Office of Inspector General

Request a Public Assistance Fair Hearing

To request a public assistance fair hearing, you may fill out the form below or submit your request in writing or by telephone using the following contact information:

Appeal Hearings Section
1317 Winewood Blvd., Bldg. 5,
Tallahassee, Florida 32399-0700
Phone: 850-488-1429

All requests for hearings regarding benefits with the Agency for Persons with Disabilities (APD) must be made with an APD local or central office. Find a local APD office.

The form below must be entirely filled out and should include any details you believe would be helpful to the hearing officer.  Once your hearing request is received with all the necessary information, an appeal will be set up, assigned to a hearing officer, and you will receive an acknowledgement letter in the mail.



I am:

Representative Information

Enter your representative information.

Applicant/Recipient Information

Applicant/Recipient information.

Please provide one or both of the following:

And / Or

What programs are you appealing?*

Select all that apply.

For any other program please call our office.



What action are you appealing?

Select all that apply.


If the Department’s action is a reduction or termination of benefits, are you seeking continued benefits while the hearing is pending? NOTE – If you ask for a hearing by the end of the last day of the month prior to the effective date of the adverse action, your benefits may continue at the prior level until the hearing decision. You will be responsible to repay any benefits continued if the hearing decision is not in your favor.


Describe the action the Department took and why you disagree with the action:


Will you need a special accommodation or professional language interpreter at the hearing?


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