If medical problems have impacted your life and made it impossible for you to work, you might be eligible to receive disability benefits. The Social Security Administration (SSA) oversees two disability programs that offer monthly benefits. There are very strict criteria to be approved for benefits, including specific medical criteria that are detailed in the medical guide, which is called the Blue Book. Your condition must last for at least a year or lead to your death.
Most disability claims are denied on the initial review. If a claim is denied, you can file an appeal and request reconsideration. If a reconsideration is also denied, you can ask for a hearing before an administrative law judge (ALJ).
While claims can be denied for many different reasons, there are some common reasons for claim denials. Most claims get denied because there is a lack of hard medical evidence that shows the severity of the condition and the restrictions or limitations that result from it. Disability Determination Services (DDS) need to see and understand the full picture of your condition.
Other causes for denials are that the individual is still working and his or her income surpasses the limit for substantial gainful activity (SGA) or the individual fails to continue with follow-up care so DDS cannot determine if the condition has continued to be troublesome or worsened.
Massachusetts has approvals that are higher than the national average. The odds of being approved on the initial review are 38.6% while about 21.2% of claims are approved during the reconsideration review. On the hearing level in Massachusetts, 50.4% of claims are approved.
Visiting the Office of Disability Adjudication and Review in Massachusetts
If your application is denied on the initial review and then denied again during reconsideration, you can request a hearing before an ALJ. These hearings take place at the Office of Disability Adjudication and Review (ODAR). At the hearing, the ALJ will question you about your condition, and the limitations and restrictions you have because of it.
You will be questioned by a vocational expert to determine if you can perform any kind of work. The questions will be related to your specific condition, and your attorney can help you prepare for the questioning. In addition to your medical conditions, your age, work history, work skills, and educational background will all be considered. In Massachusetts, there are three ODARs where hearings are held.
The Boston ODAR has 13 judges and an average 12-month wait for a hearing. There is an average 424-day processing time for claims in Boston and 45% of cases are approved on the hearing level. In Lawrence, there are eight judges and a 548-day average processing time. Lawrence has an average wait of 18 months for a hearing and there is an average approval rate of 47%. Springfield’s ODAR has a 14-month hearing wait and is staffed with six judges. Processing a claim takes about 480 days and there is a 41% approval rate for claims on the hearing level at that ODAR.
Getting Help from an Attorney
Disability claims are complex, and an attorney can improve your odds of being approved for benefits. Your attorney can help you through the entire process from filing the claim for benefits to visiting DDS or the local SSA office to make sure they have all your medical records so you can get a fair review and the severity of your condition can be understood. Your lawyer will handle all communications with DDS and SSA. Your attorney can handle any appeals that need to be filed in regards to your claim being denied.
There are several SSA offices throughout the State of Massachusetts:
Social Security Administration
10 Causeway Street, Room 148
Boston, MA 02222
Monday, Tuesday, Thursday, Friday, 9 a.m. – 4 p.m.; Wednesday 9 a.m. – 12 p.m.
Social Security Administration
30 Christy’s Drive
Brockton, MA 02301
Monday, Tuesday, Thursday, Friday, 9 a.m. – 4 p.m.; Wednesday 9 a.m. – 12 p.m.
Social Security Administration
106 Pleasant Street
Attleboro, MA 02703
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 or 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!
Additional Resources
Applying for Disability in Massachusetts
Applying for Disability in Boston
