Frequently Asked Questions | Department of Health and Human Services

What is a Fair Hearing?

If you disagree with a Department of Health and Human Services' (DHHS) decision to grant, deny, or otherwise change a benefit, license, an amount owed, or some other decision affecting you, then you have a right to a hearing. Most DHHS hearings are held by the Division of Administrative Hearings. Sometimes hearings are held before another agency.

When you have a hearing, it is our goal to make sure that the hearing process is meaningful and fair. We want to make sure that it gives an opportunity to each party to present their side of the story.

The Hearing Officer will make sure you understand the hearing process and that you have the time you need to present information relevant to your case. The Hearing Officer only makes the decision after considering the testimony of all witnesses and other evidence. The Hearing Officer will put the decision in writing. That decision will either uphold or reverse the initial decision of the Department.

Are there time limits to appeal a Decision by the Department??

Time Limits: You generally have 30 days to appeal for a hearing. Each program has different rules on appeals. It is important to read carefully the notice you get from the Department to make sure that you do not miss any deadlines for your appeal. The Division of Administrative Hearings cannot give this information to you. Be clear that you are filing for an appeal and that your letter is postmarked within the filing time period.

You may be allowed to file a late appeal. You will need to show "good cause" for filing the appeal late. "Good cause" happens when you were prevented from making the deadline by circumstances beyond your control. "Good cause" is difficult to prove, so it is very important that your appeal is filed within the time required.

How does a Hearing Get Scheduled?

You will get a scheduling letter from the Division of Administrative Hearings (unless your hearing is a child support related hearing, then you will receive a notice directly from the Division of Support Enforcement and Recovery). The letter will state the time, date and place for the hearing.

Your hearing may be held by telephone (however, it is recommended that you attend). You can also ask that your hearing be by telephone. To do this see the section below.

Witnesses may testify by telephone. However, you must make arrangements with the witness beforehand. You must also tell us that you plan to have witnesses by phone. This is so we can be sure to have things set up for your witness to testify by telephone.

What If the Date for the Hearing is Bad for Me?

Carefully note the DATE, TIME and LOCATION of the hearing. You must make every effort to attend the hearing.

If you have a very good reason and cannot make it, let us know immediately. Generally, hearings will not be postponed for personal reasons, vacations, or business appointments since these can often be re-scheduled.

How Do I get Ready for a Hearing?

This appeal hearing may be your last chance to present your case, so be prepared to do it thoroughly.

Department of Health and Human Services appeal hearings are generally said to be "de novo," Latin for afresh or anew. This is done to keep your hearing impartial and independent of the initial decision to grant or deny benefits, or a license. Therefore, the Hearing Officer who conducts the hearing is not bound by the initial decision and will base their decision only on the evidence and testimony presented at the appeal hearing.

If papers, letters, statements, or other evidence were presented previously to the Department, and could be helpful to your case, you must take responsibility for presenting this information again at your appeal hearing. If there are direct witnesses to the circumstances surrounding your case, make sure they will attend your hearing to present their information. Before the hearing, you, your attorney, or authorized representative have the right to copy the case file.

Can I Make Someone show up at the hearing?

Witnesses who are not parties to the hearing may be necessary for you to present the facts that are favorable to your case. If you ask someone to appear as a witness and they refuse, you may request that they be "subpoenaed". This means they will be required by law to appear. You also have the same right to request a subpoena for written documents or other evidence that you cannot obtain on your own.

If you need a subpoena, immediately call the Division of Administrative Hearings at (207) 624-5350. You will be sent a form to fill out.

Request for subpoena form (Word)

Do I Need to Show Up at the Hearing?

It is important that you arrive on time for your hearing. You should arrive at least 15 minutes before the scheduled time of your hearing. If you do not appear, your appeal may be dismissed or the hearing could be held without you. Your failure to appear may result in you losing all rights of further appeal.

What Happens at the Hearing?

A Hearing Officer runs the hearing. The hearing is to decide if the Department was correct in their decision. Anyone with an interest in the outcome of the hearing is a "party" to the hearing. Parties to hearings are usually the Department and you.

The hearing is a fact-finding process. It is like a trial, but not as formal. The appeal hearing is carefully controlled by the Hearing Officer. This is done to make sure each person has the same opportunity to present his/her case.

The hearing will begin with the Hearing Officer making an opening statement about what will happen during the hearing. He/she will answer any questions you might have about the hearing process. The Hearing Officer will only use information presented at the hearing in reaching his/her decision.

All testimony is given under oath and is recorded. The Hearing Officer will begin receiving testimony by swearing in the first Department witness.

The burden of proof varies depending on the issue. The party carrying the burden of proof usually presents their case first. The burden of proof generally lies with the Department to provide proof by a "preponderance of the evidence" that the decision they made was correct.

The Hearing Officer will allow the Department and its witnesses to tell their story. You will be allowed to cross-examine each of the Department's witnesses. The Hearing Officer may ask questions also. When the Department has finished presenting its case, you will then be given the opportunity to present your case. The same process of questioning and cross-examination will take place (with the Department being allowed to cross-examine you and/or your witnesses).

The Hearing Officer will close the hearing when neither side has any additional information or evidence to present. If you need clarification or have questions at any time during the hearing, ask the Hearing Officer for assistance.

Finally, it is important to remember that the hearing is held to gather facts, not to get into an argument. Arguing, or getting angry during a hearing, prevents you from clearly stating the facts of your case. You will give a much better presentation if you stay calm and do not allow emotions to cloud the issues.

What Type of Evidence is Considered?

Only evidence presented at the hearing will be considered; therefore, you should bring any documents or witnesses that can directly help your case. Carefully think through your case. Ask yourself what information, documents, or witnesses will help to establish the facts in your favor.

Choose witnesses who have first-hand information: a person who directly saw or heard the event to which they are testifying. Someone who testifies about what someone else said, saw or heard is giving hearsay; therefore, he/she can only have limited knowledge of that event. A witness with first-hand information is generally considered more reliable than hearsay evidence since he or she can be cross-examined.

Some hearsay is allowed. However, it is generally not as reliable as testimony from someone who has first-hand information. Testimony given at the hearing, under oath and subject to cross-examination, is often given more weight than hearsay statements.

How Do I Get Ready for My Hearing?

Prepare yourself for the appeal hearing.
Think about your case and ask yourself what information, documents, or witnesses will help establish the facts in your favor.
Choose witnesses who have direct, personal knowledge of events about your case.
Stick to the facts. Emotions usually cloud the issue and prevent you from presenting your case effectively.
Organize your facts on paper. Make a list of the important points you would like to present at the hearing.
Make another list of the points you think the opposing party may make. Consider what you will say or ask in response.

Can I Have an Attorney or Someone Else Represent Me?

You have the right to bring an attorney or other person to represent you at your hearing. The Hearing Officer will make sure all parties are given an opportunity to present their case.

IF YOU CHOOSE TO HAVE SOMEONE REPRESENT YOU, YOU MUST COMPLETE, DATE AND SIGN THE DHHS “APPOINTMENT OF AUTHORIZED REPRESENTATIVE” FORM. ALSO, IF YOU INTEND THAT THE AUTHORIZED REPRESENTATIVE HAVE ACCESS TO VIEW, COPY OR ACCESS YOUR PROTECTED HEALTH INFORMATION OR OTHER CONFIDENTIAL OR IDENTIFIABLE INFORMATION (“PROTECTED INFORMATION”) AND THAT PERSON DOES NOT ALREADY HAVE LEGAL STANDING OR A COURT ORDER THAT AUTHORIZES THE PERSON TO HAVE SUCH ACCESS THEN YOU MUST SUBMIT A DULY COMPLETED AND SIGNED “AUTHORIZATION TO RELEASE INFORMATION FORM.” CONTACT THE DHHS PROGRAM THAT MADE THE DECISION YOU ARE APPEALING TO OBTAIN THE FORMS.

It is the Hearing Officer's job to make sure each party receives a fair and unbiased hearing, whether or not he/she chooses to have representation. If you believe your case is complicated, or you think you may be uncomfortable presenting your case, you can hire a lawyer or representative of your choice to present your case. Your attorney or representative will be given an opportunity to question the witnesses.

If you choose to have legal representation, contact your attorney immediately to allow them ample time to prepare for the hearing. It is your responsibility to notify them of the time and place of the hearing and to pay any fees charged for such representation.

What if I Need Special Arrangements for the Hearing?

If you need special services, such as accommodations for people with disabilities or an interpreter to present your facts at the hearing, contact the DHHS program that made the decision you are appealing in advance so they can make the necessary arrangements.

Telephone Hearings and Documents in General

Telephone hearings (via "conference call") allow you to have a hearing without the expense, time or possible hazard of traveling to a central hearing site.

Telephone hearings are scheduled by the Division of Administrative Hearings. Not all hearings can be held by telephone. In deciding if a telephone hearing can be held, the Office will consider things such as the number of witnesses and documents, the length of the hearing, the distance to a central hearing site, and the safety of the participants.

In a telephone hearing, your testimony and that of your witness is taken, under oath, by phone. The Hearing Officer conducts the hearing in the same manner as an in-person hearing, using the same question and answer format. You will have the same opportunity to present your case and question the other people involved. In certain hearings, the Department's representative may conduct their portion of the hearing by telephone.

On the Notice of Hearing, you will be provided a toll free number to call with a conference code. You must call into the conference and enter the conference code as prompted by the instructions. If you do not call into the conference, your hearing will be treated as abandoned. Important: If your hearing will be by telephone, any documents or other similar types of evidence you would like to present must be provided to the other party and to the Division of Administrative Hearings no later than 7 days prior to the hearing. Even if you participate in the hearing in person, any documents or other similar types of evidence you would like to present must be provided to the hearing officer and the opposing party no later than 7 days prior to the hearing.

What Happens After the Hearing?

You will get a written decision, by mail, from the Hearing Officer approximately 30 days after the hearing is closed.

The decision may take one of two forms. For most hearings, the Hearing Officer's written decision is the final agency action. For some hearings, the Hearing Officer's written decision will be a "Recommended Decision." In this type of case, the Commissioner of the Department of Health and Human Services will have the final say and will issue a written "Final Decision."

If you do not agree with the final decision of the Hearing Officer, you can appeal the decision within 30 days, to the Superior Court. If you do not agree with the "Recommended Decision" of the Hearing Officer, you have 7 to 20 days (depending on the type of case) to write to the Commissioner to explain your exceptions to the Recommended Decision. If you do not agree with the Final Decision of the Commissioner, you can appeal the decision within 30 days, to the Superior Court.