If you are living in Massachusetts and have a disability that prevents you from working, you may be eligible for disability benefits from the Social Security Administration (SSA).
These benefits can help you pay for your basic needs and medical expenses. However, applying for disability benefits can be a complex and lengthy process.
In this article, we will explain everything you need to know about disability benefits in Massachusetts, including the types of:
- eligibility criteria
- application process
- disability determination services
Types of Disability Benefits in Massachusetts
The SSA offers two types of disability benefits:
Both programs pay monthly benefits to people with disabilities, but they have different eligibility requirements and benefit amounts.
SSDI is a program that provides benefits to workers who have paid Social Security taxes and have enough work credits. Work credits are based on your earnings and the number of years you have worked. Generally, you need 40 work credits, 20 of which were earned in the last 10 years, to qualify for SSDI.
SSI is a program that provides benefits to people who have low incomes and limited resources. You do not need to have any work history or pay Social Security taxes to qualify for SSI. SSI benefits are based on the federal benefit rate (FBR), which is the minimum amount of income that the SSA considers necessary for basic living expenses.
Eligibility Criteria in Massachusetts
To qualify for either SSDI or SSI, you must meet the SSA’s definition of disability. The SSA defines disability as a physical or mental impairment that prevents you from engaging in substantial gainful activity (SGA) and is expected to last at least 12 months or result in death.
SGA is a level of work activity and earnings that the SSA considers significant and self-supporting. In 2023, the SGA amount is $1,370 per month for non-blind individuals and $2,310 per month for blind individuals. If you are working and earning more than the SGA amount, you will not be considered disabled by the SSA.
In addition to the disability criteria, you must also meet the specific requirements for SSDI or SSI.
For SSDI, you must have enough work credits and be insured by the Social Security system.
For SSI, you must have low income and limited resources.
The SSA considers your income from:
- unemployment benefits and other sources
The SSA also considers your resources, such as cash, bank accounts, stocks, bonds, real estate, vehicles, and personal property.
Application Process in Massachusetts
If you think you may be eligible for SSDI or SSI, you can apply for disability benefits online, by phone, or in person.
When you apply for disability benefits, you will need to provide various information and documents, such as:
- Social Security number
- birth certificate or proof of citizenship
- medical records from your doctors, therapists, hospitals, clinics, and caseworkers
- laboratory and test results
- names, addresses, phone and fax numbers of your doctors, clinics, and hospitals
- names of all medications you are taking
- names of your employers and job duties for the last 15 years
- tax returns and W-2 forms for the last year
- bank account number and routing number for direct deposit
If you are applying for a child, you also need school records regarding your child’s disability. Again applying for SSDI, you also need your work history and earnings information. And if you are applying for SSI, you also need your income and resource information.
After you submit your application, the SSA will review your information and determine if you meet the basic eligibility criteria for SSDI or SSI. If you do, the SSA will send your application to the Disability Determination Services (DDS), a state agency that makes the actual decision on your disability claim.
Disability Determination Services in Massachusetts
The DDS is a division of the Massachusetts Rehabilitation Commission (MRC), which is 100% funded by the SSA. The DDS has offices in Boston and Worcester and employs more than 70 medical and psychological consultants in-house and more than 300 medical and psychological consultants throughout the state to assist in determining claimants’ eligibility for disability benefits.
They will review your medical and vocational information and evaluate your claim using a sequential evaluation process. The process involves five steps:
- Are you working and earning more than the SGA amount? If yes, you are not disabled. If no, go to the next step.
- Is your impairment severe enough to limit your ability to do basic work activities? If no, you are not disabled. If yes, go to the next step.
- Does your impairment meet or equal one of the SSA’s listings of impairments? These are medical conditions that are considered so severe that they automatically qualify you for disability benefits. If yes, you are disabled. If no, go to the next step.
- Can you do the work you did before? If yes, you are not disabled. If no, go to the next step.
- Can you do any other work that exists in significant numbers in the national economy, considering your age, education, skills, and residual functional capacity? If yes, you are not disabled. If no, you are disabled.
The DDS will notify you of its decision by mail. If your claim is approved, you will receive a notice of award that tells you how much your benefit amount is and when your payments will start.
If your claim is denied, you will receive a notice of denial that explains why your claim was denied and how you can appeal the decision.
Appeal Process in Massachusetts
If you disagree with the DDS’s decision, you have the right to appeal within 60 days of receiving the notice of denial. There are four levels of appeal:
- Reconsideration. This is a review of your claim by a different DDS examiner and medical consultant. You can submit new evidence or information to support your claim.
- Hearing. This is a hearing before an administrative law judge (ALJ) who works for the SSA’s Office of Hearings Operations. You can present your case, testify, and bring witnesses or experts to the hearing.
- Appeals Council. This is a review of your claim by the SSA’s Appeals Council. The Appeals Council can grant, deny, or dismiss your request for review, or send your case back to the ALJ for further action.
- Federal Court. This is a lawsuit filed in the U.S. District Court. You can ask the court to review the SSA’s final decision.
The appeal process can take several months or even years to complete, depending on the level of appeal and the complexity of your case.
However, you have a better chance of winning your appeal if you have a qualified disability attorney to represent you and advocate for your rights.
RELATED SEARCH: how to find a good disability lawyer
Disability benefits can be a lifeline for people who are unable to work due to a physical or mental impairment.
However, getting disability benefits in Massachusetts can be a challenging and lengthy process.
Therefore, it is important to understand the types of benefits, the eligibility criteria, the application process, and the disability determination services.
If you need help with your disability claim, you can contact the MRC DDS or consult with a disability attorney who can guide you through the process and increase your chances of success.