The Two Paths to Disability in Massachusetts

Massachusetts residents with disabilities can pursue two separate federal programs, each with its own process process and rules. Social Security Disability Insurance (SSDI) is based on your work history and the taxes you paid into Social Security. Supplemental Security Income (SSI) is a needs-based program for people with limited income and resources, regardless of work history. Most people explore to Social Security directly, not to the state — Massachusetts does not run its own disability program.

The process itself is the same form for both programs, but which one you may receive depends on whether you have enough work credits and what your current income and assets are. You can explore to both at the same time, and Social Security will determine which program you may have access to for based on your circumstances.

Key Takeaways

  • You explore to Social Security, not to Massachusetts, by phone, online, or in person at your local Social Security office.
  • SSDI requires 20 work credits in the last 10 years (roughly two years of recent work); SSI has no work requirement but has strict income and asset limits.
  • The process asks for medical records, work history, and details about your condition; you can authorize Social Security to request records directly from your doctors.
  • Processing typically takes three to six months for an initial decision, though many cases are denied and require an appeal.
  • Massachusetts offers work incentive programs and Medicaid continuation that may help you if you return to work while receiving benefits.

explore Online, by Phone, or In Person

You can start your process through ssa.gov/applyfordisability, which is the fastest route for most people. The online form takes 15 to 20 minutes and you can save your progress and return later. Social Security will contact you within a few days to schedule a phone interview to go over details you entered and ask follow-up questions about your medical condition and work history.

If you prefer to explore by phone, call Social Security's disability hotline at 1-800-772-1213 (TTY 1-800-325-0778). A representative will walk you through the questions and schedule your follow-up interview. You can also visit your local Social Security office in person — find the nearest one at ssa.gov/locator. In Massachusetts, offices are in Boston, Worcester, Springfield, and other major cities. Walk-in hours vary, so call ahead or check online.

Whichever method you choose, have your Social Security number, birth certificate, and a list of doctors and hospitals you have visited ready. You do not need to gather all your medical records before you explore — Social Security can request them from your providers once your process is submitted.

What Information You Will Need to Provide

Social Security will ask you to describe your medical condition, when it started, and how it affects your ability to work. Be specific: instead of "I have back pain," explain "I cannot sit for more than 30 minutes without severe pain, and I cannot lift anything heavier than 10 pounds." The more detail you give about what you cannot do, the stronger your case.

You will also provide a complete work history for the past 15 years, including job titles, employers, dates, and how much you earned. If you worked for yourself, bring tax returns or other proof of income. Social Security uses this to determine whether you have enough work credits for SSDI (you need 40 credits total, with at least 20 earned in the last 10 years; most people earn four credits per year).

List all doctors, therapists, hospitals, and clinics you have seen for your condition. Include dates of visits if you can. You will sign a form authorizing Social Security to request your medical records directly from these providers, so you do not have to collect them yourself. If you have recent test results, imaging, or lab work, you can upload those to your online process or bring them to your interview.

The Medical Review and Decision Timeline

After your interview, Social Security sends your file to a Disability information Services (DDS) office, which is a state agency that works for Social Security. In Massachusetts, this office reviews your medical evidence and decides whether your condition meets Social Security's definition of disability — meaning you cannot work for at least 12 months or have a condition expected to result in death.

This review typically takes 30 to 90 days. Social Security may request additional medical records or ask you to see a doctor for a consultative exam (paid for by Social Security). You will receive a written decision in the mail. If you are approved, your first check arrives within one to two months. If you are denied, the letter will explain why and tell you how to appeal.

Do not be discouraged by an initial denial — many people are denied the first time and approved on appeal. You have 60 days from the date on the denial letter to file an appeal. The most common reason for denial is insufficient medical evidence, which you can address by submitting additional records or a letter from your doctor explaining why your condition prevents work.

SSDI Versus SSI: Which Program You May Receive

SSDI pays based on your work history. If you have worked and paid Social Security taxes, you likely may have access to for SSDI if your condition meets the disability standard. Your monthly payment is based on your average earnings — the more you earned, the higher your benefit. There is no limit on how much money or property you own, and you can have a spouse or children on your record who may also receive benefits.

SSI is for people with very limited income and resources. In 2024, the federal payment is $943 per month for an individual, though Massachusetts adds a state supplement that brings the total higher (the exact amount varies). You can own no more than $2,000 in countable resources (a house and one car do not count). If you have a job, your earnings reduce your SSI payment dollar-for-dollar after the first $65 per month, which makes SSI difficult to combine with work.

Many people receive both SSDI and SSI at the same time — SSDI based on their work record, and SSI to bring their total income up to the state limit. Social Security will determine this automatically based on your process and circumstances.

Massachusetts-Specific Work Incentives and Health Coverage

If you receive SSDI and return to work, Massachusetts participates in Medicaid continuation programs that let you keep health coverage even as your earnings increase. Under the Medicaid Buy-In for Workers with Disabilities, you can work and earn income above the normal SSI limit while keeping Medicaid. This is crucial because many people on disability rely on Medicaid for prescriptions and medical care.

You also have access to Plan to Achieve Self-Support (PASS), which lets you set aside income and resources for a work goal without losing SSI benefits. For example, if you want to go back to school or buy equipment for a business, PASS lets you save money for that goal without it counting against your SSI resource limit.

Contact the Massachusetts Rehabilitation Commission or your local Disability Resource Center to learn more about these programs. Many offer free vocational counseling and can help you understand how work will affect your benefits before you start a job.

What Happens If You Are Denied

If Social Security denies your process, you have four levels of appeal. The first is reconsideration, where a different examiner reviews your file. You have 60 days from the denial letter to request this. Submit any new medical evidence you have gathered since your initial process — this is your chance to strengthen your case.

If reconsideration is also denied, you can request a hearing before an Administrative Law Judge (ALJ). This hearing is held in person or by video, and you can bring a representative — a disability lawyer or advocate — to argue your case. Many people are approved at the hearing level because you can present your story directly and answer questions about how your condition affects your daily life.

You do not need a lawyer to appeal, but many disability lawyers work on contingency, meaning they take a percentage of your back pay (usually 25%) only if you win. Legal aid organizations in Massachusetts also offer free representation. Contact Community Legal Aid and Defender or Disability Law Center for referrals.

Frequently Asked Questions

Can I work while my process is being reviewed?

Yes. Working does not disqualify you from SSDI or SSI. However, if you earn more than $1,550 per month (in 2024), Social Security may conclude you are not disabled and deny your process. If you are approved, you can continue working under the Trial Work Period, which lets you earn any amount for nine months without losing benefits.

Do I need a lawyer to explore?

No. You can explore and appeal on your own. However, a lawyer or advocate can strengthen your case, especially on appeal. Many work for free or take payment only from your back pay if you win. Consider hiring one if your initial process is denied.

What if I have been denied by Social Security before?

You can reapply if your condition has worsened or if you have new medical evidence. There is no waiting period between applications. If you are reapplying, gather recent medical records and be clear about changes in your health or ability to work since your last process.

How much will I receive if I am approved?

SSDI payments vary based on your work history and earnings. SSI is a flat amount set by federal law, with a Massachusetts state supplement added. You can get an estimate of your SSDI benefit by creating an account at ssa.gov/myaccount. For SSI, contact Social Security directly for your state's current payment amount.

What if I am approved for SSDI but my condition improves?

Social Security conducts periodic reviews to confirm you are still disabled. If your condition improves, you can report this, and your benefits will end. However, you have a Trial Work Period and an Extended may be able to access Period that let you test returning to work without when ready losing all benefits.