SSDI Denial Appeal Guide – Connecticut, Connecticut

Introduction: Why This Guide Matters to Connecticut Claimants

Connecticut’s cost of living consistently ranks above the national average, making steady income essential for residents coping with long-term medical conditions. When the Social Security Administration (SSA) denies a disability claim, the result can be devastating. According to SSA state-level data, nearly two-thirds of initial Social Security Disability Insurance (SSDI) applications filed from Connecticut are denied each year. The good news is that most denials are not the final word. Federal law gives you the right to challenge an adverse decision, and many claimants ultimately win benefits on appeal. This comprehensive, evidence-based guide—tailored specifically to Connecticut—explains why denials happen, the federal statutes and regulations that protect you, key deadlines, and local resources that can improve your odds.

We favor the claimant’s perspective while remaining factual. Every legal point is grounded in authoritative sources such as Title II of the Social Security Act, 20 C.F.R. Part 404, and federal case law from the U.S. District Court for the District of Connecticut.

Understanding Your SSDI Rights

1. What SSDI Provides

SSDI pays monthly cash benefits to insured workers who can no longer perform substantial gainful activity (SGA) due to a medically determinable impairment expected to last at least 12 months or result in death (SSA, Disability Evaluation). Benefits may also extend to certain dependents. Importantly, SSDI is not needs-based; eligibility depends on your work history and payment of FICA taxes.

2. Federal Definition of Disability

Under 20 C.F.R. § 404.1505(a), disability is the “inability to engage in any substantial gainful activity by reason of any medically determinable physical or mental impairment.” The definition is strict—part-time or light work can cause denial. However, Social Security must consider:

• Your medical signs, laboratory findings, and clinical evidence.

• Your age, education, and past relevant work.

• Whether your condition meets or equals a Listing in Appendix 1.

Tip for Connecticut claimants: Yale New Haven Hospital, Hartford Hospital, and UConn Health maintain detailed treatment records that can substantiate “objective medical evidence” required by 20 C.F.R. § 404.1521.

Common Reasons SSA Denies SSDI Claims

1. Insufficient Medical Evidence

The SSA cannot simply accept a doctor’s opinion letter. It must see objective findings—MRI scans, lab tests, or standardized psychological scores. Missing records and treatment gaps are a leading cause of denials.

2. Work Criteria Not Met

If you earned above the SGA threshold (e.g., $1,470/month for non-blind individuals in 2023) after your alleged onset date, the SSA may conclude you are not disabled.

3. Listing Not Met or Equaled

Even severe conditions like multiple sclerosis or bipolar disorder can be denied if evidence fails to meet the exact criteria listed in Appendix 1.

4. Failure to Follow Prescribed Treatment

Under 20 C.F.R. § 404.1530, claimants generally must follow treatment unless they have a good reason. Non-compliance can sink a claim.

5. Prior Denials Relied Upon

Submitting a “duplicate” application without new evidence often yields the same outcome. Instead, exhaust your appeal rights inside the same filing.

Federal Legal Protections & Regulations

1. The Social Security Act

Section 205(b) of the Act guarantees a “reasonable opportunity” for a hearing after an unfavorable determination. Section 223(d) defines disability and contains the statutory five-step evaluation system.

2. Code of Federal Regulations

• 20 C.F.R. § 404.909: 60-day deadline to request reconsideration.

• 20 C.F.R. § 404.933: Rules for requesting an Administrative Law Judge (ALJ) hearing.

• 20 C.F.R. § 404.970: Appeals Council review standards.

3. Federal Court Review

If the Appeals Council denies review, 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.

4. Due Process and Evidence Rules

Social Security Ruling 16-3p governs how subjective symptoms like pain are evaluated. The claimant’s testimony must be weighed against objective evidence but cannot be dismissed solely because tests are inconclusive.

5. Protection from Discrimination

SSA adjudicators must apply policies uniformly nationwide (SSA Hearings, Appeals & Litigation Law Manual (HALLEX) I-2-0-5). Connecticut claimants are entitled to the same standards as residents of any other state.

Steps to Take After an SSDI Denial

Step 1: Review Your Notice of Disapproved Claim

The denial letter lays out the medical and vocational evidence considered as well as the appeal window—generally 60 days from receipt (mail presumption: 5 days after the date on the letter).

Step 2: File a Request for Reconsideration (SSA-561) Most Connecticut applicants stay within the SSA Boston Region processing system, which includes the New Haven, Bridgeport, and Hartford field offices. Reconsideration is a paper review by a different examiner.

Step 3: Request an ALJ Hearing

If reconsideration fails, submit Form HA-501. Hearings for Connecticut residents are normally held at:

• Hartford ODAR Hearing Office – 135 High Street, Hartford, CT 06103.

• New Haven ODAR Hearing Office – 150 Court Street, New Haven, CT 06510.

The ALJ can take sworn testimony, call vocational or medical experts, and admit new evidence up to five business days before the hearing (20 C.F.R. § 404.935).

Step 4: Appeals Council Review

File Form HA-520. The Council may grant, deny, or remand your case. In Connecticut, Appeals Council operations are handled by the centralized Falls Church, VA office but your file is electronic.

Step 5: Federal District Court

You or your attorney may file a Complaint under 42 U.S.C. § 405(g) in the U.S. District Court (New Haven, Hartford, or Bridgeport divisions). The Court reviews whether the ALJ’s decision is supported by “substantial evidence” and compliant with law.

Statutory Deadline Summary

• Reconsideration: 60 days.

• ALJ Hearing: 60 days.

• Appeals Council: 60 days.

• Federal Court: 60 days.

Missing a deadline usually ends the claim unless you show “good cause” under 20 C.F.R. § 404.911.

When to Seek Legal Help for SSDI Appeals

1. Complexity of Medical Evidence

Claimants with multiple conditions (e.g., chronic pain plus depression) often benefit from an attorney who can frame combined limitations at Step 5 of the sequential evaluation.

2. Cross-Examination of Experts

ALJs in Connecticut frequently call Vocational Experts (VEs). An experienced Connecticut disability attorney can cross-examine the VE on job numbers and transferable skills.

3. Contingent-Fee Structure

Federal law caps most attorney fees at the lesser of 25% of past-due benefits or $7,200 (42 U.S.C. § 406(a) as updated). No fee is owed if you lose, making counsel low-risk.

4. Connecticut Attorney Licensing Rules

Attorneys must be admitted to the Connecticut Bar under Conn. Practice Book §§2-8 et seq. to practice law in state; however, any lawyer in “good standing” with SSA may represent you administratively. For federal court, pro hac vice admission requires a local sponsor.

Local Resources & Next Steps

1. SSA Field Offices in Connecticut

• Hartford: 960 Main St, Hartford, CT 06103

• New Haven: 150 Court St, New Haven, CT 06510

• Bridgeport: 1000 Lafayette Blvd, Bridgeport, CT 06604

Make appointments in advance; walk-ins may face long waits.

2. Connecticut DDS (Disability Determination Services)

Address: 55 Farmington Avenue, Hartford, CT 06105. DDS handles medical determinations at the initial and reconsideration levels.

3. Medical Providers Familiar with SSA Forms

• Yale New Haven Hospital – Large teaching hospital with multiple specialty clinics.

• UConn Health – Provides Functional Capacity Evaluations (FCEs).

• Hospital for Special Care (New Britain) – Renowned for neuro-rehabilitation.

4. Non-Profit Help

Connecticut Legal Services (income limits apply). United Way 2-1-1 Connecticut for community support.

5. Authoritative References

SSA Official Website 20 C.F.R. Part 404 Social Security Act (42 U.S.C.) U.S. District Court, District of Connecticut

6. Preparing for the Next Step

Organize all medical records, create a medication list, and keep a daily symptom journal. This documentation can corroborate testimony.

Legal Disclaimer

This article is for informational purposes only and does not constitute legal advice. Laws and agency policies change; consult a licensed Connecticut attorney about your specific situation.

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