A lumbar MRI shows a disc. It does not show pain, and the rules Social Security applies to a Michigan disability claim are written around that gap. The agency has a two-step method for weighing pain that a scan does not fully explain, and a claim that is not built to that method tends to be decided on the scan alone.

The method is in 20 C.F.R. § 404.1529. First, the record must contain objective medical evidence of an impairment that could reasonably be expected to produce the pain alleged. Second, once that impairment is shown, the agency evaluates the intensity and persistence of the pain against all of the evidence, and the regulation says in terms that it will not reject a claimant’s statements about pain solely because the objective medical evidence does not substantiate them.

That second sentence is the one a back pain claim has to hold the agency to. It is where Neumann Law Group starts when a Michigan Social Security Disability claimant from Traverse City or Detroit arrives with a denial that recites the imaging and stops.

Step One Asks Only Whether the Impairment Could Cause the Pain

A medically determinable impairment is a physical or mental abnormality shown by medical signs or laboratory findings established through medically acceptable clinical or laboratory diagnostic techniques. Under § 404.1529(b), statements about pain will not be found to affect the ability to work unless such an impairment is present, and the impairment must be one that could reasonably be expected to produce the pain alleged. Degenerative disc disease, a herniation contacting a nerve root, and spinal stenosis all clear this step on ordinary imaging.

The step is deliberately limited. The regulation states that the finding that an impairment could produce the pain does not involve any determination about the pain’s intensity, persistence, or functionally limiting effects. A claimant does not have to show at step one that the disc explains every symptom, only that it is the kind of impairment that produces symptoms of that kind. Where physical findings do not substantiate an impairment capable of producing the pain, the regulation directs the agency to develop evidence of a possible mental impairment, so a chronic pain claim with thin imaging can end up evaluated partly under the mental listings.

Step Two Weighs the Statements Against Seven Factors

Once step one is met, § 404.1529(c) governs how much the pain limits work. Objective evidence such as reduced joint motion, muscle spasm, sensory deficit, or motor disruption is described as a useful indicator that the agency must always try to obtain. The same paragraph then states that the agency will not reject statements about the intensity and persistence of pain, or about its effect on the ability to work, solely because the objective evidence does not substantiate them. The regulation lists the factors that carry the rest of the analysis.

• Daily activities.
• The location, duration, frequency, and intensity of the pain.
• Precipitating and aggravating factors.
• The type, dosage, effectiveness, and side effects of medication.
• Treatment other than medication.
• Measures used to relieve the pain, with lying flat, standing for 15 to 20 minutes every hour, and sleeping on a board given as the regulation’s own examples.
• Other factors concerning functional limitations due to pain.

Social Security Ruling 16-3p, republished at 82 FR 49462 in October 2017, governs how adjudicators apply this. It rescinded the earlier ruling that framed the question as the claimant’s credibility, removed that word from agency policy, and states that symptom evaluation is not an examination of an individual’s character. The ruling is binding on every component of the agency, including the administrative law judges who hear Michigan cases.

Most denials in pain cases quote the imaging and the examination findings and say little about the seven factors. A denial that reads that way has left the second step of its own rule undone, and the omission is where the appeal begins. One call is usually enough for us to tell you where things stand. Call us at (800) 525-6386.

What Pain Testimony Cannot Do

The regulation is equally direct about the limit. Under § 404.1529(d)(3), the agency will not substitute allegations of pain for a missing or deficient sign or laboratory finding in order to raise an impairment to listing-level severity. The four paragraphs of Listing 1.15, laid out on our back and spinal injuries page, are documentary requirements, and the documented medical need for a two-handed assistive device in paragraph D cannot be supplied by testimony about how hard walking has become.

Where the listing is not met, § 404.1529(d)(4) sends the pain evidence into the residual functional capacity assessment under 20 C.F.R. § 404.1545, which is where most back claims are actually decided. There the seven factors do their work, because a limit on how long a person can sit or stand before pain forces a change of position is a residual functional capacity finding, and it is a finding the vocational analysis at steps four and five has to respect.

A Treatment Note That Speaks to All Seven Factors

A treating provider’s notes carry the factors only if the visit records them, and a note reading “back pain, continue current regimen” records almost none of them. Visits that document where the pain is, how long it lasts, what brings it on, what the medication does and what it does to concentration, and what the patient does at home to get through the day produce a chart that answers the regulation’s questions in the regulation’s order. Statements from nonmedical sources count as well. The regulation names them alongside medical sources as evidence of how symptoms affect daily living and work.

Consistency is the other half. Section 404.1529(c)(4) directs the agency to consider inconsistencies between the claimant’s statements and the rest of the evidence, including statements by medical sources and other persons. A function report completed early in the claim and testimony given later at the disability hearing are read against each other, so a contemporaneous record of bad days, kept as they happen, is worth more than a reconstruction offered from the stand.

When the Chart and the Pain Do Not Match

A back claim denied on the imaging has usually been evaluated at one step of a two-step rule. Claimants across Michigan bring those denials to us at Neumann Law Group, and reading a denial against § 404.1529 is something we do before anything is filed. We are glad to talk through any of these questions. Call (800) 525-6386 or send us a message and we will get back to you.

A psychiatric chart in Michigan will often describe a patient’s depression as moderate, and the same word appears in Social Security’s disability listings with a different job. The listings rate limitation on a five-point scale, and where a claimant lands on that scale decides whether a mental health claim meets Listing 12.04, 12.06, or 12.15 at all.

Section 12.00F of the Listing of Impairments sets the scale at none, mild, moderate, marked, and extreme. To satisfy paragraph B of any of those listings, the disorder must produce an extreme limitation in one of the four areas of mental functioning or a marked limitation in two. Each point is then defined, and every definition turns on one phrase, whether the person can function in the area independently, appropriately, effectively, and on a sustained basis.

Neumann Law Group reads a Michigan Social Security Disability mental health file for that phrase first. A record from Kent County or anywhere else in the state that never addresses sustained functioning cannot support a marked rating, no matter how serious the diagnosis.

What Each Point on the Scale Means

The definitions in 12.00F2 are short, and the distance between the middle ones is the whole case.

• None. The person is able to function in the area independently, appropriately, effectively, and on a sustained basis.
• Mild. Functioning in the area on that basis is slightly limited.
• Moderate. Functioning in the area on that basis is fair.
• Marked. Functioning in the area on that basis is seriously limited.
• Extreme. The person is not able to function in the area independently, appropriately, effectively, and on a sustained basis.

A marked limitation, under 12.00F2, is functioning in an area of mental functioning that is seriously limited when measured independently, appropriately, effectively, and on a sustained basis. Fair and seriously limited sit one step apart on the scale and on opposite sides of the listing. The four areas the scale is applied to are understanding, remembering, or applying information; interacting with others; concentrating, persisting, or maintaining pace; and adapting or managing oneself, and the two routes through each listing, paragraphs A and B or paragraphs A and C, are set out on our mental health conditions page.

A Clinician’s Moderate Is Not the Listing’s Moderate

Section 12.00F3a addresses the vocabulary collision directly. The medical evidence may include descriptors regarding the diagnostic stage or level of the disorder, such as mild or moderate, and clinicians may use those terms to characterize the medical condition. The listing then states that these terms will not always be the same as the degree of limitation in a paragraph B area. A psychiatrist describing moderate major depressive disorder is classifying an illness, not rating a patient’s capacity to concentrate through a workday.

The listing also refuses to let any one document settle the rating. Under 12.00F3d, no single piece of information, including test results, can establish the degree of limitation of an area of mental functioning, and the degree does not necessarily reflect a specific type or number of activities the person has difficulty doing. The rating is drawn from the whole record, which is what the special technique in 20 C.F.R. § 404.1520a requires the agency to rate and document in its decision.

A treatment record built from brief medication visits tends to read as moderate in every area, because nothing in it measures sustained functioning. The chart shows whether a file is in that condition, and reading it that way takes one conversation. Call our office at (800) 525-6386 and we will walk through it with you.

Functioning at Home Does Not Prove Functioning at Work

Section 12.00F3 draws the line between the kitchen and the workplace with care. The same four areas are used at home and at work, and difficulty using one at home may mean difficulty using it at work. The reverse does not follow. The listing states that where a person is able to use an area of mental functioning at home or in the community, the agency will not necessarily assume the same ability in a work setting where the demands and stressors differ.

Section 12.00D3 goes further about daily life. The fact that a person does routine activities without help does not necessarily mean the person has no mental disorder or is not disabled, and the listing names the activities it has in mind: taking care of personal needs, cooking, shopping, paying bills, living alone, and driving a car. A denial that lists those activities as proof of capacity has cited the listing’s own examples of what does not prove it.

Support and Structure Raise the Rating

The more help a person needs, the more limited the listing finds them. Section 12.00F3e states that the degree of limitation reflects the kind and extent of supports or supervision the person receives and the characteristics of any structured setting where they spend their time, and that the more extensive the support or the more structured the setting needed in order to function, the more limited the agency will find the person to be.

Section 12.00D1 gives the examples, and they describe ordinary Michigan households. They include family members who administer medication, remind the person to eat, shop and pay bills, or change their own work hours so the person is never home alone. They include a job held only with a job coach or a supervisor’s help, and wraparound mental health services delivered in the person’s own apartment.

The last example surprises people. It is a person who lives alone with no formal supports and has created a highly structured environment by eliminating all but minimally necessary contact with the world outside their living space. Each of these is evidence of limitation, and each is invisible in a chart unless someone puts it there.

The rating comes from the whole record rather than from the diagnosis, and a denial that rates a limitation as moderate is appealable on the 60-day track described on our SSDI denial page. The appeal is the place to supply the sustained-functioning evidence the initial file lacked.

Translating a Chart Into the Listing’s Terms

Fair and seriously limited are one step apart on the scale, and the step is proved with evidence about sustained functioning that most charts were never written to contain. We represent mental health claimants at Neumann Law Group across Michigan, from Grand Rapids to Detroit. Call us at (800) 525-6386 or contact our office to arrange a consultation.

A Michigan workers’ compensation case that ends in a redemption produces one check, and Social Security treats that check as if it were still being paid out week by week. The offset that reduces disability benefits does not stop at the settlement, and the size of the reduction turns on parts of the agreement most people never read again after the magistrate signs it.

The federal rule, 42 U.S.C. § 424a, caps combined Social Security disability and workers’ compensation at the higher of 80 percent of average current earnings or the unreduced Social Security benefit, and 20 C.F.R. § 404.408 supplies the mechanics.

Two of those mechanics run in the claimant’s favor. Under § 404.408(d), amounts paid or to be paid for medical, legal, or related expenses connected with the workers’ compensation claim or the injury are excluded before the reduction is computed. Under § 404.408(l), the earnings figure that sets the ceiling is redetermined on a fixed schedule, and the redetermination can only raise what is payable.

Neumann Law Group reads redemption paperwork with the federal reduction in view for Michigan Social Security Disability clients from Wayne County to Grand Traverse County, because the same three pages settle the workers’ compensation case and set the disability benefit for years afterward. The offset itself is explained on the pages linked below, and this is about the three provisions that decide how much of a settlement it reaches.

Why a Lump Sum Does Not Escape the Reduction

Under MCL 418.835, once six months have passed from the date of a personal injury, any liability resulting from it may be redeemed by payment of a lump sum by agreement of the parties, subject to approval by a workers’ compensation magistrate. The magistrate may also, where special circumstances require it, direct that deferred payments be commuted to a lump sum at their present worth at 10 percent per year. The carrier must notify the employer of a proposed redemption at least 10 business days before the hearing on it.

The federal regulation anticipates exactly that document. Section 404.408(g) provides that where public disability benefits are paid in a lump sum as a commutation of or a substitute for periodic benefits, “such as a compromise and release settlement,” the reduction is made at the times and in the amounts the agency determines will approximate as nearly as practicable the monthly reduction. A redemption is therefore spread back out over a period and offset month by month, and the agreement’s own terms are what the agency spreads.

The Expenses the Offset Never Counts

Section 404.408(d) excludes from the computation the amounts paid, incurred, or to be incurred by the worker for medical, legal, or related expenses in connection with the claim or with the injury the settlement is based on. The exclusion holds to the extent those amounts are consistent with the applicable law and reflect either expenses already incurred or a reasonable estimate of future ones. The same paragraph then states the limit. Expenses not established by the evidence the agency requires, or not reflecting a reasonable estimate of actual future expenses, “will not be excluded.”

The regulation names the proof it will accept. The expenses may be shown by the award or compromise agreement itself, by a court order, by a detailed statement from the worker’s attorney, physician, or the employer’s insurance carrier, by bills, receipts, or canceled checks, or by other clear and convincing evidence, in any combination. A redemption that states one gross figure with no allocation gives the agency nothing to exclude. One that states the attorney fee, the medical costs the worker has already paid, and a documented estimate of future treatment gives it three figures to subtract before the offset is run.

Because MCL 418.835 allows any liability from the injury to be redeemed, a Michigan redemption often closes the employer’s medical liability along with wage loss, and the worker’s estimated future medical cost is the excludable item most often left unstated. It is also the one a treating physician’s written estimate can establish.

Whether an agreement already signed says enough to support an exclusion is a question the agreement answers in about a page, and we read one against § 404.408(d) before the disability claim is filed. We are glad to look at it with you before anything is filed. Call us at (800) 525-6386.

Whose Benefit Absorbs the Reduction First

The reduction lands on the family before it lands on the worker. Section 404.408(h)(2) provides that where a reduction is made in the total benefits payable on a worker’s earnings record, each benefit except the disability insurance benefit is first proportionately decreased, and only the excess is applied to the worker’s own benefit. The regulation’s own example shows a spouse’s and two children’s benefits reduced to zero while the worker’s benefit is reduced by the remainder.

A change in the family changes the arithmetic. Under § 404.408(i), the addition or subtraction of a beneficiary can cause the total family benefit to become, or cease to be, the applicable limit, and the reduction is recalculated as though the new number of beneficiaries had been entitled from the first month it was imposed. The benefit the family is dividing is computed under the formula on our how much SSDI pays page, and the floor described on the workers’ compensation offset page still holds, so the worker’s own benefit is never reduced below what it would have been standing alone.

The Ceiling Is Redetermined, and Only Upward

Average current earnings is not fixed for the life of the offset. Under § 404.408(l), in the second calendar year after the year the reduction was first required, and in every third year after that, the benefits still subject to reduction are redetermined, and the regulation conditions the redetermination on its not decreasing the total payable. The recalculation multiplies the original average current earnings by the ratio of the national average of total wages for the year before the redetermination to the same average for the year before the reduction was first computed, rounded down to the dollar, and the result takes effect the following January.

The regulation’s worked example applies a ratio of 1.174 and produces a higher family payment than the cost-of-living increases alone had. A Michigan worker whose offset began in 2023 is due a redetermination in 2025 and again in 2028, and each one arrives as a notice from the agency stating the figure it used. Those notices are worth checking against the original computation rather than filing.

Three Provisions Worth Checking in a Signed Redemption

Three provisions of one regulation decide how much of a redemption the offset reaches, and all three depend on what the agreement says and what the file proves. At Neumann Law Group, we handle Social Security Disability claims alongside workers’ compensation matters for injured workers across Michigan, and a first review of a proposed or signed redemption is part of that work. We are happy to talk it through with you. Call (800) 525-6386 or contact our office.

The date a Michigan Social Security Disability claim is approved has very little to do with the date its benefits begin. Three rules fix that starting point, all of them counted backward from the application rather than forward from the decision, and together they cap how many months of back pay an award can carry no matter how long the disability has lasted.

Under 20 C.F.R. § 404.621, a person who files for disability benefits after the first month they could have been entitled may receive benefits for up to 12 months immediately before the month of filing. Under 20 C.F.R. § 404.315, benefits are not payable until the claimant has been disabled for five full consecutive months, and that waiting period can begin no earlier than the 17th month before the month of application, in the regulation’s words, “no matter how long you were disabled before then.” A person disabled for years who files today can be paid for the 12 months before filing at most, and every month the filing waited is a month that fell off the back of the award.

The two rules agree with each other. Counting 17 months back and then forward through a five-month waiting period lands on the 12th month before filing, which is exactly where § 404.621 stops. Neumann Law Group runs that arithmetic at the start of every Michigan Social Security Disability claim it takes, for clients in Grand Traverse County and across the state, because the filing date is the one date in the case a claimant controls.

Five Waiting Months, Starting No Earlier Than the 17th

The waiting period is the five full consecutive months of disability that must pass before Social Security Disability Insurance benefits become payable. Under § 404.315(a)(4), it begins with a month in which the claimant was both insured for disability and disabled, and it runs regardless of how long the claim takes to decide. No waiting period applies to a claimant who was entitled to disability benefits within the five years before becoming disabled again, or to a claimant medically determined to have amyotrophic lateral sclerosis whose application was approved on or after July 23, 2020.

The 17-month limit is the part the onset date cannot move. A claimant whose disability began in January 2024 and who files in September 2026 has an onset date that is 32 months old, and the waiting period nonetheless cannot start before April 2025, the 17th month before September 2026. The five waiting months run April through August 2025, and the first payable month is September 2025. Had the same claimant filed in January 2025, the waiting period could have begun at onset in January 2024, benefits would have been payable from June 2024, and the award would carry 15 more months.

The 12-Month Ceiling on Retroactive Months

Michigan SSDI back pay reaches at most 12 months before the application month. The five-month waiting period can start no earlier than the 17th month before filing, so the earliest payable month is the 12th month before the application, however long the disability has lasted and however early the established onset date is set.

Section 404.621(a)(1) states the rule for disability benefits, and the same section shows how favorable it is by comparison, since old-age and most survivor benefits reach back only six months. Within the 12-month window, the established onset date still does real work, because a later onset shortens the payable period from the other end, and our how much SSDI pays page covers how that date is set and contested. Supplemental Security Income has no retroactive window at all, so a concurrent claimant’s SSI portion begins with the application month, a difference the SSDI versus SSI page explains alongside the programs’ other splits.

One more filing rule sits in the same section. Under § 404.621(c), an application for a period of disability must be filed while the person is disabled or no later than 12 months after the month the disability ended, extended to 36 months where a physical or mental condition prevented filing. A disability that has already resolved is not automatically unclaimable, but the clock on claiming it is short.

The most expensive month in most of these cases is the one spent deciding whether to apply. A conversation about what a filing this month would preserve takes a few minutes. One call is usually enough for us to tell you where things stand. Call us at (800) 525-6386.

The Hearing Queue Adds Months to the Award

The rules above are indifferent to how long the agency takes. Entitlement is dated from the onset date, the waiting period, and the application, and the decision date appears nowhere in the calculation, so a claim that spends a year and a half in the hearing queue at the Grand Rapids, Detroit, or Lansing office accrues benefits for every month of it. The wait at that stage, which our SSDI timeline page describes as historically the longest in the process, adds months to the award rather than subtracting them.

What does cost months is a lapsed appeal. A new application filed after a missed 60-day deadline carries a new filing date, and the 12-month and 17-month rules run from that new date, so the months between the original filing and the new one are lost to the retroactivity ceiling even though the disability never changed.

Medicare Counts Months of Entitlement, Not Months Since Onset

Health coverage follows the same dates. Under 42 U.S.C. § 426(b), a person under 65 who has been entitled to disability insurance benefits for 24 calendar months becomes entitled to Medicare Part A beginning with the 25th month of entitlement. The count runs on entitlement, which begins with the first payable month after the waiting period, not on the onset date and not on the approval date.

A claimant approved after a long appeal whose entitlement was dated retroactively can find that a meaningful part of the 24 months has already run. Those months count the same as months paid on time, because the statute counts entitlement rather than payment.

Working Out What an Application Filed Now Would Preserve

The onset date, the 17th month, the 12-month ceiling, and the Medicare count are four dates that can be placed on a calendar before a claim is filed, and placing them is the first thing we do with a new Michigan disability client. At Neumann Law Group, we handle Social Security Disability claims statewide. We are glad to talk through any of these questions. Call (800) 525-6386 or send us a message and we will get back to you.

Some Michigan Social Security Disability denials are issued before anyone at the agency reads a medical record. The claim fails on insurance coverage or on earnings, two questions Social Security answers first, and the notice that results looks much like a medical denial to the person holding it.

Social Security Disability Insurance works like the insurance its name describes. A worker is covered only while recent payroll taxes keep the coverage current, and under 20 C.F.R. § 404.130 most adults are insured for disability only if they hold 20 quarters of coverage within the 40-quarter period ending with the quarter they became disabled, and are fully insured as well. A worker who left the job years before applying can have lost that coverage before the disability began, and the strength of the medical file does not change the count.

Michigan Social Security Disability claimants from Grand Rapids to Detroit bring both kinds of denial to Neumann Law Group, and the earnings record is where we start on each of them. A coverage problem and a medical problem call for different appeals, and only one of them can be fixed with more treatment records.

How the 20/40 Rule Decides Whether Coverage Was Still in Force

Disability insured status is the coverage a worker holds under Social Security Disability Insurance by having enough recent quarters of coverage. A quarter of coverage is earned with covered wages or self-employment income, and in 2026 it takes $1,890 in covered earnings to earn one, under SSA’s annual determinations notice at 90 FR 49047. The 40-quarter period is 10 years, so the rule asks whether roughly five years of covered work sit inside the 10 years ending when the disability began.

The window moves. Every quarter that passes without work drops an old quarter off the front of the 10-year period and adds an empty one at the back, so a person who worked steadily and then stopped remains insured for a limited time afterward and then is not. A worker who last held a job in December 2020 would still have 20 quarters inside the window through the fourth quarter of 2025 and would fall to 19 in the first quarter of 2026. Practitioners call that last qualifying quarter the date last insured, and a disability that begins after it is not covered, however severe.

Younger workers get a different count. Under § 404.130(c), a person disabled before age 31 needs quarters of coverage in at least half of the quarters since the quarter after turning 21, with a floor of six quarters of coverage in the 12-quarter period ending with the quarter of disability where that span is shorter than 12 quarters.

Proving the Disability Began Before Coverage Ended

A coverage denial does not always mean the claim is over. 20 C.F.R. § 404.131 requires disability insured status in the quarter the disability began or in a later quarter in which the person was still disabled, so the decisive question becomes when the disabling limitations started, and whether that date falls inside the covered period.

A person whose date last insured passed in 2025 and whose back gave out in 2023 has a claim to make. A person whose limitations reached disabling severity only in 2026 does not, on that record.

The evidence for that question comes from the covered period, not from today. Current treatment records prove a current condition, and what a coverage case needs is documentation from before the date last insured showing the same limitations were already present, together with employment records showing why the work ended.

The agency’s own evidence rules point the same direction. 20 C.F.R. § 404.1512 directs SSA to develop a claimant’s complete medical history for the 12 months before the month last insured for disability benefits, which is the agency acknowledging that the relevant period may be years in the past.

Whether a denial was medical or a coverage denial is usually visible in the notice itself, and the two lead to different appeals. Working out which one arrived, and whether the onset date can be moved, is a short conversation. We talk these questions through with you. Call us at (800) 525-6386.

The Earnings Test That Ends a Claim at Step One

The second non-medical denial happens at the first step of the five-step evaluation. Under 20 C.F.R. § 404.1520, a claimant who is working, and whose work is substantial gainful activity, is found not disabled regardless of medical condition, age, education, or work experience. The dollar figure that defines substantial gainful activity is set each year, and for 2026 it is $1,690 a month for a non-blind claimant and $2,830 for a claimant who is statutorily blind, both from the same SSA determinations notice.

The test is applied to work actually being done at the time of the claim. A claimant who kept reduced hours through the application period and whose monthly earnings from that work exceeded the figure is denied at step one, and the denial says nothing about whether the condition is disabling. Where the work has since ended, or where the earnings figure counted was wrong, the appeal turns on pay records rather than treatment records.

Five Paper Checks Inside the Appeal Window

A denial on coverage or earnings is appealable on the same 60-day track as a medical denial, the one described on our SSDI denial page, and the appeal is where the missing pieces are supplied. Five checks belong at the front of it.

• The earnings record itself. A missing or understated year of wages changes the quarter count, and W-2 forms or tax returns correct it.
• The last insured quarter. Run the 20/40 count from the actual work history rather than from memory of when the job ended.
• Evidence from before that quarter. Treatment records, imaging, and employer records from the covered period establish onset.
• The earnings SSA counted. Confirm the months and amounts behind a step-one denial against pay records.
• Supplemental Security Income. Where coverage has genuinely lapsed, SSI has no work-credit requirement and turns on resources instead, $2,000 for an individual and $3,000 for a couple, a comparison our SSDI versus SSI page lays out.

Each of these is a paper question, and each is answerable within the 60 days without waiting on a doctor.

Sorting a Coverage Denial From a Medical One

The notice that arrives after a work-credit denial reads like every other denial, and the instinct to gather more medical records is the wrong response to it. We handle Social Security Disability appeals at Neumann Law Group for claimants throughout Michigan, from the Traverse City area to Wayne County, and we can tell you from the notice which kind of denial it is. If you would like us to look at your situation, call (800) 525-6386 or contact us through our website.

A letter from a treating physician stating that a patient is disabled and cannot work is the document Michigan claimants most often bring to a first meeting, and it is the document Social Security’s rules give the least room to. The agency is required to make that finding itself, and a statement that makes the finding for the agency is set aside without analysis.

20 C.F.R. § 404.1520b(c)(3) lists statements on issues reserved to the Commissioner as evidence that is “inherently neither valuable nor persuasive,” and the first item on the list is a statement that a claimant is or is not disabled, able to work, or able to perform regular or continuing work. For claims filed on or after March 27, 2017, the agency will not provide any analysis of how it considered such a statement.

What the rules do value is a medical opinion, which 20 C.F.R. § 404.1513 defines as a statement from a medical source about what a claimant can still do despite their impairments and whether they have specific work-related limitations.

Neumann Law Group asks treating providers for the second kind of document on every Michigan Social Security Disability claim it handles, from Detroit to Traverse City, because the first kind is discarded by rule before anyone weighs it. The distinction is one of form, and a provider who is told the form will usually supply it.

An Opinion Describes Function, a Conclusion Decides the Case

A medical opinion is a statement from a medical source about what a claimant can still do despite their impairments and about impairment-related limitations in four areas of work activity. The regulation names them.

• Physical demands. Sitting, standing, walking, lifting, carrying, pushing, pulling, and manipulative or postural functions such as reaching, handling, stooping, or crouching.
• Mental demands. Understanding, remembering, maintaining concentration, persistence, or pace, carrying out instructions, and responding appropriately to supervision, co-workers, or work pressures.
• Other demands. Seeing, hearing, and the use of other senses.
• Environmental conditions. The ability to adapt to conditions such as temperature extremes or fumes.

The reserved list in § 404.1520b(c)(3) is the mirror image. Alongside statements that a person is disabled or unable to work, it includes statements that an impairment is or is not severe, that it meets or equals a listing, that it prevents past relevant work, that a grid rule is or is not met, and, in item (v), statements of residual functional capacity made in the programmatic terms of Appendix 2’s exertional levels “instead of descriptions about your functional abilities and limitations.” A note that a patient is limited to sedentary work is on the reserved list. A note that the patient can lift 10 pounds occasionally and sit for 30 minutes before standing is a medical opinion.

How the Agency Weighs a Medical Opinion Since 2017

For claims filed on or after March 27, 2017, 20 C.F.R. § 404.1520c governs, and its first sentence removes a rule many Michigan claimants still expect. The agency will not defer to, or give any specific evidentiary weight, including controlling weight, to any medical opinion, including one from the claimant’s own medical sources. A treating physician’s opinion is no longer presumed to control.

It is evaluated for persuasiveness under five factors, and the regulation says which two are most important. Those two are supportability and consistency, and the agency must explain in its decision how it considered each of them for every medical source. The remaining factors, which it may consider without explaining, are the relationship with the claimant, including the length, frequency, purpose, and extent of treatment and whether the source examined the patient, the source’s medical specialty, and other factors such as the source’s familiarity with the rest of the record and with the program’s evidentiary requirements. Evidence received after an opinion was written can make it more or less persuasive.

Most treating-provider forms are prepared without the person completing them knowing that supportability and consistency are the test, and a form written to that test is worth more than one written to sympathy. The rules that decide what a form has to say are what we go over with new clients first. If that is where your situation sits, call us at (800) 525-6386.

Supportability and Consistency, in Practice

Supportability is defined by the source’s own work. The more relevant the objective medical evidence and supporting explanations a medical source presents to support the opinion, the more persuasive the opinion will be. A checkbox form that records limitations and cites nothing scores low on the only factor the source controls. The same form that cites the imaging, the examination findings, and the test results behind each limitation, with a sentence explaining why the finding produces the limit, scores high.

Consistency is measured against everything else in the file, including evidence from other medical sources and from nonmedical sources such as the claimant’s own function report and statements from family or former supervisors. An opinion contradicted by the same provider’s treatment notes fails both factors at once, and a note reading “doing well” in the chart the month before the form was signed is exactly the inconsistency an adjudicator will cite. A denial that recites a provider’s letter and gives it no weight has applied § 404.1520b(c)(3) correctly, and the appeal, on the 60-day track described on our SSDI denial page, is the place to replace the letter with an opinion.

The Request That Gets a Usable Opinion From a Provider

The request is for a functional statement rather than a verdict. It should give numbers and durations for the physical demands, describe concentration, pace, and response to work pressures in a psychiatric case using the four areas of mental functioning the listings themselves use, which are set out on our mental health conditions page, and state the objective basis for each limitation in the provider’s own words.

Two of the lesser factors can be supplied at the same time. A source who has treated the patient for years and examined them regularly should say so on the form, because the relationship factor rewards exactly that. A source who has been given the imaging and the prior records has the familiarity with the rest of the file that the last factor asks about, and an opinion written with the whole record in front of the provider is far less likely to contradict it.

Asking a Treating Provider for the Right Document

A doctor willing to help a patient’s claim usually writes the wrong document because nobody has told them what the right one looks like, and the difference is a page of specifics. At Neumann Law Group, we supply that page to treating providers for Social Security Disability claimants across Michigan. Call our office at (800) 525-6386, or contact us online, and we will talk it through with you.

A Michigan Social Security Disability hearing comes with a filing deadline that arrives in the hearing notice and is easy to read past. Written evidence not already in the file has to be submitted to the administrative law judge, or at least disclosed, five business days before the hearing date, and a judge who receives it later is allowed to refuse it.

The rule is 20 C.F.R. § 404.935. Each party must make every effort to get all of the evidence in front of the judge, and must inform the agency about or submit any written evidence no later than five business days before the scheduled hearing. Evidence that misses the deadline may be declined unless one of the exceptions in the rule’s second paragraph applies.

On a claim that has waited a year or more for a date at the Grand Rapids, Detroit, or Lansing hearing office, the last week before the hearing is a poor time to learn that a records request is still outstanding. The five-business-day rule is the requirement in 20 C.F.R. § 404.935 that a claimant inform the administrative law judge about, or submit, all written evidence no later than five business days before the hearing. At Neumann Law Group, we build the hearing file for Michigan Social Security Disability clients backward from that date rather than forward from the notice.

75 Days of Notice and the Six Things It Must Contain

Under 20 C.F.R. § 404.938, the notice of hearing is mailed to the last known address, or personally served, at least 75 days before the hearing date. The regulation lists what the notice has to contain.

• The specific issues to be decided in the case.
• That the claimant may designate a representative.
• How to request a change in the time or place of the hearing.
• That the hearing may be dismissed if neither the claimant nor the representative appears without good reason.
• The time and manner of appearance, whether in person, by agency video, or otherwise, and the place where the appearance is in person or by video.
• That all written evidence not already in the record must be submitted or disclosed no later than five business days before the hearing.

The notice also asks for a returned acknowledgment form, and an unreturned form prompts the agency to make contact. A claimant who reports never receiving the notice gets an amended one by certified mail. An amended notice, or a notice of a supplemental hearing after a continuance, needs only 20 days of lead time rather than 75.

Informing the Judge Counts, Even When the Records Have Not Arrived

The rule says inform or submit, and the difference is the part that saves claims. A claimant who has requested records from a named provider and not received them can tell the judge so, in writing, before the deadline. Section 404.935(b) then directs the judge to accept the evidence when it does arrive, provided no decision has yet issued, where the claimant actively and diligently sought it from the source and it was not received, or was received less than five business days before the hearing.

The other exceptions are narrower. The judge will also accept late evidence where the agency’s own action misled the claimant, where a physical, mental, educational, or linguistic limitation prevented earlier submission, or where an unusual, unexpected, or unavoidable circumstance did, with serious illness, a death or serious illness in the immediate family, and records destroyed by fire or accident given as examples. None of these covers a claimant who did not ask for the records until the hearing was close.

The duty behind the deadline is older and broader. 20 C.F.R. § 404.1512 requires a claimant to inform the agency about or submit all evidence known to the claimant that relates to whether they are disabled, in its entirety, as an ongoing duty at every level of review. The agency considers only impairments the claimant says they have or about which it receives evidence, so a condition never mentioned is a condition never evaluated.

A file that stops at the reconsideration denial is the most common shape a hearing file arrives in, and the months since that denial are usually where the useful records are. Reading an exhibit list against a provider list is the first hour we spend with a new client. We are glad to look at it with you before anything is filed. Call us at (800) 525-6386.

Why Requested Records Still Arrive Late

The agency’s own timetable shows how slowly medical records move. Section 404.1512(b) defines the every reasonable effort SSA owes a claimant as one initial request to a medical source, one follow-up between 10 and 20 calendar days later if nothing has come, and then at least 10 more calendar days for the source to reply. That is a month budgeted for one provider, assuming it answers on the second attempt. A hospital system’s release-of-information office, or a specialty practice that treats the request as a low priority, can take longer.

A treating-source functional assessment, the document a hearing most often lacks, has the same problem in a different form, because it asks a busy clinician to write something new rather than copy something old. A request made 30 days before the hearing will likely produce a document after the deadline, and the judge’s willingness to accept it will then depend on whether the request and the follow-up were documented. Once the file is closed, the hearing itself turns on testimony, and the vocational expert’s answers to the judge’s hypothetical questions, described on our Michigan ALJ hearing page, are built on whatever limitations the written record supports.

A Calendar Counted Backward From the Hearing Date

The 75-day notice period and the five-business-day deadline together leave roughly 10 weeks to finish a file. In the first week the acknowledgment goes back, the exhibit list is compared against every provider seen since the reconsideration denial, and requests go out, because the agency’s own timetable says the answers take a month.

Around the midpoint, unanswered requests get a documented follow-up and the functional assessment request goes to the treating provider with the deadline stated. Two weeks out, anything still outstanding is described to the judge in writing, by source and date requested, so that the diligence exception is on the record before it is needed.

The hearing queue at Michigan’s hearing offices, which our SSDI timeline page describes as historically the longest wait in the process, means that most of the evidence the judge will need did not exist when the hearing was requested. A file complete at reconsideration is, by the hearing date, a year out of date.

Getting the Record to the Judge While It Still Counts

Five business days is a short deadline at the end of a long wait, and it is enforced by a judge who has the discretion to enforce it. For claimants across Michigan with a hearing notice in hand, we review the exhibit list and the provider list together at Neumann Law Group. We are happy to talk it through with you. Call (800) 525-6386 or contact our office.

A Michigan veteran’s Social Security earnings record can be worth more than the pay history behind it. For active-duty service through 2001, the regulations add wages that were never actually paid, and those deemed wages count toward both the work credits that decide whether a disability claim is insured and the amount the benefit pays.

20 C.F.R. § 404.1341 adds $300 for each calendar quarter of active duty from 1957 through 1977, regardless of the wages actually paid for that quarter, and $100 for each $300 in wages paid for service from 1978 through 2001, capped at $1,200 in credits for any calendar year. Active service in the World War II and post-World War II periods carries a deemed $160 for each month of service under 20 C.F.R. § 404.1340.

Both regulations say the credits apply in determining entitlement to a benefit, in computing its amount, and “for establishing a period of disability,” which is the insured-status question a disability claim has to answer first. Neumann Law Group checks a veteran’s service dates against the earnings record at the start of every Michigan Social Security Disability claim it takes for a former service member, in Northern Michigan and across the state, because the credits are added by the agency at computation time and do not appear as wages on the statement a veteran can pull for themselves. A service year that looks thin on that statement may be worth more than it shows.

What the Credits Do for Insured Status

Disability insured status for most adults requires 20 quarters of coverage in the 40-quarter period ending with the quarter of disability, together with fully insured status, and a quarter of coverage is earned by reaching a dollar threshold of covered earnings that is set each year. The deemed wages are added to the covered earnings for the service years, so a year of active duty in the 1957 through 2001 window carries more credited earnings than the pay stubs show, and a service year that would otherwise fall short of a quarter of coverage can qualify for one. The work-credit rules themselves, and the needs-based alternative for a veteran whose coverage has lapsed, are compared on our SSDI versus SSI page.

The older credits carry a condition the newer ones do not. Under § 404.1342, the World War II and post-World War II credits are granted only where using them results in entitlement, a higher benefit, or a lump-sum death payment, and they are not granted where another federal benefit, other than one payable by the Department of Veterans Affairs, is determined to be payable based in part on the same service.

20 C.F.R. § 404.1343 then lifts that limit in the one situation that applies here. It does not apply where the credits are used solely to meet the insured status and quarters-of-coverage requirements for a period of disability.

The Minimum-Service Rule for Enlistments After 1980

Section 404.1341(d) attaches a service-length condition to the credits for later enlistments. A person who first enlisted in a regular component of the Armed Forces on or after September 8, 1980, must have completed the shorter of 24 months of continuous active duty or the full period they were called to, and a parallel rule at (d)(2) covers a person who entered active duty on or after October 14, 1982, without a prior completed 24-month period. A veteran separated early does not automatically lose the credits, because the regulation lists the discharges that keep them.

The credits survive where the discharge or release was for the convenience of the government under 10 U.S.C. § 1171 or for hardship under 10 U.S.C. § 1173, where it was for a disability incurred or aggravated in the line of duty, where the veteran is entitled to compensation for a service-connected disability under chapter 11 of title 38, or where the service member died during the enlistment. For a disabled veteran the second and third of those are the ordinary case, so an early medical separation and a VA compensation award each independently preserve the credits for the months actually served.

Whether a particular period of service earned credits, and whether an early separation preserved them, is answered from the discharge paperwork in a few minutes. A veteran who has that paperwork and a denial notice can have both read together. Call our office at (800) 525-6386 and we will walk through it with you.

The One Place a VA Award Changes the Social Security Result

The regulation just described is one of the few places where a VA determination changes a Social Security result, since entitlement to service-connected compensation is itself one of the conditions that waives the 24-month rule. Everywhere else the line holds. Under 20 C.F.R. § 404.1504, a VA disability rating is a decision made under another agency’s rules, is not binding on Social Security, and for claims filed on or after March 27, 2017 receives no analysis in the decision at all, while the medical evidence underneath the rating is considered like any other evidence.

Our VA disability and SSDI page sets out how the two programs answer different questions. The credits also stop. Section 404.1341 grants them for service from 1957 through 2001 and no later, so a veteran whose service began after 2001 is credited with actual military pay only, at the rate every other covered worker is.

Comparing Service Dates to the Earnings Statement

The earnings statement Social Security provides shows wages reported by employers, including military pay, and the deemed amounts are applied when a benefit is computed rather than displayed as a line item. A veteran reviewing the statement should compare each year of active duty against the wages shown for it, note any service year that shows low or missing wages, and keep discharge documentation showing the dates and character of service available, since it is the record the agency uses to establish the periods the credits attach to.

For a claim that was denied on insured status, the service dates are the first thing to check, because a veteran whose civilian work ended years before the disability began may still be insured once the service quarters are counted correctly. For a claim that was approved, the same review can raise the monthly amount.

Checking a Veteran’s Earnings Record for Missing Credits

The credits are automatic in principle and missed in practice, usually because nobody compared the service dates to the record. We represent veterans at Neumann Law Group in Social Security Disability claims throughout Michigan, from the Traverse City area to Detroit. Call us at (800) 525-6386 or contact our office to arrange a consultation.

Two Michigan Social Security Disability denials have nothing to do with whether the claimant is disabled. One follows a missed consultative examination. The other follows a prescribed treatment the claimant did not pursue, and both are written into the regulations as grounds on which an otherwise qualifying claim is refused.

Under 20 C.F.R. § 404.1518, a claimant who fails or refuses without good reason to take part in a consultative examination the agency arranges may be found not disabled. Under 20 C.F.R. § 404.1530, a claimant who does not follow treatment prescribed by their own medical source, where that treatment is expected to restore the ability to work, will not be found disabled unless there is a good reason.

The first rule is discretionary and the second is not, and both can be answered with a phone call or a documented explanation made at the right time. Neumann Law Group sees both denials in Michigan Social Security Disability files from Lansing to Detroit, and in nearly every one the reason existed and was never put in writing. Both rules say what a good reason is.

The Consultative Examination and the Reasons for Missing One

A consultative examination is an examination or test the agency arranges and pays for when the evidence from a claimant’s own sources is insufficient or inconsistent, and in Michigan it is scheduled through the state’s Disability Determination Services during the initial and reconsideration reviews, the stage our how to apply for SSDI page describes. Section 404.1518(a) states the consequence of not attending and, in the same paragraph, the cure. A claimant with any reason they cannot attend should tell the agency as soon as possible before the examination date, and where the reason is good, another examination is scheduled.

The regulation lists what it considers good reasons: illness on the date of the examination, not receiving timely notice or any notice at all, being given incorrect or incomplete information about the physician or the time or place, and a death or serious illness in the immediate family. The agency also considers the claimant’s physical, mental, educational, and linguistic limitations in deciding whether a reason is good. Section 404.1518(c) adds a route people rarely use. Where a claimant’s own medical source says the claimant should not take the examination or test, the claimant should tell the agency at once, and the source may agree to a different examination for the same purpose.

The Treatment Rule Applies Only After a Finding of Disability

Social Security Ruling 18-3p, published at 83 FR 49616 and applied to decisions on or after October 29, 2018, sets the order of operations. The agency decides whether a claimant failed to follow prescribed treatment only if three conditions exist: the claimant would otherwise be entitled to benefits, the claimant’s own medical source prescribed treatment for the impairment on which the disability finding rests, and there is evidence the claimant did not follow it. A treatment recommended only by a consultative examiner, a state agency medical consultant, or a medical expert at hearing does not count.

The ruling also defines the term. Prescribed treatment means medication, surgery, therapy, durable medical equipment, or assistive devices. It does not include lifestyle modifications, and the ruling names dieting, exercise, and smoking cessation as the examples. A denial built on a claimant’s failure to lose weight or quit smoking has applied a rule the ruling says does not reach those things.

Where the three conditions are met, two assessments follow, in either order. The agency asks whether the treatment, if followed, would be expected to restore the ability to engage in substantial gainful activity, a judgment it makes itself while considering the prescribing source’s prognosis. And it asks whether the claimant had good cause for not following it. A negative answer on either assessment ends the inquiry in the claimant’s favor.

A declined surgery or an unfilled prescription usually has a reason behind it that the chart never records. Getting that reason into the file before the agency asks is a short piece of work, and it is one we do with new clients. One call is usually enough for us to tell you where things stand. Call us at (800) 525-6386.

What Counts as Good Cause

The regulation gives five examples and the ruling expands them. The burden of showing good cause is on the adult claimant, and the ruling states what each reason has to be supported by.

• Religion. The established teaching of the claimant’s religion prohibits the treatment, shown by evidence of membership and of the teaching.
• Cost. The claimant cannot afford treatment they are willing to follow and no affordable or free community resource is available, with a showing of why no insurance or free clinic covered it.
• Incapacity. The claimant is unable to understand the consequences of not following the treatment.
• Medical disagreement. The claimant’s own sources disagree about the treatment, or the claimant followed one source’s treatment to the exclusion of another’s.
• Intense fear of surgery. Supported by a written statement from the claimant’s own source that the fear is a contraindication to the surgery.
• Prior history. The same or similar major surgery for the same impairment was performed before with unsuccessful results.
• High risk of loss of life or limb. Open-heart surgery, organ transplant, one-eye cataract surgery with a severe impairment of the other eye, or amputation.
• Risk of opioid addiction. The prescribed treatment is opioid medication.

Any other reason is judged case by case. Two things are excluded in terms. A claim that the claimant did not know the source had prescribed the treatment is not good cause unless incapacity is shown, and a refusal of surgery because the surgery might not succeed, or because someone the claimant knows had a bad result, is not either. The ruling calls those mere assertions about the treatment’s effectiveness.

Documenting the Reason Before the Agency Asks

Each good-cause reason has a specific proof attached to it, and the proof is easier to gather at the time than at a hearing. A cost reason needs the insurance denial or the clinic’s response. A fear-of-surgery reason needs the treating source’s written statement, and a medical-disagreement reason needs both sources’ notes in the file. Where the claimant’s reason is that the treatment was tried and failed, the earlier operative report is the evidence.

Where a denial has already issued on either ground, the reconsideration stage described on our reconsideration page is where the explanation and its proof go, and a missed examination can be rescheduled at that stage rather than argued about. The reason travels with the file to every later level.

If a Treatment Was Refused or an Exam Was Missed

Both rules turn on reasons the claimant usually had and rarely wrote down, and both are far easier to answer while the file is open than after a decision. At Neumann Law Group, we handle Social Security Disability claims throughout Michigan, and we read a denial notice against both rules before recommending anything. We are glad to talk through any of these questions. Call (800) 525-6386 or send us a message and we will get back to you.

A 56-year-old Michigan machinist limited to sedentary work is asked a question that a 48-year-old with the same file is not, and the answer usually decides the claim. The question is whether the skills built over decades on a shop floor transfer to a desk, and after 55 the regulation demands an answer that most jobs cannot give.

20 C.F.R. § 404.1568(d)(4) provides that a claimant of advanced age, meaning 55 or older, who is limited to sedentary or light work cannot make an adjustment to other work unless they have skills that transfer to other skilled or semiskilled work they can still do, or have recently completed education that provides for direct entry into skilled work. For the claimant limited to sedentary work it then sets the test. Skills transfer only if the sedentary work is so similar to the previous work that the person “would need to make very little, if any, vocational adjustment in terms of tools, work processes, work settings, or the industry.”

At Neumann Law Group, we build Michigan Social Security Disability claims for workers past 55 from Kent County to Grand Traverse County around that sentence, because the manufacturing and trades work those clients did for 30 years rarely resembles the sedentary jobs a vocational expert names. The rule is stated in one paragraph of the regulation, and the paragraph is worth reading in full.

What Transferability Means Below 55

Section 404.1568(d)(1) treats a claimant as having transferable skills when the skilled or semiskilled work activities of past jobs can be used to meet the requirements of other skilled or semiskilled jobs, which depends largely on the similarity of occupationally significant work activities. Paragraph (d)(2) says where transferability is most probable and meaningful. The other job requires the same or a lesser degree of skill, uses the same or similar tools and machines, and involves the same or similar raw materials, products, processes, or services.

Paragraph (d)(3) adds that there are degrees of transferability and that complete similarity of all three factors is not necessary, then draws a line the other way. Where skills are so narrowly specific, or were acquired in such an isolated vocational setting, that they are not readily usable in other industries, jobs, and work settings, they are not transferable, and the regulation names mining, agriculture, and fishing as its examples. One further definition does quiet work in Michigan claims. Under § 404.1568(a), a person does not gain work skills by doing unskilled jobs, and a job that can be learned in 30 days with little judgment is unskilled however heavy it was.

The Stricter Test That Starts at 55

Paragraph (d)(4) replaces the ordinary similarity analysis with a near-identity requirement, and it does so in bands.

• Age 55 or older, limited to sedentary work. Skills transfer only to skilled or semiskilled sedentary work so similar to the past work that very little, if any, vocational adjustment is needed in tools, work processes, work settings, or the industry.
• Age 55 to 59, limited to light work. The ordinary rules in paragraphs (d)(1) through (d)(3) apply.
• Age 60 or older, limited to light work. The near-identity test returns, and skills transfer to light work only where very little, if any, adjustment is needed.
• The education exception at every band. Recently completed education providing for direct entry into skilled work defeats the rule, and the Appendix 2 commentary says education completed in the remote past ordinarily does not.

Appendix 2 to Subpart P, the Medical-Vocational Guidelines, restates the sedentary version at § 201.00(f) and the light version at § 202.00(f), and § 201.00(d) states the consequence directly. The adversity of restriction to sedentary work at advanced age, for a person who can no longer perform past relevant work and has no transferable skills, “warrants a finding of disabled” in the absence of the rare case of recent education providing direct entry into skilled sedentary work.

Whether a claimant’s skills survive the (d)(4) test is usually clear from a careful description of the old job, and the description is worth writing before the hearing notice arrives. We review those descriptions against the four adjustment factors. We talk these questions through with you. Call us at (800) 525-6386.

What Very Little Adjustment Rules Out

The four factors are tools, work processes, work settings, and industry, and a proposed job has to match on all four with little or no adjustment. A CNC machinist offered a seated quality-inspection job in the same plant, using the same gauges on the same parts, is close to the test. The same machinist offered a general clerical job fails it on every factor at once, and so does an offer of dispatching, order entry, or telephone customer service in an unrelated industry.

That structure is what makes the vocational expert’s testimony answerable. At a hearing, the expert who testifies that a claimant’s skills transfer to a named sedentary occupation can be asked, factor by factor, which tools, processes, settings, and industry that occupation shares with the past work. The tables then do the rest. On the grid rules laid out on our over-50 grid rules page, a claimant of advanced age with a high school education that does not provide direct entry into skilled work is disabled under Rule 201.06 where skills do not transfer and not disabled under Rule 201.07 where they do, with nothing medical separating the two rows.

The Evidence That Proves Skills Do Not Transfer

Non-transferability is proved with a work history, not a medical record. Each past job should be described by the machines and tools actually used, the materials and products handled, the process the worker controlled, the setting, and the industry, in enough detail that a new occupation can be compared against all four factors. Where the training was employer-specific or the process existed nowhere else, that fact belongs in the description, because § 404.1568(d)(3) makes isolation and narrow specificity a reason skills do not transfer.

The medical half of the case is the exertional finding, and for a worker past 55 the sedentary finding is the one that triggers the strict test. The treating-source assessment that establishes it is described on our back and spinal injuries page, since spinal impairments are the most common route to a sedentary residual functional capacity. Dates of birth near the 55 and 60 boundaries should be flagged, because the band a claimant sits in changes which version of the test applies.

Proving the Adjustment a New Job Would Require

After 55 the question is no longer whether a claimant could learn something new, and a file that argues the point that way has conceded more than the regulation asks. We represent older Michigan workers at Neumann Law Group in Social Security Disability claims statewide. If you would like us to look at your situation, call (800) 525-6386 or contact us through our website.