How to appeal AADL cost-share exemption

If Alberta Aids to Daily Living (AADL) denies your request for exemption from cost-share, you can appeal the decision. Cost-share exemption appeals are heard by an independent committee of 3 private citizens called a Citizens’ Appeal Panel. These panels are appointed by the government, but are not employees of the government.

The panels have the power to make final decisions about your appeal. Their decisions are binding on both you and the Government of Alberta. While the panels are legal bodies, the appeal hearings are conducted in an informal manner.

Appeal process

Submit Notice of Appeal

The first thing to do when you decide to appeal the cost-share exemption denial is to complete an Cost-Share Notice of Appeal form and send it to AADL. Please review all sections of the Notice of Appeal form, and complete all questions to the best of your knowledge.

Your appeal should include the reason(s) why it is a hardship for you to pay your portion of your AADL benefits. You must include with your Notice of Appeal verification of your taxable income for the previous year, such as the Notice of Assessment from the Canada Revenue Agency. You may also include pay stubs for the present year, as well as copies of any receipts that verify your expenses that may constitute hardship.

These receipts may include items such as:

  • medication, including those from Alberta Blue Cross or private insurance companies;
  • medical examinations and treatments not covered by the Alberta Health Care Insurance Plan;
  • medical equipment and supplies and repairs to health equipment not covered by the Alberta Aids to Daily Living program;
  • other extenuating circumstances which may have caused your immediate family undue financial hardship.

Administrative review

Upon receipt of your Notice of Appeal, AADL will review your file and the information you provided in your Notice of Appeal. The AADL Director has the authority to grant you exemption from cost share, and they will notify you if exemption is granted. If the AADL Director does not approve your exemption, your appeal will be forwarded to the Citizens’ Appeal Panel.

Appeal hearing

Appeal hearings are normally scheduled on the first available date. You will be advised in writing or by phone of the date, time and location of your hearing. Hearings are held in approximately 30 different communities across the province. If you are unable to attend your hearing, contact the Appeals Secretariat at least 48 hours before your hearing.

You will be notified in writing of the panel’s decision. If you are not satisfied, you have the right to request the Ombudsman review the situation. You can reach the Ombudsman by calling 780-427-2756 in Edmonton and 403-297-6185 in Calgary.

About the appeal hearing

What to expect

  1. The chairperson introduces everyone present and goes over the rules. He or she states the decision being appealed and asks if anyone objects to the people on the panel or their right to decide.
  2. The AADL representative states the reason your application for cost-share exemption was denied. The representative provides comments that support the AADL decision. The AADL representative is there to speak for the ministerial department, and cannot speak on your behalf. He or she should be allowed to speak without interruption, and then you and the panel will have the opportunity to ask the AADL representative questions related to the submission.
  3. Then it is your turn. You can make your comments verbally or in writing. You, your witness, or the person speaking for you, are the only ones who will give information to support your request. Then the panel and the AADL representative may ask you questions.
  4. You and the AADL representative have the chance to make a final statement based on the information given at the hearing.
  5. Both you and the AADL representative then leave the hearing. The panel then makes their decision. You will be informed of the decision and the reason for the decision in writing.

Attendance at citizens’ appeal hearings

It is suggested that you appear in person. There are appeal panels in approximately 30 communities across Alberta. Appeal hearings are arranged in the community closest to your home. When attending an appeal hearing, you are welcome to bring an advocate, a friend, or a family member to help you present your case.

If you are unable to attend for reasons such as poor health or travel difficulties, you may participate by telephone. Again, an advocate, friend, or family member may assist you during the telephone hearing or act on your behalf.

If you decide to have a representative act on your behalf at the hearing (in person or by telephone), you must provide written permission for that person to represent you. The Appeal Panel will not allow anyone to represent you without your written permission.

If you have a scheduled hearing date, but cannot attend, please let the appeal panel and AADL know as soon as possible and at least a full day in advance. A new hearing date can be set, and there is no penalty for asking for a new date.

If you cannot come to the appeal, and do not let the panel know, the appeal hearing may be held without you. The panel may decide without you being present.

Appeal hearings are held in English. You are welcome to bring an interpreter, if that will help with your presentation.

How appeal panels decide

The department decides on a legal interpretation of the Acts that apply to AADL. Appeal panels can over-ride that interpretation, or policy, but they cannot go beyond the limits set by the Acts and Regulations.

  • If you would like to read the AADL Regulation, copies are available at most libraries and on the Queen’s Printer website.

Contact AADL

Contact AADL if you have any questions.

If you have questions about appeal panels or how an appeal hearing works, call the Appeals Secretariat at 780-427-2709 or toll-free by dialing 310-0000 and entering 780-427-2709 when prompted.