SSDI Attorney Guide: Appeals in Connecticut, Connecticut

SSDI Attorney Guide: What to Do After a Denial in Connecticut, Connecticut

When a Social Security Disability Insurance (SSDI) claim is denied, it can feel like the end of the road. It isn’t. If you live in Connecticut, Connecticut, federal law gives you the right to appeal that decision through a structured process. Most claimants eventually succeed by submitting strong medical evidence, following deadlines, and pursuing each level of review. This guide explains how SSDI appeals work for Connecticut residents, with a slight emphasis on protecting claimants’ rights—while remaining strictly factual and grounded in federal regulations and authoritative sources.

SSDI is a federal program administered by the Social Security Administration (SSA). It provides benefits to insured workers who have a severe, medically determinable impairment that prevents substantial gainful activity (SGA) and has lasted or is expected to last at least 12 months or result in death. See 20 CFR 404.1505 and the five-step evaluation at 20 CFR 404.1520. Your claim is first decided by a state Disability Determination Services (DDS) unit working with the SSA, and if denied, you can seek reconsideration, a hearing before an Administrative Law Judge (ALJ), Appeals Council review, and finally judicial review in federal court under 42 U.S.C. § 405(g).

For local context, Connecticut SSDI cases are handled within the SSA’s Boston Region (Region 1). Claimants in Connecticut can file appeals online, by mail, or through their local SSA field office. You can find your nearest field office by ZIP code using the SSA Office Locator. Hearings may be scheduled in person at a local hearing site or conducted by telephone or online video, depending on SSA scheduling and your case circumstances. Throughout this process, your goal is to build and present complete, consistent medical and vocational evidence that proves you meet the federal definition of disability.

If you’re looking for help with an SSDI denial appeal connecticut connecticut, this page will walk you through your rights, the appeals timeline, how to fix common denial issues, and when to consider speaking with a Connecticut disability attorney.

Understanding Your SSDI Rights

Who qualifies for SSDI

To qualify for SSDI benefits, you must meet two sets of requirements:

• Medical Disability: You have a severe, medically determinable impairment that prevents you from performing substantial gainful activity for at least 12 months or is expected to result in death. See 20 CFR 404.1505 and the five-step process at 20 CFR 404.1520.
• Insured Status: You must have worked and paid Social Security taxes long enough and recently enough to be insured, as outlined in 20 CFR 404.130. Your “date last insured” (DLI) is crucial—SSA must find you disabled before your DLI to award SSDI benefits.

Your right to appeal an SSDI denial

If SSA denies your SSDI application, you have the right to appeal through four levels of administrative and judicial review:

• Reconsideration (20 CFR 404.909, 404.907)
• Hearing by an Administrative Law Judge (ALJ) (20 CFR 404.929, 404.933)
• Appeals Council review (20 CFR 404.967–404.981)
• Federal court review under the Social Security Act, 42 U.S.C. § 405(g)

At each stage, you can submit evidence, and you generally have 60 days to appeal after you receive the denial notice. SSA presumes you received the notice 5 days after the date on it unless you show otherwise. See 20 CFR 404.901 (mailing presumption), 404.909(a)(1) (reconsideration deadline), 404.933(b)(1) (ALJ hearing), 404.968(a)(1) (Appeals Council), and 20 CFR 422.210(c) along with 42 U.S.C. § 405(g) (civil action deadline).

Your right to representation and fee protections

You have the right to be represented by an attorney or qualified non-attorney representative at any stage of the SSDI process. See 20 CFR 404.1705. Representatives’ fees must be approved by SSA and are regulated by federal law, including 20 CFR 404.1720–404.1725 and 42 U.S.C. § 406(a). This protects claimants by ensuring fees are reasonable and only paid if benefits are awarded, with limited exceptions.

Your right to submit evidence and to a fair hearing

SSA evaluates medical and nonmedical evidence, including records from acceptable medical sources, opinion evidence, and your statements about symptoms and limitations. See 20 CFR 404.1513 and 20 CFR 404.1520c (evaluation of medical opinions for claims filed on or after March 27, 2017). At the ALJ hearing level, there is a “5-day rule” (20 CFR 404.935) requiring you to submit or inform SSA about written evidence no later than 5 business days before the hearing, unless you demonstrate good cause for late submission. Hearings can be in person, by telephone, or by online video, and you can present testimony and question witnesses such as vocational experts.

Common Reasons SSA Denies SSDI Claims

Insufficient medical evidence or gaps in treatment

Many denials cite a lack of objective medical findings, inconsistent treatment, or outdated records. SSA requires medically determinable impairments supported by acceptable clinical or diagnostic evidence. See 20 CFR 404.1521 and 404.1513. Connecticut claimants should ensure complete, up-to-date records from treating physicians, specialists, hospitals, and clinics, documenting how impairments limit the ability to perform work activities.

Working above substantial gainful activity (SGA)

If you earn at or above SGA levels, SSA typically finds you not disabled. SGA is a concept defined in 20 CFR 404.1572–404.1574. Even part-time work can count as SGA if earnings and work activity are sufficiently high. Consider whether unsuccessful work attempts and special conditions are relevant; the regulations allow contextual evaluation of work efforts.

Failure to meet the insured status (date last insured)

SSDI requires insured status under 20 CFR 404.130. If your DLI has passed, SSA must find you became disabled on or before that date. Evidence must establish disability within the insured period. Some claims fail because evidence begins after the DLI without adequate retrospective support from medical sources.

Not meeting or equaling a Listing, and residual functional capacity (RFC) finds you can do work

SSA uses the Listings of Impairments in 20 CFR Part 404, Subpart P, Appendix 1 to see if conditions meet strict medical criteria for an automatic approval. Even if you do not meet a Listing, SSA determines your residual functional capacity (RFC) (20 CFR 404.1545) and assesses whether you can perform past relevant work or other jobs in the national economy (Steps 4 and 5; 20 CFR 404.1520). Denials often occur when the record does not clearly show functional limitations consistent with disability.

Inconsistent statements or noncompliance issues

SSDI decisions weigh consistency across forms, testimony, medical notes, and activities of daily living. Inconsistencies or significant noncompliance with prescribed treatment—without a good reason—can undermine credibility. The safest approach is accurate, consistent reporting and documentation of barriers to treatment when they exist.

Federal Legal Protections & Regulations

Core disability standards

• Definition of disability: 20 CFR 404.1505 describes the definition for SSDI claims.
• Five-step sequential evaluation: 20 CFR 404.1520 sets the framework used at all administrative levels.
• Medical Listings: 20 CFR Part 404, Subpart P, Appendix 1. Meeting or medically equaling a Listing can allow a finding of disability at Step 3.
• Residual functional capacity (RFC): 20 CFR 404.1545 details how RFC is assessed to determine what work, if any, you can perform.
• SGA and work activity: 20 CFR 404.1572–404.1574 define SGA and how work is evaluated.

Appeals and due process

• Administrative review process: 20 CFR 404.900–404.999 govern the levels of review (reconsideration, ALJ hearing, Appeals Council) and due process rights.
• Deadlines and good cause: Reconsideration (20 CFR 404.909) and ALJ requests (20 CFR 404.933) are generally due within 60 days of receiving the notice (with the 5-day mailing presumption at 20 CFR 404.901). Good cause for late filing is considered under 20 CFR 404.911.
• Evidence submission: 20 CFR 404.935 (5-day rule) and 20 CFR 404.1512 (your duty to submit evidence you receive).
• Appeals Council: 20 CFR 404.967–404.981 describes review standards and outcomes, including dismissal, denial, remand, or issuance of a decision.
• Judicial review: 42 U.S.C. § 405(g) allows filing a civil action in the U.S. District Court after the Appeals Council’s final action, generally within 60 days. See also 20 CFR 422.210(c).

Entitlement and payments

• Insured status and entitlement: 20 CFR 404.130 and 20 CFR 404.315 cover insured status and entitlement to disability insurance benefits, including the waiting period for cash benefits.
• Representative fees: 20 CFR 404.1720–404.1725 and 42 U.S.C. § 406(a) require SSA approval of representative fees and protect claimants from unapproved charges.
• Reopening decisions: 20 CFR 404.987–404.989 provide limited circumstances to reopen and revise determinations within specific timeframes based on good cause.

Steps to Take After an SSDI Denial

1) Read your denial notice carefully

Identify the level of denial (initial or reconsideration), the rationale (medical, technical, SGA, insured status), and the specific evidence cited. Note the date on the letter and calendar the appeal deadline. SSA presumes you received the notice 5 days after the mailing date, unless you can show otherwise (20 CFR 404.901).

2) File your appeal on time

• Reconsideration: File within 60 days of receipt (20 CFR 404.909(a)(1)).
• ALJ Hearing: File within 60 days of receipt of the reconsideration denial (20 CFR 404.933(b)(1)).
• Appeals Council: File within 60 days of the ALJ decision (20 CFR 404.968(a)(1)).
• Federal Court: File within 60 days of the Appeals Council’s notice (42 U.S.C. § 405(g); 20 CFR 422.210(c)).

If you miss a deadline, promptly request an extension with a written explanation. SSA can grant late filing for good cause under 20 CFR 404.911.

3) Strengthen your medical record

Most successful appeals hinge on better evidence. Consider these steps under 20 CFR 404.1513 and 404.1520c:

• Update records: Obtain complete treatment notes, diagnostic imaging, lab results, and specialist reports. Ensure coverage from your alleged onset date through the present, and especially through your date last insured (if applicable).
• Functional evidence: Ask treating providers to document functional limitations relevant to work: sitting/standing tolerance, lifting/carrying, reaching/handling, postural limits, off-task time, and need for unscheduled breaks or absences.
• Consistency: Align your statements on SSA forms with medical notes and daily activity descriptions.
• Comorbid conditions: Document combined effects of multiple impairments, not just one diagnosis.

4) Address specific denial issues

• SGA concerns (20 CFR 404.1572–404.1574): Provide pay stubs, employer statements, or evidence of special conditions (e.g., extra help, accommodations) that reduce true productivity. Demonstrate unsuccessful work attempts where applicable.
• Date Last Insured (20 CFR 404.130): Secure retrospective medical opinions that reasonably relate current findings back to your insured period if your evidence starts after the DLI.
• Listings (20 CFR Part 404, Subpart P, Appendix 1): If your condition may meet or equal a Listing, request that your physician track criteria precisely and include necessary objective findings.
• RFC (20 CFR 404.1545): Ask your providers to address how symptoms impact work functions consistently over time, including reliability, persistence, pace, and absenteeism.

5) Prepare for the hearing

If your reconsideration is denied, request an ALJ hearing (20 CFR 404.929, 404.933). The hearing is your best opportunity to present a complete case. Practical steps:

• Meet the 5-day rule: Submit or inform the SSA about all written evidence at least 5 business days before the hearing (20 CFR 404.935), unless you have good cause.
• Witnesses: Consider statements from family, former supervisors, or caregivers to corroborate functional limits (20 CFR 404.1513).
• Vocational expert (VE): Be ready to question VE assumptions about your past work or transferable skills. VE testimony can be central at Step 5.
• Consistency and credibility: Provide clear, truthful testimony explaining symptom severity, treatment side effects, and daily limitations that align with your records.

6) Appeals Council and federal court

If the ALJ denies your claim, you may seek Appeals Council review within 60 days (20 CFR 404.968). The Appeals Council can deny review, remand the case, or issue its own decision (20 CFR 404.979–404.981). If the Appeals Council denies review or issues an unfavorable decision, you may file a civil action in the U.S. District Court for the District of Connecticut under 42 U.S.C. § 405(g) within 60 days of receiving the notice (see also 20 CFR 422.210(c)).

When to Seek Legal Help for SSDI Appeals

Advantages of experienced representation

While you can represent yourself, a knowledgeable representative can help identify medical gaps, obtain persuasive opinion evidence, frame your RFC theory under 20 CFR 404.1545, prepare you for testifying, and cross-examine vocational experts. Representatives must follow SSA’s rules (20 CFR 404.1705 et seq.), and fees must be approved by SSA (20 CFR 404.1720–404.1725). This fee oversight protects claimants and aligns the representative’s incentive with your success.

Attorney licensing rules in Connecticut

In Connecticut, the practice of law is limited to attorneys admitted to the Connecticut Bar under rules administered by the Connecticut Bar Examining Committee. For SSDI administrative proceedings (federal), your representative may be an attorney licensed in any U.S. jurisdiction or a qualified non-attorney, subject to SSA’s representative eligibility rules (20 CFR 404.1705). If your case proceeds to the U.S. District Court for the District of Connecticut under 42 U.S.C. § 405(g), your attorney generally must be admitted to practice before that federal court pursuant to its local admission rules. Regardless of forum, representatives must obtain SSA approval of fees (20 CFR 404.1720–404.1725).

Local Resources & Next Steps for Connecticut, Connecticut Claimants

How to find and use local SSA offices

Connecticut residents can file applications and appeals online or through local SSA field offices. To find your nearest office, use the SSA’s Office Locator by entering your ZIP code. Field offices provide application support, accept appeal forms, and can explain deadlines, but they do not make final medical decisions—that’s handled by DDS in coordination with SSA.

Start here: SSA Office Locator for Connecticut ZIP codes.### Connecticut within SSA’s Boston Region

Connecticut is part of SSA’s Boston Region (Region 1). Hearings for Connecticut claimants are conducted by the SSA’s Office of Hearings Operations (OHO) and may be scheduled at a local hearing site or held by telephone or online video. Your notices will specify how your hearing will be conducted and how to object or request accommodations. The administrative review standards remain the same nationwide under 20 CFR Part 404, Subpart J.

Key forms of evidence for Connecticut claimants

• Treating source records: Complete clinical notes from Connecticut-based physicians and specialists, imaging, labs, and hospital records.
• Function-focused opinions: Statements addressing sitting/standing, lifting, manipulative limits, concentration, pace, and absenteeism consistent with 20 CFR 404.1545.
• Work history details: Descriptions of past jobs, exertion levels, skills used, and reasons for stopping work, which inform Steps 4 and 5 (20 CFR 404.1520).
• Activities of daily living: Clear, consistent statements that align with the medical record and explain variability of symptoms.

Practical timeline checklist

• Within days 1–10: Calendar deadlines; request medical records; start drafting your appeal.
• Within 30 days: File the appeal online or through your local office; request missing records; consider a representative.
• Before the hearing: Comply with the 5-day evidence rule (20 CFR 404.935); prepare testimony; review vocational issues.
• After the decision: If unfavorable, consider Appeals Council review within 60 days (20 CFR 404.968); evaluate federal court options under 42 U.S.C. § 405(g).

Authoritative resources

SSA Appeal Your Decision – Official step-by-step instructions and online filing.20 CFR Part 404, Subpart J – Administrative review process, deadlines, and procedures.20 CFR Part 404, Subpart P – Medical standards, Listings, RFC, and vocational rules.42 U.S.C. § 405(g) — Judicial Review – Filing suit in federal court after Appeals Council action.SSA Office Locator for Connecticut ZIP codes – Find your local field office.

Frequently Asked Questions for Connecticut Claimants

How long do I have to appeal my SSDI denial?

Generally, 60 days from the date you receive your notice. SSA presumes you receive it 5 days after the date on the notice unless you can show otherwise. See 20 CFR 404.901 (mail presumption), 404.909(a)(1) (reconsideration), 404.933(b)(1) (ALJ hearing), 404.968(a)(1) (Appeals Council), and 20 CFR 422.210(c) along with 42 U.S.C. § 405(g) (federal court).

Can I submit new medical evidence after a denial?

Yes. You should submit updated evidence at each level. At the ALJ level, follow the 5-day rule in 20 CFR 404.935 or explain good cause for late evidence. SSA evaluates medical evidence under 20 CFR 404.1513 and opinions under 20 CFR 404.1520c.

Do I have to stop working completely to qualify?

No. Limited work below SGA may be permissible, but earnings and work activity are strictly evaluated under 20 CFR 404.1572–404.1574. Document any special conditions, reduced productivity, or unsuccessful work attempts.

What if my Date Last Insured has passed?

SSA must find that your disability began on or before your DLI. Evidence can include retrospective medical opinions supported by clinical findings. See 20 CFR 404.130 for insured status requirements.

Will an attorney improve my chances?

Many claimants benefit from experienced representation due to the complexity of the medical and vocational rules and the evidentiary requirements. Representatives must be eligible under 20 CFR 404.1705 and have their fees approved under 20 CFR 404.1720–404.1725, which protects claimants.

How to Frame a Strong SSDI Appeal in Connecticut

Build your theory of disability

Organize the record around the five-step process (20 CFR 404.1520):

• Step 1 (SGA): Show that work, if any, is below SGA or was an unsuccessful attempt (20 CFR 404.1572–404.1574).
• Step 2 (Severity): Demonstrate severe impairments with objective findings and longitudinal treatment.
• Step 3 (Listings): Align evidence to specific criteria in 20 CFR Part 404, Subpart P, Appendix 1.
• Step 4 (Past Work): Use accurate job descriptions and exertional/nonexertional demands to explain why you cannot return to past relevant work.
• Step 5 (Other Work): Address transferable skills, erosion of the job base, off-task percentages, absenteeism, and work-preclusive limitations.

Common Connecticut case scenarios

• Spine and joint disorders: Ensure imaging correlates with neurological findings; document positional tolerances and need to alternate positions.
• Cardiopulmonary disease: Provide objective testing and exertional capacity documentation (e.g., METs estimates, oxygen use) where applicable.
• Mental health: Obtain detailed notes on concentration, persistence, pace, and social functioning; corroborate with third-party statements and therapy records.
• Autoimmune and rare conditions: Track flares, treatment effects, and cumulative symptoms over time to reflect severity consistent with the Listings’ framework.

Evidence etiquette

• Completeness: Request full charts, not just summaries.
• Clarity: Ask providers to avoid ambiguous statements; specificity helps.
• Continuity: Longitudinal evidence carries weight—sustained findings over time can be more persuasive.
• Objectivity: Objective measures paired with credible subjective reports create a stronger record.

Appeal Filing Methods for Connecticut Residents

Online, mail, or local office

Connecticut claimants can appeal online via SSA’s portal, by mailing the required forms, or by filing through a local field office. For convenience and tracking, many claimants use the online option:

SSA Appeal Your Decision – File reconsideration, hearings, and Appeals Council requests where available.SSA Office Locator for Connecticut ZIP codes – Find a local office if you prefer in-person or mail filing. Keep copies of everything you submit and confirm receipt. When feasible, submit medical records directly to the designated electronic repository or as instructed in your notice to ensure timely association with your file.

What Happens at Each Stage of Appeal

Reconsideration

A different DDS team reviews your file; you can and should add new evidence. Consider a detailed statement addressing the reasons for denial and pointing to supporting records.

ALJ hearing

You will testify under oath. The ALJ may question you, and a vocational expert may testify. The hearing is non-adversarial, but targeted questions can be probing. Comply with the 5-day rule (20 CFR 404.935), and be prepared to discuss daily limitations, past work, and treatment history.

Appeals Council

The Appeals Council reviews for legal error, abuse of discretion, unsupported findings, or the presence of new, material, and time-relevant evidence (see 20 CFR 404.970). It may deny review, remand, or issue a decision (20 CFR 404.979–404.981).

Federal court

Under 42 U.S.C. § 405(g), the U.S. District Court for the District of Connecticut reviews the administrative record to determine whether SSA’s decision is supported by substantial evidence and whether proper legal standards were applied. This is not a new hearing; no new evidence is typically submitted at this stage.

Protecting Your Deadline Rights

• 60-day rule at every level: Reconsideration, ALJ, Appeals Council, and federal court (see 20 CFR 404.909; 404.933; 404.968; 20 CFR 422.210(c); 42 U.S.C. § 405(g)).
• 5-day mailing presumption: 20 CFR 404.901 presumes you receive notices 5 days after the date on the notice.
• Good cause: 20 CFR 404.911 allows late filing for good cause (e.g., serious illness, records lost, incorrect information from SSA). Provide a detailed explanation and any documentation.

Connecticut, Connecticut: Next Steps Checklist

• Mark all deadlines immediately using the date on your SSA notice and the 5-day presumption.
• File the appeal online or at your local SSA office, and keep proof of submission.
• Request complete medical records and ask providers for function-focused opinions tied to work activities.
• Review the five-step process and shape your evidence to meet or equal a Listing or to support an RFC that precludes sustained work.
• Consider representation under 20 CFR 404.1705; ensure any fee agreement will be submitted for SSA approval (20 CFR 404.1720–404.1725).

Legal Disclaimer

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

Contact

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