Background

There are many reasons people need an advocate when they are attempting to access public benefit programs. Benefit programs are often complicated with constantly changing rules and procedures, which may lead to government errors and subsequent case closings, reduced benefits, sanctions or other action(s) harmful to the applicant/recipient. In addition, public benefits are administered by different government entities, thus application and recertification procedures, budgeting and notification rules vary, which leads to confusion and complicated bureaucratic hurdles that applicants/recipients must successfully navigate to access and maintain public benefits. Problems arise when receipt of one benefit may have implications for receipt of other benefits. For all these reasons and more it may be difficult for a household to navigate the system on their own behalf.

While government benefit programs often have formal appeal procedures in place to protect the rights of applicants and recipients, over the years advocates have learned some informal steps to successfully navigate the government benefit system on behalf of their clients. These informal procedures may effectively resolve the barrier facing the individual without having to implement the formal appeal system. Below are presented some of these informal advocacy procedures.

Summary of Informal Advocacy

INFORMAL ADVOCACY

There are a number of actions an advocate may take to assist their clients with accessing public benefits. The first is the need for information – understanding the challenge(s) the client is facing, and knowing the program’s rules and assessing whether any action can be taken to resolve their problem. Advocates should consult Benefits Plus, which details program rules and provides practical information to deal with barriers.

Advocates should attempt to work with local agency staff to try and solve the client’s problem, whether it is an application denial, a reduction or change in benefits, or case closing. By dealing directly with the local agency, and working up the “chain of command”, advocates may improve a beneficiary’s position or solve a problem without formal intervention.

As an alternative to dealing directly with the local agency staff, advocates may utilize the Advocate Inquiry Form to have HRA investigate the problem and resolve it if possible.

Remember it may be expedient to pursue formal advocacy procedures while utilizing informal advocacy to preserve “aid continuing” rights and to make sure the statute of limitations to request a hearing doesn’t expire in case informal advocacy is unsuccessful.

FORMAL ADVOCACY

Human Resources Administration

Formal advocacy includes the legal due process established by the law for adjudicating claims; this process is called a “Fair Hearing”, refer to Advocacy, Fair Hearings. Public entitlement programs, including Cash Assistance, Medicaid, Supplemental Nutrition Program (SNAP), and HEAP are secured by “due process procedures.” That is, once public entitlements are enacted into law, they are considered rights with safeguards to protect individuals from erroneous decisions by the government. When an individual’s application has been denied or a recipient’s benefits have been or will be discontinued, reduced, or suspended, the individual can appeal such action.

Social Security Administration

The Office of Disability Adjudication and Review (ODAR) administers the appeals process for the Social Security Administration (SSA) and is responsible for holding hearings and issuing decisions for appeals that claimants bring against the Social Security Administration. Refer to Advocacy, Social Security & SSI Appeals for more information on Social Security appeals.

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Advocacy

 
Benefits Plus - Solving the Public Benefit Puzzle – Community Service Society of NY