PROPOSED RULES
SOCIAL AND HEALTH SERVICES
(Financial Services Administration)
Original Notice.
Preproposal statement of inquiry was filed as WSR 08-22-051.
Title of Rule and Other Identifying Information: The department is amending chapter 388-02 WAC, department hearing rules.
Hearing Location(s): Office Building 2, Auditorium, DSHS Headquarters, 1115 Washington, Olympia, WA 98504 (public parking at 11th and Jefferson. A map is available at http://www1.dshs.wa.gov/msa/rpau/RPAU-OB-2directions.html or by calling (360) 664-6094), on November 9, 2010, at 10:00 a.m.
Date of Intended Adoption: Not earlier than November 10, 2010.
Submit Written Comments to: DSHS Rules Coordinator, P.O. Box 45850, Olympia, WA 98504-5850, delivery 1115 Washington Street S.E., Olympia, WA 98504, e-mail DSHSRPAURulesCoordinator@dshs.wa.gov, fax (360) 664-6185, by 5 p.m. on November 9, 2010.
Assistance for Persons with Disabilities: Contact Jennisha Johnson, DSHS rules consultant by October 26, 2010, TTY (360) 664-6178 or (360) 664-6094 or by e-mail at jennisha.johnson@dshs.wa.gov.
Purpose of the Proposal and Its Anticipated Effects, Including Any Changes in Existing Rules:
A. Rules to promote timeliness.
1. Prehearing conferences: The proposed rule revision makes a prehearing conference mandatory if a prehearing conference is requested by either party and clarifies the administrative law judge (ALJ) responsibility to record the prehearing. Prehearing conferences can help expedite or settle cases.
2. Notice of hearings: The proposed rule revision requires office of administrative hearings (OAH) to mail hearing notices not less than fourteen days before the hearing in most situations and requires rescheduling if requested by a party when adequate notice is not given. The proposed rule revision also requires OAH to send copies of requests for hearing to the department unless the request was received from the department. These changes support prehearing planning and opportunities for communication and settlement.
3. Late requests for review: The proposed rule revision changes the standard for granting review when a request is late from "good reason" to "good cause" to comport with the standard used elsewhere in the rules regarding the issues of lateness or failure to act.
4. Hearing record content: The proposed rule revision sets forth the required contents for administrative hearing files. Missing items can delay board of appeals (BOA) review.
B. Rules to make other process improvements.
5. Review standards: The proposed rule revision deletes review standards from the hearing rules to comport with applicable published case law and the Administrative Procedure Act.
6. What laws apply: The proposed rule revision clarifies that the ALJ should apply the substantive rules that were in effect when the department made its original decision, notwithstanding subsequent amendments, and the procedural rules that were in effect on the date the procedure was followed.
7. The proposed rule revision clarifies when notice is required regarding assignment of ALJs and the grounds and procedures for a motion of prejudice.
8. The proposed rule revision deletes the ALJ's authority to dismiss or reverse department actions when the department does not attend a prehearing conference.
9. The proposed rule revision addresses the effect of the department's indexed final orders. The RCW permits an agency to cite a final order (such as a BOA review decision) as precedent if it is included in the agency's published index of significant decisions. The proposed rule revision informs parties of this authority.
10. Equitable estoppel: The proposed rule revision clarifies the circumstances under the law in which department statements or actions which were relied upon by the appellant may be used by the appellant to defend against a department action (such as collection of an overpayment). The proposed rule amendments are made so that the rule comports with applicable appellate case law.
11. Limited authority of ALJs: The proposed rule revision clarifies that under existing law, ALJs do not have the same equitable powers as a superior court judge.
12. The proposed rule revision clarifies when and how a hearing can be converted from one format to another (i.e. in-person versus telephonic).
13. The proposed rule revision makes corrections for grammar and other minor changes for clarification.
Reasons Supporting Proposal: See Purpose above.
Statutory Authority for Adoption: RCW 34.05.020, 34.05.220.
Statute Being Implemented: Chapter 34.05 RCW.
Rule is not necessitated by federal law, federal or state court decision.
Name of Proponent: Department of social and health services, governmental.
Name of Agency Personnel Responsible for Drafting, Implementation and Enforcement: Jim Conant, 1115 Washington Street S.E., Olympia, WA 98504, (360) 664-6081.
No small business economic impact statement has been prepared under chapter 19.85 RCW. The proposed rules adopt, amend, or repeal "a procedure, practice or requirement relating to agency hearings" and under RCW 19.85.025(3) and 34.05.310 (4)(g)(i), a small business economic impact statement is not required.
A cost-benefit analysis is not required under RCW 34.05.328. The proposed rules are "procedural rules" related to agency hearings and do not meet the definition of a "significant legislative rule" under RCW 34.05.328 (5)(c)(iii). Under RCW 34.05.328 (5)(a)(i), a cost-benefit analysis is only required for significant legislative rules. A cost-benefit analysis is not required for procedural rules.
September 20, 2010
Katherine I. Vasquez
Rules Coordinator
4225.7 "Administrative law judge (ALJ)" means an impartial
decision-maker who is an attorney and presides at an
administrative hearing. The office of administrative hearings
(OAH), which is a state agency, employs the ALJs. ALJs are
not ((DSHS)) department employees or ((DSHS)) department
representatives.
"BOA" means the ((DSHS)) board of appeals.
"Business days" means all days except Saturdays, Sundays and legal holidays.
"Calendar days" means all days including Saturdays, Sundays and legal holidays.
"Deliver" means giving a document to someone in person.
"Department" means the department of social and health services.
"Documents" means papers, letters, writings, or other printed or written items.
"DSHS" means the department of social and health services.
"DSHS or department representative" means an employee of
((DSHS)) the department, a ((DSHS)) department contractor, or
an assistant attorney general authorized to represent ((DSHS))
the department in an administrative hearing. ((DSHS))
Department representatives include, but are not limited to,
claims officers and ((fair)) administrative hearing
coordinators.
"Final order" means an order that is the final ((DSHS))
department decision.
"Hearing" means a proceeding before an ALJ or review
judge that gives a party an opportunity to be heard in
disputes about ((DSHS)) department programs. For purposes of
this chapter, hearings include administrative hearings,
adjudicative proceedings, and any other similar term
referenced under chapter 34.05 RCW, the Administrative
Procedure Act, Title 388 of the Washington Administrative Code
(WAC), chapter 10-08 WAC, or other law.
"Initial order" is a hearing decision made by an ALJ that may be reviewed by a BOA review judge at either party's request.
"Judicial review" means a superior court's review of a final order.
"Mail" means placing ((the)) a document in the mail with
the proper postage.
"OAH" means the office of administrative hearings, a
separate state agency from ((DSHS)) the department.
"Party" means:
(1) The department or DSHS; or
(2) A person or entity:
(a) Named in a ((DSHS)) department action;
(b) To whom a ((DSHS)) department action is directed; or
(c) Allowed to participate in a hearing to protect an interest as authorized by law or rule.
"Prehearing conference" means a proceeding scheduled and conducted by an ALJ or review judge in preparation for a hearing.
"Prehearing meeting" means an informal voluntary meeting that may be held before any prehearing conference or hearing.
"Program" means a ((DSHS)) department organizational unit
and the services that it provides, including services provided
by ((DSHS)) department staff and through contracts with
providers. Organizational units include, but are not limited
to, administrations and divisions.
"Record" means the official documentation of the hearing process. The record includes recordings or transcripts, admitted exhibits, decisions, briefs, notices, orders, and other filed documents.
"Review" means a review judge evaluating initial orders entered by an ALJ and making the final agency decision as provided by RCW 34.05.464, or issuing final orders.
"Review judge" means a decision-maker with expertise in
((DSHS)) department rules who is an attorney and serves as the
reviewing officer under RCW 34.05.464. In ((come)) some
cases, review judges conduct hearings and enter final orders. In other cases, they review initial orders and may make
changes to correct any errors in an ALJ's initial order.
((When)) After reviewing initial orders or conducting
hearings, review judges enter final orders. Review judges are
employed by ((DSHS)) the department, are located in the
((DSHS)) board of appeals (BOA), and are not part of the
((DSHS)) department program involved in the review. See WAC 388-02-0600 for information on the authority of a review
judge.
"Rule" means a state regulation. Rules are found in the Washington Administrative Code (WAC).
"Should" means that an action is recommended but not required.
"Stay" means an order temporarily halting the ((DSHS))
department decision or action.
"You" means any individual or entity that has a right to
be involved with the ((DSHS)) department hearing process,
which includes a party or a party's representative. "You"
does not include ((DSHS)) the department or its
representative.
[Statutory Authority: RCW 34.05.020, 34.05.220, 42 C.F.R. 431.10 (e)(3), 45 C.F.R. 205.100 (b)(3), chapter 34.05 RCW, Parts IV and V. 08-21-144, § 388-02-0010, filed 10/21/08, effective 11/21/08. Statutory Authority: RCW 34.05.020, chapter 34.05 RCW, Parts IV and V, 2002 c 371 § 211. 02-21-061, § 388-02-0010, filed 10/15/02, effective 11/15/02. Statutory Authority: RCW 34.05.020. 00-18-059, § 388-02-0010, filed 9/1/00, effective 10/2/00.]
Office of Administrative Hearings
2420 Bristol Court SW((, 1st Floor))
P.O. Box 42488
Olympia WA 98504-2488
(360) 664-8717
(360) 664-8721 (fax)
(b) The headquarters office is open from 8:00 am to 5:00
p.m. Mondays through Friday, except legal holidays.
(2) OAH field offices are at the following locations:
Olympia
Office of Administrative Hearings
2420 Bristol Court SW((, 3rd Floor))
P.O. Box 42489
Olympia, WA 98504-2489
(360) 753-2531
1-800-583-8271
fax: (360) 586-6563
Seattle
Office of Administrative Hearings
One Union Square
600 University Street, Suite 1500
Mailstop: TS-07
Seattle, WA 98101-1129
(206) 389-3400
1-800-845-8830
fax: (206) 587-5135
Vancouver
Office of Administrative Hearings
5300 MacArthur Blvd., Suite 100
Vancouver, WA 98661
(360) 690-7189
1-800-243-3451
fax: (360) 696-6255
Spokane
Office of Administrative Hearings
Old City Hall Building, 5th Floor
221 N. Wall Street, Suite 540
Spokane, WA 99201
(509) 456-3975
1-800-366-0955
fax: (509) 456-3997
Yakima
Office of Administrative Hearings
32 N 3rd Street, Suite 320
Yakima, WA 98901-2730
(509) 575-2147
1-800-843-3491
fax (509) 454-7281
(3) You should contact the Olympia field office, under
subsection (2), if you do not know the correct field office.
(4) You can obtain further hearing information at the OAH web site: www.oah.wa.gov.
[Statutory Authority: RCW 34.05.353. 09-05-032, § 388-02-0025, filed 2/11/09, effective 3/14/09. Statutory Authority: RCW 34.05.020 and chapter 34.05 RCW, Parts IV and V. 05-22-076, § 388-02-0025, filed 10/31/05, effective 12/1/05. Statutory Authority: RCW 34.05.020, chapter 34.05 RCW, Parts IV and V, 2002 c 371 § 211. 02-21-061, § 388-02-0025, filed 10/15/02, effective 11/15/02. Statutory Authority: RCW 34.05.020. 00-18-059, § 388-02-0025, filed 9/1/00, effective 10/2/00.]
(1) A rule requires the OAH to provide notice of a proceeding; and
(2) The OAH does not provide the amount of notice required.
[]
[]
(2) Before your hearing is held:
(a) ((DSHS)) The department may contact you and try to
resolve your dispute; and
(b) You are encouraged to contact ((DSHS)) the department
and try to resolve your dispute.
(3) If you do not appear for your hearing, an ALJ may enter an order of default or an order dismissing your hearing according to WAC 388-02-0285.
[Statutory Authority: RCW 34.05.020. 00-18-059, § 388-02-0110, filed 9/1/00, effective 10/2/00.]
(2) If you are represented, your representative should provide the ALJ and other parties with the representative's name, address, and telephone number.
(3) The presiding officer may require your representative to file a written notice of appearance or to provide documentation that you have authorized the representative to appear on your behalf. In cases involving confidential information, your representative must file a signed written release of information on department form 17-063.
(4) If your representative is an attorney admitted to practice in this state, your attorney must file a written notice of appearance, and must file a notice of withdrawal upon withdrawal of representation.
(5) If you or your representative have put in a written notice of appearance, the ALJ should call the telephone number on the notice of appearance if you or your representative do not appear by calling in with a telephone number before a hearing (including a prehearing).
[]
(2) ((Either the ALJ or a party may request a prehearing
conference, but the ALJ decides whether to hold a prehearing
conference. OAH sends notice of the conference to all
parties.
(3))) An ALJ may conduct the prehearing conference in
person, by telephone conference call, ((by electronic means,))
or in any other manner acceptable to the parties. Your
attendance is mandatory.
(((4) A party)) (3) You may lose the right to participate
during the hearing if ((that party does)) you do not attend
the prehearing conference.
[Statutory Authority: RCW 34.05.020. 00-18-059, § 388-02-0195, filed 9/1/00, effective 10/2/00.]
(2) The ALJ must grant the first request for a prehearing conference if it is received by the OAH at least seven business days before the scheduled hearing date.
(3) The ALJ may grant untimely or additional requests for prehearing conferences.
(4) If the parties do not agree to a continuance, the OAH and/or the ALJ must set a prehearing conference to decide whether there is good cause to grant or deny the continuance.
(5) The OAH must schedule prehearing conferences for all cases which concern actions of the following department programs:
(a) Adult protective services; and
(b) The division of residential care services.
[]
(a) The actions taken;
(b) Any changes to the documents; ((and))
(c) Any agreements reached; and
(d) Any ruling of the ALJ.
(2) The ALJ must send the prehearing order to the parties at least fourteen calendar days before the scheduled hearing, except a hearing may still occur as allowed under WAC 388-02-0280(5). The parties and the ALJ may agree to a shorter time period.
(3) A party may object to the prehearing order by notifying the ALJ in writing within ten days after the mailing date of the order. The ALJ must issue a ruling on the objection.
(((3))) (4) If no objection is made to the prehearing
order, the order determines how the hearing is conducted,
including whether the hearing will be in person or held by
telephone conference or other means, unless the ALJ changes
the order for good cause.
(((4))) (5) The ALJ may take further appropriate actions
to address other concerns.
[Statutory Authority: RCW 34.05.020. 00-18-059, § 388-02-0205, filed 9/1/00, effective 10/2/00.]
(2) If you do not attend, you may not be allowed to participate in the hearing. The ALJ may dismiss your hearing request or enter an order of default against you.
(((3) If DSHS does not attend, the ALJ may dismiss or
reverse the action DSHS took against you.))
[Statutory Authority: RCW 34.05.020. 00-18-059, § 388-02-0210, filed 9/1/00, effective 10/2/00.]
[]
(2) If no ((DSHS)) department rule applies, the ALJ or
review judge must decide the issue according to the best legal
authority and reasoning available, including federal and
Washington state constitutions, statutes, regulations, and
court decisions.
(3) When applying program rules regarding the substantive rights and responsibilities of the parties (such as eligibility for services, benefits, or a license), the ALJ and review judge must apply the program rules that were in effect on the date the department notice was sent, unless otherwise required by other rule or law. If the department amends the notice, the ALJ and review judge must apply the rules that were in effect on the date the initial notice was sent, unless otherwise required by other rule or law.
(4) When applying program rules regarding the procedural rights and responsibilities of the parties, the ALJ and review judge must apply the rules that are in effect on the date the procedure is followed.
(5) Program rules determine the amount of time the department has to process your application for services, benefits or a license.
(6) The ALJ and review judge must apply the rules in this chapter beginning on the date each rule is effective.
(7) If you have a dispute with the department concerning the working connections child care (WCCC) program, the ALJ and review judge must apply the hearing rules in this chapter and not the hearing rules in chapter 170-03 WAC. The rules in this chapter apply to disputes between you and the department of social and health services.
[Statutory Authority: RCW 34.05.020. 00-18-059, § 388-02-0220, filed 9/1/00, effective 10/2/00.]
(2) The department index of significant decisions is available to the public at www.dshs.wa.gov/boa. For information on how to obtain a copy of the index, see WAC 388-01-190.
(3) If a precedential published decision entered by the Court of Appeals or the Supreme Court reverses an indexed board of appeals final order, that order will be removed from the index of significant decisions.
[]
[Statutory Authority: RCW 34.05.020. 00-18-059, § 388-02-0230, filed 9/1/00, effective 10/2/00.]
(2) Rulings that are not considered discretionary rulings for purposes of this section include but are not limited to those:
(a) Granting or denying a request for a continuance; and
(b) Granting or denying a request for a prehearing conference.
(3) ((The)) A party must send the ((request)) written
motion of prejudice to the chief ALJ at the OAH headquarters
identified in WAC 388-02-0025(1) and must send a copy to the
OAH field office where the ALJ ((works)) is assigned.
(((3))) (4) A party may make an oral motion of prejudice
at the beginning of the hearing before the ALJ rules on a
discretionary issue in the case, admits evidence, or takes
testimony if:
(a) The OAH did not assign an ALJ at least five business days before the date of the hearing; or
(b) The OAH changed the assigned ALJ within five business days of the date of the hearing.
(5) The first ((timely)) request for a different ALJ is
automatically granted. ((Any later request may be granted or
denied by)) The chief ALJ or a designee grants or denies any
later requests.
[Statutory Authority: RCW 34.05.020. 00-18-059, § 388-02-0240, filed 9/1/00, effective 10/2/00.]
(2) The OAH ((sends)) must send a notice of hearing to
all parties and their representatives((. OAH sends the notice
of hearing at least seven business days)) at least fourteen
calendar days before the hearing date. The OAH must provide
notice of seven or more business days if the case is about
child support under chapter 388-14A WAC.
(((2))) (3) If the OAH ((may)) schedules a prehearing
conference((.)), the OAH ((sends)) must send a notice of
prehearing conference to the parties and their representatives
at least seven business days before the date of the prehearing
conference ((date)) except:
(a) The OAH and/or an ALJ may convert a scheduled hearing into a prehearing conference and provide less than seven business days notice of the prehearing conference; and
(b) The OAH may give less than seven business days notice if the only purpose of the prehearing conference is to consider whether there is good cause to grant a continuance under WAC 388-02-0280 (3)(b).
(4) The OAH and/or the ALJ must reschedule the hearing if necessary to comply with the notice requirements in this section.
(5) If the ALJ denies a continuance after a prehearing conference, the hearing may proceed on the scheduled hearing date, but the ALJ must still issue a written order regarding the denial of the continuance.
(((3))) (6) You may ask for a prehearing meeting even
after you have requested a hearing.
[Statutory Authority: RCW 34.05.020. 00-18-059, § 388-02-0250, filed 9/1/00, effective 10/2/00.]
(2) ((DSHS)) The department must put the change in
writing and give a copy to the ALJ and ((the other)) all
parties.
(3) The ALJ must offer to continue ((or)) (postpone) the
hearing to give the parties more time to prepare or present
evidence or argument if there is a significant change from the
earlier ((DSHS)) department notice.
(4) If the ALJ grants a continuance, the OAH must send, a
new hearing notice at least ((seven business)) fourteen
calendar days before the hearing date. The OAH must provide
notice of seven or more business days if the case is about
child support under chapter 388-14A WAC.
[Statutory Authority: RCW 34.05.020. 00-18-059, § 388-02-0260, filed 9/1/00, effective 10/2/00.]
(2) The ALJ ((may)) must offer to continue (postpone) the
hearing to give the other parties more time to prepare or
present evidence or argument ((because of)) if there is a
significant change in the hearing request.
(3) If the ALJ grants a continuance, the OAH must send a
new hearing notice at least ((seven business)) fourteen
calendar days before the hearing date. The OAH must provide
notice of seven or more business days if the case is about
child support under chapter 388-14A WAC.
[Statutory Authority: RCW 34.05.020. 00-18-059, § 388-02-0265, filed 9/1/00, effective 10/2/00.]
(2) Before contacting the ALJ to request a continuance, a
party should contact the other parties, if possible, to find
out if they will agree to a continuance. If you are unable to
contact the parties, the OAH or ((DSHS)) the department must
assist you in contacting them.
(3) The party making the request for a continuance must let the ALJ know whether the other parties agreed to the continuance.
(a) If the parties agree to a continuance, the ALJ
((grants)) must grant it unless the ALJ finds that good cause
for a continuance does not exist.
(b) If the parties do not agree to a continuance, the ALJ
((sets)) must set a prehearing conference to decide whether
there is good cause to grant or deny the continuance. The
prehearing conference will be scheduled as required by WAC 388-02-0197 and 388-02-0250.
(4) If ((a continuance is granted, OAH sends notice of
the changed time and date of the hearing)) the ALJ grants a
continuance, the OAH must send a new hearing notice at least
fourteen calendar days before the new hearing date. The OAH
must provide notice of seven or more business days if the case
is about child support under chapter 388-14A WAC.
(5) If the ALJ denies the continuance, the ALJ will proceed with the hearing on the date the hearing is scheduled, but must still issue a written order regarding the denial of the continuance.
[Statutory Authority: RCW 34.05.020. 00-18-059, § 388-02-0280, filed 9/1/00, effective 10/2/00.]
(2) A telephone conference hearing is where all parties appear by telephone.
(3) An in-person hearing is where((:
(a) The parties appear face-to-face with the ALJ; or
(b) The parties appear by video conference)) you appear face-to-face with the ALJ and the other parties appear either in person or by telephone.
(((3))) (4) Whether a hearing is held in person or by
telephone conference, the parties have the right to see all
documents, hear all testimony and question all witnesses.
(((4))) (5) Parties ((or)) and their witnesses may appear
in person or by telephone conference ((at the discretion of
the ALJ)). The ALJ may require parties and/or their witnesses
to appear in person if the ALJ determines there is a
compelling reason, and the compelling reason is stated in a
hearing notice or prehearing order.
(6) After a telephone conference hearing begins, the ALJ may stop, reschedule, and convert the hearing to an in-person hearing if the ALJ determines there is a compelling reason to do so.
[Statutory Authority: RCW 34.05.020. 00-18-059, § 388-02-0340, filed 9/1/00, effective 10/2/00.]
[Statutory Authority: RCW 34.05.020. 00-18-059, § 388-02-0350, filed 9/1/00, effective 10/2/00.]
(a) A hearing format be converted (changed) to an in-person hearing or a telephone conference; or
(b) A witness appear in person or by telephone conference. The OAH must advise you of the right to request a change in how a witness appears.
(2) ((In all DSHS cases, except public assistance
cases,)) Except as provided in subsection (4) of this section,
a party requesting a change in how a hearing is held must show
((good cause)) a compelling reason. A party must also show
((good cause)) a compelling reason to change the way a witness
appears (in-person or by telephone conference). Some examples
of ((good cause)) compelling reasons are:
(a) A party does not speak or understand English well.
(b) A party wants to present a significant number of documents during the hearing.
(c) A party does not believe that one of the witnesses or another party is credible, and wants the ALJ to have the opportunity to see the testimony.
(d) A party has a disability or communication barrier that affects their ability to present their case.
(e) A party believes that the personal safety of someone involved in the hearing process is at risk.
(3) A compelling reason to convert how a hearing is held can be overcome by a compelling reason not to convert how a hearing is held.
(4) In public assistance cases, a party has the right to
request that a hearing be changed without showing ((good
cause)) a compelling reason to the ALJ. Public assistance
programs include:
(a) Temporary assistance for needy families (TANF);
(b) ((General or medical assistance)) Working connections
child care;
(c) Disability lifeline;
(d) Medical assistance;
(e) Food ((stamps)) assistance; and
(((d))) (f) Refugee assistance.
[Statutory Authority: RCW 34.05.020. 00-18-059, § 388-02-0360, filed 9/1/00, effective 10/2/00.]
(a) Provide evidence regarding disputed facts; and
(b) Persuade the ALJ that a position is correct.
(2) To persuade the ALJ, the party who has the burden of proof must provide the amount of evidence required by WAC 388-02-0485.
[Statutory Authority: RCW 34.05.020. 00-18-059, § 388-02-0480, filed 9/1/00, effective 10/2/00.]
(2) There are five elements of equitable estoppel. The standard of proof is clear and convincing evidence. You must prove all of the following:
(a) ((DSHS)) The department made a statement or took an
action or failed to take an action, which is inconsistent with
a later claim or position by ((DSHS)) the department. For
example, ((DSHS)) the department gave you money based on your
application, then later tells you that you received an
overpayment and wants you to pay the money back based on the
same information.
(b) You reasonably relied on ((DSHS')) the department's
original statement, action or failure to act. For example,
you believed ((DSHS)) the department acted correctly when you
received money.
(c) You will be injured to your detriment if ((DSHS)) the
department is allowed to contradict the original statement,
action or failure to act. For example, you did not seek help
from health clinics or food banks because you were receiving
benefits from ((DSHS)) the department, and you would have been
eligible for these other benefits.
(d) Equitable estoppel is needed to prevent a manifest
injustice. ((For example,)) Factors to be considered in
determining whether a manifest injustice would occur include,
but are not limited to, whether:
(i) You cannot afford to repay the money to ((DSHS, and))
the department;
(ii) You gave ((DSHS)) the department timely and accurate
information when required ((but));
(iii) You did not know that ((DSHS)) the department made
a mistake;
(iv) You are free from fault; and
(v) The overpayment was caused solely by a department mistake.
(e) The exercise of government functions is not impaired.
For example, the ((overpayment was not your fault and it was
caused solely by a DSHS mistake)) use of equitable estoppel in
your case will not result in circumstances that will impair
department functions.
(3) If the ALJ concludes that you have proven all of the
elements of equitable estoppel in subsection (2) of this
section with clear and convincing evidence, ((DSHS)) the
department is stopped or prevented from taking action or
enforcing a claim against you.
[Statutory Authority: RCW 34.05.020. 00-18-059, § 388-02-0495, filed 9/1/00, effective 10/2/00.]
(2) The official record must include, if applicable:
(a) Notice of all proceedings;
(b) Any prehearing order;
(c) Any motions, pleadings, briefs, petitions requests, and intermediate rulings;
(d) Evidence received or considered;
(e) A statement of matters officially noticed;
(f) Offers of proof, objections, and any resulting rulings;
(g) Proposed findings, requested orders and exceptions;
(h) A complete audio recording of the entire hearing, together with any transcript of the hearing;
(i) Any final order, initial order, or order on reconsideration; and
(j) Matters placed on the record after an ex parte communication.
[]
(2) The maximum time an ALJ has to send a decision is
ninety calendar days after the record is closed, but many
((DSHS)) department programs have earlier deadlines. Specific
program rules may set the deadlines.
(3) OAH must send the official record of the proceedings to the BOA. The record must be complete when it is sent, and include all parts required by WAC 388-02-0512.
[Statutory Authority: RCW 34.05.020. 00-18-059, § 388-02-0515, filed 9/1/00, effective 10/2/00.]
(1) Parts of the initial order with which the party disagrees; and
(2) Evidence supporting the party's position.
[Statutory Authority: RCW 34.05.020, 34.05.220, 42 C.F.R. 431.10 (e)(3), 45 C.F.R. 205.100 (b)(3), chapter 34.05 RCW, Parts IV and V. 08-21-144, § 388-02-0575, filed 10/21/08, effective 11/21/08. Statutory Authority: RCW 34.05.020, chapter 34.05 RCW, Parts IV and V, 2002 c 371 § 211. 02-21-061, § 388-02-0575, filed 10/15/02, effective 11/15/02. Statutory Authority: RCW 34.05.020. 00-18-059, § 388-02-0575, filed 9/1/00, effective 10/2/00.]
(2) A review judge may extend the deadline if a party:
(a) Asks for more time before the deadline expires; and
(b) Gives a good reason for more time.
(3) A review judge may accept a review request after the twenty-one calendar day deadline only if:
(a) The BOA receives the review request on or before the thirtieth calendar day after the deadline; and
(b) A party shows good ((reason)) cause for missing the
deadline.
(4) If you ask a review judge to review an ALJ decision, the time period provided by this section for requesting review of an initial order, including any extensions, does not count against any deadline, if any, for a review judge to enter the final order.
[Statutory Authority: RCW 34.05.020, 34.05.220, 42 C.F.R. 431.10 (e)(3), 45 C.F.R. 205.100 (b)(3), chapter 34.05 RCW, Parts IV and V. 08-21-144, § 388-02-0580, filed 10/21/08, effective 11/21/08. Statutory Authority: RCW 34.05.020, chapter 34.05 RCW, Parts IV and V, 2002 c 371 § 211. 02-21-061, § 388-02-0580, filed 10/15/02, effective 11/15/02. Statutory Authority: RCW 34.05.020. 00-18-059, § 388-02-0580, filed 9/1/00, effective 10/2/00.]
(2) If a party decides to respond, that party must send the response so that BOA receives it on or before the seventh business day after the date the other party's review request was mailed to the party by BOA.
(3) The party ((must)) should send a copy of the response
to all other parties or their representatives.
(4) A review judge may extend the deadline in subsection (2) of this section if a party asks for more time before the deadline to respond expires and gives a good reason.
(5) If you ask for more time to respond, the time period provided by this section for responding to the review request, including any extensions, does not count against any deadline, if any, for a review judge to enter the final order. A review judge may accept and consider a party's response even if it is received after the deadline.
[Statutory Authority: RCW 34.05.020, 34.05.220, 42 C.F.R. 431.10 (e)(3), 45 C.F.R. 205.100 (b)(3), chapter 34.05 RCW, Parts IV and V. 08-21-144, § 388-02-0590, filed 10/21/08, effective 11/21/08. Statutory Authority: RCW 34.05.020. 00-18-059, § 388-02-0590, filed 9/1/00, effective 10/2/00.]
(2) Review judges may return (remand) cases to the OAH for further action.
(((2) The review judge has the same decision-making
authority as the ALJ when reviewing initial orders in the
following cases, but must consider the ALJ's opportunity to
observe the witnesses:
(a) Licensing, certification and related civil fines;
(b) Rate-making proceedings;
(c) Parent address disclosure;
(d) Temporary assistance to needy families (TANF);
(e) Working connections child care (WCCC);
(f) Medical assistance eligibility;
(g) Medical or dental services funded by Title XIX of the Social Security Act;
(h) Adoption support services; and
(i) Eligibility for client services funded by Title XIX of the Social Security Act and provided by the aging and disability services administration.
(3) In all other cases, the review judge may only change the initial order if:
(a) There are irregularities, including misconduct of a party or misconduct of the ALJ or abuse of discretion by the ALJ, that affected the fairness of the hearing;
(b) The findings of fact are not supported by substantial evidence based on the entire record;
(c) The decision includes errors of law;
(d) The decision needs to be clarified before the parties can implement it; or
(e) Findings of fact must be added because the ALJ failed to make an essential factual finding. The additional findings must be supported by substantial evidence in view of the entire record and must be consistent with the ALJ's findings that are supported by substantial evidence based on the entire record.
(4))) (3) Review judges may not review ALJ final
orders((. See)) for the types of cases listed in WAC 388-02-0217(2) ((for cases in which the ALJ enters a final
order)).
(((5))) (4) A review judge conducts the hearing and
enters the final order in cases covered by WAC 388-02-0218.
[Statutory Authority: RCW 34.05.020, 34.05.220, 42 C.F.R. 431.10 (e)(3), 45 C.F.R. 205.100 (b)(3), chapter 34.05 RCW, Parts IV and V. 08-21-144, § 388-02-0600, filed 10/21/08, effective 11/21/08. Statutory Authority: RCW 34.05.020, chapter 34.05 RCW, Parts IV and V, 2002 c 371 § 211. 02-21-061, § 388-02-0600, filed 10/15/02, effective 11/15/02. Statutory Authority: RCW 34.05.020. 00-18-059, § 388-02-0600, filed 9/1/00, effective 10/2/00.]
4221.2DSHS Board of Appeals
P.O. Box 45803
Olympia, WA 98504-5803;
(2) The general telephone numbers of the BOA are:
(360) 664-6100
1-877-351-0002 (toll free)
(360) 664-6178 (TTD)
(360) 664-6187 (fax);
(3) The physical location of the DSHS Board of Appeals (BOA) is:
Blake Office Bldg. East, 2nd Floor
4500 10th Ave. SE
Lacey, WA 98503)) The information included in this section is current at this time of rule adoption, but may change. Current information and additional contact information are available on the department's internet site, in person at the board of appeals office, or by a telephone call to the board of appeal's main public number.
Department of Social and Health Services Board of Appeals |
|
Location | Office Building 2 (OB-2) First Floor Information 1115 Washington Street Olympia, Washington |
Mailing address | P.O. Box 45803 Olympia, WA 98504-5803 |
Telephone | (360) 664-6100 |
Fax | (360) 664-6187 |
Toll free | 1-877-351-0002 |
Internet web site | www.dshs.wa.gov/boa |
[Statutory Authority: RCW 34.05.020. 00-18-059, § 388-02-0030, filed 9/1/00, effective 10/2/00.]