• Each applicant has the right to adequate written notice that his/her application for benefits has been approved or denied.  If the application is approved, the applicant shall receive a written notice stating what benefits are granted.  If the application is denied, the written notice shall include the following:
  
  
  • a statement of the reason for denial;
  • the specific regulation supporting such action; and
  • an explanation of the applicant's right to request a fair hearing, to be represented at the hearing, and the availability of low or no cost legal services from public and private sources.

• Each applicant shall have a timely disposition.  For non-disability-related MA applicants, 'timely disposition' means the right to receive a determination of MA eligibility within 45 days after filing an application, provided that the Department received the required information in a timely manner (see Section 2.3:  Time Standards in Part III for a full discussion of application processing timeframes, including a discussion of circumstances under which the timeframes can be extended).
  
  For disability-related MA cases (SR), the Department has 90 days to make an eligibility determination.  If after 45 days the disability determination has not yet been made, the Department must assess the individual's eligibility for MA for all non-financial and financial criteria except disability.  Within 90 days, the full MA eligibility determination must be made.  If found eligible for disability-related MA, eligibility is retroactive to the date of application.
  
  If an individual establishes eligibility for Medicaid under a non-disability related Medicaid category (such as a disabled parent who has income of less than 200 percent of the FPL) prior to establishing disability, the individual's Medicaid application must be approved under the non-disability related program type (AR or AX).  However, the applicant maintains the right to be considered for SR Medicaid.  Persons on SR Medicaid are are not placed in managed care.  If disabled caretakers wish to receive services in the fee-for-service system, they must complete the medical evaluation form or provide proof of a Social Security Administration (SSA) determination of disability.  Since the SSA shares eligibility information with IMA through computer matching (BENDEX and SDX interfaces), the SSR must use any verification of disability status that is available through these sources.  If the applicant/recipient wishes to receive services through the fee-for-service system, the case should be converted to SR Medicaid after disability is confirmed. 
  
  
• Each applicant has the right, verbally or in writing,  to request a fair hearing within 90 days following the denial of eligibility. If this occurs, no benefits will be paid until and unless a decision is made in favor of the applicant.
  
  
• Each applicant enrolled in and served by a health benefits plan as part of his/her MA benefits has additional rights to grievance procedures under D.C. Law 12-274, Health Benefits Plan Members Bill of Rights Act of 1998. 

• Each applicant shall have the right to a timely disposition, including the right to receive a determination of TANF eligibility within 45 days after filing an application, provided that the  Department received the required information in a timely manner (see Section 2.3.1: Household-Caused Delays in Benefits Processing in Part III).
  
  
• Each applicant has the right, verbally or in writing, to request a fair hearing within 90 days following the denial of eligibility. If this occurs no benefits will be paid until and unless a decision is made in favor of the applicant.
  
  
• Each applicant has the right to refuse to admit any representative of the Department into his/her home for an inspection of the premises.

• See TANF, except there is no right to refuse access to a Home Review investigator.

• Each applicant shall have a timely disposition, including the right to receive a determination of FS eligibility within 30 days of application, provided the Department received the information in a timely manner.
  
  
• Each applicant has the right to be screened for expedited FS.  If the applicant is eligible for expedited FS, the benefits, and an EBT card to access them, must be made available within seven days.
  
• Each applicant has the right to file an FS complaint which is forwarded to the United States Department of Agriculture.
  
  
• Each applicant has the right to request a fair hearing within 90 days following an adverse  action.
  
  
• Each applicant has the right to request a waiver of the eligibility or recertification interview in an office of the Department because the individual has or is involved in one of the following:
  
  
  • illness,
  • dependent care responsibilities,
  • mental or physical handicap,
  • inclement weather,
  • transportation difficulties,
  • age sixty or older, or 
  • Work schedule prevents individual from going to the service center.

The Department will determine on a case-by-case basis whether to reschedule an in-office interview or schedule a telephone or in-home interview.