It uses something it calls a 5-Step Sequential Evaluation. Step 1 determines if one is performing work activity considered at or above Substantial Gainful Activity (SGA). Step 2 determines if one has a medically determinable impairment that is considered severe by the SSA. Step 3 determines if one’s medical condition meets or equals a Social Security Listing. If not, Step 4 determines if one is unable to perform past relevant work activity. If not, Step 5 determines if the individual can perform any work in the national economy. A person is usually approved at Step 5, but sometimes at Step 3. See this link.

Work activity is allowed. After nine trial work months ("trial work period" or TWP) that do no have to be consecutive, your gross earnings must stay below SGA levels. In 2023, the monthly amount considered SGA is $1470 for non-blind individuals. Sick, vacation, and disability pay do not count toward SGA. If one is seeking SSI disability benefits rather than SSD benefits, any work earnings will reduce, and may eliminate, benefits. The TWP rules do not apply. See this link.

Both are allowed and may actually be encouraged by treating medical providers. However, a Social Security judge will consider the amount of time and the duties involved in making a final determination as to whether or not that volunteer work or schooling constitutes the same as work activity.

Absolutely! In fact, if you are out of work and receiving workers’ comp benefits for many years, you may harm your Social Security disability claim by waiting until your WC claim is settled before filing a disability claim. Depending on a number of factors, your disability benefits may be reduced by a little or a lot. However, I can help you learn what your potential benefit will be when we meet.

In Maine, it can take as little as three months or as long as two years. Once an application is filed, the claim is forwarded to a State agency for medical review; that takes an average of 3 months. If denied, a Request for Reconsideration needs to be filed within 65 days of the date on the denial. The claim returns to the State agency for another medical review by a different person; that takes an average of 4-5 months. If denied again, a Request for Hearing before an administrative law judge needs to be filed, again within 65 days of the date of the denial. The current backlog at the judge’s office is about a year to get a hearing date. It is my experience that most claims are not approved until after a claimant has a hearing.

No! In fact, I strongly recommend that you object to having a video teleconference hearing. I believe it is much more advantageous to meet the judge face to face so that he/she can see you personally, taking in the “whole you.” Symptoms like a tremor, restless legs, or emotional issues may not come across as clearly on a TV screen.

Absolutely. We will meet about a week before the hearing to go over the medical evidence in your claim, review any possible negative issues that may be present, and to prepare your testimony. I hope to make you feel as prepared as possible for your meeting with the judge.

First, you need to be fully invested in your claim and do what needs to be done to prove your case. That may mean seeing appropriate specialists to treat physical and emotional conditions. You need to follow your doctors’ orders, including taking all prescribed medications, following up on referrals, and keeping all appointments. A judge reviews the entire medical record and wants to be sure that you are doing everything you can to improve your health. For example, if you have a breathing disorder and you smoke cigarettes, you are not helping your claim. If you have pancreatitis or a liver disorder and continue to drink alcohol, you are not helping your claim. Another way to help your claim is to have one or more of your treating medical providers write a letter in support of your claim. That letter needs to include your diagnoses, the signs and symptoms you have due to your conditions, treatment and medication you have tried, and a detailed list of restrictions imposed on you based on the severity of your conditions. Just saying you are unable to work is not helpful for your claim.

SSDI benefits can be paid back a maximum of one year from the date of an application, depending on the established onset date of disability. There is a 5-month waiting period from the actual onset date before a person is payable (there is no waiting period for Disabled Adult Child benefits). For example, if you are found disabled as of March 30, 2022, your benefits would be payable as of September 2022. If you are found disabled as of March 30, 2020 but you did not apply until March 30, 2022, your benefits would be payable as of March 2021. If you have prior applications, they may be able to be reopened. We can discuss your personal circumstances when we meet to go over your claim. SSI benefits are payable the month after the application date. For example, if you applied on March 30, 2022, your benefits would be payable beginning April 2022. Again, there are rules about reopening prior applications that I can discuss with you.

SSI benefits are normally processed first, and that is done by your local Social Security office. The time frame is usually around four weeks for payment, but it can take less or more time depending on how long it takes to get your financial information, i.e., household wages, TANF, unemployment, etc. The more you can assist the claims representative in obtaining your financial data, the faster you will get paid.
SSDI benefits are processed by a Payment Center, usually in Baltimore or New York. If an individual is also entitled to SSI benefits, those are processed before SSDI benefits so it may take 6-8 weeks to get SSDI past-due benefits. If workers’ compensation offset is involved, it can take longer.

I am available to meet with you Monday through Friday, 9 a.m. to 4 p.m. I am sure we can come up with a time that works for both of us!