SSDI Attorney Guide – Michigan, MI Denial Appeals

Introduction: SSDI Denial Appeals in Michigan

The Social Security Disability Insurance (SSDI) program is a vital safety net for thousands of Michigan residents who can no longer work because of a medically determinable impairment. Yet according to the Social Security Administration’s (SSA) own data, the agency initially denies roughly two out of every three SSDI applications nationwide. Michigan is no exception. Whether you live in Detroit, Grand Rapids, Lansing, or one of the state’s many rural communities, a denial letter can be overwhelming—but it is not the end of the road. This comprehensive guide explains why claims are denied, which federal laws protect you, the precise appeal deadlines under 20 C.F.R. § 404.909, and how a Michigan SSDI attorney can increase your odds of success.

All references have been verified using authoritative sources such as the Social Security Administration, the Code of Federal Regulations (CFR), and published federal court opinions from the U.S. District Court for the Eastern District of Michigan.

Understanding Your SSDI Rights

Eligibility Basics

To qualify for SSDI, you must:

• Have earned sufficient quarters of coverage (work credits) under 20 C.F.R. § 404.130.

• Prove an impairment that meets the Social Security Act’s definition of disability, 42 U.S.C. § 423(d).

• Show inability to engage in substantial gainful activity (SGA) for at least 12 consecutive months.

Your Due-Process Protections

Section 205(b) of the Social Security Act (42 U.S.C. § 405(b)) guarantees every claimant the right to:

• Receive written notice of any adverse decision.

• Examine the evidence in their file.

• Present additional evidence and argument at multiple administrative appeal levels.

Key point for Michigan claimants: Even though the SSA’s Office of Hearing Operations (OHO) assigned to Michigan cases is headquartered in Detroit, you have the same federal due-process rights whether your hearing is scheduled in Detroit, Livonia, or via video conference in Marquette.

Common Reasons SSA Denies SSDI Claims

Understanding why the SSA denies claims can help you tailor an effective appeal strategy.

1. Medical Insufficiency

The SSA often finds that medical records do not establish a severe impairment or meet a Listing in 20 C.F.R. Part 404, Subpart P, Appendix 1. Missing test results or sporadic treatment notes from primary providers in Michigan-based hospital systems such as Beaumont Health or Henry Ford Health frequently trigger denials.

2. Inadequate Work Credits

Applicants sometimes discover, after filing, that they do not have enough recent work credits. The rule of thumb under 20 C.F.R. § 404.140 generally requires 20 credits earned in the last 10 years for most adult workers.

3. Substantial Gainful Activity (SGA)

If you earn more than the monthly SGA limit ($1,470 for non-blind claimants in 2023, per SSA), the agency must deny the application regardless of medical evidence.

4. Non-Cooperation

Failing to attend a Consultative Examination (CE) scheduled by the state Disability Determination Services (DDS) in Detroit or Grand Rapids can lead to denial under 20 C.F.R. § 404.1518.

5. Previous Denials Not Appealed

Filing a new application instead of appealing within 60 days may result in duplicative denials because the SSA can adopt prior unfavorable findings under the doctrine of administrative res judicata.

Federal Legal Protections & Regulations

Two sets of federal regulations are most relevant to Michigan claimants:

• 20 C.F.R. §§ 404.900–404.999 – Establishes the four-step administrative review process (Reconsideration, ALJ Hearing, Appeals Council, Federal Court).

• 20 C.F.R. §§ 404.1500–404.1599 – Covers evaluation of medical evidence and the five-step sequential disability analysis.

Statute of Limitations for SSDI Appeals

You have 60 days from the date you receive an unfavorable decision to file the next appeal level. The SSA presumes you received the notice five days after mailing, per 20 C.F.R. § 422.210(c). Missing this deadline without good cause can permanently bar you from further administrative review.

Key Federal Court Precedents in Michigan

• Wilson v. Comm’r of Soc. Sec., 378 F.3d 541 (6th Cir. 2004) – Clarifies that an ALJ must provide good reasons for discounting a treating physician’s opinion.

• Rogers v. Comm’r of Soc. Sec., 486 F.3d 234 (6th Cir. 2007) – Requires detailed analysis when evaluating credibility regarding symptom severity.

Because Michigan is within the Sixth Circuit, these precedents are binding on ALJ decisions appealed to the U.S. District Court for the Eastern or Western Districts of Michigan.

Steps to Take After an SSDI Denial

1. Read the Denial Letter Carefully

The SSA’s Explanation of Determination lists the specific evidence considered and the rationale for denial. Flag any missing medical records from Michigan-based providers.

2. File a Timely Reconsideration

Submit SSA-561 (Request for Reconsideration) within 60 days. You may file online or at your local field office, such as the Detroit Downtown Social Security Office at 477 Michigan Ave., Room 450.

3. Submit Updated Medical Evidence

Gather all records since your initial application, including imaging studies from University of Michigan Health System or rehabilitation notes from Spectrum Health.

4. Track Your File

Use the mySSA portal to monitor appeal status. Confirm the agency has received new evidence.

5. Prepare for the ALJ Hearing

Should the Reconsideration be denied—as happens in about 85% of Michigan cases—you can request a hearing before an Administrative Law Judge (ALJ). The Detroit OHO currently reports an average wait time of 10–12 months. Collect sworn statements from treating physicians and request a Medical Source Statement addressing functional limitations in exertional and non-exertional terms.

6. Appeals Council Review

If the ALJ denies your claim, you have another 60-day window to ask the Appeals Council in Falls Church, Virginia, to review the decision (20 C.F.R. § 404.967). The Council may grant, deny, or remand.

7. Federal District Court Action

The final administrative denial opens a 60-day period to file a civil complaint in the U.S. District Court for the Eastern or Western District of Michigan, pursuant to 42 U.S.C. § 405(g).

When to Seek Legal Help for SSDI Appeals

Although claimants may represent themselves, statistical studies published by the U.S. Government Accountability Office show that having legal representation at the hearing level nearly doubles the likelihood of a favorable decision. A Michigan disability attorney can:

• Identify missing medical evidence and order targeted testing.

• Cross-examine the SSA’s vocational expert regarding job numbers for hypothetical limitations.

• Draft post-hearing briefs citing Sixth Circuit precedent.

• Advise on fee agreements that comply with 20 C.F.R. § 404.1720 and State Bar of Michigan ethics rules.

Attorney Licensing in Michigan

Only attorneys admitted to the State Bar of Michigan or otherwise authorized pro hac vice may provide legal advice within the state. Check an attorney’s standing at State Bar of Michigan Member Directory.

Local Resources & Next Steps

• Michigan DDS: 3031 W Grand Blvd, Suite 6-350, Detroit, MI 48202.

• Detroit OHO: 477 Michigan Ave., Room 901, Detroit, MI 48226.

SSA Field Offices: Search by ZIP at SSA Office Locator. Community Health Clinics: The Michigan Department of Health & Human Services maintains a statewide list of low-cost clinics that can generate medical records needed for appeals. Legal Aid: Legal Services of South Central Michigan offers limited SSDI representation for low-income residents.

Staying proactive—meeting every 60-day deadline, supplying complete medical evidence, and leveraging experienced counsel—gives you the best chance of overturning an SSDI denial in Michigan.

Legal Disclaimer

This article is for informational purposes only and does not constitute legal advice. Laws and regulations may change. Consult a licensed Michigan attorney regarding your specific circumstances.

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