1. A. Overview of Appeals.

   1. 1. An Applicant or VR Client may Appeal a decision made by VR that affects the provision of VR services.

   2. 2. VR shall make the following Appeal resolution options available:

      1. a. Informal review;
      2. b. Mediation; or
      3. c. Hearing.

   3. 3. VR shall provide an Applicant or VR Client with a notice of Appeal rights and Client Assistance Program information when:

      1. a. An individual applies for VR services;
      2. b. VR makes a decision about eligibility for VR;
      3. c. VR makes a decision regarding a VR Client’s placement into an OOS Priority Category;
      4. d. VR develops an IPE with the VR Client; and
      5. e. At any time that VR makes a decision that affects the provision of VR services and intends to reduce, suspend, or terminate planned services or goods.
   4. 4. An Applicant or VR Client may request case record documents as described under R6-4-208(B)(2) to use during the Appeal process.
   5. 5. An Applicant or VR Client may be accompanied and represented by an Authorized Representative during the Appeal process and shall be notified of the availability of the Client Assistance Program. All expenses incurred for such representation, including legal fees, shall be the responsibility of the Applicant or VR Client.

   6. 6. VR shall not suspend, reduce, or terminate VR services being provided to an individual, including evaluation and Assessment services and IPE development, pending a resolution of an Appeal unless:

      1. a. The Appellant requests suspension, reduction, or termination of services; or
      2. b. VR has evidence that the services have been obtained through misrepresentation, fraud, collusion, or criminal conduct on part of the individual.
   7. 7. The RSA Ombudsman or designee shall receive all Appeal requests and route the Appeal requests to the appropriate authority for disposition.

2. B. Requests for Appeal: form; time limits; timeliness.

   1. 1. An Applicant or VR Client shall have 20 calendar days from the mailing or email date of a written decision letter from VR to submit a written request for Appeal to VR. VR shall accept a formal written request for an Appeal via mail, email, or fax.

   2. 2. An Applicant or VR Client shall submit a written request for an Appeal using:

      1. a. A VR Appeal request form; or

      2. b. Any other written communication that includes:

         1. i. A description of the specific VR decision being appealed;
         2. ii. The Appellant’s contact information and signature;
         3. iii. The date; and
         4. iv. An indication of whether the Appellant is willing to resolve the issue through an informal review, Mediation, or Hearing. If the Appellant chooses only a Hearing, the Appellant shall indicate that the Appellant is declining all other options for resolution in the written request. VR shall deem failure to indicate whether the Appellant is willing to resolve the issue through an informal review or Mediation to be election of a Hearing only.

Historical Note

New Section made by final rulemaking at 31 A.A.R. 3921 (October 3, 2025), effective November 2, 2025 (Supp. 25-3).