Appendix I, Fair Hearing Case Record Filing Guide | Texas Health and Human Services

Revision 14-1; March 31, 2014

Always file the most current material on top of the appropriate section.

Left Side of Folder	Right Side of Folder
Topmost item(s) are: Fair hearing tracking sheet or Form H4809, Update After Fair Hearing Data Entry Form	Topmost item(s) are: Decision cover letter Fair hearing decision

Left Side of Folder

Right Side of Folder

Topmost item(s) are:

Fair hearing tracking sheet or Form H4809, Update After Fair Hearing Data Entry Form

Topmost item(s) are:

Use tabs to separate the remaining items:

Correspondence (most recent on top)	Administrative Review (for use as needed)
Examples include, but are not limited to: Emails regarding the fair hearing Form H4800, Fair Hearing Request Summary; Form H4803, Notice of Hearing; Form H4804, Request and Authorization for Fair Hearing Record to Remain Open; Form H4806, Request for Another Appointment - Request to Withdraw; and Form H4807, Action Taken on Hearing Decision Appellant's statement of representation Appellant's postponement request Note: If any of these documents become exhibits, label and file under Exhibits Admitted instead.	Examples include, but are not limited to: Appellant's administrative review request and any accompanying documents Hearings administrator email Email with name of attorney assigned to review Emails relating to decision and/or review Recording of hearing (tape or CD) Reopen: (for use as needed) Appellant’s request to reopen appeal and any accompanying documents

Correspondence (most recent on top)

Administrative Review (for use as needed)

Examples include, but are not limited to:

Emails regarding the fair hearing
Form H4800, Fair Hearing Request Summary; Form H4803, Notice of Hearing; Form H4804, Request and Authorization for Fair Hearing Record to Remain Open; Form H4806, Request for Another Appointment - Request to Withdraw; and Form H4807, Action Taken on Hearing Decision
Appellant's statement of representation
Appellant's postponement request

Note: If any of these documents become exhibits, label and file under Exhibits Admitted instead.

Examples include, but are not limited to:

Reopen: (for use as needed)

Exhibits Not Admitted: (for use as needed)	Exhibits Admitted:
Items determined irrelevant or otherwise inadmissible by the hearings officer Items provided to the hearings officer, but not offered by participants Duplicates of exhibits admitted	File exhibits in ascending numeric order