Alan Block is a staff attorney at Neighborhood Legal Services, Inc. in Buffalo, New York. He specializes in Social Security Law.

In past issues of Mental Health World, I began to explain how to begin a claim with the Social Security Administration (SSA) for either Social Security Disability Insurance (SSD) or Supplemental Security Income (SSI) benefits. Suppose you have made your application, you have waited patiently (or impatiently!) for many months, and the decision finally arrives in the mail – "We have contacted all the doctors and other sources you have told us about, we have reviewed the reports from both your sources and our sources very carefully, and we have concluded that your condition is not serious enough to be disabling under our regulations." Is that all there is?

Some people, with very severe medical problems, get easily flustered or frustrated, and they read no further. It’s certainly understandable, but possibly a serious mistake! For those who overcome their frustration, and who feel certain that the decision denying their case is wrong, there are still more steps to take to try to get your case allowed.

Read your decision letter carefully – it will have a section called "YOUR RIGHT TO APPEAL." In the past, the first time your case was denied, your appeal was called a reconsideration. If you again disagreed with the reconsideration, your next appeal was a hearing before an Administrative Law Judge of the Social Security Administration. If you still disagreed with the hearing decision, your appeal was a request for Appeals Council review by the Appeals Council in Falls Church, Virginia, and the next appeal was to Federal Court, asking for judicial review. Beginning April 1, 2000, Social Security is beginning a "test" throughout New York State to see if it can issue more accurate and speedier decisions by eliminating the reconsideration; in cases getting the first decision after that date, your first appeal will go directly to the Administrative Law Judge hearing.

You begin an appeal just like you begin an application: by telling the Social Security Administration, in writing, that you disagree with the decision in your case. Social Security will issue a receipt to you to prove you have begun an appeal. Keep that receipt safe, because if Social Security later can find no record of your appeal, your receipt will help you continue your case. Without that receipt, you may be out of luck, no matter how "disabled" the records show that you are.

If you have received an unfavorable decision at any level of review, and you are even thinking about an appeal, there are three things that are the most important to remember: 60 days! 60 days! 60 days! You have 60 days from the date you receive your decision, and with very few exceptions, only 60 days to begin any of these appeals. You make a very serious mistake if you believe you can begin your appeal later and be easily excused. One day late, for Social Security purposes, may be no different from 6 months late or 2 years late and you may lose important legal rights! The best advice is to appeal well within your particular 60 day period and don’t take any chance at all of possibly being too late!

Do you need a lawyer, paralegal, or other legal representative to begin an appeal? You do not technically need a lawyer either to begin your appeal, or to continue it. Certainly, some applicants have successfully appealed their unfavorable decisions on their own. However, many Social Security Disability (SSD) and Supplemental Security Income (SSI) applicants whose claims have been denied do try to get legal help. Experienced legal representation is a good idea for several reasons.

First, an experienced legal representative is familiar with the rules Social Security uses. Second, an experienced legal representative can review the records Social Security has collected and he or she can identify the strengths and weaknesses in your case. It is only in very rare cases that the existing records in your file will definitely show that your case should be either clearly allowed or clearly denied; most cases are unclear. Third, an experienced legal representative can ask your own doctors, or other professionals who provide services to you, important questions Social Security may have never asked. Fourth, an experienced legal representative can suggest other things you may be able to do to overcome the weaknesses in your case. Fifth, an experienced legal representative who has undertaken all of these efforts can offer you an independent opinion to help you make the best decision about whether to continue with your case.

When should you begin to think about getting legal representation? There is no single answer. Some lawyers feel it is important for you to get legal help when you first begin your disability claim. In our office, we have decided to take cases only after you have been denied and you are asking for a hearing. Keep in mind that Social Security has already taken several months to collect the records and information it needed to deny your case; your legal representative is also going to need time to get what he or she needs to support an allowance of your case. Remember, your legal representative’s hands are often tied if you ask for help only three or four weeks before your hearing date!

You have the right to have anyone who agrees to help with your case represent you. This right does not mean that Social Security, or anyone else, is required to provide you with low-cost or free legal representation. Many legal services offices do, in fact, provide free legal help with Social Security and SSI cases, but these offices often have to make difficult choices about who gets, and who does not get, free legal help. Other agencies may also have attorneys, paralegals, or lay advocates who can provide this service. A person who cannot get, or does not qualify for, free legal representation may be able to make arrangements with a private attorney who will charge a fee for representation, which the Social Security Administration must approve.