Appeals
Standard Appeals
An Appeal is a request to review an Action. An Action occurs when previously authorized services are denied, reduced, suspended or terminated; when payment is denied for a service; when services are not provided in a timely manner; or the County fails to act within the time frames for the disposition of grievances, standard appeals, or expedited appeals.
- The member may submit an appeal orally or in writing. Oral appeals must be followed up with a written, signed appeal.
- An appeal must be filed within 90 days of the date of the Action.
- The member will receive a written resolution within 45 days.
Expedited Appeal
If you are concerned about the length of time the law allows for the resolution of your Appeal, you may request an EXPEDITED APPEAL.This Appeal is filed when the member's life, health, or ability to have or maintain maximum function is at risk.
- The member will receive a written resolution within 3 working days.
- If the expedited appeal is denied, a written notice will be sent to the member and the standard appeal process will begin.
State Fair Hearings
If you do not agree with the disposition of your appeal you can ask for a State Hearing and a judge will review your case. You may also request an expedited State Hearing.
You can ask for a State Hearing by phone, electronically, or in writing:
- By phone: Call 1-800-952-5253. If you cannot speak or hear well, please call TTY/TDD 1-800-952-8349.
- Electronically: You may request a State Hearing online. Please visit the California Department of Social Services' website to complete the electronic form: https://secure.dss.cahwnet.gov/shd/pubintake/cdss-request.aspx
- In writing: Fill out a State Hearing form or send a letter to:
California Department of Social Services
State Hearings Division
P.O. Box 944243, Mail Station 9-17-37
Sacramento, CA 94244-2430
Be sure to include your name, address, telephone number, Date of Birth, and the reason you want a State Hearing. If someone is helping you ask for a State Hearing, add their name, address, and telephone number to the form or letter. If you need an interpreter, tell us what language you speak. You will not have to pay for an interpreter. We will get you one.