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Request a Fair Hearing
You may request a fair hearing in any of the following ways.
Once your fair hearing request is
processed, we will send you notification (OAH-4420 Acknowledgement of a Fair Hearing Request) by US Mail.
- FILL OUT THE ONLINE REQUEST FORM → Online Request Form
Note: For security purposes, you have 15 minutes to complete this form. Otherwise your request will not be received and you will need to start over. You must have javascript enabled in order to use the online forms.
- PRINT OUT AND COMPLETE THE FAIR HEARING REQUEST FORM AND SEND IT TO US BY FAX OR MAIL.
To preserve any aid-continuing rights, be sure to fax or postmark your request as described in the Notice of Intent.Open a printable copy of the Fair Hearing Request form in PDF format → Printable Request Form (PDF version)
Open a printable copy of the Fair Hearing Request form in HTML format (Adobe Reader not required) → Printable Request Form (HTML version)
Fax the completed form to: 1 (518) 473-6735
or
Mail the completed form to:
New York State Office of Temporary and Disability Assistance
Office of Administrative Hearings
P.O. Box 1930
Albany, NY 12201-1930
If your request involves an issue about health benefits or services provided under your Managed Care Plan or Managed Long Term Care you can write to:
NYS Office of Temporary and Disability Assistance
Office of Administrative Hearings
Managed Care Hearing Unit
P.O. Box 22023
Albany, New York 12201-2023
- CONTACT US BY TELEPHONE
Statewide Toll Free: 1 (800) 342-3334
NOTE: FOR NEW YORK CITY EMERGENCY FAIR HEARINGS ONLY- CALL 1 (800) 205-0110. DO NOT USE THIS TELEPHONE NUMBER FOR ANYTHING EXCEPT EMERGENCIES. REQUESTS THAT DO NOT INVOLVE EMERGENCIES CANNOT BE TAKEN AT THIS NUMBER.
For Hearing Impaired, TTY phone number: 1 (877) 502-6155
- REQUEST A FAIR HEARING IN PERSON AT EITHER OF THE FOLLOWING LOCATIONS (New York City Only):
Office of Temporary and Disability Assistance
Office of Administrative Hearings
14 Boerum Place, 1st Floor
Brooklyn, New York 11201
Directions to Boerum Place
Office of Temporary and Disability Assistance
Office of Administrative Hearings
330 West 34th Street, 3rd Floor
New York, New York 10001
Directions to 330 West 34th Street