Ohio Administrative Code|Rule 5101:6-5-03 | State hearings: denial and dismissal of state hearing requests.

                                                
(A) The local agency shall not deny or
		  dismiss any request for a state hearing. All requests shall be sent to the
		  bureau of state hearings, in accordance with rule 5101:6-5-01 of the
		  Administrative Code.
(B) When a state hearing request is
		  denied or dismissed, the individual and authorized representative shall be
		  provided written notice describing the denial or dismissal, with a copy to the
		  local agency.
When a hearing request involves multiple issues,
		  and when the appellant withdraws his or her request with regard to some but not
		  all of the issues under appeal, notice of dismissal of the withdrawn appeals
		  may be included in the JFS 04005 "State Hearing Decision" (rev.
		  3/2003) rather than provided via separate notice.
When the hearing request involves one of the
		  medical determination issues listed in paragraph (C)(2) of rule 5101:6-6-01 of
		  the Administrative Code, a copy of the notice shall be sent to the appropriate
		  medical determination unit.
When the hearing request involves a managed care
		  plan or "MyCare Ohio" plan, copies of the notice shall be sent to the
		  managed care plan or "MyCare Ohio" plan and to the unit within the
		  Ohio department of medicaid (ODM) administering the medicaid managed care
		  programs.
(C) Except as provided in paragraph
		  (D)(1) of this rule, a state hearing request may only be denied prior to the
		  mailing of the JFS 04002 " Notice to Appear for a Scheduled Hearing"
		  (rev. 1/2015), and only for the following reasons:
(1) The request is
			 untimely, as defined by rule 5101:6-3-02 of the Administrative
			 Code.
If the request indicates that proper notice was
			 not received, the request shall be accepted and the issue of timeliness shall
			 be determined as a preliminary matter at the hearing.
(2) The request was not
			 made by the individual or authorized representative, or written authorization
			 specifically designating the person making the request to act on the
			 individual's behalf was not submitted with the request.
Such a denial must be consistent with the
			 provisions of rule 5101:6-3-02 of the Administrative Code.
(3) The request concerns
			 an issue that is not appealable under the provisions of rule 5101:6-3-01 of the
			 Administrative Code.
If the issue as stated in the request is
			 unclear, the bureau of state hearings shall request clarification from the
			 individual.
(4) The sole issue of the
			 request is a change in state or federal law, or local agency policy adopted
			 pursuant to options authorized in state law, that requires automatic
			 adjustments of benefits for classes of recipients, unless the reason for the
			 request is the misapplication of the change to the appellant's individual
			 circumstances.
(5) The request concerns
			 the placement of the assistance group for food assistance on an alternate
			 issuance system or the length of time the assistance group remains on this
			 system.
(6) It is clear that the
			 issue has been previously decided through the state hearing
			 process.
(D) After a state hearing request is
		  scheduled.
(1)  A state hearing
			 request may be denied after it is scheduled:
(a) In accordance with rule 5101:6-10-1 of the
				Administrative Code,
(b) When the appellant has not exhausted all managed care
				plan appeal processes in accordance with rule 5160-26-08.4 of the
				Administrative Code, or
(c) When the appellant has not exhausted all "MyCare
				Ohio" plan appeal processes in accordance with rule 5160-58-08.4 of the
				Administrative Code.
(2) For any program or
			 issue not identified in paragraph (D)(1) of this rule, a state hearing request
			 may no longer be denied, but must be heard, or dismissed as described in
			 paragraphs (E)(1) and (E)(2) of this rule. Dismissal of a state hearing request
			 constitutes a binding decision on the hearing request. 
(3) In the event that a dismissal notice
			 is issued in error, it may be reversed by the hearing authority allowing for
			 the state hearing process to continue.
(E) A request for a state hearing may be
		  dismissed only for the following reasons:
(1) The appellant or
			 authorized representative withdraws the hearing request, before the state
			 hearing decision is issued.
(2) The request is
			 abandoned. A state hearing request is "abandoned" when the individual
			 or authorized representative fails, without good cause, to attend the state
			 hearing. A "state hearing" is defined as the initial state hearing, a
			 hearing that has been rescheduled, or a hearing that has been
			 continued.
(a) When the hearing has been abandoned, the individual and
				authorized representative shall be notified that the hearing request will be
				dismissed if good cause for failing to attend is not shown within ten days of
				the mailing date of the notice.
(b) The hearing shall be rescheduled if the individual or
				authorized representative contacts the hearing authority, in writing or by
				telephone, within the ten-day period and establishes good cause.
(c) The request shall be dismissed as abandoned if the bureau of
				state hearings does not receive a showing of good cause within the ten-day
				period. The date of dismissal is the day after the ten-day period
				ends.
(d) If the individual contacts the hearing authority but fails to
				establish good cause, the individual shall be given written notice of that
				determination and of the right to and the method of obtaining an administrative
				appeal. Copies shall be sent to the local agency.
(e) "Good cause" is defined as death in the immediate
				family, sudden illness or injury of the individual or a member of the
				individual's immediate family, or other circumstances that reasonably
				prevented attendance at the hearing.
(f) The hearing authority shall have final authority to determine
				if good cause was timely shown. Verification of good cause may be
				required.