officer. The decision will include any direction to program staff. The cover letter will include how the appellant can request judicial review, the time frames for requesting judicial review and the appropriate legal aid information.

The attorney will provide a copy of the decision to the appellant, appellant's representative and e-mail a scanned copy with all appropriate signatures to the hearings administrator, the director of appeals and the appropriate hearings manager.

If the hearing was related to a Texas Workforce Commission (TWC) sanction, the attorney will also provide a copy to TWC via mail at the following addresses:

Loretta Robertson
Texas Workforce Commission
101 E. 15th Street, Room 440T
Austin, TX 78778
512-936-6265
Fax: 512-463-7379

The attorney may choose to discuss the case with his supervisor. Ex parte communication does not include discussing the decision with supervisors in the attorney's chain of command.

2141.1 New Information Received During the Administrative Review

Revision 14-4; Effective November 14, 2014

When appeals go to administrative review, appellants often give new information (information the appellant did not offer during the hearing) that the hearings officer may not have considered. Additionally, the appellant may give information directly to the reviewing attorney after the record has gone to administrative review. If the appellant hires an attorney, the attorney may decide to submit a brief to the reviewing attorney. The brief should be no more than five pages.

In both instances, the hearings officer has a chance to decide whether the information would have altered the original decision.

If the appellant offers new information before the appeal goes to administrative review, the appeal goes back to the hearings officer for review. The hearings officer decides if the information is new and if it would have changed the original decision. After reviewing the information, the hearings officer either reopens the hearing or issues a new decision upholding the original decision.

If the hearings officer upholds the original decision, he states that the information given does not constitute new evidence. If the evidence is in fact new information, he states that it would not have altered the original decision. The appeal then goes to the reviewing attorney for administrative review.

If the appellant offers new information after the administrative review has gone to the reviewing attorney, the reviewing attorney sends the case back to the hearings officer. The hearings officer then decides whether the new information would have changed the original decision.

The reviewing attorney may not consider any information in the administrative review that was not available to the hearings officer or not included in the hearing record. The reviewing attorney decides whether the decision was correct in light of the evidence admitted at the hearing and the application of relevant policy (law) to that evidence.

The reviewing attorney may consider legal briefs the appellant submits during the administrative review process, unless they contain any information that was not available to the hearings officer or not included in the hearing record.

If the legal briefs contain new information, the reviewing attorney must send the case back to the hearings officer for consideration, and the hearings officer will make a new decision.

2142 Hearings Administrator's Responsibility

Revision 11-4; Effective June 1, 2011

Upon receipt of the attorney's decision, the database and tracking spreadsheet will be updated with the outcome and date of decision.

If the decision is a reversal and some action needs to be taken by program, the hearings administrator will direct the hearings manager to send the decision and Form H4807, Action Taken on Hearing Decision, to program and track for completion.

2143 Hearings Manager Responsibilities

Revision 10-4; Effective July 16, 2010

The hearings manager will provide the decision and Form H4807, Action Taken on Hearing Decision, to the appropriate program staff if the attorney’s decision requires program to take an action, track for completion and provide that information to the hearings administrator.