The following is a summary of the main concepts covered in this guide:
- An appeal is a request to review one or more denied program
applications, product delivery, assessment delivery, issue, or prior
appeal decisions.
- There are three appeal types: hearing appeal, hearing review
appeal, and judicial review appeal. Hearing type appeals are decided
by a hearing official. Hearing review appeals are decided by a panel
of hearing reviewers. Judicial review appeals are decided by the
courts.
- A legal action is a directive, action or other activity
concerning a participant that is conducted by a legal authority. There
are three main categories of legal action: legal hearing, legal
petition, and legal order. Legal hearings are managed in the same way
as hearings held for Appeals.
- All appeals have one or more appellants who initiate the appeals
process and a respondent who defends the decision that gave rise to
the appeal.
- Different users and case participants play a role on each appeal
type.
- Each appeal type has a lifecycle which tracks the progress of
the appeal case from creation, through reaching a decision,
implementing the decision, and closing the appeal.
- Each legal action created, i.e., legal petition, legal hearing,
legal order can be tracked and managed from creation to
closure.
- Tasks such as filing an appeal, reaching a decision on an
appeal, and implementing appeal decisions are regulated by
deadlines.
- Appeal process, appeal security, and legal action configuration
is managed as part of system administration.