Guide: Social Security Lawyers Near Me, SSDI — California, California

California, California SSDI Denials and Appeals: A Practical Guide from Social Security Lawyers Near You

Facing a Social Security Disability Insurance (SSDI) denial in California can feel overwhelming. The process is federal, but your experience is local: your claim is initially evaluated by a state agency working with the Social Security Administration (SSA), your hearing will be scheduled through a California hearing office, and federal court review—if needed—will be in a U.S. District Court located in California. This guide gives you a clear, claimant-focused roadmap through the SSDI appeals process, your rights, and what to expect at each stage, grounded in federal law and official SSA regulations.

SSDI is a federal insurance benefit for workers who paid sufficient Social Security taxes and can no longer engage in full-time, competitive work due to a medically determinable impairment lasting (or expected to last) at least 12 months or to result in death. California claimants must meet both medical and non-medical eligibility rules. If you received a denial, remember: most SSDI claims are not approved at the initial level, and the appeals system exists so you can ask a new reviewer—or a judge—to take a fresh look at your case.

In California, your initial medical determination is made by the state disability determination service (DDS) in partnership with SSA, as required by federal regulations. If you appeal, your hearing is conducted by a federal Administrative Law Judge (ALJ). Throughout, federal rules control deadlines, evidence submission, and hearings. This guide explains the steps under the Code of Federal Regulations (CFR) and the Social Security Act—without speculation—so you can act in time, strengthen your record, and protect your rights.

Below you’ll find: a plain‑English summary of your rights; the most common reasons SSA denies claims; the key federal rules that matter; the steps to take immediately after a denial; when to hire a lawyer; and California‑specific pointers for locating your local SSA office and hearing site. If you need help now, an experienced California disability attorney can guide you at any stage and ensure you meet every deadline.

Key links to start your appeal

SSA: Appeal a Decision (Start Your Appeal Online)SSA Office Locator (Find Your California Field Office)eCFR: 20 CFR Part 404, Subpart J (Hearings, Appeals and Review)eCFR: 20 CFR 404.1520 (How SSA Decides if You Are Disabled)eCFR: 20 CFR 422.210 (Filing a Federal Court Action)

Understanding Your SSDI Rights

Your rights in an SSDI claim come from the Social Security Act and SSA regulations. Some of the most important are:

• Right to appeal: You have the right to appeal an adverse determination at each stage, within set deadlines. Federal rules establish each step: reconsideration, hearing before an Administrative Law Judge (ALJ), Appeals Council review, and federal court. See, for example, 20 CFR 404.909 (reconsideration), 20 CFR 404.933 (requesting a hearing), 20 CFR 404.968 (Appeals Council review), and 20 CFR 422.210 (civil action in U.S. District Court).
• Right to a decision based on the correct legal standard: SSA must evaluate disability under the sequential evaluation process described in 20 CFR 404.1520. This includes assessing your medically determinable impairments, severity, whether you meet or equal a Listing, your past relevant work, and your ability to adjust to other work in the national economy.
• Right to submit evidence and be heard: You may submit medical and non-medical evidence and provide testimony at a hearing. Evidence rules appear in 20 CFR 404.1512 (your duty to submit evidence) and the “five‑day rule,” 20 CFR 404.935 (timely submission of evidence before an ALJ hearing), with exceptions for good cause.
• Right to representation: You may appoint a qualified representative, including an attorney or non‑attorney representative, as defined in 20 CFR 404.1705. Representatives’ fees must be approved by SSA under the Social Security Act, 42 U.S.C. § 406, and 20 CFR 404.1720–404.1730.
• Right to a written decision and to review your file: You are entitled to a written notice of the decision and the reasons for it. You may review the evidence used in deciding your case.
• Right to fair procedures and good‑cause exceptions: If you miss a deadline for good cause, SSA can extend the time to appeal. See 20 CFR 404.911.

California claimants also have practical access rights: SSA offers hearings by telephone or online video in addition to in‑person hearings, which is important in a large state where travel can be significant. Regardless of format, the same federal standards apply, and the ALJ will issue a written decision explaining the findings and rationale.

Common Reasons SSA Denies SSDI Claims

Every denial notice should state the main reason your claim was denied. Understanding these common issues helps you target your appeal:

• Insufficient medical evidence of a severe impairment: SSA requires objective medical evidence from acceptable medical sources. If records are sparse, outdated, or do not document functional limitations, SSA may find your impairment “not severe” or not disabling. See 20 CFR 404.1512 (evidence) and 20 CFR 404.1521 (definition of non‑severe impairments).
• Ability to do past work or other work: Under 20 CFR 404.1520, SSA may find you can perform your past relevant work or adjust to other work, based on your residual functional capacity (RFC), age, education, and work experience. The Medical‑Vocational Guidelines (the “Grids”) are found at 20 CFR Part 404, Subpart P, Appendix 2.
• Work activity above substantial gainful activity (SGA): If you are working and earning at or above SGA, SSA generally finds you not disabled. The rules are at 20 CFR 404.1571–404.1574. SGA thresholds change periodically; check SSA for current amounts.
• Not insured on your alleged onset date: SSDI requires that you have “insured status” based on your work history. If your “date last insured” (DLI) passed before you became disabled, SSA will deny. See 20 CFR 404.130–404.131.
• Noncompliance or failure to attend consultative exams: If you do not attend a scheduled consultative examination or fail to cooperate with requests for information, SSA may deny for insufficient evidence. See 20 CFR 404.1517–404.1519t.
• Impairment not expected to last 12 months: To qualify, the impairment must be expected to result in death or last at least 12 months. See 20 CFR 404.1509.
• Substance use materiality findings (in applicable cases): In limited circumstances, SSA may deny if drug addiction or alcoholism is a contributing factor material to the disability finding. See 20 CFR 404.1535.

California claimants should pay special attention to the completeness of medical records. Because care is often spread among large hospital systems and specialty clinics, it’s common for critical testing or specialist notes to be missing from the initial record. You have the right and duty to submit all relevant evidence you can obtain, and to inform SSA about any evidence you cannot get on your own.

Federal Legal Protections & Regulations

SSDI appeals are governed by the Social Security Act and federal regulations. The following provisions are central to protecting your rights:

• Appeals framework: The appeals process is set out in 20 CFR Part 404, Subpart J. Key sections include reconsideration (20 CFR 404.909), hearings (20 CFR 404.929–404.961), Appeals Council review (20 CFR 404.967–404.981), and judicial review (20 CFR 422.210), which implements the judicial review provision of the Social Security Act at 42 U.S.C. § 405(g). Time limits (statutes of limitations for appeals):

• Reconsideration: Generally 60 days to file after you receive the denial, with a presumption that you received the notice 5 days after the date on it. See 20 CFR 404.909(a) and 20 CFR 404.901 (definitions, including the 5‑day mailing presumption).

• ALJ hearing: Generally 60 days from the reconsideration determination. See 20 CFR 404.933.

• Appeals Council review: Generally 60 days from the ALJ decision. See 20 CFR 404.968.

• Federal court: Generally 60 days from receipt of the Appeals Council’s notice (or 60 days from the ALJ decision if the Appeals Council denies review and that denial notice starts the clock). See 20 CFR 422.210(c) and 42 U.S.C. § 405(g).

• Sequential evaluation: SSA must apply the five‑step process at 20 CFR 404.1520. This ensures a uniform national standard.

• Evidence submission and the five‑day rule: At the hearing level, you must submit all written evidence no later than 5 business days before the hearing or notify SSA about it under 20 CFR 404.935. The ALJ can accept late evidence for good cause.

• Right to representation and fees: You may appoint a representative under 20 CFR 404.1705. Fees require SSA approval under 20 CFR 404.1720–404.1730 and 42 U.S.C. § 406.

• Burden of proof and vocational evidence: You bear the burden through step four; at step five, SSA must show there is other work you can perform. The Medical‑Vocational Guidelines are at 20 CFR Part 404, Subpart P, Appendix 2.

• Reopening decisions: SSA may reopen a determination under specific conditions and time frames. See 20 CFR 404.988–404.989.

These protections apply uniformly to California claimants. While your case is decided locally, the governing law is federal, ensuring that your appeal is evaluated under the same standards used nationwide.

Steps to Take After an SSDI Denial

Act promptly. The 60‑day appeal deadlines are firm, with limited good‑cause exceptions. Here is a step‑by‑step approach grounded in federal rules and practical experience:

• Read your denial notice carefully. Identify whether the denial is an initial determination or reconsideration. Note the stated reasons, your appeal deadline, and any instructions for submitting evidence.
• Calendar the 60‑day deadline and add five days for mailing, if applicable. The presumption is that you receive SSA notices 5 days after the date on the notice, unless you can show otherwise. See 20 CFR 404.901. File your appeal online via SSA’s iAppeals portal to avoid mail delays. Start your appeal on SSA’s official site.- Reconsideration is the first appeal for medical denials; request an ALJ hearing after an unfavorable reconsideration. See 20 CFR 404.909 and 20 CFR 404.933.

Gather and submit updated medical evidence. Under 20 CFR 404.1512, you must submit all evidence known to you that relates to whether you are disabled, including:

• Diagnostic imaging, lab results, and specialist reports;

• Function reports and third‑party observations documenting day‑to‑day limitations;

• Physical therapy, pain management, or mental health treatment notes;

• Work history details, job demands, and attempts to work.

• At the hearing level, follow the five‑day evidence rule. Submit evidence at least 5 business days before the hearing or notify the ALJ about outstanding records. See 20 CFR 404.935. If you cannot meet the deadline for a good reason (e.g., late‑received records), request that the ALJ accept late evidence and explain why.

• Prepare your testimony and address functional limits. The ALJ will consider your residual functional capacity (RFC). Be ready to explain how your symptoms limit sitting, standing, lifting, concentration, pace, and persistence, and how often you need to rest, elevate, or lie down. Tie your testimony to objective medical findings where possible.

• Anticipate vocational expert (VE) issues. At many hearings, a VE will testify about jobs in the national economy. You or your representative may question the VE about job numbers, transferable skills, and whether the hypothetical RFC reflects all of your documented limitations. The burden at step five is on SSA.

• Consider representation. A knowledgeable representative can help frame issues, obtain critical records, and cross‑examine the VE. Representation is your right under 20 CFR 404.1705; fees are subject to SSA approval under 42 U.S.C. § 406 and 20 CFR 404.1720–404.1730.

• Keep SSA informed of address changes and availability. Missed deadlines and missed hearings can lead to dismissal. If you cannot attend a scheduled hearing, promptly request to reschedule and explain the circumstances.

• If the Appeals Council denies review, evaluate federal court. You generally have 60 days to file a civil action in the U.S. District Court for the judicial district where you reside in California. See 42 U.S.C. § 405(g) and 20 CFR 422.210.

When to Seek Legal Help for SSDI Appeals

While you may represent yourself at any stage, legal help is often beneficial in the following situations:

• Complex medical conditions or multiple impairments: Coordinating records from multiple specialists and translating medical findings into vocational limitations is challenging. A representative can help ensure the record is complete and aligned with the regulatory framework.
• Past work with heavy or complex demands: If your past relevant work requires detailed analysis of physical and mental demands, a representative can present evidence demonstrating why you cannot return to it.
• Adverse vocational testimony: Cross‑examining a vocational expert and addressing job‑numbers methodology can be critical to winning at step five.
• Missed deadlines or procedural hurdles: If you need to argue good cause for late evidence or a late appeal, an experienced advocate can present your request under 20 CFR 404.911.

About attorney qualifications in California: If you choose a California disability attorney, they must be licensed and in good standing with the State Bar of California to practice law in California courts. For representation before SSA specifically, both attorneys and qualified non‑attorneys can represent you under 20 CFR 404.1705. Regardless of who represents you, fees must be approved by SSA per 42 U.S.C. § 406 and 20 CFR 404.1720–404.1730.

Local Resources & Next Steps in California

Although SSDI is federal, your case moves through local California offices:

SSA field offices in California: SSA operates numerous field offices across California, including in Los Angeles, San Diego, San Jose, San Francisco, Sacramento, Fresno, Riverside, and other communities. Use the official SSA Office Locator to find the address, hours, and services for the office nearest you: SSA Office Locator.- Hearing locations (OHO) in California: If you request a hearing, your case will be assigned to an Office of Hearings Operations (OHO) that serves your area. Hearings can be held by phone, online video, or in person. Major California population centers are served by nearby hearing offices; confirm your assignment and contact details in your hearing notice or by contacting SSA. Online services: California claimants can file appeals, upload documents, and track their case status online: Appeal a Decision. Tip: Keep a master list of your treatment providers, including addresses and dates of service, and promptly inform SSA about any new providers or hospitalizations. Under 20 CFR 404.1512, you must submit or identify all evidence related to disability that you know about.

Detailed Overview of the SSDI Appeals Stages

1) Reconsideration

After an initial denial, the first appeal is reconsideration. A different adjudicative team at the state DDS reviews your claim. You generally have 60 days to request reconsideration after you receive the denial (20 CFR 404.909), with a 5‑day mailing presumption (20 CFR 404.901). Submit any new medical records, clarify your functional limitations, and respond to any specific issues identified in the denial.

2) Hearing Before an Administrative Law Judge (ALJ)

If reconsideration is denied, request an ALJ hearing (20 CFR 404.933). The ALJ is independent of the prior decision makers and will evaluate your case de novo under the five‑step process (20 CFR 404.1520). Key features:

• Evidence deadline: The five‑day rule at 20 CFR 404.935 requires submitting or identifying evidence at least 5 business days before the hearing, subject to good‑cause exceptions.
• Testimony: You can testify about symptoms and limitations. The ALJ may call vocational and medical experts. You or your representative can question witnesses.
• Decision: The ALJ issues a written decision explaining the findings of fact and application of law.

3) Appeals Council Review

If the ALJ denies your claim, you may request review by the Appeals Council within 60 days (20 CFR 404.968). The Appeals Council may deny review, grant review and issue its own decision, or remand your case for a new hearing. The Appeals Council generally considers whether the ALJ applied the correct law, whether substantial evidence supports the decision, and whether there were procedural errors.

4) Federal Court

After the Appeals Council’s final action, you can file a civil action in the U.S. District Court for the judicial district where you reside in California. See 42 U.S.C. § 405(g) and 20 CFR 422.210. The court reviews the administrative record to determine whether the SSA decision is supported by substantial evidence and consistent with law. Deadlines are typically 60 days from receipt of the Appeals Council notice (20 CFR 422.210(c)).

Strengthening Your Case: Evidence and Strategy

• Objective medical findings: Imaging, labs, clinical exams, and standardized testing carry weight. Ensure that diagnostic studies and specialist evaluations are in the record.
• Longitudinal treatment history: Ongoing treatment that documents a consistent pattern of limitations is persuasive. Gaps in care may require explanation.
• Function‑by‑function limitations: The RFC analysis considers sitting, standing, walking, lifting/carrying, postural activities, concentration, persistence, and pace. Address each area with specific examples and support from medical notes.
• Adherence and side effects: Document side effects (e.g., sedation, cognitive issues) and medical reasons for any non‑adherence or treatment changes.
• Work history and transferable skills: Provide detailed descriptions of past jobs and their physical/mental demands to show why you cannot return to that work.

Because California is home to large integrated health systems, make sure you request complete records, including imaging reports, test results, and clinician notes. If records are stored on different platforms, note that in your submission and notify the ALJ of any pending requests under 20 CFR 404.935.

Deadlines, Continuances, and Good Cause

Appeals deadlines are enforced, but SSA can extend deadlines for good cause (20 CFR 404.911). Examples can include serious illness, records delayed despite diligent efforts, or misdirected mail. If you need an extension or to submit late evidence, promptly file a written request explaining the circumstances and include any documentation you have.

Special Topics That Often Impact California Claims

• Multiple treating sources: Urban and suburban California claimants may see multiple specialists. Make sure all providers are identified to SSA and that records are requested from each.
• Transportation and access barriers: If travel to a consultative examination or hearing is difficult, inform SSA. Remote options may be available; the legal standards are the same regardless of format.
• Work attempts: Brief, unsuccessful work attempts may not count as substantial gainful activity under 20 CFR 404.1574(a)(1) and related guidance. Explain why attempts ended and provide supporting medical documentation.

Frequently Asked Questions

How long do I have to appeal an SSDI denial in California?

Generally, 60 days from the date you receive the notice (with a presumption of receipt 5 days after the date on the notice). See 20 CFR 404.909 (reconsideration), 20 CFR 404.933 (hearing), 20 CFR 404.968 (Appeals Council), and 20 CFR 422.210 (federal court).

Do I need a lawyer for my SSDI appeal?

No, but many claimants find representation helpful, especially at the hearing stage. Representation is authorized by 20 CFR 404.1705, and fees must be approved by SSA under 42 U.S.C. § 406 and 20 CFR 404.1720–404.1730.

Where is my local SSA office in California?

Use SSA’s Office Locator: Find your local office. You can also file and track appeals online.### What if I missed my deadline?

Request an extension and explain why you missed it. SSA can accept late filings for good cause under 20 CFR 404.911. Act quickly and provide documentation.

What happens if the Appeals Council denies my request?

You typically have 60 days to file a civil action in the U.S. District Court for your area in California. See 42 U.S.C. § 405(g) and 20 CFR 422.210.

How California Claimants Can Navigate the Process Efficiently

• Start the appeal online the day you receive the denial. Preserve your rights first, then build the record.
• Request and review your medical records. Confirm that key imaging, specialist notes, and test results are included.
• Prepare detailed function statements. Be specific about how symptoms limit your daily activities and work-related functions.
• Track and meet the five‑day evidence rule. Notify the ALJ promptly about any late-arriving records per 20 CFR 404.935.
• Consider a representative early. An advocate can identify missing evidence and prevent procedural mistakes.

Federal Court Review in California

If your claim reaches federal court, the judge does not take new evidence but reviews the administrative record to determine whether SSA’s decision is supported by substantial evidence and is legally correct. The action is filed in the U.S. District Court serving your residence in California under 42 U.S.C. § 405(g) and 20 CFR 422.210. If the court finds legal error or insufficient support, it can remand the case for a new hearing or, in rare circumstances, order an award of benefits if the record compels that result.

Checklist: What to Do This Week

• Mark your 60‑day deadline and set reminders.
• File your reconsideration or hearing request online.
• List all treatment providers and request records.
• Draft a one‑page summary of your functional limitations tied to medical evidence.
• If you want help, consult a California disability attorney to review your file and plan your appeal.

Important Note on Search Terms

Many Californians search for “social security lawyers near me” after an SSDI denial. Whether you hire a representative or proceed on your own, ensure your appeal follows the governing law. For search relevance: SSDI denial appeal california california.

Authoritative References

SSA: Appeal a Decision (Official)20 CFR 404.1520 – Sequential Evaluation of Disability20 CFR Part 404, Subpart J – Hearings, Appeals and Review20 CFR 404.935 – Five‑Day Evidence Rule20 CFR 422.210 – Judicial Review (Federal Court)

Legal Disclaimer

This guide provides general information for California residents and is not legal advice. Laws and regulations change, and your facts matter. Consult a licensed California attorney about your specific situation.

Next Step

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