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Consumers' Rights and Responsibilities CONSUMERS' RIGHTS Consumers' rights are safeguarded under law. These rights include: The right to apply for any public benefit. The applicant must be given the opportunity to apply for public benefits and be allowed to submit a completed application. If someone at the agency tells the applicant they are ineligible for benefits and does not allow them to apply, the applicant should insist on applying and speak to a supervisor. The right to a timely decision. The agency must mail a written decision regarding the applicant’s eligibility within certain time frames, as indicated below. 30 days for Family Assistance applicants of public assistance 45 days for Safety Net Assistance applicants of public assistance 30 days for Food Stamps 30 days for pregnant women for Medicaid 45 days for AFDC, single/childless couples, and aged categories of Medicaid 90 days for the disabled category of Medicaid The Social Security Administration (SSA) operates under few time limitations, as there are no specific time limits in which SSA must take action. Regulations state that the action taken by SSA must not take effect until after the receipt of notice. Thus, there are fewer rights to appealing to SSA for delays in resolving a claim. For other benefits, see the requisite sections. The right to a written notice of government agency decisions. The government agency must mail a written notice of all decisions regarding the applicant's/recipient's case, including acceptance, denial, reduction, or termination of benefits. Do not accept oral determinations. The notice must state: the action being taken the reason the action is taken how to appeal the decision the time limits in which to appeal decisions The right to adequate and timely notice of change or termination of benefits. If in receipt of Public Assistance, Food Stamps or Medicaid and a notice is sent regarding a reduction or termination of benefits, the agency must mail a notice at least ten days prior to the effective date of the proposed action. 1. The right to aid continuing. If benefits will be reduced or terminated, the recipient can request that benefits continue as before until a fair hearing decision is made. The individual must request a fair hearing and ask for aid continuing at the same time. The request must be made before the effective date of action. 1. The right to look at their case records. HRA: A consumer's case record is kept at the local agency; various departments may have different documentation, however, the consumer has the right to examine the record at the various departments, except for adoption, foster care or child protective records. Some local agencies have converted to a paperless system. If this is the situation, write to: Director, Office of Communications NYS Department of Social Services 40 North Pearl Street Albany, NY 12243-0001 SSA: Individuals have the right to view all documentation SSA collects during an administrative procedure. They should contact the District Office to obtain access to these files. Once the case has been scheduled for a hearing, the claimant should arrange to obtain a copy of their case file at: Office of Hearings and Appeals (OHA) 26 Federal Plaza, Room 2909 New York, NY 10278 (212) 264-8819 Advocacy Tip: While claimants have the right to view their case documents, the District Office may offer some resistance in providing them. Claimants and their advocates should be persistent to overcome these barriers. 2. The right to appeal to a higher authority. If an individual believes a worker is not acting in accordance with the rules and regulations of the benefit program, they have the right to speak to a supervisor or a service representative. If unsuccessful, they can continue up the administrative ladder. 3. The right at all times to receive fair and equal treatment regardless of age, gender, race, color, disability, religious creed, or political belief. HRA: When a City worker mistreats, misinforms, refuses to comply with the law or engages in misconduct of any kind, the A/R has the right to file a grievance. Grievances should include the nature of the complaint, who perpetuated it, when the treatment occurred and who may have heard or seen the incident, and should be mailed to: Burton Blaustein, Deputy Commissioner, NYC HRA, Family Independence Administration 180 Walter Street, New York, NY 10038 (212) 331-4641 Once the complaint has been filed contact Iris Bailey of HRA’s Office of Constituent and Community Affairs at (212) 331-4643 to be sure the problem is effectively resolved. Also contact: Affirmative Action Bureau Office of Minority Program Development NYS Department of Family Assistance 52 Washington Street Rennselaer, NY 12144 (518) 474-3715 NYC Human Rights Commission 40 Rector Street, 10th floor New York, NY 10006 (212) 306-7500 Additionally, the Coalition for an Accountable and Respectful HRA has launched a campaign to force HRA to respect the rights and dignity of recipients of services, document unprofessional conduct, and make HRA investigate and explain every instance of worker misconduct. For more information, contact Andrew Friedman at “Make The Road By Walking” at (718) 418-7690. Social Security Administration: If a claimant believes an Administrative Law Judge treated them unfairly, they should write a complaint and include their name, address, phone number, Social Security number, the nature of the complaint and who perpetuated it, when the treatment occurred and who may have heard or seen the incident. Mail this to: The Chief Administrative Law Judge Office of Hearings and Appeals 5107 Leesburg Pike Falls Church, VA 22041-3255 CONSUMERS’ RESPONSIBILITIES Consumers also have responsibilities they must adhere to in order to comply with the law. These responsibilities include: 1. The responsibility to answer all questions pertinent to the application completely and honestly. 2. The responsibility to make a reasonable effort to obtain the documentation and information needed to determine eligibility. When applying for benefits, proof must be provided to document eligibility. If a consumer is unable to get the necessary documentation, the caseworker should help obtain the proof. 3. The responsibility to report changes. If the recipient's situation changes, they must report it to the agency. Proof of the change must also be provided. If changes are not recorded, such as additional income or resources, benefits may be recouped at a future date. Legal action could be taken against the recipient for concealment. 4. The responsibility to cooperate with child support cooperation requirements. Applicant/recipients for Public Assistance, Medicaid and Child Care services must demonstrate they have met child support cooperation criteria. Public Assistance recipients must also cooperate to establish and enforce cash support orders. 5. The responsibility to make all appointments and recertification the agency requires. Federal and state regulations require each case be reviewed periodically to determine if the recipient continues to be eligible. This review is called recertification. If the individual is unable to make an appointment or recertification, they must let the worker know why and reschedule. If a recertification is missed, without informing the worker, the case may be closed. In addition, the local center can call the consumer in for non-recertification appointments. The consumer has the responsibility to go to these appointments, regardless of how many times they are called to appear.
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