Current through Register 1536, December 6, 2024
Section 8.04 - Payment Pending Appeal to Secretary(1) If an applicant or recipient whose benefits are to be denied or terminated disputes the facts of his or her eligibility or amount of benefits, then benefits shall be continued until a DVS hearing has been held pursuant to 801 CMR 1.02 (Fair Hearing Regulations,) and a written decision issued. Conversely, if there is no dispute in material facts relating to the recipient's eligibility for or amount of benefits, then benefits shall stop until a favorable written decision is rendered. Any party aggrieved by a DVS decision shall have the right of further review by filing a timely appeal with the Division of Administrative Law Appeals (DALA.)(2) The decision of the DVS hearing officer to uphold the reduction, termination or denial of benefits shall take effect in accordance with a written decision. An appeal to DALA shall not stay the decision unless the DVS hearing officer grants a stay.(3) DVS may recover benefits under certain circumstances involving an appeal.(a) If benefits are paid because the applicant appealed, and such appeal is denied, or if the Secretary grants such an appeal and the decision is subsequently reversed by DALA, DVS may recover the amount of all benefits that were paid pending the outcome of the appeal.(b) The applicant has the right to waive receipt of benefits pending appeal. Upon successful appeal, the applicant shall be paid the amount he or she would have received for the period pending the appeal.(c) If the Secretary decides to recover the amount of benefits paid pending appeal, his or her decision will include the amount of money owed by the applicant and a statement informing the applicant that the recipient has the right to request a waiver subject to the provisions of 108 CMR 8.07(3).(d) If a veterans' agent fails to pay benefits ordered in a decision following an appeal, the Secretary shall request that the Treasurer of the Commonwealth be informed of such refusal or failure and thereafter such benefits shall be paid to the applicant by the Commonwealth. If the Commonwealth shall be called upon to pay such benefits on behalf of any city or town, the total of any such benefits paid in any such calendar year shall be assessed upon such city or town, or deducted from funds that may be due such city or town from the Commonwealth.