Applying for Disability in Michigan
How to apply and qualify for SSD, SSI in Michigan (MI)
Note: If you have already filed a claim and been denied for disability, or are wondering what to do in the event of a Social Security denial, proceed to the reconsideration and hearing appeal sections below.
Level I: Disability Application - Approximately 60 percent of all claims for disability are denied at the disability application level in Michigan. While the rate of denial seems high, it is actually considerably lower than in many states. In most states, the rate of denial at the application level approaches or exceeds 70 percent.
For the bulk of individuals who are denied initially, the best course of action will be to follow the appeals process, as opposed to filing a brand new claim. Individuals who file new claims are almost universally denied for the same reasons that the prior claim was denied.
While the first appeal, the request for reconsideration, has a denial rate that is even higher than for initial claims (on average, 80+ percent of reconsideration appeals are denied), by the time a case has progressed to the disability hearing level (the second appeal), the odds of winning disability benefits are, statistically, in the claimant's favor.
Filing for disability in Michigan
filing for SSI disability, or filing a claim that is based on both SSI and SSD (a concurrent claim) since SSI claims cannot be taken online.
A disability claim is best initiated when the application for disability begins with an application interview that is conducted in person (or over the phone if the claimant has transportation or mobility issues).
During this interview, the CR will inquire into a number of topics but the most important important information obtained from the person filing for disability benefits will regard their A) medical history and B) work history.
Both types of information are used to determine if a case meets the necessary requirements and qualifications under SSA rules and guidelines and thereby arrive at a decision on a disability case.
Both types of information are also entirely dependent on what the claimant supplies at the time of application so claimants should be very careful in providing full and complete information as it can make a distinct difference on a case.
For many claimants, writing down the medical and work histories before the actual visit to the Social Security office takes place will be wise and practical and may help avoid a situation where crucial information is left out.
The Social Security list of impairments
The first means of approving a claim occurs when the claimant's medical records inddicate that they have a physical or mental condition that satisifes the requirements of a listing in the Social Security Disability list of impairments.
Most claims in Michigan are not approved in this manner because the approval criteria for a listing tends to be very specific. Additionally, the majority of medical conditions are not included in the listing manual, also known as the blue book.
The second means of being approved for disability
For claimants who cannot qualifying for disability on the basis of a listing, the medical records that are gathered in a case will allow a disability examiner to determine in what ways the individual is functionally limited, either mentally or physically, or both mentally and physically.
Functional limitations include the ability, and inability, to sit, stand, walk, carry, lift, reach, bend, hear, see, tolerate environmental hazards, concentrate, remember, learn new information, and interact with supervisors and co-workers. Reductions in any one of these--and, of course, a number of other--areas of functional capacity will diminish a person's ability to engage in work activity.
Disability examiners review medical records, and statements from a claimant's physician, or physicians, for signs of functional limitations and the sum total of this evaluation is an RFC, or residual functional capacity rating. This is essentially an assessment of what a person can, and can no longer, do.
The RFC rating is completed on an RFC form and is measured against the demands of the claimant's relevant past work, i.e. potentially any jobs they have performed in the 15 year period prior to becoming disabled.
For this purpose, then, the claimant's work history is used to determine the demands of the claimant's past work, and also their skill levels. This allows a comparision between their current abilities and limitations (their RFC) so that a finding can be made as to their ability to go back to their former work, or switch to some other type of work if they can no longer do their past work.
Individuals who are judged incapable of doing their past work or any other work generally meet the qualifications for SSDI or SSI and are approved for disability.
Most claimants in Michigan, however, are found capable of doing other work and are denied on this basis, making one or more appeals necessary. Fortunately, those who appeal at least as far as the Social Security hearing level will have a much higher chance of receiving a disability award.
Level II: Request for Reconsideration - A claim that is denied at the disability application level in Michigan may be appealed. The first appeal is known as a request for reconsideration.
A reconsideration is requested by contacting the Social Security office where the initial claim was filed. Once SSA is notified that a claimant wishes to file an appeal, they will mail the necessary paperwork. The claimant will have 60 days, plus 5 additional days for mailing time, from the date of the denial to get the appeal filed (the denial date is usually stamped in the upper right hand corner of the denial letter).
Claimants should keep in mind that to file a disability appeal in a timely manner, it is not enough for the claimant to have their appeal put in the mail and postmarked by the deadline. Social Security must actually have received the appeal paperwork by the 65th day for it to be considered timely.
Late appeal situations
When an appeal is not received within the time allotted for the deadline, the claimant will be forced to begin with a new claim, which will require additional months of case processing time.
Note: Claimants should make a copy of all appeal paperwork before mailing their documents to Social Security. This is in the event that SSA does not receive the appeal.
Additionally, to ensure that the appeal is received prior to the deadline, claimants should conduct a followup status call to the Social Security office to verify that their appeal has been received. This can be done within 10-14 days of sending the appeal.
The qualifications for disability at the reconsideration level are the same as at the disability application level. A case may be approved on the basis of satisfying the requirements of a listing (in the Social Security Disability list of impairments), or approved on the basis of the medical evidence indicating that the claimant cannot return to substantial and gainful work activity, or it may be denied.
Approval chances at the reconsideration level
Cases at the first appeal level in Michigan typically stand a higher chance of being denied for disability benefits versus the initial claim level. This is because the reconsideration process is practically identical to the application process--unless there is a very significant change in the claimant's condition, or in the evidence that is available, it is unlikely for a reconsideration examiner to effectively overturn the decision of the prior examiner.
Individuals who are denied on a reconsideration, however, will have, statistically, a much higher chance of being approved at a disability hearing.
Note: Reconsideration appeals are presently suspended in the state of Michigan. Conjecture holds that the reconsideration appeal may return; however, currently, individuals who have been denied on a disability application may immediately file a request for a disability hearing.
Level III: Request for Hearing before an Administrative Law Judge - The disability hearing is the second Social Security appeal available to claimants and may be requested only after a reconsideration appeal has been denied.
Like all appeals, the hearing must be requested within 60 days of the date of the prior denial, but, ideally, should be requested immediately after receiving notification of the denial of the reconsideration appeal to avoid unnecessary case processing delays, as well as the possibility of a missed appeal deadline.
Basic facts about disability hearings
1. The hearing will take place at an ODAR - ODAR stands for office of disability adjudication and review. This is simply government-speak for "the hearing office". In fact, years ago the hearing was called more simply the "office of hearings and appeals", OHA for short.
After a request for hearing is submitted to a Social Security office (either by the claimant, or the claimant's disability attorney or non-attorney disability representative if they have representation--which is certainly advised at the hearing level), the case is transferred to the hearing where it waits to be scheduled. During this time, a claimant or their representative may call to check the status of the claim.
However, it will generally be pointless to contact the Social Security itself. Typically, it will be best to call ODAR. However, even doing this will not be very productive. While the case is at the hearing office, the staff there will only be able to inform a claimant if their case has been assigned to a judge or not, or if it has been scheduled or not. And, of course, once the case is scheduled, both the claimant and their lawyer are notified of the date, time, and place of the hearing.
Where is a disability hearing usually held? At the hearing office. But in some instances, the hearing will be held in an alternate location if the claimant is too far away to travel to the hearing office. Many states have multiple hearing offices, but even in states like North Carolina which has at least four hearings office located throughout the state, getting to a hearing office can sometimes mean hours of driving which can be very difficult for claimants who have musculoskeletal problems and cannot be in a fixed, seated position for very long, or are subject to vertigo or seizures.
2. Video hearings may be scheduled for claimants as well - However, claimants who receive a notice of hearing involving a televised appearance by a judge may wish to consider if this is in really in their best interests. One of the primary advantages of disability hearings is the fact that, unlike the earlier levels where they never meet the decision-maker on their case, at a hearing they are both seen and heard by the decision-maker. This may offer advantages since it becomes less possible for the claimant and their medical issues to be reduced to being just a paper or electronic file.
3. The hearing decision will be made by an ALJ - ALJ stands for administrative law judge. ALJs make decisions in a wide variety of administrative law. Social Security ALJs, however, are specially trained to make decisions on Social Security Disability and SSI disability cases. They are familiar with all rules, regulations, and court rulings that affect disability claims administered under the Social Security Administration. One stereotype of Social Security judges is that they are rude, condescending, and unfair. While it is true that many judges will seem "less than personable", the fact remains that a claimant who has been denied on a disability application will stand a far better chance of receiving a disability award from a judge.
4. The judge may have have expert witnesses present -- Judges very often have either a medical expert or vocational expert present at a hearing. Sometimes they have both. The medical expert will deliver an opinion on the claimant's functional capabilities and the vocational expert will deliver an opinion on the claimant's likelihood of being able to perform certain types of employment, given their age, restrictions, education, and job skills. When experts are called to a hearing by a judge, it is even more important for a claimant to have a disability lawyer or representative present who can respond to their testimony.
5. The judge may send you to a medical exam - This does not happen often. But in some cases the judge will do what a disability examiner often does, which is to schedule the claimant for a consultative medical exam with an independent doctor who has contracted to provide such services for SSA. When the ALJ does this, it means that the case is lacking either recent medical records, or any records at all for one of the claimant's medical conditions.
6. The requirements for disability are the same at a hearing - A Social Security judge will use the same criteria for approval because the qualifications for disability are the same at all levels of the disability system. The judge will be looking to determine whether or not the the claimant has at least one medical condition or mental condition that satisfactorily satisfies the Social Security definition of disability which states that the condition must be severe, must last for at least one year, and must either meet the requirements of a disability listing, or prevent the claimant from working and earning a substantial and gainful income for at least a full year.
7. There are two mechanisms for receiving a disability award - As we have already stated, judges award disability benefits in two ways: they decide that the claimant has a condition that meets or equals a disability listing in the Social Security list of impairments, or they decide that the claimant is eligible to receive a medical vocational allowance, an approval in which it is decided that the claimant cannot do their past jobs, or use their job skills to switch to a new form of work.
Note: The disability award rate for Michigan disabilty hearings is a state-wide average. The various Social Security Hearing offices in Michigan approve cases from a range of 38.1 percent to 57.9 percent. This range is fairly wide; at the low end, it is significantly below both the national average and the disability award rate for SSA region 5 (47.7%); at the high end, it surpasses both. (Disability award rates for the various hearing offices in Michigan listed near the bottom of the page).
About the Author: Tim Moore is a former Social Security Disability Examiner in North Carolina, has been interviewed by the NY Times and the LA Times on the disability system, and is an Accredited Disability Representative (ADR) in North Carolina. For assistance on a disability application or Appeal in NC, click here.
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Rates of Approval for Individual Social Security Hearing Offices in Michigan
Detroit MI hearing office - disability award rate of 38.1 percent
Flint MI hearing office - disability award rate of 57.9 percent
Grand Rapids MI hearing office - disability award rate of 46.7 percent
Lansing MI hearing office - disability award rate of 47.7 percent
Livonia MI hearing office - disability award rate of 55.5 percent
Mt Pleasant MI hearing office - disability award rate of 48.1 percent
Oak Park Pleasant MI hearing office - disability award rate of 54.8 percent