Administrative Review by Director

GA Policy [127]

Administrative Review by Director

If the applicant/recipient or the General Assistance Program Manager is dissatisfied with the decision of the Hearing Officer he/she may request an administrative review by the Director of the Social Services Agency or his/her designee. Such request must be filed in writing within 15 days after notification of the decision of the Hearing Officer, with the Director, Social Services Agency, 333 W. Julian Street, San Jose, CA 95110. The claimant may file a request for a review beyond the 15 days if good cause exists as specified in GA 231. The request must specifically state the reason or reasons why the applicant or recipient believes the Hearing Officer's decision was incorrect. The Director or the Director's designee shall review the Hearing Officer's decision.

Within 15 days after receiving the request for review, the Director or designee shall notify the applicant or recipient and the General Assistance Program Manager whether the Hearing Officer's decision was correct. The Hearing Officer's decision shall stand pending the Director's review.

Applicant/Recipient Request

An applicant/recipient who is dissatisfied with the decision of the Hearing Officer may request an administrative review by the Director of the Social Services Agency.

Supervisor or Worker’s Request

If, after consultation with the EW Supervisor, a worker believes that the decision of the Hearing Officer does not comply with GA rules and regulations, s/he is to notify the GA Social Services Program Manager. The GA Social Services Program Manager may, at that point, request an administrative review by the Director of the Social Services Agency.

Request and Contents

The request for administrative review shall:

  1. Be completed using the “General Assistance Administrative Review by Director” (GA 40). The form is Online on SSA Intranet -DEBS Forms Library.
  2. State on the GA 40 specifically the reason(s) why it’s believed that the Hearing Officer's decision is incorrect.
  3. Be sent (the completed GA 40 request) by the District Office to the DEBS Director or the Director’s designee to complete the “Office Use Only” section of the form.
  4. Be filed/completed within 15 days after the date of the notification of the decision of the Hearing Officer, unless good cause exists.

Director's Review

The Director of the Social Services Agency or the Director's designee shall:

  • Review the Hearing Officer's decision.
  • Make a determination for correctness of the decision and complete the “Office Use Only” section of the GA 40.

Return the completed GA 40 to the Appeals unit within the 15 days allotted time to ensure the applicant/recipient or Agency staff is notified of the decision.

Administrative Review (A/R) Process

The process below must be followed for GA Administrative Reviews:

WHO ACTION
Client
  • Submits a GA 40 request and supportive documents for Administrative Review.

Note: Clients may also submit an A/R request in any other written statement. The statement must contain the specific reasons of why the client believes the Hearing Officer’s decision was incorrect.
GA/VS Clerk
  • Receives and date stamps the GA 40 (or other form of AR request) submitted by the client.
  • Scans the request and sends it to the Appeals e-mail: asbappeals@ssa.sccgov.org.
  • Forwards the original GA 40 (or other form of AR request) to the Appeals clerk.
Appeals Clerk
  • Receives and date stamps the original GA 40 (or other form of AR request) received from GA/VS clerk or directly from the client.
  • Makes appropriate entries in the Clerical Administrative Review (A/R) log.
  • Creates a TMT request and assigns it to the Appeals Supervisor.
Appeals Supervisor
  • Receives the GA 40 from the Appeals Clerk.
  • Reviews the request and researches VSAS/CalWIN in order to make a recommendation.
  • Documents the recommendation in CalWIN/VSAS.
  • Generates an Approval or Denial Recommendation Letter (GA 1124 A or GA 1124D) and forwards it to the Director or Director’s designee.

NOTE: If it is determined that there are other ineligibility factors not covered in the AR request, the Appeals Supervisor must notify the case EW for immediate action and must note also notify the client of these findings by noting them in any Approval Recommendation Letter as appropriate.
Director or Director’s designee
  • Receives the GA 40 with Recommendation Letter from Appeals Supervisor.
  • Makes an Administrative Review determination.
  • Signs the Approval or Denial Recommendation Letter and forwards it back to the Appeals Supervisor.
Appeals Supervisor
  • Receives the Approval and Denial Recommendation Letters from the Director or Director’s designee and follows the process below:
  • Makes the appropriate entries in VSAS for the approved reviews to automatically generate a VS appointment letter (code H2).
  • Emails a list of all approvals to the VS Employment Counselor (EC) Lead(s).

    • NOTE: Benefits should NOT be restored until client complies with Vocational Services

  • Forwards all Approval and Denial Recommendation Letters to the Appeals Clerk.
Appeals Clerk
  • Receives all recommendation letters (approved and denied) from the Appeals Supervisor.
  • Mails the letter to clients and forwards a copy for IDM scanning, along with the GA 40 and all appropriate documents/verifications.
VS Lead
  • Receives the e-mail from the AO with the list of completed A/Rs
  • Ensures that appropriate entries are made in CalWIN and VSAS.

NOTE: Benefits should NOT be restored until client complies with Vocational Services.

Approved/Denied Administrative Review Forms (GA 1124A and GA 1124D)

The process below is to be followed after the AR letter is sent to the client:

WHO ACTION
Client
  • Receives the Denial or Approval AR Letter
  • If AR Review is:
    • Denied:
      • No further Action is needed.
      • Client must reapply for benefits after sanction end-date.
    • Approved:
      • The client must comply with VS and must attend the scheduled VS appointment provided with the AR approval letter.

      • NOTE: If the client does not show for the scheduled VS appointment, and does not contact VS and/or provide good cause verification for not showing to the appointment, by the end of the month in which the appointment was scheduled, the benefits cannot be restored, and a new application will be required.
VS Employment Counselor
  • Interviews the client and assigns activities.
  • Deletes the sanction in CalWIN.
  • Forwards an “Eligibility Worker/Vocational Services Communication” (GA 53), to clerical to create a TMT for the EW to request for benefits to be restored.
  • Documents case actions in VSAS and CalWIN Case Comments window.
EW
  • Receives GA 53 from VS clerk (TMT).
  • Restores benefits as instructed.

Related Topics

Non-Automatic Hearings

Non-Automatic Hearing Process