N.Y. Comp. Codes R. & Regs. tit. 8 § 247.3

Current through Register Vol. 46, No. 51, December 18, 2024

Section 247.3 - Administrative review and mediation

(a) Time limitation for requesting administrative review. Requests for administrative review shall be made no later than 90 days after the individual is informed of the agency decision or action which the individual seeks to review.

(b) Requesting an administrative review or mediation.

(1) A request for administrative review or mediation shall be made in writing to the district office at which the individual has received or applied for service.

(2) If the individual is unable to write, the request shall be taken in dictation at the district office, upon request by the individual.

(3) Each request shall be signed by the individual or representative or, in the event the request was taken in dictation, the request shall be witnessed by two agency employees.

(c) Scheduling of administrative review or mediation.

(1) If the individual agrees, upon receipt of a request for administrative review, an initial review conference shall be scheduled as soon as possible at a site convenient to all parties prior to the date that an administrative review is scheduled. The opportunity for mediation shall be available whenever a hearing is requested.

(2) If the individual has requested either an administrative review or mediation, such shall be scheduled to occur as soon as possible at a site convenient to all parties. The district office manager or other reviewer may decline to schedule an administrative review if he or she determines that the review is not likely to resolve the disagreement.

(d) Notice. Notice of a scheduled administrative review shall be mailed by the reviewer, and notice of a mediation shall be sent to the individual. The notice shall include but not be limited to the time, date, place and nature of the review or mediation, and the name of the reviewer or mediator. An explanation of the review or mediation procedure and the individual's right to representation shall be included with the notice.

(e) Request for rescheduling. Prior to the day on which the administrative review or mediation is scheduled, a reviewer or mediator may, with the consent of the individual or upon a showing of good cause, change the date, time or place of the review or mediation upon written notice to the parties involved.

(f) Default. Failure to appear at a scheduled review or to give notice of an inability to appear shall be deemed a waiver of the right to a review or mediation, unless the individual applies promptly to the reviewer or mediator for relief from the default. Such application shall include documentation of the reasons for the individual's failure to appear and shall be granted if the individual establishes good cause for such failure.

(g) Withdrawal from administrative review or mediation. The parties to an administrative review or mediation may resolve the issues causing the disagreement prior to an administrative review or mediation. If, as a result of this resolution, the individual is satisfied and wishes to withdraw the request for administrative review or mediation, the individual shall submit a signed written withdrawal. However, an administrative review or mediation shall not be delayed or cancelled because of the possibility of a negotiated agreement, unless the individual requests a delay or cancellation.

(h) Selection of reviewer or mediator.

(1) The reviewer for the administrative review shall be the district manager or an associate counselor or other staff member designated by the district manager, of the district office at which the individual has received or applied for service. To the fullest extent possible, the district office manager or other likely reviewer shall not become involved in decisions or actions that may result in the individual's request for administrative review.

(2) The mediator shall be a person selected from a list of qualified mediators knowledgeable in laws relating to the provision of vocational rehabilitation services.

(i) Duties and powers of the reviewer. The reviewer shall conduct an administrative review of the issues and evidence presented at the review, and shall render a decision in accordance with the relevant statute, regulations and such evidence. The reviewer may request a statement of the issues from the individual and the agency.

(j) Form of decision. The decision shall be a comprehensive statement by the reviewer containing the following elements:

(1) a statement of the issue or issues involved;

(2) a clear and complete statement of fact as supported by evidence presented at the review;

(3) reference to all laws, regulations and other legal bases for the decision;

(4) a concise statement of the conclusions drawn, and the basis for such conclusions; and

(5) a clear statement of the actions to be taken to implement the decision.

(k) Time limitation for decision. The reviewer shall render a decision and give notice of the decision within five days from the completion of the review.

(l) Notice of the decision.

(1) The reviewer shall mail a copy of the decision to appropriate agency staff and the individual and authorized representative.

(2) If the decision is favorable to the individual, and the individual withdraws the request for an impartial hearing pursuant to section 247.4(f) of this Part, the decision shall be final and the counselor shall begin implementation of the decision within 20 days of its receipt.

(3) If the decision is adverse to the individual, the reviewer shall include a statement in the decision informing the individual that an impartial hearing will be scheduled unless the individual withdraws the request for review.

N.Y. Comp. Codes R. & Regs. Tit. 8 § 247.3