What is the process of appealing a denial of disability benefits?

In Rhode Island, the process of appealing a denial of disability benefits is overseen by the Department of Human Services, Office of Quality Assurance (OQA). There are two stages of appeal: first, the administrative review, and second, the fair hearing. The administrative review allows the claimant to gather new evidence and information and submit it to the OQA for a reconsideration of the case. During the administrative review, the claimant or their representative can present documents and statements to support their case. The OQA has the authority to reverse or modify the original decision. If the claimant is still unhappy with the decision after the administrative review, they can file an appeal for a fair hearing. This is a hearing before an administrative law judge who is authorized to overturn or uphold the original decision. The judge will hear testimony from the claimant and may consider additional evidence that was not presented in the initial review. The decision of the administrative law judge is final unless the claimant subsequently requests a review in court. At this point, the claimant or their representative can appeal the administrative law judge’s decision to the Superior Court in Rhode Island. The Superior Court has the authority to reverse or affirm the administrative law judge’s decision. In summary, if a claimant is denied disability benefits in Rhode Island, they can pursue a two-stage appeals process overseen by the Department of Human Services, Office of Quality Assurance. If they are still unsatisfied, they can then appeal to the Superior Court.

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