There is a 3-step dispute resolution process available to beneficiaries/recipients
and ENs that are not State VR agencies. The process is available after the parties
sign an Individual Work Plan (IWP) (see DI 55020.001B.1.). The purpose of the process is to resolve disputes that arise during the implementation
of the IWP. For example, a dispute could arise about the services spelled out in an
IWP, or about the beneficiary's/recipient's participation in the plan.
The first step of this dispute resolution process involves an internal grievance procedure
that each EN is required to have. Under this procedure beneficiaries/recipients have
the opportunity to work with representatives of the EN to try to resolve the dispute
that has arisen. If the dispute is not resolved using these procedures, both the beneficiary/recipient
and the EN have the option of contacting the PM for assistance in resolving the dispute.
The second step of this dispute resolution process involves a full review of the matter
in dispute by the PM. The PM will make a recommendation to the beneficiary/recipient
and EN as to how the dispute might be resolved. After receiving the PM's recommendation,
either party to the dispute may request a review by SSA.
The third step of this dispute resolution process involves bringing the dispute to
SSA. SSA's decision with regard to the dispute is final. If either party to the dispute
is unwilling to accept SSA's decision, that party has the right to terminate its relationship
with the other.
NOTE: The PM will refer the request for SSA review to staff in the Office of Employment
Support Programs (OESP) where the final SSA decision will be made by the Dispute Resolution
Both the beneficiary/recipient and the EN may use an attorney or other individual
of their choice to represent them at any step in the dispute resolution process.
At any stage in the dispute resolution process, a beneficiary/recipient can seek and
receive assistance from the State P&A system. SSA awards grants to the P&A system
in each State and U.S. Territory to provide services under the Protection and Advocacy
to Beneficiaries of Social Security (PABSS) program (see DI 55001.005B.).
ENs must inform beneficiaries/recipients of the availability of P&A services at three
times. They are when:
the EN and beneficiary/recipient sign the individual work plan (IWP);
services in the beneficiary's/recipient's IWP are reduced, suspended, or terminated;
a dispute arises about the services spelled out in the IWP or the beneficiary's/recipient's
participation in the program.
Field components have no direct role in disputes between beneficiaries/recipients
and ENs that are not State VR agencies.
Refer beneficiaries/recipients with complaints about an EN to MAXIMUS, SSA's the PM
or suggest they contact their State's P&A system.
MAXIMUS' toll free numbers are:
1-866-968-7842 (1-866-YOUR TICKET); and
TTY/TDD 1-866-833-2967 (1-866-TDD 2WORK).
Refer ENs with complaints about a beneficiary/recipient that they are serving to MAXIMUS.
Refer State P&A employees who are representing beneficiaries/recipients in a dispute
with an EN to MAXIMUS.
EXCEPTION: Answer any general, program-related questions the P&A employee may have.