How to File for Disability in Maine

The Social Security Administration (SSA) provides disability benefits to workers who can no longer be gainfully employed because of a qualifying disability. In Maine, you can file online or at one of the state’s nine field offices. Don’t be surprised if you are initially rejected. Fortunately, you can bring several appeals, and most people who receive benefits get them after a hearing.

Part 1
Part 1 of 3:

Gathering Information

  1. Not every disabled person qualifies for disability benefits. The SSA's impairment listing manual, which is also called their blue book, lists a number of impairments, both physical and mental, that will automatically qualify an individual for SSDI or SSI. Check to make sure you meet the following requirements: [1]
    • The disability must prevent you from doing any kind of gainful, substantial work.
    • The disability must be expected to last at least a year or result in your death.
  2. SSA will need your medical history to determine whether you qualify for disability benefits. You can request the medical records from every doctor or hospital that has treated your current condition. You might have to pay for these records. [2]
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  3. If you can’t afford to get copies of your medical records, SSA will request them for you. Provide the following information so SSA can request the appropriate records: [3]
    • All diagnosed conditions.
    • A description of your symptoms and complaints.
    • The names of all treating physicians.
    • The names and addresses of all treatment providers, whether doctors, clinics, or hospitals.
    • Any information about medical exams you underwent as part of a workers’ compensation claim.
    • A list of any medications you have been prescribed and/or are taking.
  4. There are really two disability programs. One is Social Security Disability Insurance (SSDI). However, a second program is called Supplemental Security Income (SSI). Only low-income people qualify for SSI. You can receive both if you qualify, but you’ll need to provide income information.
    • Gather recent paystubs or proof of self-employment income. You will also need to provide bank statements, insurance policies, and proof of investment income.
    • Demonstrate your financial need. A claim representative can help you determine if you qualify, because the math is a little complicated. Generally, a single person can’t earn more than $735 a month, but not all income counts. A couple can earn up to $1,103 per month. You must also have fewer than $2,000 in assets. [4]
  5. You might still be able to do work based on your work experience and education. If so, you won’t qualify for disability. [5] Write down a list of all employers you have worked for during the past 15 years. Include the following information: [6]
    • Your job titles.
    • The dates you worked each job.
    • A description of the work you performed.
    • The date your medical condition began to impact your ability to do your job.
    • Financial documents that demonstrate low income if you're applying for SSI:
      • Pay stubs or proof of income.
      • Bank statements.
      • Insurance policies.
      • Paperwork about any investments you have.
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Part 2
Part 2 of 3:

Applying for Benefits

  1. You can apply for SSDI online at https://www.ssa.gov/disabilityssi/ . Click on “Apply for Disability” and provide all requested information. After you complete the application, a representative may contact you to request additional information.
    • You can also apply for SSI benefits online if you are between 18 and 65, have never been married, and haven’t applied for or received SSI in the past. All other people should apply at a field office.
  2. Call your nearest field office and schedule an interview. At the interview, you will discuss your disability and what benefits you are eligible for. You can find a list of field offices at http://www.maine.gov/dhhs/ofi/services/dds/offices.htm . Make sure you bring the following documents to your interview: [7]
    • Medical records.
    • Workers' compensation paperwork.
    • Names and dates of birth for your spouse and children.
    • Dates of marriages and divorces.
    • Banking information.
    • Contact information for someone who can find you if the SSA can't.
    • Medical release form SSA-827 if it's included in your packet.
    • Completed "Medical and Job Worksheet-Adult."
  3. You also have the option of applying by phone. You can call 1-800-772-1213. If you are hard of hearing, call 1-800-325-0778. [8] Before calling, have the following items ready and within reach: [9]
    • Your medical records.
    • Workers' compensation paperwork.
    • Names and dates of birth for your spouse and children.
    • Dates of marriages and divorces.
    • Banking information.
    • Contact information for someone who can find you if the SSA can't.
    • Medical release form SSA-827 if it's included in your packet.
    • Completed "Medical and Job Worksheet-Adult."
  4. Sometimes, you will need to have a medical examination or tests after you apply. The state office might need more medical information before they can make a determination on your application. The state office should pay for the exam and related travel expenses. [10]
    • If you don’t want the exam, you have the right of appeal. However, the agency will have to make a decision without the information they want, so expect to be denied. Consult with a lawyer as soon as possible.
  5. Your claim will be sent to the state’s processing agency, called the Disability Determination Services (DDS). An examiner will review your information and make a determination. In particular, the examiner will check whether your disability appears on their list of impairments. [11]
    • Only about 30% of claims are approved at the initial stage, so don’t be surprised if you are denied. [12]
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Part 3
Part 3 of 3:

Appealing a Denial

  1. This is your first level of appeal. You only have 60 days to file, so don’t delay. You should call SSA and ask that appeal forms be sent to you. Complete all forms and keep a copy for your records. Wait two weeks and then call the SSA office to check on the status of your appeal. You will probably receive a decision within a month or two. [13]
    • Once you submit the appeal, the state’s disability office will review it. Only a handful of appeals are approved at the reconsideration level.
  2. After reconsideration, your next appeal is a hearing before an administrative law judge. You only have 60 days to request a hearing, so act quickly. Around half of claimants are successful at the hearing stage, so you have a 50% chance of securing your benefits. [14] Read your letter from SSA to find out how to request a hearing.
    • Unfortunately, you can expect to wait at least a year before you have a hearing. [15] However, if you win, you will get retroactive benefits back to the date when your disability began.
  3. An experienced disability attorney will be a great help as you prepare for your hearing. You can find one by calling the Maine Bar Association at 1-800-860-1460 and asking for a referral. [16] Your lawyer will help you build the strongest case possible for the hearing.
    • Lawyers will represent you on “contingency.” This means you don’t pay them unless they win. If they do win, they take a percentage of your unpaid disability benefits (called “backpay”). Currently, federal law limits your lawyer to 25% of the backpay amount up to $6,000. [17] However, in rare circumstances, such as when a lawyer takes your case up the appeals courts, they may be able to collect more.
    • However, you might have to pay for costs such as copying, requesting records, and postage. This amount shouldn’t be more than a couple hundred dollars.
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      References

      1. ↑ http://www.maine.gov/dhhs/ofi/services/dds/faqs.htm
      2. ↑ http://www.disabilitysecrets.com/disability-resources-maine.html
      3. ↑ http://www.ssdrc.com/state-maine-me-getting-started.html
      4. ↑ http://www.disabilitysecrets.com/resources/social-security-disability/supplemental-security-income-ssi/income-limits-eligibility.htm
      5. ↑ http://www.maine.gov/dhhs/ofi/services/dds/faqs.htm
      6. ↑ http://www.ssdrc.com/state-maine-me-getting-started.html
      7. ↑ https://www.ssa.gov/disability/Documents/Checklist%20-%20Adult.pdf
      8. ↑ https://www.ssa.gov/planners/disability/dapply.html
      9. ↑ https://www.ssa.gov/disability/Documents/Checklist%20-%20Adult.pdf
      1. ↑ http://www.maine.gov/dhhs/ofi/services/dds/faqs.htm
      2. ↑ http://www.ssdrc.com/state-maine-me-getting-started.html
      3. ↑ http://www.disabilitysecrets.com/disability-resources-maine.html
      4. ↑ http://www.ssdrc.com/state-maine-me-getting-started.html
      5. ↑ http://www.ssdrc.com/state-maine-me-getting-started.html
      6. ↑ http://www.nolo.com/legal-encyclopedia/maine-disability-benefits-social-security-disability-insurance-ssi.html
      7. ↑ http://www.mainebar.org/page/AttorneyRequest
      8. ↑ http://www.disabilitysecrets.com/question16.html

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