Maine Social Security Disability Claims Blog

Since 1974, The Law Offices of Joe Bornstein have been getting Mainers the justice they deserve. 1-800-CALL-JOE (1-800-2255-563)

Social Security and Veterans Disability Programs: Similarities and Differences

Posted in Uncategorized

Many veterans do not realize that it is possible to receive both Social Security disability benefits and VA disability benefits at the same time.  The Social Security Administration and Veteran’s Administration each offer two basic disability-based benefit programs.  If you are a veteran with medical conditions that prevent you from working, you may be eligible for benefits from one or both of these two federal  government run programs.

The Social Security Administration (SSA) offers two separate disability benefits programs:  Social Security Disability Insurance Benefits (SSDI) and Supplemental Security Income (SSI).  Both programs require a finding that a person is “disabled” (meaning having one or more medical or psychological conditions that last, or are expected to last, at least one year or end in death, and which prevent performance of full-time work on a sustained basis over time and without substantial accommodations).  Eligibility for SSDI requires insured status obtained by past work and payment of the social security taxes through payroll withholding. Eligibility for SSI is established from means tests for income and assets. Income and assets must be below a certain level in order to qualify for SSI benefits, in addition to establishing disability.   More information about SSDI and SSI can be found at

Similarly, the VA has two disability-related benefits programs:  VA disability benefits (also known as “service-connected disability”), and the VA pension program.  Eligibility for VA service-connected disability is based on a finding of disability arising from one or more medical conditions that are related to a wound, injury, or illness acquired while on active duty in the Armed Forces.  Eligibility for service-connected disability does not take into consideration any income or assets the veteran may have. Unlike service-connected disability, the VA pension program is needs-based, similar to Supplemental Security Income (SSI)- a VA pension is paid to a veteran who has very little or no income and is disabled based on non-service disabilities.  More information about Veterans benefits can be found at

A veteran who applies for disability benefits at the SSA, the VA, or both, should remember that he or she may be entitled to benefits under more than one program.

Getting Medical Treatment When You Don’t Have Health Insurance

Posted in Uncategorized

One of the most difficult challenges facing individuals seeking social security disability benefits, and a question we hear often, is: “How can I get medical treatment and prescription medications if I do not have health insurance?”

In Social Security cases, claimants must prove that they have what is called a “severe medical impairment(s).”  This can be a physical, or mental, impairment, or a combination of both.  Proof of a severe medical impairment requires consistent medical treatment records documenting the illness or injury . We know that  many claimants do not have health insurance to pay for necessary medical treatment, and that most social security disability claimants do not have the money to pay for medical provider visits and prescription medications.

Compounding this problem,  changes to MaineCare adopted over the last few years have resulted in many claimants losing their MaineCare coverage, or being found ineligible for MaineCare because they do not meet the program requirements.

Fortunately,  there are available medical resources to many claimants to obtain necessary medical treatment despite the lack of health insurance.  Most of the hospitals in Maine have “Free Care” programs. If a claimant applies for and is approved for free care by a hospital, that free care provides access to treatment not only from that hospital but also to physicians, counselors, and other medical providers in the medical practices owned by that hospital. A claimant who has lost health insurance coverage should submit an application for free care at the nearest hospital that offers such a program.

In addition,  a claimant should seek treatment from one or more of the free health care clinics in the State of Maine that are available to treat claimants with no incomes. A directory of free clinics in Maine can be found at<> and<>.

Why it is Necessary to Seek Treatment/Evaluation from an “Acceptable Medical Source” when Pursuing Social Security Disability

Posted in Social Security Basics

In the evaluation of your disability claim, the Social Security Administration will evaluate the day-to-day limitations caused by your medical conditions only after confirming that your medical conditions have been correctly diagnosed under their rules. The diagnosis of your medical condition(s) must be confirmed by a diagnosis from an “acceptable medical source”.

Under the Social Security regulations, medical providers who are considered to be an “acceptable medical source” for purposes of diagnosis and providing medical opinions are:

*       Licensed physicians (medical or osteopathic doctors)
*       Licensed or certified psychologists
*       Licensed optometrists (for the measurement of visual acuity and visual fields)
*       Licensed podiatrists (for purposes of establishing impairments of the foot, or foot/ankle only)
*       Qualified speech-language pathologists (for purposes of establishing speech or language impairments only)

The medical records from treating providers who are not on the SSA’s list of approved experts are still very important. These records inform the SSA about you and your treatment. They assist the SSA to determine how severe a medical condition is, the symptoms it causes and how your symptoms  limit  your ability to function physically and mentally. These records inform the SSA about the treatment you have received and how effective or ineffective it is. By regularly attending your scheduled medical appointments these records also inform the SSA about your motivation to cooperate with your healthcare providers and to try to get better.

Severe Impairments: Why Symptoms Alone Are Not Enough

Posted in Uncategorized

Back pain, widespread joint pain, fatigue, feeling sad, irritable or anxious are symptoms that many Mainers experience on a daily basis. These symptoms may be interfering with your daily activities, your relationships with your family and friends, and preventing you from focusing or making it to your job on a daily basis. Keep reading to find out why you will need to see a doctor for an examination and diagnosis of your symptoms if you plan to pursue a claim for Social Security Disability Insurance Benefits or Supplemental Security Income.

At the second step of Social Security’s five step sequential evaluation of disability, the SSA will determine whether your medical impairment is “severe” under the SSA program rules. If your medical condition(s) meet this basic test, the SSA will then consider how these condition(s) affect your day-to-day functioning. The starting point of this evaluation is to have medical evidence documenting not just the symptoms you are experiencing, but a medical condition that is reasonably causing these symptoms. The diagnosis of your medical impairment must be confirmed by a medical doctor and/or medically acceptable imaging (e.g., x-ray, MRI, CT scan) and laboratory testing (e.g., blood work, biopsy, stress test). The SSA can not find you to be disabled on the basis of symptoms alone when there has been no diagnosis of a medical condition by an acceptable medical professional.

Only once a medical condition has been appropriately diagnosed and the symptoms reasonably likely to be caused by the impairment(s) will the SSA consider whether the impairment(s) and resulting symptoms cause exertional (strength activities) or non-exertional (nonstrength activities) limitations. To continue past Step 2, your medical impairment(s) and resulting symptoms must cause more than a minimal limitation upon your ability to perform basic work activities. Remember, without an appropriate diagnosis, the SSA will not consider the symptoms that are affecting you on a daily basis. It is important to see a doctor (MD or DO) or psychologist as soon as possible for a full evaluation of your symptoms for appropriate testing, diagnosis, and treatment. Office visits notes, imaging or operative reports, and laboratory findings are the best evidence to document your medical impairments and the relationship between your symptoms and these medical conditions.

MaineCare – Information on How to Apply

Posted in Uncategorized

MaineCare provides healthcare coverage for eligible individuals and families. There are two coverage categories:


– “Non-categorical” coverage: Provides partial MaineCare benefits to individuals and couples who meet certain income guidelines. Currently “non-categorical” coverage is frozen (not open to new applicants) but it is recommended that you still apply to get on the waiting list.

“Categorical” coverage: Provides full MaineCare benefits to individuals and families who fall under a specific coverage group. Some of the coverage groups include:  children 18 and under, children age 19-20, parents or guardians, pregnant women, adults who are medically eligible for nursing care or living in residential care facilities, women who have breast or cervical cancer, seniors age 65 and older, and adults with disabilities.  For a full list click here. (


How to apply:

To get a MaineCare application you can call the DHHS statewide toll-free number 1-877-543-7669 or the Consumers for Affordable Health Care Helpline 1-800-965-7476, visit your local DHHS office, or print an application from the internet for adults :( or families with children (  Once you fill out an application it must be mailed to or dropped off at a local DHHS office. DHHS must make a decision within 45 calendar days from the date they get the application (if the application is complete) or they must send the family a short-term medical card to use until a decision is made. You may also do a pre-screening, open an account or renew on-line. (


Things to Remember:

  • If your request is denied at first, it is crucial to ask for reconsideration immediately by calling the regional DHHS office and asking for a fair hearing. Eligibility decision appeals must be sent within 30 calendar days of the date of the DHHS written opinion.
  • Make sure to complete an annual review each year and promptly notify DHHS of address changes or changes in income or assets. These are two common reasons that people lose their MaineCare coverage.
  • If you have a problem or complaint you can call DHHS and talk to a MaineCare Eligibility Specialist to see if your issue can be worked out.


For more information on applying for MaineCare check out the resources below:

–    Maine Equal Justice Partners – Tips for the Applicant (

–    Consumers for Affordable Health Care website  ( and HelpLine – 1-800-965-7476

–    MaineCare Services website (

Finding the Medical Treatment You Need: Free or Low Cost Resources in Maine

Posted in Uncategorized

A crucial part of qualifying for Social Security Disability Insurance or Supplemental Security Income benefits is having a record of medical treatment. In order to determine if you are disabled, the Social Security Administration needs to see medical evidence from acceptable medical sources ( such as licensed physicians and psychologists, documenting your medical condition. Also, in most cases you will need to show that despite treatment, your impairments persist. Therefore, it is important to have medical records that document your medical condition and show your continued treatment.  

However, getting the medical treatment you need is not always easy, especially when you do not have insurance or cannot work. Luckily, there are many inexpensive or free resources in Portland and throughout Maine to help you get the treatment you need.

Resources and free clinics in the Portland Area:

Resources and Free Clinics in Maine:

Hospitals Offering Free or Low Cost Care:


Getting Ready to Apply for Disability Benefits

Posted in Uncategorized

While there are several different ways to apply for Social Security Disability benefits, online applications offer the most convenience. If you choose to apply for benefits using the Social Security Administration’s official online forms, you are able to start your disability claim immediately without the need to wait for a scheduled appointment.

HOW TO APPLY ONLINE:  Visit and select ‘Apply for disability benefits.’ Once there, you will see an easy-to-follow four-step process ( outlined for you. These steps include:


1. Review the Adult Disability Checklist  (  – this is a detailed list of the information you must have ready in order to apply online. The information includes, but is not limited to: dates of marriages and divorces, names and birthdates of your minor children, a list of medicines you are taking and who prescribed them, and any information about insurance or workers’ compensation claims you have filed.

2. Complete the Disability Benefit Application (– this is the formal application that you will complete online either for yourself or for someone else. The Social Security Administration estimates that filling out the application will take you between 10 and 30 minutes.  You are given the option of saving your application along the way to allow for taking breaks.

3. Complete the Adult Disability Report – this is a document that accompanies the official application. This report will require you to provide detailed information about your medical history and current conditions, treatment and doctors, education background, and employment history. For more details on how the online disability report works click here. (

4. Complete the Authorization to Disclose Information form (SSA-827) – You have the option of doing this electronically as part of your disability report, or you can print and mail the form to your local Social Security office.


For more information on applying for benefits online and what information to gather before you start, read through the Social Security Administration’s page on applying online for disability benefits. (

Should I Apply for Social Security Disability Benefits?

Posted in Social Security Basics, Uncategorized

The Social Security Administration uses a five-step process when deciding whether an individual’s medical condition will establish eligibility for disability benefits. At each of the five steps, if a claimant does not meet the specific requirements of that step, the claim for benefits may be denied.  The five questions asked by Social Security are:


1.  Are you currently employed?

If you are currently employed, and earning more than approximately $1,000 per month, it is unlikely that you will be considered to be disabled by  Social Security.

2.  Do you have a medical condition which is considered ‘severe’ by Social Security?

To be successful in a claim for Social Security disability benefits, you must have a medical condition, or combination of conditions, which are severe enough to prevent you from doing basic work-related activities.  If your conditions do not prevent you from performing these activities, you will not be considered disabled by Social Security.

3.  Is your medical condition recognized by the Social Security?

Certain medical conditions are considered by  Social Security to be so severe that they automatically qualify an applicant for disability benefits.  To view this list of conditions, go to If your condition is not on the list, Social Security will review your medical records to determine whether your condition is equal in severity to a condition on the list.

4.  Are you able to perform your previous work?

If Social Security determines that your medical condition is severe, but not equal in severity to a condition on their list, they will then evaluate the type of work you did previously, and will make a determination about whether you are able to return to that type of work.

5.  Are you able to perform other types of work?

If you are no longer able to perform the functions of your past jobs, Social Security will make a determination about whether you are able to adjust to other types of work. In making this determination, they will consider your age, education, past work experience, and any transferable skills you may have from your previous work. If Social Security determines that you can adjust to other types of work, your claim for disability benefits will be denied.


Having an experienced attorney to assist you in the Social Security application process can make a big difference in the final outcome of your claim.  Our law firm specializes in representing Mainers in their claims for Social Security Disability benefits. We have successfully represented over 4,000 Mainers in their claims for Social Security Disability benefits.

For more information, please call us at 1-800-772-4624.

Social Security Disability vs. Supplemental Security Income

Posted in Social Security Key Terms

At our law firm we are frequently asked – what is the difference between Social Security Disability and Supplemental Security Income? These two terms are often used and discussed interchangeably; however, there are important differences between the two programs.

Defining SSD & SSI:

Social Security Disability Insurance (SSDI) is a FICA tax-funded, Federal insurance benefits program. To be eligible for SSD benefits, you must be unable to hold a job due to severe medical impairments (physical or mental), and you must have been actively employed and paying Social Security taxes long enough to obtain insured status under the SSD program.

Supplemental Security Income (SSI) is a need-based program that pays supplemental income to qualfied disabled applicants regardless of whether they have ever worked and paid Social Security taxes.  To be eligible for SSI benefits, applicants must have a severe mental or physical impairment that makes them unable to perform a job.  Applicants must also have a family income that is below the level established by the Social Security Administration for SSI eligibility.

Similarities between SSD & SSI:

  • Both programs pay monthly benefits to applicants
  • Both programs are administered by the Social Security Administration
  • Both programs require the same medical standards in order to be disabled for applicants age 18 or older

Differences between SSD & SSI:

  • Social Security Disability benefits are based on your earning history.  When you apply for SSD benefit, the Social Security Administration will provide you with specific information about what your monthly benefit amount would be.
  • Supplemental Security Income is not based on your past earnings. The monthly benefit amount is established by government regulations.  Personal income and the income of family members may be taken into account in establishing the amount of monthly SSI that will be paid.


Posted in Miscellaneous

Welcome to the Law Offices of Joe Bornstein’s official Social Security Disability blog. We have created this blog to be a resource for you through the long and often grueling process of applying for Social Security Disability benefits.

The Social Security application process can be difficult to navigate on your own.  Let us help you cut through the ‘red tape,’ find answers to frequently asked questions, and make sense of a system that can seem overwhelming.

In this blog, we will answer many of your questions, including:

  • What are the differences between Social Security Disability and Supplemental Security Income?
  • What is my doctor’s role in helping me to receive Social Security Disability benefits?
  • What are the medical conditions that make me eligible for benefits?
  • What are the financial requirements that make me eligible for benefits?
  • What is the application and denial process like?
  • How can an attorney help me obtain Social Security Disability benefits?