You can also use this form to ask for a medical program or food benefit hearing, or you can make an oral request.
90 days: you have 90 days to request a hearing for food benefits, medical eligibility, and for TANF reductions for not cooperating with your case plan.
Other situations: DHS must receive your request within 45 days from the date on the notice.
Continuing benefits: you can ask for your benefits to stay the same until the hearing decision.
Representation: for food benefits and for medical programs, anyone may represent you.
Printed editions: 12/18 (page 1), 2/1/18 (page 3).
| Question | Answer |
|---|---|
| Form Name | Form MSC 0443 |
| Form Length | 3 pages |
| Fillable? | Yes |
| Fillable fields | 73 |
| Avg. time to fill out | 13 min |
| Edition | Rev 12/18 |
| Where to file | For other benefits, return the form to a DHS or OHA office |
| Other names | MSC 0443, MSC0443, MSC 044, DHS MSC 0443, Administrative Hearing Request |
Dhs Form Msc 044 isn’t the one you’re looking for?