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This document provides the findings of fact and conclusions of law regarding an Administrative Disqualification Hearing concerning an Intentional Program Violation related to Food Stamp Benefits.
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Enter your personal information in the appropriate sections, including your name, address, and contact details.
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Fill in the case or reference number, if applicable.
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Who needs State of West Virginia Department of Health and Human Resources Board of Review Decision?

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Individuals who have received a decision from the West Virginia Department of Health and Human Resources and wish to appeal that decision.
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Individuals seeking to challenge eligibility determinations for benefits or services.
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Persons who feel their rights or benefits under state health programs have been improperly denied.
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The State of West Virginia Department of Health and Human Resources Board of Review Decision is an official ruling or determination made by the Board in response to appeals related to benefits or services provided under health and human resources programs.
Individuals who disagree with a decision made regarding their eligibility or entitlement to benefits from programs administered by the Department of Health and Human Resources may file a request for a review by the Board.
To fill out the form, the appellant must provide personal details, the specific decision being appealed, reasons for the appeal, and any supporting evidence. It's important to follow the provided instructions carefully to ensure all necessary information is included.
The purpose is to provide a formal process for individuals to appeal decisions made by the Department that they believe are incorrect, ensuring that everyone has the opportunity for a fair review of their situation.
The report must include the appellant's personal information, details of the original decision being appealed, the grounds for the appeal, and any documentation or evidence supporting the claim.
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