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State of West Virginia DEPARTMENT OF HEALTH AND HUMAN RESOURCES Office of Inspector General Board of Review. O. Box 2590 Fairmont, WV 26555 Joe Man chin III Governor Martha Yeager Walker Secretary
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A disqualification hearing held in June is a legal proceeding to determine whether an individual or entity should be disqualified from certain benefits, services, or positions based on specific criteria.
Individuals or entities that wish to contest their disqualification status or those mandated by regulatory bodies to report or respond to a disqualification notification are required to file.
To fill out the disqualification hearing form, ensure to provide accurate personal or entity details, attach necessary documentation, and clearly state the reason for contesting the disqualification.
The purpose of the disqualification hearing is to review evidence, assess the validity of disqualification claims, and provide an opportunity for the involved parties to present their case.
The form must report personal identification details, specific grounds for disqualification, relevant dates, and any supporting documentation or evidence.
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