Approximately 27% of Maine residents have some form of disability, but only 7% of them receive Social Security Disability benefits. The state spends nearly $4.5 billion annually on disability services which is approximately 37% of its healthcare spending.
Any form of disability can drastically increase the need for medical services and financial assistance.
Therefore, if you are disabled and live in Maine, your first step should be to apply for Social Security Disability Income (SSDI) before exploring other state-specific services that may provide additional aid.
Unfortunately, the Social Security Administration (SSA) denies most first-time claims for benefits. In fact, your odds of being approved for SSD are only about 30%.
The good news is that you can appeal the decision if your claim is denied, and many people are ultimately successful in getting the benefits they deserve.
This post covers everything you need to know about Social Security local to Maine.
How Do I Qualify for Social Security Disability Benefits in Maine?
SSDI is a federal government-sponsored program, and eligibility requirements remain the same in all the states, except for a few exceptions.
You can qualify for SSDI in two ways: either through your own work history or through the work history of a family member.
To qualify based on your work history, you must have worked and paid Social Security taxes for a certain number of years. The number of years you need to have worked depends on your age.
For example, if you are younger than 24 years old, you need to have worked and paid Social Security taxes for at least one and a half years. You must have worked for at least three years if you are between 24 and 31 years old.
The number of years required increases with age until it reaches ten years for people who are 60 years old or older.
You can also qualify for SSD based on the work history of a family member, even if you have never worked yourself.
For example, you may be able to get benefits if your spouse is disabled or if your parent(s) worked and paid Social Security taxes long enough to qualify for benefits.
You must meet certain relationship requirements to qualify for SSD based on a family member’s work history.
Medical Qualification
In addition to meeting work and relationship requirements, you must also meet medical qualifications to receive SSD benefits.
The SSA uses a five-step process to determine whether you are medically qualified for SSD. The first step is to determine if you are currently working. If you are working and your earnings average more than $1,220 per month (or $2,040 if you are blind), you will not qualify for benefits.
The second step is to determine whether your disability is “severe.” A disability is considered severe if it limits your ability to do basic work activities.
The third step is to determine whether your disability meets or equals a listing in the SSA’s “Blue Book” of disabling conditions. If your disability does meet or equal a listing, you will be automatically approved for benefits.
If your disability does not meet or equal a listing, the fourth step is to determine whether you can still do the work you did before your disability.
If you cannot, the fifth and final step is to determine whether or not there is any other type of work you can do, given your age, education, and work experience. If the SSA determines that there is no other work you can do, you will be approved for benefits.
If you are unsure whether you meet all of the requirements for SSD, you can contact your local Maine Social Security office to speak with someone who can help you determine if you qualify.
How Do I Apply for SSD in Maine?
There are several ways to apply for SSD in Maine. You can start your application online at the SSA’s website. You can also call the SSA’s toll-free number at 1-800-772-1213 to make an appointment to apply in person at your local Maine Social Security office.
When you apply for SSD, you will be asked to provide information about yourself, your work history, and your medical condition. You will also need to provide copies of any medical records you have related to your disability.
You can speed up the application process by ensuring you have all the required information and documents before starting your application. You can find a list of the required information and documents on the SSA’s website.
What Happens After I Apply for SSD in Maine?
After you apply for SSD, your application will be sent to the Maine Disability Determination Services office. This office is responsible for making disability determinations for the state of Maine.
A claims examiner will review your application and any medical evidence you have submitted. The claims examiner may also ask you to provide additional information or documents.
The claims examiner may also arrange for you to have a medical examination. The exam will be conducted by a doctor who is independent of the SSA. The doctor will provide the SSA with a report detailing your medical condition and how it affects your ability to work.
After reviewing all the information, the claims examiner will decide whether or not you are disabled. If you are approved for benefits, you will receive a notice in the mail detailing your benefit amount and when you can expect to start receiving payments.
If you are denied benefits, you will also receive a notice in the mail. The notice will explain why you were denied and what you can do if you disagree with the decision.
If you disagree with the decision, you can file an appeal. The appeals process can be complex, so it is essential to speak with an experienced Maine SSD attorney before moving forward.
How Can I Appeal a Denial in Maine?
Unfortunately, almost 70% of the initial applications are denied in Maine. Therefore, it is essential to be aware of the appeals process just in case your initial application is denied.
Typically, you must start the appeals process within 60 days of receiving your denial notice. The first level of appeal is called reconsideration.
During the reconsideration, your application will be reviewed by someone who did not work on your original claim. They will look at all evidence in your file and may ask for additional information or medical tests.
Approximately 85% of claims are denied at the reconsideration level. You can appeal to an administrative law judge if your claim is denied again.
During this hearing, you will have the opportunity to present your case in person and question witnesses. The judge will then decide based on the evidence presented.
If you are not satisfied with the judge’s decision, you can appeal to the SSA’s Appeals Council. The Appeals Council will review your case to determine if the judge made any errors. If they find that there were no errors, they will deny your appeal.
If the Appeals Council denies your appeal, you can file a civil suit in a federal district court.
Get Help Applying for SSD in Maine
Applying for SSD can be a complex and confusing process. An experienced Maine SSD attorney can help you navigate the process and ensure you have the best chance of success.
Your attorney can help you gather the required information and documents, file your initial application, and appeal a denial if necessary.
Don’t try to go through the SSD process alone – contact us today for help.
