How Can Seniors Appeal an IHSS Hours Reduction?
Receiving notice that your IHSS hours are being reduced can be alarming and stressful, especially when you depend on those services to remain safely at home. However, IHSS recipients have the right to appeal decisions they believe are incorrect. Understanding the appeals process and acting quickly can help protect your benefits.
Understanding Your Notice of Action
When the county changes your IHSS benefits, you will receive a Notice of Action explaining the decision. This document states what change is being made, the effective date, and the reason for the change. Read this notice carefully and note the deadline for requesting a hearing, which is typically 90 days from the date of the notice.
However, there is a critical distinction regarding timing. If you request a hearing before the effective date of the reduction, your benefits will continue at the current level until the hearing is resolved. This is called aid paid pending. If you wait until after the effective date, your hours will be reduced while you await the hearing, even if you ultimately win your appeal.
Requesting a State Hearing
To appeal an IHSS decision, you must request a State Hearing through the California Department of Social Services. You can request a hearing by phone, online, by mail, or by fax. When you call or submit your request, explain that you are appealing your IHSS Notice of Action and want to continue receiving your current benefits until the hearing.
Be sure to keep a copy of your hearing request and note the date you submitted it. If you requested aid paid pending, follow up with your county IHSS office to ensure your benefits continue uninterrupted.
Preparing for Your Hearing
Once your hearing is scheduled, you will receive notice of the date, time, and whether it will be held in person or by phone. Use the time before your hearing to gather evidence supporting your need for the hours you previously received. Medical documentation from your physicians describing your conditions and limitations is particularly valuable.
Write down specific examples of how your functional abilities have not improved or have worsened since your last assessment. Document incidents where you needed assistance but could not get it, or times when lack of help led to problems. If your condition varies from day to day, describe your worst days, not just your best ones.
What Happens at the Hearing
At your State Hearing, an Administrative Law Judge will hear testimony from you and from a county representative. You will have the opportunity to explain why you need your previous hours and present your evidence. The county will explain why they reduced your hours.
You can bring witnesses to support your case, such as family members who observe your daily needs or healthcare providers familiar with your condition. You can also bring a representative to help you present your case, such as a family member, social worker, or advocate.
After the Hearing
The Administrative Law Judge will issue a written decision, usually within 60 days of the hearing. If you win, your hours will be restored, and you may receive back payment for any hours you lost. If you lose, you can request a rehearing or file a court appeal, though these options have strict deadlines.
Even if you lose the initial hearing, changes in your condition or circumstances can support a new request for increased hours in the future. Each IHSS assessment is a new opportunity to document your current needs.
Getting Help with Your Appeal
All Seniors Foundation assists IHSS recipients with the appeals process when their hours are reduced or their applications are denied. We can help you understand your rights, prepare documentation, and navigate the hearing process. Do not accept a reduction in hours without exploring your appeal options. Contact us for support in protecting your IHSS benefits.
