FORM RSA-722

ANNUAL REPORT ON APPEALS PROCESS

INSTRUCTIONS

Purpose:

Form RSA-722 was developed to comply with the specific reporting requirements of 

Section 102(c) of the Rehabilitation Act (the Act) as amended by the Workforce 

Innovation and Opportunity Act. This section delineates the procedures by which 

applicants for and eligible individuals of State vocational rehabilitation (VR) 

programs may appeal decisions made by personnel of the VR unit/agency that 

affect the provision of VR services to them. Individuals may request that their 

disputes be resolved through mediation and/or an impartial due process hearing. 

(In some States, a Fair Hearing Board, established by a State before January 1, 

1985, carries out the responsibilities of the impartial hearing officer (IHO).) The 

State may elect to establish a procedure that enables either party to seek review of 

a decision rendered by the IHO. Finally, either party may file a civil action if either 

remains unsatisfied with the final administrative decision.

Section 102(c)(8) of the Act requires the State VR Director to collect and report 

data on the appeals process to the Commissioner. A summary of this 

information is included in the Commissioner's Annual Report submitted to 

Congress pursuant to section 13 of the Act. Section 102(c)(8)(B) specifies the 

information that is to be collected:

1. A copy of the standards used by State reviewing officials for 

reviewing decisions made by IHOs;

2. Information on the number of hearings and reviews sought from the 

IHOs and the State reviewing officials, including the type of 

complaints and the issues involved;

3. Information on the number of hearing decisions made that were not 

reviewed by the State reviewing officials;

4. Information on the number of the hearing decisions that were 

reviewed by the State reviewing officials, and, based on the 

reviews, the number of hearing decisions that were:

a. sustained in favor of the individual;

b. reversed in favor of the individual;

c. sustained in favor of the agency; and

d. reversed in favor of the agency; and

5. Copies of all decisions rendered by the IHOs and State reviewing 

officials.

While Form RSA-722 was designed initially to respond to the mandate of law, it 

also will enable the Commissioner to monitor the appeals process in the State 

agencies that has been set up to safeguard the rights of individuals with 
disabilities. The form itself is devised to approximate the sequence of the 

appeals process and contains a series of checks and balances throughout to 

simplify the completion of the report.

Line-by-line Instructions:

State & Agency: Enter the name of the State and check the appropriate box to 

indicate whether the agency is a general or combined agency, or whether the 

agency serves only individuals who are blind.

Fiscal Year: Enter the Federal fiscal year to which the form relates.

I. MEDIATION:

A. Requests for Mediation:

NOTE: Section 102(c)(4) of the Act sets forth the requirements for the 

mediation process. A "mediation request" can be counted in several 

ways, including: (1) when an individual actually requests mediation 

directly; (2) when an individual requests a hearing, but agrees to 

mediation when it is suggested by the agency; and (3) when an individual 

is in the hearing process and the individual agrees to engage in mediation 

upon the IHO’s recommendation. Each of these examples would 

constitute a "request for mediation."

Line 1: Enter the number of requests for mediation that were pending on 

October 1. These mediation requests were carried over from the 

prior fiscal year.

Line 2: Enter the number of mediation requests made since October 1. It 

does not matter who actually made the request.

Line 3: Enter the total number of mediation requests during the fiscal year. 

Add lines I.A1 and I.A2. It does not matter whether a mediator 

actually acted on these requests during the fiscal year. This 

number also forms the basis for the data in column (a) of Part V of 

this form (Types of Complaints/Issues Involved in Disputes).
B. Disputes Resolved During the Mediation Process:

Line 1: Enter the number of disputes resolved/settled prior to a written 

mediation agreement. There may have been one or more 

mediation sessions. However, there is no requirement that any 

mediation sessions occurred. The key here is that settlement was 

reached prior to the development of a mediation agreement.

Line 2: Enter the number of disputes resolved with a mediation agreement. 

In these instances, the parties met with a mediator and reached a 

settlement that was put into writing.

Line 3: Add lines I.B1 and I.B2. This is the total number of disputes 

resolved during the mediation process.

Line 4: Enter the number of disputes that were not resolved during the 

mediation process. In these instances, one or both of the parties 

halted the mediation process before it was completed.

C. Mediation Requests Carried Over:

Line 1: Enter the number of requests for mediation that were pending on 

September 30 and will go through the mediation process during the 

next fiscal year. There was insufficient time to act on these 

requests during the fiscal year. Subtract lines I.B3 and I.B4 from 

I.A3.

II. IMPARTIAL HEARING PROCESS:

A. Requests for Impartial Hearings:

NOTE: Section 102(c)(5) of the Act sets forth the requirements for the 

impartial hearing process.

Line 1: Enter the number of appeals that have yet to be concluded by the 

impartial hearing officer (IHO) and remain in any stage of 

processing as of October 1, the beginning of the Federal fiscal 

year. This figure should be the same as the number of appeals in 

process on September 30 from the report submitted for the prior 

fiscal year.

Line 2: Enter the number of requests for an impartial hearing filed during 

the fiscal year. This number does not include the number of 

requests that were pending at the start of the fiscal year.
Line 3: Add lines II.A1 and II.A2. This is the total number of appeals 

requiring action by the IHO during the fiscal year. It does not 

matter whether the IHO actually heard these cases during the fiscal 

year. This number is also the basis for data reported in column (b) 

of Part V of this form (Types of Complaints/Issues Involved in 

Disputes).

Line 4: Enter the total number of appeals, for which a request for a hearing 

was made (from line II.A3), in which the parties attempted 

mediation prior to requesting a hearing. The Act makes it clear that 

parties are not required to attempt mediation first; however, many 

will attempt to resolve the dispute at the lowest possible level (i.e., 

mediation) prior to requesting a formal hearing.

B. Disputes Resolved during the Impartial Hearing Process:

Line 1: Enter the number of disputes that were resolved before an IHO 

could render a decision. In most of these cases, the parties settled 

the dispute prior to actually getting to the hearing. However, 

sometimes, the parties reached a settlement just as the hearing 

was beginning or soon after it began. The key fact to keep in mind 

when recording data for this line entry is that the dispute was 

resolved without the IHO rendering a decision.

Line 2: Enter the number of decisions rendered by an IHO that largely or 

entirely supported the position of the individual on the major 

issue(s). A major issue is one deemed vital to the individual in 

his/her initiation or successful completion of VR services.

Line 3: Enter the number of decisions rendered by an IHO that largely or 

entirely supported the position of the State VR agency on the major 

issue(s).

Line 4: Add lines II.B2 and II.B3. This is the total number of decisions 

actually rendered by an IHO during the fiscal year.

Line 5: Add lines II.B1 and II.B4. This is the total number of disputes that 

were resolved somehow at some point during the hearing process 

(i.e., after a request for a hearing was made)

Line 6: Enter the number of disputes that were not resolved during the 

hearing process during the fiscal year. This line entry includes 

those situations in which the individual died, left the State, or 

withdrew his/her request for a hearing for whatever reason.

C. Impartial Hearing Requests Carried Over:
Line 1: Enter the number of requests for impartial hearings that were 

pending on September 30 and will go through the impartial hearing 

process during the next fiscal year. There was insufficient time to 

act on these requests during the fiscal year. Subtract lines II.B5 

and II.B6 from II.A3.

III. REVIEW OF IHO DECISIONS:

NOTE 1: Section 102(c)(5)(D) gives States the option of establishing 

procedures by which a party may seek an impartial review of an

IHO decision prior to filing a civil action. If the State has 

established such a procedure, either party may request a review of 

the IHO decision. 

The form asks agencies to check the appropriate box as to whether 

their State has established these review procedures. If your State 

has NOT established these procedures, then you should skip the 

entire section III. If your State HAS established these review 

procedures, you must provide the data requested in section III.

NOTE 2: For those State VR agencies that must complete Section III, it is 

important to enter information (in section III.B of this form) for only 

those times when the reviewing official actually reviewed the IHO 

decision in accordance with the "standards of review" established 

by the agency.

A. Requests for Review of IHO Decisions:

Line 1: Enter the total number of requests for review of IHO decisions that 

were pending on October 1 of this fiscal year. These are requests 

that were carried over from the prior fiscal year because these 

requests had not been acted upon before the end of the prior fiscal 

year.

Line 2: Enter the total number of new requests for review of IHO decisions 

that were made since October 1 of this fiscal year.

Line 3: Add lines III.A1 and III.A2. This is the total number of requests for 

review of IHO decisions available during this fiscal year. This 

information forms the basis of the data reported in column (c) of 

Part V of this form.

B. Reviews of IHO Decisions Completed:
Line 1: Enter the number of IHO decisions largely or entirely favoring the 

individual that were substantially, if not totally, sustained by the 

reviewing official. In other words, the position of the individual was 

upheld on the major issue(s) by the reviewing official in this final 

administrative decision.

Line 2: Enter the number of IHO decisions largely or entirely favoring the 

individual that were substantially, if not totally, reversed by the 

reviewing official. In other words, the reviewing official found clear 

and convincing evidence that the IHO's decision was erroneous as 

a matter of law and/or policy. As a result of this final administrative 

decision, the position of the State agency was ultimately upheld on 

the major issue(s).

Line 3: Enter the number of IHO decisions largely or entirely favoring the 

State agency that were substantially, if not totally, sustained by the 

reviewing official. In other words, the reviewing official upheld the 

position of the agency on the major issue(s) in this final 

administrative decision.

Line 4: Enter the number of IHO decisions largely or entirely favoring the 

State agency that were substantially, if not totally, reversed by the 

reviewing official. As a result of this final administrative decision, 

the reviewing official ultimately upheld the position of the individual 

on the major issue(s).

Line 5: Add lines III.B1 through III.B4. This is the total number of reviews 

of IHO decisions that were completed during the fiscal year.

Line 6: Enter the number of IHO decisions that were not reviewed. 

Subtract line III.B5 from II.B4.

C Review of IHO Decisions Carried Over:

Line 1: Subtract line III.B5 from line III.A3. This is the total number of 

requests for reviews that were unable to be completed during the 

fiscal year. These will be carried over to the next fiscal year.

IV. CIVIL ACTIONS:

A. Civil Actions Filed:
NOTE: Section 102(c)(5)(J) grants the right for either party to file a civil 

action.

Line 1: Enter the total number of civil actions that were pending on October 

1 of this fiscal year. These civil actions had been filed (regardless 

of by whom) in a previous year, but had not been resolved by the 

end of the prior fiscal year. These were carried over from last fiscal 

year.

Line 2: Enter the number of new civil actions that were filed since October 

1. It does not matter which party filed the civil action.

Line 3: Add lines IV.A1 and IV.A2. This is the total number of civil actions 

requiring resolution by the court system during this fiscal year. This 

information forms the basis for the data reported in column (d) of 

Part V of this form.

B. Civil Actions Resolved:

Line 1: Enter the number of civil actions in which the court resolved the 

dispute largely, if not entirely, in favor of the individual's position on 

the major issue(s) and, in so doing, sustained the final 

administrative decision, which also had favored the individual's 

position.

Line 2: Enter the number of civil actions in which the court resolved the 

dispute largely, if not entirely, in favor of the individual's position on 

the major issue(s) and, in so doing, reversed the final administrative 

decision, which had favored the agency's position.

Line 3: Enter the number of civil actions in which the court resolved the 

dispute largely, if not entirely, in favor of the agency's position on 

the major issue(s) and, in so doing, sustained the final 

administrative decision, which also had favored the agency's 

position.

Line 4: Enter the number of civil actions in which the court resolved the 

dispute largely, if not entirely, in favor of the agency's position on 

the major issue(s) and, in so doing, reversed the final administrative 

decision, which had favored the individual's position.

Line 5: Add lines IV.B1 through IV.B4. This is the total number of civil 

actions resolved during this fiscal year. 

Line 6: Enter the number of disputes that were not resolved during the civil 

action process during the fiscal year. This line entry includes those 
situations in which at least one of the parties filed a civil action but 

the action was dismissed for some reason. The individual may 

have died or left the State or one of the parties may have withdrawn 

the request for civil action for any reason.

C. Civil Actions Carried Over:

Line 1: Subtract lines IV.B5 and IV.B6 from IV.A3. This is the total number 

of civil actions that were still pending on September 30 of this fiscal 

year and will be carried over to the next fiscal year.

V. TYPES OF COMPLAINTS/ISSUES INVOLVED IN DISPUTES:

It is possible for two or more of the complaints/issues listed on lines 1 through 7 

to be involved in any given appeal. To complete Part V, State agencies are 

asked to record each complaint/issue that can be identified per dispute in the 

appropriate column. 

Column (a) -- Mediation: For each line entry in Part V, enter the number of 

requests for mediation, according to the type of complaint or issue involved. It 

does not matter whether the dispute was resolved during the mediation process. 

The total number of requests for mediation is found on Line I.A3. 

Column (b) -- Impartial Hearings: For each line entry in Part V, enter the number 

of requests for an impartial hearing, according to the type of complaint or issue 

involved. It does not matter whether the issue was resolved during the hearing 

process or whether the IHO actually rendered a decision. The total number of 

requests for an impartial hearing is found on Line II.A3. 

Column (c) -- Reviews of IHO Decisions: For each line entry in Part V, enter the 

number of requests for review of IHO decisions, according to the type of 

complaint or issue involved. It does not matter whether the reviewing official 

actually completed the review. The total number of requests for a review of IHO 

decisions is found on Line III.A3.

Column (d) -- Civil Actions: For each line entry in Part V, enter the number of 

civil actions filed, according to the type of complaint or issue involved. It does not 

matter whether the civil action was resolved. The total number of civil actions 

available to the court is found on Line IV.A3.

Line 1: Applicant Eligibility for VR: Enter the number of disputes in 

which the major issue involved the applicant's eligibility for VR 

services. An example of a situation that would fit this category is: 

the State VR agency closes an individual's service record before a 

determination of eligibility, but the applicant believes he/she should 

receive services.
Line 2: Nature/content/scope of IPE: Enter the number of disputes in 

which the individual's major issue involved the nature or content or 

scope of the Individualized Plan for Employment (IPE). This would 

include disagreements about what course of action should be taken 

and what services should be provided to affect an employment 

outcome. It would also include disagreements about the 

employment goal desired by the individual.

Line 3: Quality of Counseling Services: Enter the number of disputes in 

which the individual's major issue involved the delivery and quality 

of counseling services that the individual received. Examples 

would include complaints about counselor responsiveness, 

attentiveness and competence.

Line 4: Delivery/quality of other VR Services: Enter the number of 

disputes in which the individual's major issue involved the delivery 

or quality of one or more services other than counseling (i.e., 

diagnostic and evaluative testing, restoration, training, placement, 

etc.). This category also includes those disputes in which the 

individual is complaining about how useful or effective the services 

were, the location of sites where the services were to be provided, 

and the timing and frequency of services.

Line 5: Cost of Services: Enter the number of disputes in which the 

individual's major issue involved some aspect of the cost of 

services. This category could include complaints regarding issues 

of comparable services and benefits, fee for services, needs-based 

determinations, an agency's refusal to pay for certain services, etc.

Line 6: Termination of Services/Service Record Closure: Enter the 

number of disputes in which the individual's major issue involved 

the suitability and desirability of the service record closure. For 

example, this category could include situations in which the 

individual is dissatisfied with a particular job placement for which 

the State agency has claimed or will claim that an employment 

outcome has been achieved. This category should also be used to 

report those disputes in which the agency wants to terminate 

services and close the service record on the ground that the 

individual is not cooperating.

Line 7: All other Complaints/Issues: Enter the number of disputes in 

which the individual's major issue involves a complaint that is not 

covered by any of the above categories. 

VI. DESCRIPTION OF DUE PROCESS PROCEDURES:
Section 102(c)(1) of the Act requires that State agencies establish procedures for 

mediation and review through an impartial due process hearing in order for 

disputes regarding determinations made by agency personnel to be resolved. 

Section 102(c)(8)(B)(i) requires that the State develop standards of review to be 

used by the reviewing official when reviewing IHO decisions. 

State agencies should describe fully in this narrative portion of the report their 

mediation, due process procedures, and standards for review. This description 

should be sufficiently detailed so that responses can be summarized and 

reported to the Congress in the Annual Report. State agencies are required to 

describe the review process as an attachment to their State plan. Any agency 

that has revised its procedures for review since the last State Plan submission 

should attach a copy of those revisions to Form RSA-722. In no event, however, 

should the data in Parts I through V of Form RSA-722 be withheld because of 

any timing, legal or other problem in providing a revised description of the review 

process.

VII. FINAL IHO and REVIEW DECISIONS

Section 102(c)(8)(A) requires RSA to collect copies of the final decisions issued 

by IHOs and reviewing officials conducting the reviews of IHO decisions. Please 

send copies of all of these decisions along with the completed RSA-722.

Person to Contact about this Form: Print the name of a person who can 

answer questions about the contents of Form RSA-722 should they arise. 

Include this person's phone number and e-mail address (if applicable).

Authorized Signature: The appropriate State agency official should sign the 

form to certify that it is complete and correct. The person should also date the 

form.

TRANSMITTAL OF THE REPORT:

Within 30 days after the end of the fiscal year covered by the report, send a copy 

of Form RSA-722 to RSA.

The RSA-722 reports may be sent by mail or electronically using one of the options 

listed below.

Electronic Mail addresses 

Specific instructions and the URL for key entry/on-line and editing of data directly 

into the RSA management information system can be found at: http://rsa.ed.gov.
The RSA Central Office E-Mail address for the RSA-722 is: 

Edward.West@ed.gov

US Mail 

This report may be mailed via U.S. mail to:

U.S. Department of Education

Rehabilitation Services Administration

Attn: Ed West

400 Maryland Avenue, S.W.

PCP 5098

Washington, DC 20202-2800

PAPERWORK REDUCTION ACT BURDEN STATEMENT:

According to the Paperwork Reduction Act of 1995, no persons are required to 

respond to a collection of information unless such collection displays a valid OMB 

control number. Public reporting burden for this collection of information is 

estimated to average 2 hours per response, including time for reviewing 

instructions, searching existing data sources, gathering and maintaining the data 

needed, and completing and reviewing the collection of information. The 

obligation to respond to this collection is required to obtain or retain a benefit 

(Rehabilitation Act of 1973, as amended by the Workforce Innovation and 

Opportunity Act). Send comments regarding the burden estimate or any other 

aspect of this collection of information, including suggestions for reducing this 

burden, to the U.S. Department of Education, 400 Maryland Ave., SW, 

Washington, DC 20210-4537 or email ICDocketMgr@ed.gov and reference the 

OMB Control Number 1820-0563. Note: Please do not return the completed 

Annual Report on Appeals Process (RSA-722) form to this address.