139 NOTICES OF DECISION (NOD) SR 05-07, 12/05 (FAM-A)

Notify individuals of case decisions on * a Notice of Decision (NOD). Each NOD must include all of the following:

• the name, address, and telephone number of the District Office;

• the individual’s name and address;

• the case number and current date;

• the name of the worker to contact for more information, when possible;

• the effective date of the action;

• an action message which describes the effect of the decision or the change or action that is occurring which requires notification to the individual; and

• the calculation which determined the benefit level and amount when the action being taken is the result of a financial eligibility determination.

Each NOD also includes:

• a reason message which describes why a negative action is occurring and the policy manual reference(s) on which the action is based; or

• the names of eligible individuals in the household when a case is determined to be eligible.

The action and reason messages are derived from a financial eligibility calculation performed by New HEIGHTS, a worker-selected entry in New HEIGHTS, or a decision by the worker for which New HEIGHTS may not be able to provide either a timely or a detailed message.

The Form 810, Notice of Rights and Responsibilities, is enclosed with every NOD.

Exceptions:

§   Notification of eligibility for Healthy Kids-Silver medical insurance is provided by New Hampshire Healthy Kids Corporation.

§   Notify individuals of approval or denial of a claim of good cause for refusing to cooperate in establishing paternity or securing support payments on Form 781, Good Cause Claim/FVO Decision.

§   Individuals are notified of recoupment or corrective payments on * the BV0019, Demand Letter for Overpayment, or the BI0003, Notice of Underpayment.