Administrative Hearing Request Packet - Michigan

Michigan Administrative Law Updated August 11, 2026 Free Word and PDF

ADMINISTRATIVE HEARING REQUEST PACKET — MICHIGAN

Important scope

This packet is a drafting aid, not a universal Michigan appeal form.

Under MCL 24.203(3), a contested case exists when law requires an agency to determine a named party's legal rights, duties, or privileges after an opportunity for an evidentiary hearing. The Michigan Administrative Procedures Act supplies procedures for a qualifying contested case, but it does not itself create a hearing right for every adverse agency action.

Before using the request, identify all five items below from the adverse-action notice and the agency-specific statute, rule, policy, or official form:

Required item Verified information
Source creating the hearing right [________________________________]
Filing deadline and triggering event [________________________________]
Required recipient [________________________________]
Required form or required contents [________________________________]
Permitted filing and service methods [________________________________]

Do not send this packet to MOAHR merely because MOAHR may later conduct the hearing. Many hearing requests must first be submitted to the referring agency, and some programs use a direct MOAHR route.

1. Agency-route screen

Public-assistance and Medicaid matters

The current MOAHR public-assistance page separates these routes:

Matter Initial route
MDHHS eligibility decisions involving FAP, FIP/SDA, CDC, SER, DSS, State SSI Payment, Medicaid, MIChild, or Healthy Michigan Plan Submit the current hearing-request form or another permitted written request to a local MDHHS office. A Food Assistance Program request may also be made verbally to the local office.
Medicaid-covered services, PACE disenrollment, or waiver-application decisions Use the current MOAHR-BSD form and submit the request, adverse-action notice, and any required guardianship papers through the destination and method stated on that form.
Managed-care, CMHSP/PIHP, MI Health Link, or MI Choice Waiver appeal Complete the required internal appeal first unless the organization failed to respond as required, then use the current state-fair-hearing route identified by MOAHR.
Michigan Rehabilitation Services or Adoption Subsidy Services Submit the request to the assigned worker or local office.

For any other matter, use the adverse-action notice and the responsible agency's current official instructions. Tax Tribunal, workers' compensation, unemployment, public-service-commission, professional-licensing, environmental, education, and other proceedings have distinct statutes and rule parts. Do not transplant a deadline, form, or filing address from another program.

Intake checklist

☐ Copy of the complete adverse-action notice obtained

☐ Agency and program identified precisely

☐ Statute or rule creating the hearing right identified

☐ Deadline calculated from the correct triggering event

☐ Required agency form checked

☐ Correct recipient and filing method confirmed

☐ Internal review or exhaustion requirement checked

☐ Continued-benefit or automatic-stay rule checked, if any

☐ Proof of timely transmission or receipt planned

2. Cover letter to the correct recipient

[__/__/____]

VIA: [________________________________]

[________________________________]

[Agency, division, or tribunal]

[________________________________]

[Address or approved electronic destination]

Re: Request for administrative hearing

Affected person or entity: [________________________________]

Agency reference number: [________________________________]

Notice date: [__/__/____]

Date received: [__/__/____]

Dear [________________________________]:

The undersigned requests the hearing authorized by [exact agency-specific statute, rule, or notice provision: ________________________________] to contest the action described in the attached notice.

The request is timely because [state the controlling deadline, triggering event, and calculation: ________________________________].

The requested issues and relief are stated in the attached hearing request. Please provide written confirmation of receipt and any case or docket number.

Respectfully submitted,

Signature: ________________________________

Name: [________________________________]

Capacity: ☐ Affected person ☐ Attorney ☐ Other authorized capacity: [________________]

Michigan Bar No., if applicable: [________________________________]

Address: [________________________________]

Telephone: [________________________________]

Email: [________________________________]

Enclosures: [________________________________]

3. Request for administrative hearing

A. Parties and agency action

Affected person or entity: [________________________________]

Mailing address: [________________________________]

Telephone: [________________________________]

Email: [________________________________]

Attorney or other authorized representative, if permitted: [________________________________]

Agency and division: [________________________________]

Agency reference number: [________________________________]

Action challenged: [________________________________]

Date of notice: [__/__/____]

Date notice was received: [__/__/____]

Effective date of action: [__/__/____]

B. Authority, deadline, and filing route

Source creating the hearing right: [________________________________]

Exact filing deadline: [________________________________]

Trigger for that deadline: [________________________________]

Deadline calculation: [________________________________]

Required recipient: [________________________________]

Required form or attachments: [________________________________]

Permitted filing method used: [________________________________]

Any required internal review completed: ☐ Yes ☐ No ☐ Not applicable

Explanation and supporting document: [________________________________]

C. Hearing request

The affected person or entity requests an administrative hearing concerning the agency action identified above.

Short and plain statement of disputed matters:

  1. [________________________________]

  2. [________________________________]

  3. [________________________________]

Agency findings or conclusions disputed:

  1. [________________________________]

  2. [________________________________]

Legal authority supporting the request:

  1. [________________________________]

  2. [________________________________]

D. Relief requested

☐ Withdraw or reverse the challenged action

☐ Modify the action as follows: [________________________________]

☐ Remand for further agency proceedings

☐ Issue, renew, restore, or continue the identified license, permit, benefit, or status, if authorized: [________________________________]

☐ Other relief authorized by the governing law: [________________________________]

E. Stay or continued-benefit request

Do not use this section unless a separate statute, rule, notice, or order authorizes the requested interim relief. The APA does not supply one universal pre-hearing stay test.

Authority for interim relief: [________________________________]

Recipient authorized to decide the request: [________________________________]

Required standard: [________________________________]

Facts supporting each required element:

[________________________________]

[________________________________]

Requested order and duration:

[________________________________]

F. Signature

I certify that the factual statements in this request are accurate to the best of my knowledge and that the attached materials are true copies unless otherwise identified.

Signature: ________________________________

Name: [________________________________]

Date: [__/__/____]

4. Attachment list and transmission record

Attachments

☐ Complete adverse-action notice

☐ Required agency form

☐ Document establishing the hearing right or filing instructions

☐ Statement of disputed issues

☐ Supporting exhibits permitted at the request stage

☐ Authorization or appearance document, if required

☐ Internal-appeal decision, if required

☐ Guardianship or other capacity document, if required

☐ Separate stay or continued-benefit request, if authorized

Transmission record

Item Entry
Recipient [________________________________]
Destination [________________________________]
Method [________________________________]
Date and time sent [__/__/____] [____]
Date received, if available [__/__/____]
Confirmation or tracking number [________________________________]
Person confirming receipt [________________________________]

5. After referral to MOAHR

The rules below govern a MOAHR proceeding only to the extent their scope provision applies and no controlling statute or specialized rule displaces them.

Notice of hearing

MCL 24.271 requires reasonable notice in a contested case, including the hearing's date, hour, place, and nature; the legal authority and jurisdiction; the particular statutes and rules involved; and a short and plain statement of the matters asserted.

When the notice arrives, record:

Notice item Entry
MOAHR docket number [________________________________]
Administrative law judge [________________________________]
Hearing date and time [__/__/____] [____]
Remote access or location [________________________________]
Governing statutes and rules [________________________________]
Issues stated in notice [________________________________]
Motion deadline [__/__/____]
Exhibit deadline [__/__/____]
Contact or approved filing mailbox [________________________________]

If the notice is materially unclear, consider a request for a more definite and detailed statement under MCL 24.271(2)(d).

Filing and service after a case is open

Under R 792.10109, filings may be made by mail, personal delivery, fax, or an approved electronic filing system. Email ordinarily requires authorization. Administrative Hearing Standard No. 2024-1 authorizes email filing for MOAHR case types unless an electronic system already applies or the ALJ or hearing officer directs otherwise. An email filing must use the approved MOAHR group mailbox stated in the notice, include the docket number in the subject line, and copy the other parties.

R 792.10110 requires a party to serve filed documents on all other parties and to file a statement of service identifying the method, server, persons served, date, and place of service. Email service between parties requires their agreement.

Do not use the MOAHR general-information email as a filing destination unless the notice, governing form, rule, or authorized official identifies it for the case.

Prehearing conference

R 792.10114 permits a prehearing conference addressing subpoenas, factual and legal issues, stipulations, official notice, exhibits, witnesses, motions, scheduling, settlement, and other matters promoting an orderly hearing. A conference may occur in person, by telephone, by video, or electronically.

Prepare:

☐ Precise issue list

☐ Requested relief and supporting authority

☐ Witness list and short testimony summary

☐ Exhibit list

☐ Stipulations that may narrow the dispute

☐ Pending or anticipated motions

☐ Subpoena needs and statutory authority

☐ Accessibility or format request

☐ Settlement position, if appropriate

Motions

Under R 792.10115, a request for ALJ action outside a hearing must be written, state specific grounds, describe the requested action, cite supporting authority, and be served. Unless the ALJ approves otherwise or scheduling makes compliance impossible, a motion is due at least 14 days before the hearing; a response may be filed within 7 days after service.

Motion requested: [________________________________]

Authority: [________________________________]

Requested order: [________________________________]

Filing deadline: [__/__/____]

Response deadline: [__/__/____]

Discovery and subpoenas

R 792.10117 provides that discovery is not allowed in a contested case unless a statute, another rule, or the ALJ grants leave.

MCL 24.273 requires an agency to issue a requested subpoena only when another statute authorizes that agency to issue subpoenas. MCL 24.280(1)(b) authorizes a presiding officer to sign and issue subpoenas in the agency's name, and R 792.10106(1)(n) limits subpoena authority to the extent authorized by statute.

Before requesting a subpoena, identify:

Requirement Verified information
Statute authorizing this agency to subpoena [________________________________]
Witness or documents sought [________________________________]
Relevance and particularity [________________________________]
Issuing procedure or required form [________________________________]
Service method [________________________________]
Witness fee and mileage requirement [________________________________]
Enforcement court, if needed [________________________________]

Evidence and exhibit exchange

MCL 24.275 and R 792.10125 apply the civil rules of evidence as far as practicable while permitting evidence commonly relied on by reasonably prudent persons. Irrelevant, immaterial, or unduly repetitious evidence may be excluded, and recognized privileges apply.

Under R 792.10126, unless the ALJ allows otherwise, documentary evidence must reach the ALJ and opposing parties at least 7 days before the hearing. If the notice was issued less than 30 days before the hearing, the default deadline is no later than 1 business day before the hearing, subject to good cause.

Exhibit Description Source/authentication witness Sent to ALJ Served on parties
[____] [________________________________] [________________________________] [__/__/____] [__/__/____]
[____] [________________________________] [________________________________] [__/__/____] [__/__/____]
[____] [________________________________] [________________________________] [__/__/____] [__/__/____]

Remote or in-person format

R 792.10121 permits all or part of a hearing by telephone, video conference, or other electronic means while preserving substantive and procedural rights. Administrative Hearing Standard No. 2024-1 makes remote proceedings the default.

A party may submit a written good-cause request for an in-person proceeding based on accessibility limitations, specific evidentiary issues, or other unique circumstances. The ALJ or hearing officer decides the request.

Requested format: ☐ Remote ☐ In person

If in person, facts establishing good cause:

[________________________________]

[________________________________]

6. Hearing preparation

MCL 24.272 gives parties an opportunity to present oral and written argument, present evidence, cross-examine witnesses, and submit rebuttal evidence. If a properly notified party fails to appear and no adjournment is granted, the agency may proceed in that party's absence.

Issue and proof chart

Issue Governing authority Required facts Supporting evidence Opposing position
[________________________________] [________________________________] [________________________________] [________________________________] [________________________________]
[________________________________] [________________________________] [________________________________] [________________________________] [________________________________]

Witness plan

Witness Facts established Exhibits Direct questions Anticipated cross
[________________________________] [________________________________] [________________________________] [________________________________] [________________________________]
[________________________________] [________________________________] [________________________________] [________________________________] [________________________________]

Hearing checklist

☐ Notice, scheduling orders, and governing rules reviewed

☐ Remote connection or hearing location confirmed

☐ Exhibits exchanged by the controlling deadline

☐ Proof of service retained

☐ Witness availability confirmed

☐ Authentication and foundation planned

☐ Objections and responses prepared

☐ Requested findings and relief tied to authority

☐ Private or identifying information appropriately redacted

7. Decision, rehearing, and judicial review

Identify the document received

MCL 24.281 governs a proposal for decision when the final decision-makers did not hear the case or read the record. R 792.10131 requires an ALJ proposal for decision when no statute, rule, or delegation gives the ALJ final-decision authority. The proposal should state findings of fact, conclusions of law, and the rationale.

MCL 24.285 governs the final decision or order. It must include separately captioned findings of fact and conclusions of law and must be based on the record as a whole and competent, material, and substantial evidence.

Document received: ☐ Proposal for decision ☐ Final decision or order ☐ Other: [________________]

Date mailed or delivered: [__/__/____]

Exceptions deadline, if any: [__/__/____]

Decision-maker with final authority: [________________________________]

Record and rehearing

MCL 24.286 identifies the official hearing record and requires recording of oral proceedings where evidence is presented. A requested transcript is ordinarily paid for by the requesting party unless other law provides otherwise.

MCL 24.287, not MCL 24.285, governs rehearing under the APA. A rehearing request must be filed within the time fixed by the APA for judicial review, but a specialized statute or agency rule may control or alter the route.

Rehearing authority and deadline: [________________________________]

Grounds: [________________________________]

Effect on review deadline: [________________________________]

Judicial review screen

The general APA review provisions apply only when a special statutory review proceeding does not control.

  • MCL 24.301 generally requires exhaustion and a final decision or order.
  • MCL 24.302 gives priority to an applicable special statutory review proceeding.
  • MCL 24.303 generally places an APA petition in the circuit court where the petitioner resides or has its principal place of business in Michigan, or in Ingham County, subject to statutory exceptions.
  • MCL 24.304 generally requires filing within 60 days after mailing of the final decision or order, or after the rehearing decision when rehearing was timely requested. Filing does not itself stay enforcement.
  • MCL 24.306 supplies the general grounds for setting aside an agency decision and authorizes affirmance, reversal, modification, or remand.

Before filing for review, complete:

Review item Verified information
Special review statute, if any [________________________________]
Exhaustion completed [________________________________]
Final-order mailing date [__/__/____]
Rehearing request and effect [________________________________]
Filing deadline [__/__/____]
Court and venue [________________________________]
Required pleading and attachments [________________________________]
Record/transcript request [________________________________]
Stay authority and requested terms [________________________________]
Applicable court rule [________________________________]

8. Sources and references

This template must be reviewed and customized by a qualified Michigan attorney. Confirm the live agency notice, form, deadline, recipient, filing method, specialized rules, and review statute before use.

Insert Image

Insert Table

Watch Ezel in action (sample case)Choose a plan

All changes saved
Save
Export
Export as DOCX
Export as PDF
Generating PDF...
administrative_hearing_request_packet_mi.pdf
Ready to export as PDF or Word
AI is editing...
Chat
Review

Draft it in the editor

The AI drafts each section from your answers and you review every word. Drafting from scratch takes hours; finish yours for $99 one time.

  • Built on this template
    Uses the Michigan version and the statutes it cites.
  • Formatted like the template
    Captions, numbering and layout stay intact.
  • AI editing
    Rewrite any section from your own notes.
  • Export as PDF and Word
    Yours to review, sign, or file.
Secure checkout via Stripe
Need to customize this document?

About this template

Last updated
August 11, 2026
Citations checked
August 11, 2026
Jurisdiction
Michigan
Category
Administrative Law

Legal authority

  • MCL 24.203(3) (definition of contested case)
  • MCL 24.271 to 24.287 (procedures in contested cases)
  • MCL 24.301 to 24.306 (judicial review)
  • Mich. Admin. Code R 792.10106, R 792.10109, R 792.10110, R 792.10114, R 792.10115, R 792.10117, R 792.10121, R 792.10125, R 792.10126, R 792.10130, and R 792.10131
  • MOAHR Administrative Hearing Standard No. 2024-1

Administrative law covers how you interact with government agencies, from filing a comment on a proposed rule to appealing a denied license or benefit. Agency processes have their own forms, deadlines, and evidence standards that are different from what courts use. Getting the paperwork wrong usually means missing a deadline or losing the right to appeal, so precision in these documents matters as much as it does in a courtroom filing.

Not legal advice

This template is provided for informational purposes. We recommend having an attorney review any legal document before signing, especially for high-value or complex matters.

Checked against the law it cites

A reviewer verified this template's legal citations against the official source on August 11, 2026.

Draft your Administrative Hearing Request Packet - Michigan in the editor

Answer a few questions, let the AI editor draft each section from your answers, review it, and download Word and PDF. $99 one time, or $249 per month for every document and every Ezel app.