SSDI Reconsideration in California: What to Do

Receiving a denial from the Social Security Administration (SSA) for your disability benefits claim can feel devastating—but it is far from the end of the road. The reconsideration stage is the first formal step in the SSDI appeals process, and understanding how it works in California can make the difference between losing your benefits permanently and ultimately winning the support you deserve.

What Is SSDI Reconsideration?

After the SSA issues an initial denial, you have the right to request a reconsideration. At this stage, a different SSA examiner—one who was not involved in the original decision—reviews your entire claim from scratch. That reviewer examines the evidence already in your file, plus any new medical records, treating physician statements, or other documentation you submit.

In California, reconsideration requests are processed through the SSA's program service center and the state's Disability Determination Service (DDS), which operates under a contract with the federal SSA. This means your case is handled at the state level but must comply with federal SSDI rules and medical criteria.

You must file your reconsideration request within 60 days of receiving your initial denial notice. The SSA adds five days to account for mail delivery, giving you approximately 65 days from the date on the denial letter. Missing this deadline can forfeit your right to appeal and force you to start an entirely new application.

Why Most Initial Claims Are Denied in California

California's denial rate at the initial application stage consistently hovers around 60–65%, which is roughly in line with the national average. Common reasons for denial include:

• Insufficient medical documentation to establish a severe, long-term impairment
• The SSA's determination that you can still perform your past work or other jobs
• Failure to follow prescribed treatment without a medically acceptable reason
• Earnings above the Substantial Gainful Activity (SGA) threshold ($1,620/month in 2024)
• Missing or outdated medical records from treating providers
• Lack of a qualifying work history or insufficient Social Security credits

Understanding the specific reason for your denial is critical before filing for reconsideration. The denial notice will include a detailed explanation, and your attorney or advocate can help you identify exactly what evidence gaps exist in your file.

How to Strengthen Your Reconsideration Request in California

The reconsideration stage has a lower approval rate than the hearing stage—roughly 10–15% of reconsiderations are approved nationwide. However, that does not mean you should treat it as a formality. Building the strongest possible record now sets you up for success if your case proceeds to an Administrative Law Judge (ALJ) hearing.

Obtain updated medical records. If months have passed since your initial application, your condition may have worsened or new diagnoses may have emerged. Request updated records from every treating physician, specialist, therapist, and hospital where you have received care. California has specific medical record request timelines under state law—providers generally have 15 days to respond to requests, so submit them early.

Get a detailed Residual Functional Capacity (RFC) statement from your doctor. A treating physician's RFC statement describing your functional limitations—how long you can sit, stand, walk, lift, and concentrate—carries significant weight. An RFC that aligns with SSA's disability criteria can be decisive. Ask your doctor to be as specific as possible, citing objective findings like MRI results, range-of-motion tests, or neurological evaluations.

Document the impact on daily activities. The SSA evaluates not just your diagnosis but how your condition affects your ability to function on a daily basis. Detailed personal statements describing limitations in cooking, driving, bathing, concentrating, or managing stress can supplement clinical records.

Address any gaps in treatment. If you missed appointments or stopped treatment, provide written documentation explaining why—financial inability, lack of transportation, or a physician's recommendation to discontinue a medication are all acceptable explanations under SSA rules.

Filing the Reconsideration Request: Step by Step

You can submit your reconsideration request in three ways: online at the SSA's website, by calling 1-800-772-1213, or in person at your local California Social Security field office. Along with the appeal form (SSA-561), you should also submit:

• A completed Disability Report – Appeal (SSA-3441), which allows you to report any changes in your condition, new medical providers, or new medications since you filed your original application
• An Authorization to Disclose Information to the SSA (SSA-827) for each new medical provider
• Any new medical records, test results, or physician letters not previously submitted

Once filed, the DDS will notify you of its reconsideration decision by mail. Processing times in California typically range from three to six months, though cases involving terminal illness, military service, or Compassionate Allowance conditions may be expedited.

What Happens After Reconsideration Is Denied

If your reconsideration is denied, you retain the right to request a hearing before an Administrative Law Judge. ALJ hearings represent the most successful stage of the SSDI appeals process—approval rates at hearings nationally exceed 50%, and claimants who are represented by an attorney or advocate fare significantly better than those who appear alone.

At the hearing, you will have the opportunity to present testimony, submit additional evidence, and challenge the SSA's reasoning directly. A vocational expert may testify about the types of jobs you can or cannot perform, and your attorney can cross-examine that witness. In California, ALJ hearings are conducted through ODAR (Office of Disability Adjudication and Review) hearing offices located in cities including Los Angeles, San Francisco, Sacramento, San Diego, and Oakland.

Do not waive reconsideration in California. Although some states participate in a pilot program that allows claimants to skip directly to an ALJ hearing, California is not one of them. Reconsideration is a mandatory step in the process, and skipping it—or missing the deadline—means starting over from scratch and losing your established onset date, which can cost you months or years of back pay.

Each level of appeal carries its own strict deadline. After a reconsideration denial, you have 60 days to request an ALJ hearing. After an unfavorable ALJ decision, you can appeal to the SSA's Appeals Council and, ultimately, to federal district court. At every stage, preserving deadlines and building a thorough evidentiary record are essential.

Need Help? If you have questions about your case, call or text 833-657-4812 for a free consultation with an experienced attorney.

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