Are medical problems interfering with your ability to do daily activities? Have you considered applying for disability benefits because you are unable to work? The Social Security Administration (SSA) oversees disability benefits. To qualify for disability benefits, your condition must last at least a year or longer and specific medical criteria must be met. A medical guide, which is called the Blue Book, is used to determine if an individual is disabled and eligible for benefits.
Most claims are denied, but an appeal can be filed. When you file an appeal, you are asking Disability Determination Services (DDS) to reconsider your claim. If the reconsideration also receives a denial, you can appeal again and request a hearing before an administrative law judge (ALJ) at the Office of Disability Adjudication and Review (ODAR).
While claims can be denied for many reasons, there are some reasons that are much more common than others. Most claims get denied because of the lack of hard medical evidence. Hard medical evidence will show the severity of your condition, confirm your diagnosis, and clearly reveal any limitations or restrictions you suffer because of your health problems. You need to make sure DDS has access to all your records so you can get fair consideration.
Another cause for claim denial is that the individual is still working enough to exceed the substantial gainful activity (SGA) limits. If you don’t get follow-up care and ongoing treatment, your claim can be denied for that as well. In Maine, 29.8% of disability claims are approved during initial consideration while 11.6% are approved during reconsideration. The approval rate on the hearing level is 73.2% in Maine, which is much higher than the national average.
Visiting the Office of Adjudication and Review in Maine
If your claim is denied and you ask for reconsideration and then the reconsideration is denied, you will ask for a hearing before an ALJ at the ODAR. In Maine, there is only one ODAR. Located in Portland, the average wait time for a hearing is 13 months. The office has seven judges and the average processing time for a claim is 467 days. Maine has one of the highest approval rates on the hearing level in the country. The national average is 18 months for a hearing date and 582 days for claim processing. The hearing process is very detailed and you can benefit significantly by having legal representation.
At the hearing, you will be questioned by the ALJ and a vocational expert. These questions will relate to your specific medical problems. Your attorney can help you prepare for questioning. Your age, medical conditions, work history, and educational background are all taken into consideration during the questioning so the judge can determine what kind of work, if any, you can perform. You have the greatest chance for having your claim approved on the hearing level.
Getting Help from a Disability Attorney
Disability claims are complicated and the odds of being denied benefits are very high. A Social Security attorney can make a significant difference in the outcome of your case. Your attorney can help you by going with you to the local SSA office and making sure all your medical records are in your file, in order and ready for review. Your lawyer can also handle the communications with the SSA representatives and DDS. Your attorney will also file any needed appeals and help you get your claim on track. There are eight SSA filed offices located in the state:
Social Security Administration
600 Turner Street, Suite 5
Auburn, ME 04210
Monday, Tuesday, Thursday, Friday, 9 a.m. – 4 p.m.; Wednesday 9 a.m. – 12 p.m.
Social Security Administration
550 Forest Avenue, Suite 150
Portland, ME 04101
Monday, Tuesday, Thursday, Friday, 9 a.m. – 4 p.m.; Wednesday 9 a.m. – 12 p.m.
Social Security Administration
202 Harlow Street, Room 208
Bangor, ME 04401
Monday, Tuesday, Thursday, Friday, 9 a.m. – 4 p.m.; Wednesday 9 a.m. – 12 p.m.
Your claim can get started online at the Social Security Administration website, on the phone by calling 1-800-772-1213, or by visiting your local SSA office. If you are ready to get started, complete the Free Case Evaluation Form on this page and get a free case review from a disability attorney today!
