Guide to SSDI Denials & Appeals in Michigan, MI

Introduction: Why a Michigan-Focused SSDI Guide Matters

The Social Security Disability Insurance (SSDI) program is a critical lifeline for more than 200,000 disabled workers in Michigan, MI. Yet the Social Security Administration (SSA) denies the majority of first-time SSDI applications nationwide—roughly 67% according to SSA 2023 data. If you live in Detroit, Grand Rapids, Traverse City, or anywhere else in the Great Lakes State, understanding why denials happen and how the federal appeals system works is essential to protecting your economic security. This guide draws only from authoritative sources such as the Social Security Act, the Code of Federal Regulations (CFR), SSA Program Operations Manual System (POMS), and published federal court rulings. While we slightly favor the claimant’s perspective, every fact stated here is verifiable and complies with SSA rules.

Understanding Your SSDI Rights in Michigan

What SSDI Provides

SSDI is a federal benefit funded by payroll taxes under Title II of the Social Security Act § 223. If you have earned enough quarters of coverage and meet SSA’s definition of disability, you are entitled to monthly cash benefits and eventual Medicare eligibility after 24 months of entitlement.

Federal Definition of Disability

Under 20 CFR 404.1505, disability means the inability to engage in substantial gainful activity (SGA) because of a medically determinable physical or mental impairment that has lasted—or is expected to last—at least 12 continuous months or result in death.

Key Claimant Rights

The right to representation by an attorney or qualified non-attorney at any stage of the claim (Social Security Handbook § 0204).

• The right to review and copy your claims file (20 CFR 404.1512).

• The right to appeal any adverse action within 60 days of the date you receive the notice (20 CFR 404.909).

• The right to a de novo hearing before an Administrative Law Judge (ALJ) not previously involved in your denial (20 CFR 404.929).

Common Reasons the SSA Denies SSDI Claims

Although every case is unique, SSA decision writers frequently rely on the following grounds when issuing denials for Michigan residents:

• Insufficient Medical Evidence – Missing diagnostic imaging, lack of longitudinal treatment records, or non-compliance with prescribed therapy can lead to an “insufficient evidence” determination at 20 CFR 404.1520(b).

• Residual Functional Capacity (RFC) Findings – Disability Determination Services (DDS) physicians may conclude you can still perform past relevant work or adjust to other work in the national economy, resulting in denial at Step 4 or Step 5 of SSA’s sequential evaluation process.

• Exceeding Substantial Gainful Activity (SGA) – In 2024, monthly earnings above $1,550 for non-blind claimants or $2,590 for blind claimants generally bar eligibility (20 CFR 404.1574).

Not Disabling for 12 Continuous Months – Short-term impairments and post-surgical recoveries frequently fail the durational requirement (20 CFR 404.1509).

• Failure to Cooperate – Missing consultative examinations or refusing to provide requested evidence can trigger a denial under 20 CFR 404.1518.

Federal Legal Protections & Regulations You Should Know

Appeals Framework

The SSA’s four-level administrative review process is codified at 20 CFR 404.900–404.999:

• Request for Reconsideration

• Administrative Law Judge (ALJ) Hearing

• Appeals Council Review

• Federal District Court

Each level is subject to a 60-day deadline from receipt of the prior decision (SSA presumes you receive notices 5 days after the mailing date, per 20 CFR 404.901).

Important Statutory Sections

• Social Security Act § 205(g) – Grants U.S. District Courts jurisdiction to review final SSA decisions.

• Social Security Act § 223(d) – Defines disability and sets the 5-step sequential evaluation.

• 20 CFR 404.1513 – Identifies acceptable medical sources, including licensed psychologists and advanced practice registered nurses.

Attorney Representation & Fee Limits

Under 42 U.S.C. § 406(a) and 20 CFR 404.1720, attorney fees are capped at the lesser of 25% of past-due benefits or $7,200 (2024 cap) unless a petition for a higher fee is approved by SSA.

Steps to Take After an SSDI Denial in Michigan

1. Read the Denial Notice Carefully

The notice details the medical and vocational findings SSA used. Identify whether the denial occurred at Step 2 (severity), Step 4 (past work), or Step 5 (other work). This will shape your appeal strategy.

2. File a Timely Request for Reconsideration

You have 60 days plus 5 mailing days. File online through SSA’s Appeal Portal or at a local SSA field office (see Michigan addresses below). Missing the deadline generally forfeits your right unless you show good cause under 20 CFR 404.911.

3. Submit Additional Medical Evidence

Per 20 CFR 404.1512(a), you bear the burden of providing evidence. Request updated treatment notes, objective test results, and functional capacity evaluations from providers such as University of Michigan Health System or Spectrum Health in Grand Rapids.

4. Consider Obtaining Written Opinions

Treating physician statements (also known as medical source statements) that address work-related limitations can carry significant weight, especially if well-supported by clinical findings (20 CFR 404.1520c).

5. Prepare for the ALJ Hearing

If reconsideration is denied, request a hearing. Michigan claimants may appear via video or in person at the Detroit, Flint, Grand Rapids, Lansing, or Livonia Office of Hearings Operations (OHO). Median wait times in FY 2023 ranged from 7–11 months, per SSA data.

When to Seek Legal Help for SSDI Appeals

Although representation is optional, SSA statistics show claimants with lawyers are more likely to succeed at the ALJ level. A Michigan disability attorney can:

• Analyze medical and vocational evidence to craft a theory of disability.

• Cross-examine SSA vocational experts on Dictionary of Occupational Titles job numbers.

• Ensure adherence to Hallex hearing procedures, increasing due-process protections.

• Navigate post-hearing briefs and possible Appeals Council arguments citing Sixth Circuit precedent (e.g., Blankenship v. Bowen, 874 F.2d 1116 (6th Cir. 1989)).

Local Resources & Next Steps for Michigan Residents

SSA Field Offices

• Detroit Field Office: 1149 Griswold St., Suite 300, Detroit, MI 48226. Phone: 888-748-7691.

• Grand Rapids Field Office: 3045 Knapp St. NE, Grand Rapids, MI 49525. Phone: 877-319-5710.

• Lansing Field Office: 5210 Perry Robinson Circle, Lansing, MI 48911. Phone: 877-512-5944.

Michigan Disability Determination Services (DDS)

DDS handles medical evaluations and consultative exams. Address: 3038 W. Grand Blvd., Suite 3-200, Detroit, MI 48202.

Vocational & Medical Resources

Michigan Rehabilitation Services – job retraining and placement.

• University of Michigan Health System – specialty clinics for neurology, orthopedics, and mental health evaluations.

Statute of Limitations for Federal Court

If the Appeals Council denies review, you have 60 days to file a civil action in the U.S. District Court for the Eastern or Western District of Michigan, pursuant to Social Security Act § 205(g). Filing fees ($402 as of 2024) may be waived through an in-forma-pauperis motion.

Attorney Licensing in Michigan

Attorneys representing SSDI claimants in Michigan must be in good standing with the State Bar of Michigan. Ethical rules are governed by the Michigan Rules of Professional Conduct; advertising and contingency fee arrangements are permissible so long as they align with 42 U.S.C. § 406 and SSA fee approval.

Conclusion

An SSDI denial is not the final word. By understanding federal regulations, Michigan-specific resources, and the strict timelines involved, you can maximize your chances of a favorable outcome. Acting quickly and, when appropriate, securing experienced legal representation can make a decisive difference.

Disclaimer: This article is for informational purposes only and does not constitute legal advice. For advice specific to your situation, consult a licensed Michigan attorney.

If your SSDI claim was denied, call Louis Law Group at 833-657-4812 for a free case evaluation and claim review.