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Client Appeal Rights, Procedures

Status: Archived

Approved Date: November 12, 2018

  • Specialist makes a determination and fully informs the client.
  • Summarize in a Task Note the client’s expressed dissatisfaction with a determination or the determination is ineligible or no longer eligible and notify Office Director
  • Office Director reviews case, fully consults with the client and makes final determination
    • If Office Director made original determination or was involved in the making of the original determination, review and final determination should be conducted by another Office Director
  • If client is dissatisfied with final determination, send the Office Director Letter to the client.
  • If final determination involves an ineligible or no longer eligible decision, the case shall remain open during the 30 day calendar appeal process available to the client.
  1. The Specialist makes a determination and fully informs the client.
  2. If the client is dissatisfied with the determination or if the determination is ineligible/no longer eligible, the Specialist summarizes in QE2 task notes and notifies his/her office director.
  3. The office director reviews case and fully consults with the client. The office director makes the final determination. If the office director made the original determination or was involved in making the original determination, the review is to be conducted by a different office director who will make the final determination.
  4. If the client is dissatisfied with the final determination the Office Director sends the Office Director letter to the client.
  5. If the final determination involves an ineligible or no longer eligible decision, the case should not be closed until the 30 days has elapsed from the date of the final determination since the client has 30 calendar days to appeal.

Any determination made by VR staff that a client is dissatisfied that affects the provision of services or involves a determination of ineligible/no longer eligible shall be reviewed by the office director. The office director makes the final determination. If the office director made the original determination or was involved in making the original determination, the review is to be conducted by a different office director who makes the final determination.

When a client disagrees with the final determination, the client shall be informed in writing of:

  • the availability of assistance from the Client Assistance Program;
  • the right to a timely review through an impartial due process hearing; and
  • the right to pursue mediation.

VR staff must fully consult with the client in person, by phone, or as a last resort by letter (email/text) unless the client has died, or there is no way to contact the individual.

VR cannot reduce, suspend, or stop disputed VR services currently being provided to a client at the time of the filing of the petition, including assessment services and IPE development, pending informal resolution, mediation, or a determination by an impartial hearing officer unless:

  • The client, or his/her representative requests the reduction, suspension, or termination of the service; or
  • VR has evidence that the services have been obtained through misrepresentation, fraud, collusion, or criminal conduct by the client, or his/her representative.

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