Stand Up for Your Rights at DHS

Stand Up for Your Rights at DHS

Last updated: June 2008

 

Dealing with the Illinois Departments of Human Services and Public Aid

Table of Contents

Introduction
Part I: Summary: Appeals and Grievances
Part II: How to be a Good Advocate for Yourself
Part III: Details, Explanations and Advice

Appeals

1. What is an appeal?
2. How do I know if I should I file an appeal?
3. What can I appeal?
4. How do I appeal?
5. Do I need a lawyer?
6. When should I appeal?
7. What happens after I file the appeal?
8. What happens at a pre-hearing conference?
9. What if IDHS asks me to withdraw my appeal?
10. How do I find out about the hearing?
11. What if I can't go?
12. What happens if I miss the hearing?
13. How do I get ready for the hearing?
14. What happens at the hearing?
15. What happens if I win the appeal?
16. How do I know when my appeal has been decided?
17. How long will it take before my case is decided?
18. What if I disagree with the hearing officer's decision?

Grievances

19. What can I do if I don't like how my caseworker treats me?
20. How do I file a grievance?
21. When should I file a grievance?
22. What happens when I file a grievance?
23. What happens at the grievance meeting?
24. What happens after the grievance meeting?
25. Can anything bad happen to me if I file a grievance?

Child Support Procedures

Sample Forms for Appeals

Notice of Appeal
Notice of Change in Benefits
Notice of Pre-hearing Conference
Request to Withdraw Appeal
Notice of Hearing
Notice of Dismissal of Appeal
Letter requesting payment for delayed appeals
Grievance Form

Part IV: Blank Forms --- Appendix 1

Notice of Appeal
Request to Withdraw Appeal
Letter requesting payment for delayed appeals
Client Grievance Form
Administrative Accountability Analysis Request for Explanation
Administrative Accountability Analysis Conference Request Form
Let's Get It Right! Reporting Form

List of Legal Services Programs --- Appendix 2

Introduction

This manual explains how you can protect your rights when you deal with the Illinois Department of Human Services and the Illinois Department of Healthcare and Family Services.  In this manual, we will call the Illinois Department of Human Services "IDHS" and the Illinois Department of Healthcare and Family Services "IDHFS."

IDHS is the main welfare department. IDHS is in charge of cash benefits and Food Stamps. Every time you meet with your caseworker, you are in an IDHS office. Many people call IDHS "public aid" because that is what it used to be called. In this manual, we will call it IDHS.

IDHFS is in charge of medical assistance (including FamilyCare and All Kids) and child support assistance programs.  You might get mail or notices sometimes from HFS as well as from IDHS.

This manual explains what you can do:

  • If you don't agree with something that was done to your case;
  • If you want IDHS to take some kind of action in your case, but they haven't; or
  • If you feel that an IDHS employee treated you badly.

This manual focuses mostly on the appeals and grievance processes for IDHS and IDHFS. You can use these processes to challenge things that IDHS does that affect your case. You can also use the appeals process described in this manual to challenge things that IDHFS does that affect your Medicaid. There are also some special procedures for child support that we describe briefly at the very end of the manual.

Even though most of the advice in this manual applies to both IDHS and IDHFS, we will usually mention only IDHS. We are doing this just to make the manual simpler.

This manual explains how you can make IDHS review your case and give you a hearing. This process is called an appeal.

This manual also explains what you can do if you feel that you have been treated badly by an IDHS employee. If you feel you have been treated badly, you can file a grievance. You can file both an appeal and a grievance if you want.

The advice in this manual applies to these programs:

  • cash assistance (TANF, AABD, General Assistance (GA), Transitional Assistance (TA), or P-3)
  • Food Stamps
  • Medicaid, Family or KidCare
  • child care assistance.

There are also some special procedures for child support. These procedures are described very briefly at the end of the manual.

You can use this manual if you:

  • have tried to apply for aid
  • have applied for aid
  • get aid
  • used to get aid

The manual has four parts.

  1. The first part is a short summary of the appeals and grievance processes. This section reminds you of the steps you should take for an appeal or a grievance. The details are in the third part of the manual.
  2. The second part tells you how to be a good advocate for yourself with IDHS. This part can help you whenever you deal with IDHS, even if you never file an appeal or a grievance.
  3. The third part is a more detailed discussion of the appeals and grievance processes. This part includes a lot of information and advice about how to make the processes work best for you. You don't have to read it all at once. You could read the different parts as you go through different stages of your appeal or grievance.
  4. The fourth part contains copies of forms and notices. It includes blank copies of all forms that you might have to fill out. You can copy and use these forms. You can also find them on the IDHS website at http://www.dhs.state.il.us/serviceproviders/dhs_dhs-forms.asp

This manual was written by the Sargent Shriver National Center on Poverty Law. For more information, visit our website at www.povertylaw.org.  Development and production of this manual were funded by a generous grant from the Lloyd A. Fry Foundation.

Note to advocates and service providers:

The manual explains the appeals and grievance processes clearly so that you can advise your clients and so that you can serve as a representative in an appeal or a grievance. Please feel free to make copies of this manual to distribute to your clients and colleagues. The manual is also available at our website at www.povertylaw.org.

IDHS changes policies often. An up-to-date copy of the IDHS policy manual can usually be found on the IDHS website at http://www.dhs.state.il.us/ts/cfsmm/.  

Part I Summary: Appeals and Grievances

This part is a summary. The details and explanations are in Part 3.

Appeals

Make an appeal when:

  • you don't agree with something IDHS has done in your case, or
  • you want IDHS to take some action in your case but they have not.

The appeal must be sent to IDHS on time: 

  • within 60 days of the date of a notice (90 days for Food Stamps);
  • any time if you did not get a notice.

If you file the appeal quickly, your aid will not be cut right away.

  • if you file before 10 days after the "date of notice," or
  • if you file any time before the "date of change" on the notice.

While IDHS is deciding your appeal, you will keep getting the same aid.

  • Both the date of notice and the date of change should be on any notice you get from IDHS about an action in your case.
  • This rule about continuing to get the same aid does not apply to child care assistance or Medicaid spend-down at the end of an approval period.

To make an appeal:

  • Fill out a Notice of Appeal form. A copy is in the back of this manual in Appendix 1. You can also ask for this form at your local IDHS office.
  • Take or mail the Notice of Appeal to your local IDHS office. Be sure to make a copy for your records.

Attend the pre-hearing conference to discuss your appeal. This is a good time to try to resolve your problem. If you miss the pre-hearing conference, you can still have a hearing. 

  • If IDHS agrees to solve your problem, you can withdraw the appeal. IDHS will ask you to sign a form. Be sure to write on the form what IDHS has promised to do before you sign it. Make sure IDHS also signs the form.
  • If IDHS says that they are right, ask to see the written policy.
  • If you think IDHS might be wrong, do not withdraw the appeal.

Attend the hearing.

  • Bring your evidence and witnesses with you.
  • Be ready to explain your side to the hearing officer.

You can have someone speak for you at both the pre-hearing conference and the hearing. This person is your representative. Your representative can be anyone you choose, including a friend, a family member, a social worker, or a lawyer.

Grievances

File a grievance when:

  • you don't like the way your caseworker or another IDHS employee has treated you.

File a grievance

  • within 60 days of the event you are complaining about.

To file a grievance:

  • Fill out a Notice of Grievance form. A copy is in the back of this manual in Appendix 1. You can also ask for this form at your local IDHS office.
  • Take or mail the Notice of Grievance to your local IDHS office. Keep a copy for your records.

If your grievance is dismissed without a meeting, you can appeal that dismissal using the appeals procedures described in this manual.

Attend a meeting to discuss the grievance.

  • Be ready to talk about what happened.
  • Bring any evidence that you have to show that your version of what happened is true.

Remember: A grievance is about how you were treated, not the amount of benefits you receive. Only an appeal can get you benefits. However, you can do both if you feel you were treated poorly and you should get more benefits.

Part II: How to be a Good Advocate for Yourself

There are some things you can do to protect yourself when you are dealing with IDHS. Protecting yourself means that you are being a good advocate for yourself. It is a good idea always to do these things, even if you are not thinking about filing an appeal or a grievance, If you do file an appeal or a grievance, these things will make it much easier for you to win.

1) Keep track of all your conversations with IDHS. The best way to do this is to get a notebook. In the notebook, write down the date and time every time you call or go to the IDHS office. You should do this even if you don't get to talk to anybody. If you do talk to someone, always ask for his or her name. Write down his or her name, along with what happened in the conversation, (If the person refuses to give you his or her name, write that down, too.)

Here is an example of what a page of your notebook might look like.

June 1, 2007   8: 30 am   Delivered check stubs to the IDHS office. Left them in the mailbox at the front desk in an envelope with my caseworker's name, Mrs. Doe, on it.

June 15, 2007   1O: OO am   Did not get aid.  Called IDHS office.  Caseworker was busy.  Left message for my caseworker with Mr. Smith.

June 16, 2007   9: 00 am   Called caseworker.  No answer.
Same day  11: OO am   Called caseworker.  Left message with a woman who would not give me her name.

June 17, 2007   10: 00 am   Called caseworker.  Spoke to her.  She said she never got check stubs.  She said I should deliver them directly to her tomorrow.

 

2) Keep copies of everything that you give to IDHS. This includes check stubs, verifications, forms, and other important papers. When you turn something in at the IDHS office, ask for a receipt. Also, if a log is available, always sign the log. The log is the sign-in sheet for the IDHS office.

3) Keep everything you get from IDHS. Find a special place, like a box or a drawer, and put all the IDHS papers in this place.

  • Keep all forms and notices that you get from your local office.
  • Keep all notices and letters you get in the mail.
  • If a notice or letter comes in the mail, keep the envelope. Staple the envelope to the back of the notice that came in it. That way, you will be able to prove when the notice was mailed by pointing to the postmark on the envelope. Sometimes it is important to show when a notice was mailed.
  • Ask your caseworker for a copy of every document you sign at IDHS. For some documents, IDHS might charge you 10 cents a page.
  • If you are able to get a receipt when you turn in a document, keep the receipt.

Even if you haven't done any of these things, you can still file an appeal or a grievance. But if you have done these things, you will have a better chance of winning.

Part III  Details, Explanations and Advice

1. What is an appeal?

  • An appeal is a way to get IDHS to change what it has done in your case.
  • An appeal is also a way to get IDHS to do things that it is supposed to do, but has not done.

2. How do I know if I should I file an appeal?

It is almost always a good idea to file an appeal immediately when something happens in your case that you are not happy about.

Filing an appeal immediately protects your rights. It makes sure that someone will pay attention to your case. If you wait for your caseworker to take care of the problem, you could lose your right to appeal.

Sometimes people think that they should try to work things out with caseworkers or supervisors before filing an appeal.  That is not a good idea if it takes more than a day or two to resolve the issue.  You can always work things out after you file the appeal. 

Advice: Sometimes people are afraid to appeal because they think it will make their caseworker angry. Usually, it is a good idea to appeal anyway. Appealing shows your caseworker that you know your rights. Appealing also means that a supervisor must get involved with the case. Clients sometimes find that they are treated better, not worse, afterwards. If you are treated badly after you file an appeal, you can file more appeals and also a grievance. We talk about how to file a grievance later in this manual.

3. What can I appeal?

You can appeal anything that IDHS does or does not do that affects your case.

Here are some examples of things you can appeal:

You get a notice that there is a change in your aid. For example, you can appeal if:

  • You get a notice saying that your Food Stamps or cash grant will be reduced.
  • You get a notice saying that your Food Stamps, cash assistance or Medicaid will be terminated.

Your aid stops without notice. For example, you can appeal if:

  • You try to use your LINK card and find that you have not gotten the aid you were expecting.
  • You do a Food Stamps recertification but your Food Stamps stop anyway.

IDHS does not take action. For example, you can appeal if:

  • Your benefits get cut or cancelled after you leave many phone messages for your caseworker, but she doesn't return your phone calls, or you can't even reach someone in the local office to leave a message.
  • You apply for aid and do not get a decision from IDHS for more than 45 days.
  • You apply for aid and IDHS does not give you expedited Food Stamps within 5 days even though you have no more than $100 cash.
  • You ask your caseworker to add a new household member to your assistance unit but she doesn't do it.
  • You lose your job. You ask your caseworker to increase your TANF grant and your Food Stamps. She does not do this.
  • Your benefits get cut or cancelled after you move because IDHS does not change your address.

IDHS does not let you apply or denies your application. For example, you can appeal if:

  • You try to apply for aid but IDHS says that it is not taking any more applications that day.
  • You try to apply for aid but are told that you can not get aid and will not be allowed to apply. (You always have the right to apply!)
  • You apply for aid, but your application is denied, even though you have no income.
  • You are very sick and cannot work. You apply for aid, but your application is denied because IDHS says that you are not disabled.

Special advice for problems with applications: Appeals can take a long time, so it is usually a good idea to appeal and to re-apply. You can do both. If your second application is approved and then you win your appeal, IDHS will give you the extra benefits you would have received if your earlier application had been approved.

Overpayments. For example, you can appeal if:

  • IDHS says you have to pay back the aid you got because they say you were working, but you really were not working.
  • IDHS says that you have to pay back the aid you got when you were working, but you think you owe less than they say you do.

Assignments to work-related activities. For example, you can appeal if:

  • You are a teen parent in high school. You apply for aid and your caseworker tells you that you must quit school and look for a job to get aid.
  • Your caseworker tells you to go to a job search program but you want to complete the GED program or training you are in.
  • You do not agree with the work requirements your caseworker gave you.
  • Your caseworker tells you that you must get a job or she will cut you off.
  • Your caseworker tells you to go to "Work First" or job search but you do not know how to read.
  • Your caseworker tells you to go to a work program but you are taking care of your disabled child or other relative.

Problems with child care assistance. For example, you can appeal if:

  • Your application for child care assistance was denied.
  • You think that the amount of money you pay for child care (the parent copayment) is higher than it should be.
  • You gave an application to the Child Care Resource and Referral Agency. The child care agency keeps sending the application back, even though you gave them all the information they asked for.
  • The person who takes care of your child has not been paid even though you turned in all the papers.

Problems with Medicaid or KidCare. For example, you can appeal if:

  • Your income has not changed, but your Medicaid spenddown goes up.
  • You have been made to get prior approval for all your medical procedures.
  • You have been getting Medicaid but suddenly your benefits are stopped.

Remember -- your Medicaid appeal might be with IDHFS, not IDHS. Either way, the procedures will be the same.

Advice about Medicaid appeals: If you live in Chicago and want help with a Medicaid appeal, contact Nelson Soltman at the Legal Assistance Foundation of Chicago at (3 12) 347-8331. Or, if you live in Cook County, you can call the Cook County Public Benefits Hotline at (888) 893-5327. If you do not live in Cook County, see the list of legal services programs at Appendix 2.

Remember -- these are just examples. You can appeal any action or failure to take action that has a bad effect on your case.

Advice: Sometimes caseworkers say you can't appeal. Sometimes caseworkers say that you should not appeal because you will lose. This is very bad advice. You can always appeal anything IDHS does with your case that you don't like. It is your right to appeal. Caseworkers often have no idea whether you will win or not. Ignore this advice and insist on your right to appeal.

4. How do I appeal?

Filing an appeal is very easy.

  • There are two ways you can file an appeal. You can:

    (1) Call the IDHS Bureau of Assistance Hearings at (800) 435-0774.
             OR
    (2) Fill out the Notice of Appeal form. An example is on the next page. A blank copy is at the back of this manual in Appendix 1.
     
  • On the form, explain why you are appealing. Write one or two sentences. For example, you might write, "I got a notice telling me my Food Stamps will be cut off."
  • Send the form to the Bureau of Assistance hearings or your local office.  You can do this by fax, mail, or hand delivery.  You can turn it in at the front desk.  You do not need to see your caseworker.  (For General Assistance, if you live outside of the City of Chicago, you should turn your appeal into your local Public Aid Committee.)
  • Keep a copy of the form for your records. If you bring the form in to your local office, ask them for a receipt. If you fax the form, save the fax transmission report that shows you faxed the notice of appeal.

Advice: Sometimes local offices lose appeal notices.  You might prefer to send your appeal directly to the Bureau of Assistance Hearings, 401 S. Clinton Street, 6th Floor, Chicago, Illinois 60607, FAX 312- 793-3387.  Or you can call 1-800-435-0774 (TTY 877-734-7429) to appeal.  If you call this number, ask for the name of the person that you talked to.  Write down that name and the date and time that you called.  Also ask the person for your appeal number, and write that down too. 

Special Advice for Child Care Appeals: If you are appealing about a problem with your Child Care Resource and Referral Agency, you may be better off turning your Notice of Appeal form into that agency or mailing it to: Bureau of Child Care and Development, 400 lles West Lawrence, Springfield, IL 62762. If you do turn in your form to your local IDHS office or appeal by calling the l-800 number or by writing to Assistance Hearings, be sure to state clearly that the appeal is about childcare benefits.

5. Do I need a lawyer?

You do not need a lawyer to appeal.

You can do an appeal by yourself. You can also appoint someone to speak for you. That person is called your representative. Your representative can be anyone you want. Sometimes it can help to have a representative. Your representative may be someone who you think can help you tell your story. For example, your representative could be a lawyer, social worker, pastor, friend or family member.

Advice: You do not need a lawyer in order to appeal. But if you want a lawyer, you can try to get one through a legal services program. If you live in Cook County, call the Cook County Public Benefits Hotline at (888) 893-5327. If you live outside of Cook County, look at the list of legal services programs in Appendix 2 and call the program for your county.

Be sure to put the representative's name, address and phone number on the Notice of Appeal. That way, the representative will get copies of all the notices you get about the case. The representative can also fill out the Notice of Appeal for you and can sign it (noting that she is signing as your representative). You should give the representative something in writing saying he or she can represent you that he or she can show to IDHS.

Advice: You can get a representative after you file the appeal, if you want. Find out who is the "appeals coordinator" at your local office. Tell that person about your representative. Also tell the Bureau of Assistance Hearings. Call or write the Bureau of Assistance Hearings at IDHS, 401 South Clinton, Chicago, Illinois 60607, 1-800-435-0774, FAX (312) 793-8573. Ask the Bureau of Assistance Hearings to send copies of all notices to your representative. Or you can bring the representative to the hearing or the pre-hearing conference and tell IDHS  that you have a representative. If you do it this way, the representative might not get all of the notices that you get.

6. When should I appeal?

There are some important rules about when to appeal.

IDHS considers an appeal filed on the day it gets the Notice of Appeal, unless it is mailed. If it is mailed, the postmark date is the date on which the appeal is filed.

If you are appealing a notice you have gotten

If an appeal is not made on time, you can lose your appeal even if IDHS did something wrong in your case. For cash and medical benefits, you must appeal within 60 days of the "date of notice" which is on the top of the notice. For child care benefits, you also have 60 days from the date of notice to appeal. For Food Stamps, you must appeal within 90 days of the "date of notice." Click to get an example of a "date of notice." Day one is the day after the date of notice.

If the 60th or 90th day is a weekend or holiday, the appeal is on time if IDHS gets it or it is postmarked on the next business day.

If the envelope the notice came in is postmarked after the "date of notice," the postmark date is the date to count from. Save the envelope as proof.

 

Advice: Sometimes it is worth appealing even if you are past the time limit. If something has happened to your case that is wrong, sometimes IDHS will fix it even if the appeal is too late.

Advice: Food Stamps have a longer time limit than other kinds of benefits. But if your appeal involves both Food Stamps and other aid, you still have to file the appeal within 60 days to cover all the different types of aid.

IMPORTANT: If you are appealing a notice that tells you your aid will be stopped or cut, you can continue getting full aid during the appeal.

  • Try to appeal within 10 days of the date on the notice or before the "date of change."
  • The date of change usually appears on the top of the first page of the notice. So does the date of notice.
  • If you appeal within that time period, IDHS cannot take the action it was going to take until the appeal is resolved. You will continue to get your full aid. This is called "aid paid pending appeal."

Example: Ms. Jones gets a new job, and she tells her caseworker. Ms. Jones then gets a notice saying that she will get no more aid because of her new job. Ms. Jones thinks that she should still get some aid. She files the appeal before the date of change on her notice and continues to get full aid until the appeal is decided.

Click for a sample of Illinois Department of Public Aid's Notice of Change here.

Advice: Be sure to mark the boxes on the Notice of Appeal form that say you want to continue to get cash assistance and Food Stamps. On the example form, we have shown how to check those boxes.

Advice: If you lose the appeal, you may have to pay back the aid you got while the appeal was pending. IDHS can collect the overpayment in small amounts (about ten percent) out of your monthly aid, or in other ways if you go off of aid altogether. If you go off aid altogether, IDHS can collect an overpayment by taking a tax refund or by hiring a collection agency to get the money from you.

If you do not want aid paid pending appeal, mark the boxes that say you do not want your aid to continue. When you decide whether or not to ask for aid pending appeal, keep in mind that it can sometimes take months for an appeal to be decided so you might be better off asking for aid paid pending appeal if you can.

Advice: Sometimes caseworkers say you can't get aid while you are appealing. If this happens, you can tell the caseworker to look in her Policy Manual at section 01-07-04. If that doesn't work, file another appeal!

Advice: The earlier you appeal, the more chance you have of keeping Advice: your aid with no interruption. If you appeal only a few days before the date of change, your aid may be late. It is also a good idea to call the caseworker or her supervisor to remind them that you have asked for aid paid pending appeal.

Even when you are receiving aid paid pending appeal, your aid may be cut or stopped for reasons having nothing to do with the appeal.

Example: Ms. Washington gets a notice that her aid will be cut because one of her children has moved out of the house. This is not true, so she files an appeal and asks for aid paid pending appeal. While the appeal is pending, Ms. Washington gets a job. She reports her job to her caseworker. Even though Ms. Washington is getting aid paid pending appeal, her caseworker still reduces her aid because she got a job.

There are also exceptions to the rule of aid pending appeal.

  • You cannot get aid paid pending appeal if you are appealing the end of a spenddown or Food Stamp approval period.
  • You cannot get aid paid pending appeal if you are appealing the termination of child care assistance.

You can still appeal, of course. You just can't get aid paid pending appeal. If you win, you will you will get benefits dating back to when you were cut off.

You also cannot get aid paid pending appeal if you are applying for aid or if IDHS has already cut your benefits and it is more than 10 days after the "date of notice" and it is also after the "date of change."

Example: Mr. Arroya applies for aid. He has no income and he is disabled. His application is denied. He files an appeal. He cannot get aid pending appeal because he was not getting aid in the first place. If he wins the appeal, he will get retroactive benefits.

Advice: If you are not sure if you can get aid paid pending appeal, ask for it anyway on the notice of appeal form. It doesn't hurt to ask.

If you are appealing something you did not get a notice for:

There is no time limit for the appeal. It is always better to appeal as soon as possible.

Example: Ms. Smith goes to her local IDHS office to apply for aid. A caseworker takes her application, but Ms. Smith never gets benefits or hears anything back. Ms. Smith can appeal this at any time.

Advice: IDHS staff may say that an appeal is too late if it is filed more than 60 days after something for which you got no notice. Remind them of the rule that there is no time limit when a client did not get a notice. You can say, "This rule is in your Policv Manual at section 01-07-03."

7. What happens after I file the appeal?

Within 7 days, IDHS is supposed to review your case. They might decide at that point that they made a mistake. They might decide that they were right and do nothing. They might decide that something altogether different needs to be done.

Advice: This review often does not happen. If it does happen, you will get a notice if IDHS decides it has made a mistake or if they decide to do something different. If IDHS decides it has made a mistake, you can stop your appeal. (See the section called "What if IDHS asks me to withdraw my appeal?" .) If they take a different action, you can appeal that action if you don't agree with it.

Within 10 days, you should get a notice of a "pre-hearing conference," also called a "pre-hearing meeting", "pre-appeal conference" or sometimes just "pre-appeal." (An example of a pre-hearing conference notice is on the next page.) If you are appealing denial of expedited Food Stamps, the pre-hearing conference should be held within 2 days.

Advice: If you have not heard anything about the pre-hearing conference after two weeks of filing your appeal, call your local office. Call your caseworker's supervisor to ask for the pre-hearing conference. To find out who the supervisor is, call the main number at your local office. You can ask who your caseworker's supervisor is by using your caseworker's name or the caseload number that is on your medical card.

If you want to attend the pre-hearing conference but can't attend at the scheduled time, call the person whose name is on the notice and ask to change the date. It is best if you can call before the conference, but you can still call afterwards if you missed it and want to reschedule.

Click here for a sample of IDHS's Pre-Appeal Conference Appointment Letter.

8. What happens at a pre-hearing conference?

A pre-hearing conference is a meeting between you, your caseworker's supervisor, and your caseworker. (Often the caseworker does not go to this meeting.) Be sure to bring any papers about your case with you to this meeting.

For certain Medicaid appeals and for child care appeals, the pre-hearing conference may be with staff from outside the local office.

Sometimes, the pre-hearing conference is held by telephone. If it is difficult for you to go to the local office (because, for example, you are working during the day), you can ask to have the pre-hearing conference by telephone. If your appeal is about a child care problem, it will probably be held by telephone with someone from the Bureau of Child Care and Development in Springfield.

You can ask for child care payments if you need childcare to attend the pre-hearing conference. You can make this request up to 30 days after hearing date. If your caseworker does not know about this policy, tell her to look at the Policy Manual at section 01-07-13.

Special advice for AABD disability applicants: If you are trying to show that you are disabled so that you can get AABD benefits, you can submit new medical evidence at any time while you are waiting for your hearing. You can do this at the pre-hearing conference or at any time later. Bring or send the medical evidence to your local office. Ask them to send the evidence to Springfield for another review. Sending additional evidence is the best way to get an AABD medical card, instead of waiting for the hearing. If you do bring this information to the hearing, the hearing will be postponed so that the new evidence can be looked at in Springfield.

If you have a representative, you should go to the pre-hearing conference with your representative. If you have a representative, IDHS should not hold the pre-hearing conference without your representative.

Advice: You do not have to go to the pre-hearing conference. However, it is almost always a very good idea to go to the pre-hearing conference. At the conference, IDHS should evaluate if they did the right thing. If they need some information from you, you can give it to them then (or agree to bring it in on another day). Very often, it is possible to come to an agreement at the pre-hearing conference.

You should take any papers about your case with you to the pre-hearing conference. This includes records that you have kept about your contact with IDHS. You should also take any papers you think IDHS will need to see to solve your problem, such as, for example, a doctor's note or your paycheck stubs.

Sometimes, IDHS will insist that what they did was correct.

Advice: Do not take IDHS's word that they are right. You should demand to see the written policy.

9. What if IDHS asks me to withdraw my appeal?

At the pre-hearing conference, IDHS will probably ask you to withdraw the appeal.

But you should withdraw your appeal only if:

  • IDHS has said you are right and has agreed to give you your full aid or to make the changes you have requested; or
  • IDHS and you have come to a compromise that you agree with; or
  • IDHS has shown you the written policy and you are sure they were right in the first place; or
  • If you are sure that you agree with IDHS or if you do not think there is any chance you will get a better result in a hearing.

Advice: You should not withdraw your appeal just because IDHS says you are going to lose. If you withdraw the appeal, you may not be able to appeal the same incident again.

A blank Request to Withdraw Appeal form is attached here.

Advice: If you agree to withdraw the appeal, clearly write on the withdrawal appeal form whatever IDHS has promised to do.

Example: At Ms. Goldberg's pre-hearing conference, IDHS promises to lift her sanction, Ms. Goldberg agrees to withdraw her appeal. On the appeal withdrawal form, she writes that she has agreed to withdraw her appeal because IDHS has promised to lift the sanction.

Click here for a sample of IDHS's Request to Withdraw Appeal.

Advice: Always keep a copy of the withdrawal of appeal form signed by both you (or your representative) and by the local office staff. If lDHS does not do what they promised, you can appeal their failure to live up to the agreement described in the withdrawal of appeal form.

Sometimes you might want to withdraw the appeal if it is very clear that IDHS was right about your case.

Advice: You never have to withdraw the appeal even if you think you will lose. It is your right to continue with the appeal. You should not withdraw your appeal just because IDHS says that you will lose.

Special advice if you are appealing a sanction: Do not withdraw the appeal unless IDHS agrees to remove the record of the sanction.  If IDHS has agreed it was wrong or that you had good cause, make sure IDHS has agreed to remove any record of the sanction from your file before you withdraw the appeal.  This is important because every time you get sanctioned, the sanction is worse than the last time.  If IDHS agrees that you should not have been sanctioned, that sanction should not count.  Your next sanction should be no worse than this one.  If your caseworker refuses to agree to this, ask to speak to a supervisor. 

If IDHS does not do what they said they would do on the withdrawal of appeal form, you should file another appeal about that. Attach a copy of the withdrawal of appeal to show what IDHS agreed to do.

10. How do I find out about the hearing?

After the pre-hearing conference, you will get a notice of hearing. This notice will tell you

  • where to go (probably your local IDHS office).
  • when to be there.

Click here for a sample of IDHS's Bureau of Assistance's Hearing Notice.

11. What if I can't go?

If you cannot attend the hearing, you must contact this office to request a delay:

Bureau of Assistance Hearings
Department of Human Services
401 South Clinton, 6th Floor
Chicago, IL 60607
Phone: (800) 435-0774, Fax: (312) 793-8573

You must make your request for a delay in writing. Include your case number and the appeal number. You must show a good reason for missing the hearing, like illness or having to work. IDHS will not give you a delay just because you want more time.

If you do not hear back that your delay has been granted, you should try to go anyway.

Advice: lDHS almost never gives delays ahead of time. If you really cannot go to the hearing, try to send someone in your place. That person can explain why you are not there and can ask for a delay.

Advice: If you miss the hearing without good cause, IDHS will dismiss your appeal. It will be very hard to appeal again.  This is different from the pre-hearing conference.  If you miss the pre-hearing conference, nothing bad will happen to your case or your appeal.

Advice: If there are certain times that will be difficult for you to attend a hearing, you can request that the hearing be scheduled at a different time. You can make this request even before the first hearing is scheduled. For example, you could write to IDHS at the address above and explain that because you work from 9: 00 a.m. to 1: 00 p.m., you would like to have your hearing scheduled for 2: 00 p.m. or later. Include your case number and the appeal number if you know it. There is no guarantee that IDHS will do what you ask, but it is worth asking them anyway.

You do not need to make the request for a delay in writing for the first delay of an appeal that is only about Food Stamps. For the first delay of a Food Stamps-only appeal, you do not need to show a good reason.

Advice: It is a good idea to make your request in writing anyway. Remind IDHS in your request that for Food Stamps you do not need to show a good reason to get a first delay.

Advice: You might get a notice of a hearing even if you have already withdrawn the appeal. When that happens, you can ignore the notice of the hearing. Nothing bad will happen to your case if you ignore that notice.

12. What happens if I miss the hearing?

If you miss the hearing, you will get a notice saying that your appeal was dismissed. A sample Notice of Dismissal of Appeal is attached. The notice will say that your appeal can be started again if you can show "good cause" for missing the hearing, You must respond to the notice within 10 days. Good cause includes:

  • death in the family;
  • personal injury or illness that reasonably keeps you from attending, or
  • sudden and unexpected emergencies.

Also, sometimes people do not receive notices for hearings. If this happens, you should explain that you did not attend the hearing because you had no notice.

Advice: You may get a notice dismissing the appeal even if you attended the hearing or got a delay before the hearing. If that happens, write a letter saying what happened to the Bureau of Assistance Hearings, Department of Human Services, 401 South Clinton, Chicago, IL 60607. In the letter, ask to have your appeal reinstated and your hearing rescheduled. Do this as soon as possible.

If you miss the hearing without good cause, your appeal may be dismissed. This means that you have lost the appeal and IDHS will not change the decision they made in your case. If you think that you had a good reason for missing the hearing, you might be able to have a court reinstate your appeal. Look at the section called "What if I disagree with the hearing officer's decision?"

13. How do I get ready for the hearing?

(1) Statement of Facts. At least two days before the hearing, you should get a copy of a "statement of facts." This is IDHS's version of what happened. If you do not get a statement of facts, you can ask for a delay at the hearing if you want one.

(2) Reviewinq your case file. You and your representative have a right to see your case file before or during the hearing. You can make an appointment to see the case file before the hearing with the caseworker or supervisor.

If you were denied the opportunity to see your case file before the hearing, you can ask for a delay so that you can see it.

Advice: You can look at your file during the pre-hearing conference. It can help to look at it with an IDHS staff member to explain what some of the papers mean. But don't assume that they are correct about everything they tell you. Ask a lot of questions, especially if something doesn't seem right to you. Or you can ask to speak to a supervisor.

You can get free copies of anything in the file that relates to a Food Stamps appeal. For other programs, IDHS can charge 10 cents a page for copies.

Advice: Often appeals involve many programs. If the appeal includes a Food Stamp issue, you should be able to get free copies of many of the papers in the file even if they also relate to other programs.

(3) Child care. You can ask for child care payments if you need them to attend the hearing or the pre-hearing conference. You can make this request for child care payments up to 30 days after the hearing date. If your caseworker does not know about this policy, tell her to look at the Policy Manual at section 01-07-13.

14. What happens at the hearing?

At the hearing:

  • A hearing officer is in charge. The hearing officer will have a tape recorder. He or she will ask you to state what you are appealing.
  • All the witnesses will be asked to swear or affirm to tell the truth.
  • You can ask questions of IDHS's witnesses. If you have a representative, your representative should do this for you, but you will still have to be there. Usually, the hearing officer first asks the caseworker to explain why they did what you are appealing.
  • You will then have the chance to tell the hearing officer what happened and to show your papers.
  • Your witnesses will have a chance to talk.
  • At the end, you can summarize why you should win.

Bring to the hearing any papers you have about the case. You should also bring any witnesses who will help support your case. If you have a witness who cannot come, ask that person to write a letter explaining what they know about your case.

Example: Ms. Jones applied for benefits, A week after she applied, she received a notice informing her to come to a meeting. She received the notice after the meeting had already happened. She called the intake worker who sent the notice but was told that it was too late and that her application would be denied. Ms. Jones appeals this decision. She brings to the pre-hearing conference a copy of the notice and the envelope it came in, which shows that the notice was postmarked only the day before the meeting.

Special advice for AABD applicants: At the hearing, you have a right to explain to the hearing officer why you think that you are disabled. You can also have witnesses testify for you. If you have had an SSI hearing before an Administrative Law Judge, the same information you talked about there should be told to the hearing officer in this hearing.

You can bring new or additional medical evidence to the hearing, but it is better to submit it ahead of time.

At the hearing, you can object to evidence if it is hearsay. Hearsay means that the evidence was said or written by somebody who is not at the hearing. You must say the word "hearsay." You cal also question whether the hearsay evidence is reliable.

Example: Ms. Grange's aid was cut off because the caseworker thought that her children had gone to live with their father. At the hearing the caseworker says, "Your neighbor told me your kids went to live with their daddy." Ms. Grange says, "that's hearsay."

At the hearing you can also ask questions of any of IDHS's witnesses.

15. What happens if I win the I appeal?

If you win:

  • You can get whatever aid you should have gotten but did not.
  • You will also get the aid you are entitled to from then on.

If you lose:

  • IDHS will not change the decision it made in your case.
  • If you have been getting aid paid pending appeal, you will owe that money back to IDHS. IDHS can collect the money in small amounts out of your monthly aid. IDHS can also do things like collect your tax refund and try to send a collection agency to get the money from you.

Advice: If you think the overpayment you have been charged with is too big, you can appeal it. If you are no longer on assistance and you have been charged with an overpayment that you agree you owe, it is probably a good idea to try to set up a payment plan. As long as you make small payments each month, IDHS will probably not send your case to a collection agency. If IDHS does send your case to a collection agency, you should still try to make a payment plan, this time with the collection agency.

If you lose, you can ask a court to review your appeal. See the section called "What if I disagree with the hearing officer's decision?"

16. How do I know when my appeal has been decided?

IDHS will issue a written Final Administrative Decision. You will get a copy of this in the mail.

17. How long will it take before my case is decided?

TANF, Medicaid, and AABD hearings are supposed to be held, decided, and the decision implemented within 90 days of when you filed the appeal.

Food Stamp hearings should be held and decided within 60 days of when you filed the appeal, and the decision implemented within 10 days of the decision.

If you ask for a delay, that delay will extend the time limits, IDHS will have longer to decide the appeal.

IDHS often misses these deadlines. In some cases, you can get some money from IDHS if IDHS misses the deadlines.

For TANF, Medicaid, and AABD, if IDHS does not decide and implement an appeal within 90 days after you file your appeal, you can get a $100 payment. You can get another $100 for each 30 day period the decision is not implemented. This is because of a lawsuit called Jeffries. If you have an overpayment, IDHS will keep this money and apply it to the overpayment.

For Food Stamps, if IDHS does not decide and implement an appeal within 60 days and you did not get full Food Stamps pending the appeal and you ultimately win, you may be eligible for a $100 payment and for another $100 for each additional 30 day period the decision is not implemented. This is because of a lawsuit called Dietrich. If IDHS decides 95% of the Food Stamps appeals in a month on time, no Dietrich payments will be available that month.

You cannot get both Jeffries and Dietrich payments at the same time, but you can get Dietrich payments for the period before you become eligible for Jeffries payments. You cannot get Jeffries or Dietrich payments if you withdraw your appeal.

You should automatically receive these payments within 60 days after you qualify. If you have not received a payment within 60 days after you believe you qualify, you can contact the Office of Legal Services, Department of Human Services, 100 South Grand Avenue, East, Springfield, Illinois 62762. Click here to see a form letter. You can fill this out and send it in. Click here to see a sample of a filled out letter.

18. What if I disagree with the hearing officer's decision?

You have 35 days from the date on the Final Administrative Decision (but it could be as long as 6 months if the only issue is Food Stamps) to go to court. A judge will review the IDHS decision.

Advice: It is a good idea to have a lawyer for this process. (You don't have to have one). If you get a Final Administrative Decision that you do not agree with, quickly get help from a lawyer. See Appendix 2 for a list of legal services programs around the state.

Grievances

19. What can I do if I don't like the way my caseworker treats me?

You can file something called a "grievance." A grievance is a complaint about treatment by the caseworker or any other IDHS employee. It is not about a decision made in your case.

Here are some examples of reasons to file a grievance:

  • Your caseworker makes bad remarks about you.
  • Your intake worker is rude to you or treats you disrespectfully.
  • Your caseworker won't return your phone calls.
  • Your caseworker loses the papers that you give her.
  • Your local office administrator ignores IDHS policy.

Sometimes, you might want to file both an appeal to fix your case, and a grievance to complain about the how the caseworker treated you.

Example: Ms. Henry has one child. Her caseworker demands information about her child's father. Ms. Henry does not know exactly where he is, but she is able to give some helpful information about him. Her caseworker sanctions her anyway. He also tells her that he thinks she must have been using drugs or was a prostitute because she does not seem to know much about her child's father. Ms. Henry appeals the sanction, but she also files a grievance to complain about the way her caseworker treated her.

20. How do I file a grievance?

You can file a grievance by giving IDHS a written complaint. It is best to use the IDHS grievance forms. (A blank form is attached here.) You can give this form to any IDHS office, but it is best to turn it in at your own local office. Click here for a filled out sample form for IDHS'S CLIENT GRIEVANCE FORM.

21. When should I file a grievance?

You must file your grievance within 60 days of the incident you are complaining about.

22. What happens when I file a grievance?

The grievance goes to a mediator. If the mediator thinks your grievance is not about something worth complaining about, he will tell you within 10 work days. Then your grievance will be over. You have the right to appeal this decision. Use the appeals process described in this manual.

If the mediator finds that the grievance is about something worth complaining about, he will call you to a meeting. This should happen within 10 work days of getting the grievance. The people at the meeting should include:

  • you and/or your representative, if you have one;
  • the IDHS employee who you are complaining about; and
  • the mediator.

23. What happens at the grievance meeting?

At the grievance meeting, you will have the chance to tell the mediator what happened that you are complaining about. You should bring with you any evidence that you have. For example, if someone else heard what your caseworker said, bring that person with you or have him or her write a letter saying what they heard.

24. What happens after the grievance meeting?

The mediator will tell you in writing within 15 days if the grievance was found to have merit. He will tell you of any action being taken in your case. You might get a new caseworker, for example. You will not find out about any action taken against the employee. If your grievance is found to have merit, it will go into the worker's file. If there are enough grievances in the file, the worker could be fired, demoted or disciplined.

25. Can anythinq bad happen to me if I file a grievance?

IDHS staff is not allowed to retaliate against someone who files a grievance. If they do, file an appeal and another grievance.

Child Support Procedures

There are three different procedures you can use if you are having trouble with child support for a child who lives with you. The Illinois Department of Healthcare and Family Services (IDHFS) is in charge of the Child Support Program. Even though IDHFS is in charge of the program, sometimes you might have to talk to your IDHS caseworker about your child support case, especially if you have not yet established paternity. Here are the 3 procedures:

  1. If you have a problem with your IDHS caseworker, file an appeal as described in this manual. For example, if your IDHS caseworker sanctions you for not giving enough information about the other parent of your child, you can file an appeal.
  2. If you are concerned that IDHFS' Child Support Program is not doing a good job in trying to get the other parent of your child to pay child support, ask for an administrative accountability analysis.


    To ask for an administrative accountability analysis, send a letter to:

    IDHFS Child Support Program
    Administrative Accountability Analysis
    509 S. 6th Street
    Springfield, Illinois 62701-1825

    In the letter, include all the information you have about the other parent of your child. You should also explain what it is you want the Child Support Program to do. For example, you could say that you want them to find out where the other parent is working.

    Instead of the letter, you can also use a form to request an Administrative Accountability Analysis. This form is attached here. This is called a Request for Explanation form.

    The Child Support Program should respond within 30 days. If they do not respond within 30 days, you can ask for a meeting using the form called the Request for a Conference form. If they respond and you do not agree with what they tell you or if you have more questions, you can also ask for a meeting using the same form.

  3. If the Child Support Program is collecting child support, and you are concerned about how much of that child support is being turned over to you, ask for an account review.


    To ask for an account review, send a letter to:

    IDHFS Child Support Program
    "Agee" Account Review Request
    P.O. Box 19152
    Springfield, IL 62794-9152

    In the letter, describe your concerns. If you have gotten monthly statements from the Division of Child Support Enforcement, include a copy of the monthly statements you are concerned about. (If you don't have the monthly statements, send the letter anyway). There sometimes are delays in getting an answer.

    If you are not happy with the results of the account review and you receive TANF, you can file an appeal, as described in this manual.

    If you are not happy with the results of the account review and you do not receive TANF, you should ask for a redetermination. If you are not happy with the results of the redetermination, you can ask a court to review those results. You may want to get a lawyer for this process. See Appendix 2 for a list of legal services programs around the state.

     

  4. If you are paying or supposed to be paying child support and you think that the Child Support Program has made mistakes about what you owe, you should write a letter.  In the letter describe your concerns.  Include copies of any documents (like notices or court orders) related to your concerns.

    Send the letter to:

    IDHFS Child Support Program
    Data Gathering Unit
    P.O. Box 19152
    Springfield, IL 62794-9152

 

Appendix 1

We recommend that you copy these forms instead of tearing them out of the book.

You can find the forms in the body of the article or follow the link here.

Appendix 2

Cook County

Public Benefits Hotline
Toll Free (888) 893-5327

Legal Assistance Foundation of Metropolitan Chicago
Central Intake
111 W. Jackson Blvd., 3rd Floor
Chicago, IL 60604
(312) 341-1070
TTY: (866) 889-8647
(user name: lafmcgo)

Northwest Office
1279 N. Milwaukee Ave., Suite 407
Chicago, IL 60622
(773) 572-3200

South Side Office
10 West 35th Street
Chicago, IL 60616

West Side Office
3333 West Arthington Street
Chicago, IL 60624
(773) 321-7900

North Suburban Office
828 Davis Street, Suite 201
Evanston, IL 60201
(847) 475-3703

South Suburban Office
900 East 162nd Street, Suite 101
South Holland, IL 60473
(708) 271-4950

Northern Illinois

Batavia
Serving DeKalb and Kane Counties
201 Houston Street, Suite 200
Batavia, Illinois 60510
(630) 232-9415 and (800) 942-4612

Carol Stream
Serving DuPage County
350 South Schmale Rd., Suite 150
Carol Stream, IL 60188
(630) 690-2130 and (800) 690-2130
TTY: (630) 690-230

Galesburg
Serving Knox, Warren, Henderson, McDonough and Fulton Counties
1614 East Knox Street
Galesburg, Illinois 60901
(815) 935-2750 and (800) 346-2864
TTY: (815) 935-2764

Kankakee
Serving Kankakee, Iroquois and Kendall Counties
191 South Chicago Street
Kankakee, IL 60901
(815) 935-2750 and (800) 346-2864
TTY: (815) 935-2764

Ottawa
Serving Bureau, Grundy, LaSalle, Lee and Putnam Counties
1021 Clinton Street
Ottawa, IL 61350
(815) 434-5903 and (800) 892-7888

Peoria
Serving Peoria, Marshall, Tazewell, Stark and
Woodford Counties

331 Fulton Street, Suite 600
Peoria, IL 61602
(309) 674-9831 and (800) 322-2280

Rock Island
Serving Henry, Mercer, Rock Island and
Whiteside Counties
208 18th Street #202
Rock Island, Illinois 61204
(309) 794-1328 and (800) 322-9804
TTY: (309) 793-1302

Rockford
Serving Boone, Carroll, Jo Daviess, Ogle,
Stephenson and Winnebago Counties

975 North Main Street
Rockford, Illinois 61103
(815) 965-2902 and (800) 892-2985
TTY: (309) 793-1302

Waukegan
Serving Lake and McHenry Counties 
325 West Washington Street, Suite 100
Waukegan, Illinois 60085
(847) 662-6925 and (800) 942-3940
TTY: (847) 622-4441

Will County Legal Assistance
Serving Will County
5 East Van Buren Street, Suite 310
Joliet, Illinois 60432
(815) 727-5123
TTY: (815) 723-1718

Bloomington
Serving Livingston, McLean, and eastern Woodford Counties
316 W. Washington Street
Bloomington, IL 61701
(309) 827-5021 and (800) 874-2536
TTY: (309) 828-3986

Central and Southern Illinois


Land of Lincoln Legal Assistance Foundation
All new matters: (877) 342-7891

Alton
Serving Adams, Bond, Brown, Calhoun, Greene,
Hancock, Jersey, Macoupin, Madison, Montgomery, Pike and Schuyler Counties

413 East Broadway
Alton, IL 62002
(618) 462-0029 and (800) 642-5570

Champaign
Serving Champaign, Clark, Coles, Crawford, Cumberland, DeWitt, Douglas, Edgar, Effingham, Ford, Jasper, Moutrie and Vermillion Counties
Champaign Office
1817 South Neil Street, Suite 203
Champaign, IL 61820
(217) 356-1351 and (800) 747-5523
 

Carbondale
Serving Alexander, Clay, Edwards, Fayette, Franklin, Gallatin, Hamilton, Hardin, Jackson, Jefferson, Johnson, Lawrence, Marion, Massac, Perry, Pope, Pulaski, Richland, Saline, Union, Wabash, Wayne, White and Williamson Counties
Old National Bank Building, Third Floor
509 South University Avenue
(618) 457-7800 and (800) 642-5335

East St. Louis Office
Serving Clinton, Monroe, Randolph, St. Clair, and Washington Counties
8787 State Street, Suite 101
East St. Louis, IL 62203
(618) 398-0958

Springfield Office
Serving Cass, Christian, Logan, Macon, Mason, Menard, Morgan, Sangamon, Scott and Shelby Counties
Illnois Realtors Building
3180 Adloff Lane, Suite 201
Springfield, Illinois 62703
(217) 529-8400 and (800) 252-8629

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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