DDRS Waiver Manual

In all cases, the decision of the Administrative Law Judge is based solely on the evidence introduced at the
hearing and the appropriate federal and State laws and regulations. The Administrative Law Judge signs
the decision, which also contains the findings of fact and the conclusion of law. The decision is to be
explained to the appellant upon request.
Section 8.15: Actions of the Administrative Law Judge’s Decision
Unless an Agency Review is requested, the decision of the Administrative Law Judge shall be binding upon
the DDRS or the Office of Medicaid Policy and Planning and is to be enacted.
Section 8.16: Agency Review
Any party may request an Agency Review if dissatisfied with the decision made by the Administrative Law
Judge. The Agency Review request must be made in writing to the FSSA’s Office of Hearings and Appeals
(OHA) or the ultimate agency authority, within 10 calendar days following receipt of the hearing decision.
After an Agency Review is requested, the OHA or the ultimate agency authority will write to all
parties to acknowledge receipt of the request and to provide information concerning the
review.
No new evidence will be considered during the Agency Review; however, any party may submit
a written Memorandum of Law, citing evidence in the record, for consideration.
The Secretary of the FSSA or the Secretary’s designee shall complete the agency review. The
decision made at Agency Review will be sent to all appropriate parties.
Section 8.17: Judicial Review
The appellant, if not satisfied with the final action, may file a petition for judicial review in accordance with
IC 4-21.5-5.
Section 8.18: Lawsuit
If a lawsuit is filed, all inquiries should be directed to the FSSA Office of General Counsel or the Attorney
General’s Office.
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