Form for Initiating an Appeal

(1) An appeal is initiated by a request for a fair hearing, at which time a request for an optional informal administrative review and/or mediation may also be made. (2) An appeal shall be initiated by a written request, either on the form provided by the local office or the program unit from which the individual seeks services. It shall be addressed to the attention of the Client Appeals Coordinator at the Massachusetts RehabilitationCommission, Administrative Office at 27 Wormwood Street, Boston, Massachusetts 02210-1616 or any subsequent address for the Commission’s Administrative Office. (3) An individual’s request for an appeal shall state that the individual is challenging a Commission determination, action or inaction and summarize the nature of the grievance, be signed by the individual or representative and contain the individual’s address and a phone number if possible, where the individual may be contacted.