Will I Qualify For Disability Benefits in Massachusetts?

Qualifying for Social Security Disability or SSI disability in Massachusetts begins with an application for disability benefits. You can file for disability online, or by phone, or in person with your local Social Security office. It really does not matter which method you choose to file your disability application; the decisional process is the same.

If you decided to file in person, you can file an application for disability at any of the 32 Social Security district offices located in Massachusetts, If you chose to file your disability application online, you do not have the option of filing for SSI or Supplemental Security Income disability at this time. Therefore, if you think you can meet the income and resource limits of this need-based disability program you should just file an application with your district office.

Note: If you file your disability application online, be sure to complete your disability medical report form (SSA3368) and electronically sign your medical release form (SSA827), and make sure to submit the forms.

If you choose to file your disability claim with your local Social Security office, a claims representative will complete all the necessary forms and have you sign your medical release. They will also evaluate your income and resources to see if you might qualify for SSI disability.

After the disability application has been filed

At this point, your disability claim will be sent to a Massachusetts Disability Determination Services office for a medical disability determination. Massachusetts has two Disability Determination Services offices that are located in Boston MA and Worscester MA.

When it arrives in DDS, it will be assigned to a disability examiner for a disability determination. The examiner reviews the information in your disability case file and if they feel there will be enough medical information to make their disability determination, they will request medical records from the medical sources you provided on you SSA 3368 medical report form.

Social Security law requires that disability examiner use current medical treatment to make their actual disability determination. This means they must have medical treatment notes that are no older than ninety days old to make a disability determination. While they can consider older medical treatment notes in making their determination for the purpose of establishing your onset date (which impacts how much back pay you may receive as well as eligibility for medicare), they cannot make a decision without current medical evidence.

If you have a lot of medical evidence that is more than three months old but nothing current, they may require you to go to a consultative examination (a medical exam or mental examination performed by a paid medical professional) to evaluate the current status of your disabling condition. Once the examiner has all of the necessary information, they will make their medical disability determination.

Rates of approval at the disability application and reconsideration levels

In Massachusetts the approval rate for initial disability claims is about 40% and this is fairly high considering the average national approval rate for initial disability claims is about 32%. But, while the initial disability claim approval rate if fairly high, it still means that 60% of those who filed an initial disability claim were denied disability benefits.

If your disability claim is denied, you can appeal your denial with a reconsideration appeal. Reconsideration appeals rarely result in an overturning of the initial disability claim decision unless the disability examiner made an error or you submit new medical evidence that would support a finding of disability.

The Massachusetts reconsideration appeal approval rate is extremely high at 22.4% when compared to the national average reconsideration appeal approval rate of 11.3%. However, even with a reconsideration appeal approval rate of 22.4%, the majority of those who file a reconsideration appeal are still denied.

The Disability hearing appeal in Massachusetts

If your reconsideration appeal is denied, you will have to request a disability hearing before an administrative law judge if you wish to continue your case. While it takes a long time to reach your disability hearing, you have your best chance to qualify for disability benefits with Social Security at this level.

Generally, administrative law judges approve more disability claims than they deny. They may have vocational or medical experts offer testimony during the hearing but, in the end, they alone make the disability decision.

The average disability hearing approval rate in Massachusetts is 61.1 % which is slightly higher than the national disability hearing rate of 58.3%.

Regardless of state, unfortunately, approximately 40 percent of claimants are denied at a disability hearing, making it vital that the hearing is properly prepared for, and that the case that is presented to an administrative law judge is solidly grounded on Social Security rules.

About the Author: Tim Moore is a former Social Security Disability Examiner in North Carolina, has been interviewed by the NY Times and the LA Times on the disability system, and is an Accredited Disability Representative (ADR) in North Carolina. For assistance on a disability application or Appeal in NC, click here.

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