053-1 Wyo. Code R. § 1-1

Current through April 27, 2019

Section 1-1 - Appeals Procedures

(a) All applicants and clients shall be informed of the procedures for informal as well as formal resolution of disagreements, including the name and address of the Administrator of the designated state unit (DSU) with whom appeals for an Administrative Review, Mediation and Formal Hearings are to be directed in writing. (Department of Workforce Services, Division of Vocational Rehabilitation, 1100 Herschler Building, Cheyenne, Wyoming 82002).

(b) Applicants and clients shall be given the name and address of the Client Assistance Program (C.A.P.) (638-7668 or 1-800-821 -3091) and the description of services available from this source. Applicants and clients will be notified in writing of individual's rights and availability of assistance from C.A.P. at application, when the IPE is developed and when rehabilitation services are reduced or suspended.

(c) Any applicant for or recipient of vocational rehabilitation services who is dissatisfied with a determination made by personnel of the DSU that effect the provision of vocational rehabilitation services concerning the furnishing or denial of services may request a timely review of those determinations. Applicants who are found ineligible for services and previously eligible individuals who are determined to be no longer eligible for services are permitted to challenge the determination of ineligibility. The individual has the right to be represented by a person of their choice at all levels of appeals and they have the right to submit evidence. If informal resolution fails, a formal hearing will be conducted within 60 days of the written request. The CAP is available to assist the applicant or eligible individual during all levels of the appeals process.

(d) The appeal procedures may begin at any level. The DVR appeals process consists of four levels:

• (i) Level 1: Informal Review: If the client is dissatisfied with a decision made by his/her counselor and it can't be resolved by discussing the issue with the counselor, he/she can request that the area manager review the decision. The counselor will help schedule the managerial review.

• (ii) Level 2: Administrative Review: Administrative review of the decision will be completed by a previously uninvolved Vocational Rehabilitation administrative staff person. The applicant or client is encouraged to participate in the informal review and in the administrative review. The decision will be provided to the client in written form along with a description of how client can access the next level in the appeals process.

• (iii) Level 3: Mediation: The mediation process is voluntary on the part of all parties, is not used to deny or delay the right of the individual to a formal hearing or to deny any other right afforded to the individual under Title I of the Act, and is conducted by a qualified and impartial mediator who is trained in effective mediation techniques. A list of qualified mediators will be maintained by the state. The state will pay the cost of mediation and formal hearing. Mediation will be scheduled in a timely manner and in a convenient location for all the parties of the dispute. All discussions that occur during mediation will be kept confidential. If an agreement is reached, that agreement must be put in writing.

• (iv) Level 4: Formal Review (Fair Hearing): Formal review (fair hearing) will be conducted by an Impartial Hearing Officer (IHO) from the Office of Administrative Hearings (OAH). Applicants and eligible individuals have the right to be represented during the mediation and formal review. The Fair Hearing will be held within 60 days of receipt of the client's request for review unless the parties jointly agree to a specific extension of the time. Selection of the IHO will be in accordance with the requirements of Section 102(c)(5) of the Rehabilitation Act, as amended.

(e) The second, third and fourth levels of review must be requested in writing. Client will have 10 (ten) days to request each review. This request will be addressed to the DSU Administrator.

(f) The IHO will provide a full written report of the findings and the grounds for decision within 30 days of the completion of the hearing to the applicant or eligible individual or the individual's representative and the DSU.

(g) Either party may request a review of the decision of the IHO within 20 days of the decision. The chief official of the designated state agency (Department of Workforce Services) shall provide an opportunity to submit additional evidence and information relevant to the appeal.

(h) The chief official shall not overturn or modify a decision of the IHO that supports the individual with a disability, unless it has been determined, based on clear and convincing evidence, that the decision of the IHO is clearly erroneous on the basis of being contrary to Federal or State law, the approved State Plan, Federal regulations, or any State regulation or policy that is consistent with Federal requirements.

(i) The chief official shall make a final decision in writing, including a full report of the findings and grounds for the decision, within 30 days of providing notice of intent to review. A copy of the decision shall be provided to the individual or his/her designated representative.

(j) The chief official shall not delegate responsibility for making the final decision to any officer or employee of the Designated State Unit.

(k) During the appeals process, DVR shall not suspend, reduce or terminate vocational rehabilitation services, including evaluation and assessment services, being provided to the individual, unless the individual or the individual representative requests it, or unless such services have been obtained through misrepresentation, fraud, collusion, criminal conduct on the part of the individual or the individual's representative.

(l) The chief official shall use the following standards when determining whether to review a hearing officer's decision.

• (i) Is the initial decision supported by substantial evidence?

• (ii) In reaching the initial decision, has the Impartial Hearing Officer given appropriate and adequate interpretation to such factors as:
  • (A) The Federal statute and regulations as they apply to the specific issue;
  • (B) The State Plan as it applies to the specific issue in question;
  • (C) Approved Federal and State policy as it applies to the issue in question;
  • (D) State agency options in the delivery of services if such options are permissible by Federal statute or regulation;
  • (E) Restrictions in the Federal statutes or regulations with regard to such supportive services as maintenance and transportation;
  • (F) Key portions of conflicting testimony.

(m) At the request of one or both parties, reasonable time extensions for good cause are allowable, except for the 20-day limit for either party to request an impartial review of the IHO's decision. The IHO's decision will be sent to the RSA Regional Commissioner.

(n) Either party may file a civil action for review of the final decision issued by the IHO or the reviewing official.

053-1 Wyo. Code R. § 1-1