N.J. Admin. Code § 10:48-1.6

Current through Register Vol. 56, No. 21, November 4, 2024

Section 10:48-1.6 - Process for requesting an appeal

(a) An initial appeal shall be made in writing to the Administrative Practice Office, Division of Developmental Disabilities, P.O. Box 726, Trenton, NJ 08625-0726.

(b) Appeals of eligibility under N.J.A.C. 10:46-2 or specific offers of non-waiver-funded services shall be initiated within 30 days from the date on the written notification of ineligibility or offer.

(c) Appeals of the denial, suspension, reduction, or termination of waiver services must be made, in writing, within 20 days from the date of the notice of such action.

(d) Appeals of services shall be limited to those services indicated in the service plan or appropriate for inclusion in a service plan that were requested and denied.

(e) The request for appeal shall be in writing and shall contain the information required below. This information shall be the basis of an initial pleading should the matter be transmitted to the Office of Administrative Law. An appeal shall be denied if the required information is not provided. The request shall include:

1. Name and address of appellant;

2. Name and address of person receiving services or applying for services from the Division, if the appeal is made by the person's legal guardian or authorized representative;

3. A brief statement of the matter under appeal;

4. A list of potential witnesses, if known; and

5. Reference to the law, rule, regulation or policy alleged to be violated, if known.

(f) The Administrative Practice Office shall review the appeal. If the Administrative Practice Office determines that the matter does not conform to the definition of appeal, it shall set forth the reasons for this conclusion in writing and direct, as applicable, the individual to seek other means of redress.

(g) The appellant shall be notified in writing that the matter does not conform to the definition of an appeal within 10 working days of receipt by the Administrative Practice Office.

(h) The appeal shall be reviewed to determine if it is a contested or non-contested matter.

1. If the matter is determined to be contested, the requirements of N.J.A.C. 10:48-2 shall apply.

2. If the matter is determined to be non-contested, the requirements of N.J.A.C. 10:48-3 shall apply.

i. The appellant shall be notified in writing that the matter is non-contested.

ii. If the appellant disagrees, he or she may request a review of that decision by the Assistant Commissioner.

(i) If the matter does not meet the conditions of this section, and the appellant believes that the matter is contested as defined in this chapter, the appellant shall set forth his or her reasons supporting that the matter should be considered contested in writing.

N.J. Admin. Code § 10:48-1.6

Amended by 46 N.J.R. 2364(a), effective 12/1/2014