If you are getting DD Waiver services and the regional center decides that you are no longer eligible for a DD Waiver service, you have the right to appeal. If you think you meet the criteria for a service under the DD Waiver, remember to write that on your fair hearing request form. For example, you can write: “I also want my right to this service to be determined under the DD Waiver – federal Medicaid rules.” 

An appeal about a DD Waiver service is similar to an appeal under the Lanterman Act. You may have claims under both the Lanterman Act and the DD Waiver. If this happens, you will have a hearing. An Administrative Law Judge (called ALJ for short) will consider your claims under the Lanterman Act first. If the ALJ agrees with you on your Lanterman Act claims, the appeal stops there, and you will get the services or supports you asked for. ^[1]If the regional center is found responsible for providing the service under the Lanterman Act, the regional center would have the authority to conclude that the service is also coverable under the DD … Continue reading

If the ALJ does not agree with you on the Lanterman Act claims, the ALJ should consider your DD Waiver and Medi-Cal claims separately.

To learn more about appeals, see Chapter 10.