OTDA Home Programs & Services Fair Hearings Request a Fair Hearing
Request a Fair Hearing
You may request a fair hearing in any of the following ways:
- Online Request Form
- Mail or Fax a Printable Request Form
- Request by Telephone
- Request in Person (NYC and Albany only)
Once your fair hearing request is processed, we will send you notification (OAH-4420 Acknowledgement of a Fair Hearing Request) by US Mail.
State Supplement Program (SSP) Fair Hearings
SSP Fair Hearings will be conducted by telephone, pursuant to 18 NYCRR 358-5.12, unless an in-person hearing is requested by the individual or authorized representative. If you would like an in-person hearing, please notify an Office of Administrative Hearings staff member when requesting a fair hearing. You may indicate your request for an in-person hearing in the comments section of the on-line hearing request form or in the reason section of the printable form.
Online Request Form
You may request a Fair Hearing using the Fair Hearing Online Request Form. You must have JavaScript enabled in order to use the online forms.
- Fair Hearing Online Request Form (English)
- Fair Hearing Online Request Form (Arabic)
- Fair Hearing Online Request Form (Bengali)
- Fair Hearing Online Request Form (Chinese)
- Fair Hearing Online Request Form (French)
- Fair Hearing Online Request Form (Haitian Creole)
- Fair Hearing Online Request Form (Italian)
- Fair Hearing Online Request Form (Korean)
- Fair Hearing Online Request Form (Polish)
- Fair Hearing Online Request Form (Russian)
- Fair Hearing Online Request Form (Spanish)
- Fair Hearing Online Request Form (Urdu)
- Fair Hearing Online Request Form (Yiddish)
Mail or Fax a Printable Request Form
Complete a printable version of the Fair Hearing Request Form (PDF). To preserve any aid-continuing rights, be sure to fax or postmark your request as described in the Notice of Intent.
- Fair Hearing Request Form (English)
- Fair Hearing Request Form (Arabic)
- Fair Hearing Request Form (Bengali)
- Fair Hearing Request Form (Chinese)
- Fair Hearing Request Form (French)
- Fair Hearing Request Form (Haitian Creole)
- Fair Hearing Request Form (Italian)
- Fair Hearing Request Form (Korean)
- Fair Hearing Request Form (Polish)
- Fair Hearing Request Form (Russian)
- Fair Hearing Request Form (Spanish)
- Fair Hearing Request Form (Urdu)
- Fair Hearing Request Form (Yiddish)
This form may be faxed to 518-473-6735 or mailed to the following address:
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
Request by Telephone
Telephone request for Fair Hearings can be made by calling our statewide toll-free number: 1-800-342-3334
If you live in NYC and need to request an emergency Fair Hearing, you may call 1-800-205-0110. This number is only for emergency situations. Requests that do not involve emergencies will not be taken at this number.
Speech or Hearing Impaired Individuals
Please contact the New York Relay Service at 711 and request that the operator call us at 1-877-502-6155. Service at this number will only be provided to callers using TDD equipment.
Request in Person
A request for a Fair Hearing may be made in person at the following locations:
New York City
Office of Temporary and Disability Assistance
Office of Administrative Hearings
5 Beaver Street
New York, NY 10004
Directions to 5 Beaver Street
Albany
Office of Temporary and Disability Assistance
Office of Administrative Hearings
40 North Pearl Street
Albany, New York 12243
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