Part 4: Appendices: Glossary of Services, Acronyms, Sample Letters

Date

Office Director

Office of Intellectual and Developmental Disabilities

P.O. Box 4706

Columbia, SC  29240

Re: Request for Reconsideration of [Denial of Eligibility, Denial of Services, Reduction of Services] for [ID/RD, HASCI, or Community Supports] Waiver

Dear Office Director:

I am writing to request that the Office of Intellectual and Developmental Disabilities reconsider its decision to [deny eligibility, deny services, or reduce services] under the [ID/RD, HASCI, or Community Supports] Waiver program.  A copy of the denial is enclosed.

I feel this decision was incorrect for the following reasons: [List reasons why your denial is incorrect. Focus on showing why the person needs the service and supply any supporting documentation available from doctors and other medical professionals. You can also list any other alternatives that were tried and failed to meet the person’s needs.]

I have attempted to resolve this issue by: [List any correspondence with case managers or reviewers involved in making the decision.]

I would like: [Describe your ideal resolution, i.e., finding that the person is eligible for a waiver, approving services, etc.]

I request for my services to continue pending the outcome of the hearing. I also request a complete copy of my case file. Please let me know if you need anything further to proceed with this request.

Thank you very much for your assistance.

Sincerely,

(Signature)

Print Name:

Address:

Telephone:

Email:

cc:

Disability Rights South Carolina

3710 Landmark Drive, Suite 208

Columbia, SC 29204