Why Legal Representation Changes Your Odds
Social Security disability claims are denied at the initial level roughly 63 to 67 percent of the time nationwide. Filing an application and waiting does not get most people approved. What changes the outcome is working with experienced Los Angeles Social Security disability lawyers who know the file and the adjudicators. Additionally, what also helps is knowing how to build a winning record before you ever walk into a hearing room.
At Devermont & Devermont, we have been representing disability claimants in Los Angeles for three generations. We know the local ODAR office and the wait times. Furthermore, we know what Los Angeles ALJs look for and what mistakes sink claims that should have been won.
SSDI vs. SSI: Which Program Are You Applying For?
The Social Security Administration runs two separate disability programs. Many applicants don’t realize they’re different – with different rules – and that mistake costs them money they’re legally owed.
Social Security Disability Insurance (SSDI)
- Based on your work history and Social Security tax contributions
- Requires sufficient work credits (generally 40 credits, 20 earned in the last 10 years)
- No income or asset limits after approval
- Five-month waiting period before benefits begin
- Medicare eligibility begins 24 months after your entitlement date
Supplemental Security Income (SSI)
- Need-based – no work history required
- Subject to strict income and resource limits
- In California, the 2026 combined rate is $1,233.94/month for an eligible individual
- Comes with automatic Medi-Cal enrollment
- No five-month waiting period
You can receive both at the same time if your SSDI payment falls below the SSI benefit rate – what’s called concurrent benefits. Many Los Angeles claimants qualify for both and never know it. At the start of every case, we make sure you’re applying for every benefit you’re entitled to.
What the Numbers Look Like in Los Angeles
In 2026, the Substantial Gainful Activity (SGA) threshold for non-blind disabled individuals is $1,690 per month. Earn more than that from work and SSA will generally find you are not disabled, regardless of your medical condition.
The initial denial rate isn’t an accident. SSA’s initial review is handled by state agency examiners who rarely see claimants in person and often work from incomplete records. The ALJ hearing level is where most winning cases are actually decided. Nationally, ALJs approved approximately 57 percent of cases in FY2023 according to an OIG report – a rate that improves significantly when claimants are represented by an attorney. In the Los Angeles region, ALJ hearing wait times regularly exceed 12 to 18 months. Working with experienced Los Angeles Social Security disability lawyers who can get your case properly structured from the beginning is not optional if you want to win.
The Los Angeles ODAR Office and Your ALJ Hearing
If your claim is denied at the initial and reconsideration levels, your next step is a hearing before an Administrative Law Judge. In Los Angeles, those hearings are handled through the Office of Disability Adjudication and Review (ODAR). This is your most important opportunity in the entire process.
There’s often a vocational expert at the hearing – a witness SSA calls to testify about what jobs exist in the national economy that someone with your limitations could perform. Challenging that testimony requires knowing how SSA evaluates residual functional capacity (RFC). It also requires knowing how to expose flaws in the hypothetical questions the ALJ poses.
Under 20 C.F.R. § 404.1710, your representative has the right to access your complete SSA file. We can subpoena medical records, submit additional medical opinions, examine vocational experts, and present RFC evidence tailored to how SSA rules require the ALJ to evaluate your claim.
What Happens After a Denial
If you are denied, you have 60 days from the date of the denial notice – plus a 5-day mail allowance – to file your appeal. The SSA appeal process has four stages – reconsideration, ALJ hearing, Appeals Council, and federal court. We cover each level in detail in our guide to the four levels of disability appeals and our walkthrough of how to appeal a Social Security disability denial in Los Angeles. Missing that deadline forces you to start over and lose your original filing date, which directly affects your back pay eligibility.
The ALJ hearing is where most winning cases are decided – nationally, ALJs approved 57 percent of cases in FY2023 according to an OIG report. That’s more than triple the reconsideration rate, and it’s the stage where having experienced Los Angeles Social Security disability lawyers makes the greatest measurable difference.
What a Los Angeles Social Security Disability Lawyer Actually Does
We don’t just fill out paperwork. We review your entire medical history and identify the gaps SSA will use to deny your claim before a decision-maker ever sees your file. Furthermore, we work with your treating physicians to obtain opinion letters that address your functional limitations in the specific language SSA’s RFC analysis requires.
Additionally, we identify whether you meet or equal a Listing under SSA’s impairment criteria – which can result in approval without the full five-step evaluation. We also assess whether your case qualifies for a medical-vocational allowance, the most common path to approval at the hearing level. At the hearing, we prepare you for the ALJ’s questions, challenge vocational expert testimony, and make the arguments that we know from decades of local practice work in Los Angeles.
Common Reasons Claims Are Denied in Los Angeles
After three generations in this practice, the patterns are clear:
- Insufficient medical evidence – SSA denies claims where the record doesn’t document severity and functional limitations in clinical terms. A diagnosis alone isn’t enough.
- Gaps in treatment – If you stopped seeing a doctor for financial reasons or because your condition fluctuates, SSA uses those gaps against you.
- Conflicting physician opinions – When a treating physician’s opinion is inconsistent with their own notes, SSA will discount it.
- Failure to address all impairments – Many claimants focus on their primary diagnosis and don’t document how multiple conditions combine to limit functioning. SSA must consider the combined effect of all impairments.
- Missed deadlines – Sixty days goes fast when you’re dealing with a serious disability. Missing the window means losing your original filing date and your back pay.
- Going unrepresented – Represented claimants win at significantly higher rates than those who go through the process alone.
What Representation Costs – the Short Version
Disability attorneys don’t bill by the hour. The fee structure is set by federal law: your attorney receives 25% of whatever past-due benefits SSA awards, up to a $9,200 cap (42 U.S.C. § 406; POMS GN 03940.003). SSA withholds that amount from your back pay and sends it directly to your lawyer – you never cut a check. If the case doesn’t result in an award, you owe nothing. It’s a system designed so that people who can’t work can still afford experienced legal help.
Frequently Asked Questions
What is the difference between SSDI and SSI?
SSDI is based on your work history. SSI is need-based with no work history requirement. For a more detailed comparison, read our guide on the SSDI vs SSI difference in Los Angeles. You can receive both simultaneously if your SSDI payment is low enough and you meet SSI’s financial rules. The 2026 California SSI rate is $1,233.94/month for an individual. Many Los Angeles claimants qualify for concurrent benefits and never know it.
Can I work while my disability case is pending?
You can work below the SGA threshold – $1,690/month in 2026 – without it automatically disqualifying you. Working above SGA while claiming disability is a serious problem. Discuss any work activity with your attorney before SSA uses it against you.
Do I need a lawyer at the initial application stage?
You can file without one, and many people do. But the decisions made at the initial stage – how your impairments are described, which records are submitted, how your work history is framed – affect every stage that follows. Starting with Los Angeles Social Security disability lawyers means the record is built correctly from day one.
What if my doctor says I am disabled but SSA still denies me?
SSA doesn’t automatically accept treating physician opinions. It evaluates the supportability and consistency of every medical opinion in the record. If your doctor’s opinion was disregarded, that’s frequently grounds for a successful appeal at the ALJ level or in federal court – especially when the opinion addresses RFC limitations directly.
How much back pay could I receive?
For SSDI, back pay runs from your established onset date, subject to the five-month waiting period and the 12-month retroactivity cap. For SSI, benefits don’t go back before your application date. Given Los Angeles ALJ wait times, back pay in a successful SSDI case is often substantial. Your attorney fee is capped at 25% of that amount, up to $9,200.
What medical records should I bring to my first meeting with a disability lawyer?
Bring everything you have – treatment records, imaging reports, lab results, prescriptions, hospital discharge summaries, and any correspondence from SSA. Don’t worry about organizing it perfectly. We review the full medical history and identify what’s missing. The gaps in your record are often more important than what’s already in it.
Can I apply for both SSDI and SSI on the same application?
Yes – and we make sure every client is evaluated for both programs. Many Los Angeles claimants qualify for concurrent benefits, where a low SSDI payment is supplemented by SSI up to the California rate. Filing for both at the outset protects your rights under each program and avoids having to go back and file separately later.
Call Devermont & Devermont – Free Consultation
Three generations of our family have represented disability claimants in Los Angeles. We know this process, we know the local system, and we know what it takes to win. If you’ve been denied, if you have a hearing coming up, or if you’re not sure whether to apply – call us. There’s no charge for the consultation, and you pay nothing unless we win.
Call (310) 730-7309 today or reach out online to schedule your free consultation.
