Welcome. I am a Social Security disability lawyer in Maine. This site is written for Social Security disability claimants, their legal representatives, and the network of people involved in the Social Security disability claim process.
If you have a Social Security disability or SSI claim in Maine or New Hampshire, please contact Gordon Gates or ask for a free Social Security claim evaluation.
I received a wonderful thank you note today from a client who recently received a fully favorable decision for a Social Security disability claim. The last sentence said:
The relief that I have now in knowing that I can pay my bills is tremendous.
This is a universal feeling from claimants who are awarded disability benefits: tremendous relief. The note was a touching reminder that claimants experience enormous hardships while waiting for a determination of their Social Security disability claim.
From time to time I ask my clients to keep a journal, to keep track of their "good days" and "bad days" over a period of several months. For certain impairments, such a fibromyalgia, such a journal can be very helpful.
There is no listed impairment for fibromyalgia. So the case has to be decided at steps 4 and 5 of the sequential evaluation process. Furthermore, fibromyalgia does not fit well into the Social Security RFC analysis, because on a given day, a claimant may be able to do all the requirements of light work. The next day, however, the same claimant may be unable to get out of bed due to pain secondary to fibromyalgia.
The most likely route to a favorable decision for such a Social Security disability claim is that the administrative law judge determines that for several days each month you will be unable to work due to your fibromyalgia. As a result, the judge rightfully concludes that you are unable to maintain employment, and should be awarded Social Security disability benefits. You can help the judge make this determination by keeping a journal, so that you have an accurate record of how many "bad days" you have each month due to your fibromyalgia.
A journal can be helpful for claims based on other impairments, including chronic fatigue syndrome, chronic pain, depression and anxiety.
Your medical records – the doctor’s treatment notes and progress notes – are created to keep track of your medical care, as a tool to assist your doctor with your treatment. Those notes are not created to be used for the purpose of establishing a disability claim. However, your medical records are the principal evidence for your Social Security disability claim, and they will be used by the Social Security Administration to assess your work-related limitations.
In general, doctors do not focus on your functional limitations. So it is important to tell your doctor what your limitations are. It will help your doctor better understand your medical condition. It may also help your disability case, since eventually those limitations will end up in the doctor’s progress notes, and those notes will be used by SSA to establish your work-related limitations.
Instead of saying "my back hurts when I stand too long," say "after 15 minutes of standing my back hurts so much that I have to sit down for 15 minutes." Give the doctor some specific details to quantify your medical problems. The same is true for mental limitations, such as depression or anxiety. Rather than saying "my depression is a little better (or a little worse) this month," say "I was so depressed that I could not leave the house for 6 days last month." Give your doctor some specifics.
My clients often have questions about the disability claim process. So here is a description of the claim process in Maine and New Hampshire from start to finish.
A Social Security disability claim may be filed in person at the nearest Social Security office, online, or by telephone. The location of every Social Security office in Maine is here (the same information for New Hampshire is here).
There is a new federal magistrate in Portland.
In Maine, the magistrate judge in Portland is the person who handles the Social Security appeals in U.S. District Court. For the past twenty years the magistrate has been Judge David Cohen, and one couldn’t have asked for a fairer hearing of a Social Security appeal.
The new magistrate is John H. Rich III, and I must say I am very pleased about his appointment. He is an excellent choice for that important position.
I received a fully favorable decision today from the Social Security Administration for one of my clients. Now, that is not unusual, but I have spent an unusual amount of time on this particular case, so it was very gratifying to get the fully favorable decision.
The client has chronic pain secondary to Lyme disease, and has been having a rough time. It was important to get a decision as soon as possible, without waiting the year that it takes in Maine to get a hearing before an administrative law judge.
Fortunately, the client has a very supportive primary care doctor, and also has been consulting a leading Lyme disease specialist from Boston. So the medical evidence was there. But chronic pain and chronic fatigue cases can be difficult to get granted "on the record" without a hearing. It took months of phone calls and letters and updated medical opinions to persuade the SSA.
Every case has a story. I am glad this story will have a happy ending. The client will recover from the Lyme disease, and then will be able to return to work. Meanwhile, however, the client will receive well deserved Title II Social Security disability benefits.
Step 3 of Social Security’s 5-step sequential evaluation process is a determination whether or not a disability claimant “meets or equals a listing.” The Social Security Administration has regulations describing more than 150 categories of medical conditions. These are called “listed impairments,” or “listings.” The listed impairments are medical conditions that are severe enough to presumptively preclude a person from working. If you “meet or equal a listing” you will be granted benefits, without the necessity of proceeding to steps 4 and 5 of the sequential evaluation process.
An official from the Social Security Administration spoke at a recent conference I attended. He said that 10 or so years ago, 90% of all the disability claims were decided based on the listings. Today, however, just 50% of the claims are decided based on the listings. That’s a big change, but what does it mean for you?
It means that the most obvious disability claims are still determined according to the listings, and can often be resolved at the initial or reconsideration level. But the remaining 50% of the claims – the ones that are not determined according to the listings – are much more complicated. Those claims will be decided according to your ability to do your past relevant work (step 4 of the sequential evaluation process) and your ability to do other work (step 5 of the sequential evaluation process). Those claims probably will require a hearing before an administrative law judge.
An experienced Social Security attorney can improve the likelihood that you receive the disability benefits you deserve.
When you apply for Social Security disability or SSI, the Social Security office gives you a packet of forms to fill out. The forms give Social Security information about you, the nature of your medical problems, the names and addresses of the doctors that have been treating you, and details about your work history, among other things. I recently took on a case involving an error in the work history report. Had the claimant filled out that form accurately when applying for disability, the claim already would have been granted.
Social Security evaluates every case according the to the 5 step sequential evaluation process. Step 4 is a determination whether or not you can return to your past relevant work. "Past relevant work" is work in the past 15 years that was perfomed at the SGA level. If you could return to past relevant work, Social Security denies your disability claim. All Social Security does at step 4 is match your physical and mental abilities to the physical and mental requirements of the previous work. So, for example, if your doctor limits you to lifting less than 10 pounds, and your past work required you to lift 20 pounds occasionally, then you cannot do your past work. Social Security would then proceed to step 5, which is a determination of whether or not you can perform other work.
At step 5, however, Social Security takes into account your age, and makes some assumptions about whether a person at an advanced age could transition to other work. This is why claimants over 50 years old have a much better chance of being found disabled. But you never get to these claimant-friendly rules unless you get past step 4. That is one reason why it is very important to rule out your past work.
When considering the requirements of your past work, Social Security looks at the work history report you completed when you applied for disability. In this new case of mine, the treating physician limited the claimant to lifting less than ten pounds. During my initial interview, the claimant stated that it was necessary to lift over 10 pounds at the past jobs. Since my new client was over 50 years old, had a sedentary residual functional capacity and an unskilled work background, the claimant would be found disabled at step 5. Great case!
Unfortunately, the claimant did not pay attention when completing the work history report, and stated that it was only necessary to lift "Less than 10 lbs" for the previous jobs. Social Security denied the claim at step 4, finding that the claimant had the capacity to return to past work. And that was the right decision based upon the information given.
Now, once the claimant came to me, I submitted an amended work history report that reflects the actual lifting required by the claimant's past work. There are also other physical limitations other than just the lifting. So the claim will probably get granted. But the claimant will likely have to wait for a hearing before an ALJ, which takes about a year in Maine. Had the work history report been completed accurately initially, the claimant would already be receiving disability benefits.
If an initial claim for Social Security disability or SSI is denied, the claimant can request a reconsideration of the claim within 60 days of the date of that denial. At reconsideration, the previous evidence is reevaluated and any new evidence is considered, and a new determination is made.
Claims filed in the Region I after August 1, 2006 have been sent to the Office of the Federal Reviewing Official in Falls Church, Virginia for reconsideration. This new office was supposed to improve the reconsideration process. Unfortunately, that office has been overwhelmed by the number of cases, and what used to take a few weeks or months was taking several months or even longer. I have several clients with disability claims languishing at the FedRO level.
The Social Security Administration has now pulled the plug on the FedRO. By final rule published in the Federal Register on January 15, 2008 the SSA suspended the transfer of new claims to the FedRO. That rule has now taken effect in Maine and New Hampshire. That means that reconsideration of Maine claims will now be undertaken by DDS in Augusta. In New Hampshire, denied claims proceed directly to the ALJ level, as they did before the FedRO. The good news is that DDS is much faster than the FedRO. The bad news is that the claims currently at the FedRO will remain there until they are decided.
