SSI and SSDI: Denial & Appeal Guide – Connecticut, CT

Introduction: A Connecticut-Focused Guide to SSDI Denials and Appeals

If you live in Connecticut and received a denial on your Social Security Disability Insurance (SSDI) claim, you are not alone—and you have the right to appeal. The Social Security Administration (SSA) follows uniform federal rules, but how you gather medical evidence, meet deadlines, and access local resources in Connecticut can make a real difference. This guide explains what a denial means, how the federal appeals process works, and the practical steps Connecticut residents can take to protect their rights. While the focus here is SSDI, we also highlight key distinctions from Supplemental Security Income (SSI) to help you avoid confusion. Throughout, we slightly favor the claimant’s perspective while remaining strictly factual and grounded in authoritative sources.

SSDI is a federal insurance program for workers who paid Social Security taxes and become disabled under the Social Security Act’s definition. A denial does not end your claim—there are multiple levels of appeal, each with specific timelines and evidentiary rules. Under 20 CFR 404.900, the administrative review process includes reconsideration, a hearing before an Administrative Law Judge (ALJ), Appeals Council review, and federal court. Most importantly, the clock to appeal is short, and missing a deadline can force you to restart the process.

Connecticut claimants navigate the same federal rules as claimants in other states, but accessing your treating providers (for example, major health systems and smaller practices across the state), coordinating with your local SSA field office, and understanding where you would file a federal court case (if necessary) are all state-specific considerations. This guide explains:

• Your core SSDI rights, including how disability is defined and evaluated under federal law.

• Common reasons SSA denies claims and how to address them with solid evidence.

• Exact appeal levels and deadlines, with citations to the Code of Federal Regulations (CFR) and Social Security Act.

• Local information for Connecticut residents, including how to find your nearest SSA office and where federal court review occurs.

• When and how to seek legal help, including representation and fee rules the SSA must approve.

Primary SEO phrase included for discoverability: SSDI denial appeal connecticut connecticut. If you need immediate assistance, you can contact SSA directly or speak with a Connecticut disability attorney for advice specific to your situation.

Understanding Your SSDI Rights

What SSDI Is—and How It Differs from SSI

SSDI provides benefits to people who have a qualifying work history and become disabled under federal law. SSI is a separate, needs-based program for people with limited income and resources. While both can be denied for lack of medical proof, SSI denials often involve financial eligibility issues as well. Your appeal rights exist for both programs, but this guide emphasizes SSDI procedures and standards.

The Federal Definition of Disability

The Social Security Act defines disability for SSDI purposes as the inability to engage in substantial gainful activity (SGA) due to a medically determinable physical or mental impairment that has lasted or is expected to last at least 12 months or result in death. See 42 U.S.C. § 423(d). SSA does not award partial or temporary disability benefits. The focus is on functional limitations and duration, not merely a diagnosis.

The Five-Step Sequential Evaluation

SSA uses a five-step sequential evaluation to decide disability claims, codified at 20 CFR 404.1520. In brief:

• Substantial Gainful Activity (SGA): Are you working at a level the SSA considers substantial? If yes, the claim is typically denied at step one. See 20 CFR 404.1572 for SGA.

• Severe Impairment: Do you have a medically determinable impairment (or combination) that significantly limits basic work activities? If not, denial occurs at step two.

• Listings: Does your condition meet or medically equal a listed impairment? If yes, you are found disabled at step three.

• Past Work: Given your residual functional capacity (RFC), can you perform your past relevant work? If yes, not disabled.

• Other Work: Considering age, education, work experience, and RFC, can you adjust to other work in the national economy? If yes, not disabled; if no, disabled.

SSA evaluates your medical evidence, objective findings, treatment history, and statements about symptoms. For adults, work capacity—physical and mental—is central. Older claimants may benefit from vocational rules found in 20 CFR Part 404, Subpart P, Appendix 2 (often called the “Medical-Vocational Guidelines” or “grids”).

Your Right to Representation

You have the right to appoint a representative at any stage. Representatives may be attorneys or qualified non-attorney representatives, as permitted by 20 CFR 404.1705. Representatives must follow SSA’s rules of conduct and standards of responsibility (see 20 CFR 404.1740). Any fee must be approved by the SSA under the Social Security Act and regulations, commonly through a fee agreement or fee petition process governed by 42 U.S.C. § 406 and 20 CFR 404.1720.

Common Reasons SSA Denies SSDI Claims

Insufficient Medical Evidence

Denials often result from inadequate medical documentation of functional limitations. SSA requires evidence from acceptable medical sources and records that support diagnosis, severity, and ongoing limitations. Gaps in treatment, missing specialist records, or a lack of objective testing can all undermine your claim. Ensure that Connecticut providers—whether hospital systems, clinics, or individual practitioners—send complete records to SSA.

Work Activity Above SGA

If SSA finds you engaged in substantial gainful activity (as defined in 20 CFR 404.1572), the claim may be denied at step one. Some claimants attempt to work part-time or sporadically while disabled. Even limited earnings or inconsistent hours can create confusion; be prepared to document the nature of your work, accommodations, and any failed work attempts.

Failure to Follow Prescribed Treatment

In some cases, if SSA determines you failed to follow prescribed treatment without good reason, it may weigh against your claim. The specifics depend on the medical context, risks, and feasibility. If you have reasons for not following certain treatments—for example, side effects, access issues, or contraindications—make sure these are documented in the medical record.

Short Duration or Improvement

SSA requires a continuous 12-month duration of disability (or expected duration) under 42 U.S.C. § 423(d). If your condition improves quickly, or your records do not show ongoing functional limits, SSA may deny the claim. Updated records from Connecticut providers can be critical to demonstrate persistence and severity over time.

Inconsistencies in the Record

SSA examines consistency across medical records, function reports, and third-party statements. Conflicting statements about daily activities or work capacity can result in a denial. Keep your reports consistent and accurate, and correct any errors promptly.

Federal Legal Protections & Regulations

Appeals Are Guaranteed—But Time-Limited

The SSA appeals framework is laid out in 20 CFR 404.900 et seq. and in the Social Security Act at 42 U.S.C. § 405(b), (g). After an initial denial, you typically have 60 days to appeal, with an additional 5 days presumed for mailing. See 20 CFR 404.909 (reconsideration requests) and 20 CFR 404.911 (good cause for late filing). You should file as soon as possible to avoid deadline disputes.

The Four Levels of Administrative and Judicial Review

• Reconsideration: A different reviewer re-examines your case. Deadline: 60 days (20 CFR 404.909).

• Hearing Before an ALJ: If reconsideration is denied, request a hearing (20 CFR 404.933). You can present evidence and testify.

• Appeals Council Review: If the ALJ denies your claim, request review under 20 CFR 404.968. The Appeals Council may deny review, issue a new decision, or remand.

• Federal Court: If the Appeals Council denies or issues an unfavorable decision, you may file a civil action under 42 U.S.C. § 405(g). For Connecticut residents, this action is filed in the U.S. District Court for the District of Connecticut, consistent with § 405(g), which directs filing in the judicial district where you reside.

Evidence Requirements and the Five-Day Rule

Before your ALJ hearing, you must submit or inform SSA about all written evidence at least five business days before the hearing date, unless an exception applies. See 20 CFR 404.935. This rule is strictly enforced. If you obtain new records from Connecticut providers shortly before the hearing, notify the ALJ immediately and request an exception if necessary.

Reopening and Revising Decisions

In certain circumstances, final decisions can be reopened. For Title II (SSDI), SSA may reopen within four years of the notice of the initial determination for good cause. See 20 CFR 404.987–404.989 (including 20 CFR 404.988). Reopening is discretionary and fact-specific.

Steps to Take After an SSDI Denial

1) Mark Your Deadline and File the Appeal Correctly

Appeal within 60 days of receiving the denial notice (plus the 5-day mailing presumption), unless the notice specifies otherwise. For initial denials, file a reconsideration request. You may appeal online using SSA’s forms and instructions, or by contacting SSA to file. See SSA’s official appeals page for the appropriate process and forms.

2) Identify and Fix Evidence Gaps

Review your denial letter carefully. It usually indicates the reasons for denial and key evidence considered. Then:

• Request complete medical records from all relevant Connecticut providers. Ask for treatment notes, imaging reports, lab results, and specialty evaluations.

• Seek opinion evidence from treating specialists that explains your diagnoses, functional limitations, and prognosis. Detailed functional assessments aligned with SSA criteria can be decisive.

• Document symptom frequency and impact through pain diaries, migraine logs, or other contemporaneous records.

• Address inconsistencies in dates, daily activities, and work history forms.

3) Prepare for Reconsideration and Hearing

At reconsideration, a new reviewer assesses your file. Update evidence promptly—do not assume SSA automatically obtains every record. If you proceed to a hearing (20 CFR 404.933), be ready to testify about your limitations, treatment adherence, side effects, and daily activities. Understand the five-step evaluation and how your RFC limits sustained work-related activities (sitting, standing, lifting, concentrating, interacting, attendance, pace, and persistence).

4) Follow the Five-Day Evidence Rule

Make sure the ALJ receives or is informed about all written evidence at least five business days before the hearing. If late evidence emerges—such as a freshly completed specialist opinion—immediately notify the hearing office and request acceptance under 20 CFR 404.935 exceptions.

5) Consider Representation

Skilled representation can help develop the record, obtain persuasive medical opinions, prepare you for testimony, and examine vocational experts. Representatives must comply with SSA’s rules (20 CFR 404.1705, 404.1740), and fees must be approved by SSA (42 U.S.C. § 406; 20 CFR 404.1720). You may choose a Connecticut-licensed attorney or a qualified non-attorney representative permitted to practice before the SSA.

6) Keep SSA Informed and Respond Promptly

Provide timely responses to SSA requests. If you change address or phone number within Connecticut or move elsewhere, notify SSA right away to avoid missed notices and deadlines.

When to Seek Legal Help for SSDI Appeals

Indicators You Should Consult a Professional

• Your denial cites insufficient medical evidence, and you need help obtaining specialist records or opinion evidence.

• You have a complex medical picture (multiple conditions, fluctuating symptoms, or mental and physical impairments) requiring a careful RFC analysis.

• You are approaching an ALJ hearing and must comply with 20 CFR 404.935’s five-day evidence rule.

• Your case involves unsuccessful work attempts, accommodations, or borderline vocational factors (e.g., age, education) that implicate the medical-vocational guidelines.

• You are considering Appeals Council review or a federal court action under 42 U.S.C. § 405(g).

Attorney Licensing in Connecticut and SSA Representation Rules

To provide legal advice about Connecticut law or to represent clients in Connecticut state courts, an attorney must be properly admitted to the Connecticut bar under state rules. For Social Security cases, both attorneys and qualified non-attorney representatives may represent claimants before SSA, as allowed by 20 CFR 404.1705. Regardless of who represents you, SSA must approve any fee (42 U.S.C. § 406; 20 CFR 404.1720). If you prefer an attorney licensed in Connecticut, you can verify admission and good standing through the Connecticut Judicial Branch.

Local Resources & Next Steps for Connecticut Claimants

Finding Your Local SSA Field Office in Connecticut

SSA maintains field offices across Connecticut to assist with applications, appeals, and account services. To find the most current office address and hours for your area (for example, in cities such as Hartford, New Haven, or Bridgeport), use the official SSA Office Locator. You can also contact SSA’s national number for assistance.

• SSA Office Locator: Use your ZIP code to identify the nearest Connecticut office, current hours, and contact options.

• National SSA Phone: 800-772-1213 (TTY: 800-325-0778)

Where a Federal Court Case Is Filed If You Need One

If your claim reaches the federal court stage, Connecticut residents file civil actions under 42 U.S.C. § 405(g) in the U.S. District Court for the District of Connecticut. The decision to file in federal court is significant; strict deadlines apply after the Appeals Council’s final action, and there are detailed rules about what the court can review and the relief it can grant. Consult counsel promptly if you are considering this step.

Coordinating With Your Connecticut Healthcare Providers

Timely, detailed medical records are vital. Ask your Connecticut providers to supply complete and legible records, including imaging, lab results, mental health treatment notes (if applicable), and functional assessments. If a provider is unsure what SSA needs, request that they describe specific work-related limitations (for example, limits on lifting, standing, sitting, attendance, concentration, and social interaction). Consistent documentation over time is one of the strongest predictors of a successful appeal.

Detailed Walkthrough of the SSDI Appeals Process

Reconsideration (20 CFR 404.909)

After an initial denial, file your reconsideration request within 60 days. A different examiner will review your file, including new evidence you submit. Do not wait for SSA to collect records—proactively send updated treatment notes, diagnostic results, and opinion letters. If your condition has worsened or new diagnoses have emerged, highlight that development. Continue treatment and keep your contact information current so you do not miss consultative examinations scheduled by SSA.

ALJ Hearing (20 CFR 404.933 and 404.935)

If reconsideration is denied, request a hearing before an Administrative Law Judge. This is often the best opportunity to present your case. The ALJ may hear testimony from you, a vocational expert, and sometimes a medical expert. Prepare to explain your symptoms, good days and bad days, and how often you cannot persist at work tasks or attend reliably. Provide medical opinions that tie clinical findings to specific work limitations. Remember the five-day rule: submit or notify the ALJ about all written evidence at least five business days before the hearing (20 CFR 404.935), or request an exception promptly if new evidence becomes available late.

Appeals Council Review (20 CFR 404.968)

If the ALJ’s decision is unfavorable, you have 60 days to request Appeals Council review. The Appeals Council may deny review, issue a favorable decision, or send your case back (remand) for another ALJ hearing. When requesting review, identify legal or factual errors, conflicts with SSA policy, or significant evidence the ALJ did not consider. Provide any new and material evidence that relates to the period on or before the ALJ decision date, and explain why it could change the outcome.

Federal Court (42 U.S.C. § 405(g))

After the Appeals Council acts, you typically have 60 days to file a civil action in federal court. The court reviews the administrative record to determine whether SSA’s decision is supported by substantial evidence and whether the correct legal standards were applied. Courts may affirm, reverse, or remand for further proceedings. Because federal litigation is technical and deadline-driven, many claimants seek counsel for this stage.

Building a Persuasive Connecticut SSDI Appeal Record

Medical Evidence Strategy

• Continuity of Care: Regular treatment with Connecticut providers strengthens credibility and documents longitudinal severity.

• Specialist Input: In complex cases, specialist opinions (e.g., neurology, orthopedics, psychiatry) can clarify functional limits.

• Objective Findings: Imaging, lab tests, and neuropsychological evaluations, where appropriate, can corroborate symptom reports.

• Function-Focused Opinions: Ask providers to address standing/sitting tolerance, lifting/carrying, postural limitations, manipulative restrictions, concentration, persistence, pace, and attendance.

Symptoms, Daily Activities, and Work History

Consistency is crucial. Align your function reports, testimony, and medical notes. If you perform limited daily tasks, explain pacing, rest periods, assistance needed, and post-exertional effects. If you attempted work in Connecticut but could not sustain it, document why—absences, slowing, pain flares, or cognitive issues—so SSA understands the functional reality.

Vocational Evidence and the Grids

For older claimants, vocational factors can be favorable under the Medical-Vocational Guidelines in 20 CFR Part 404, Subpart P, Appendix 2. Prepare to discuss your past relevant work in detail: exertional level, skill level, and transferability of skills. If a vocational expert testifies, your representative can cross-examine with realistic limitations reflected in your medical evidence.

Key Deadlines, Extensions, and Good Cause

Standard Appeal Deadlines

• Reconsideration: 60 days from receipt of the denial notice (20 CFR 404.909).

• ALJ Hearing: 60 days from receipt of the reconsideration denial (20 CFR 404.933).

• Appeals Council: 60 days from receipt of the ALJ decision (20 CFR 404.968).

• Federal Court: Generally 60 days from receipt of the Appeals Council’s action (42 U.S.C. § 405(g)).

SSA presumes you received a notice 5 days after the date on the notice unless you show otherwise. See 20 CFR 404.901 (definitions) and 20 CFR 404.911 (good cause). If you miss a deadline, you may request an extension by showing good cause under 20 CFR 404.911. Do not delay—waiting makes extensions harder to obtain.

Reopening Time Limits

Under 20 CFR 404.987–404.989, SSA may reopen certain determinations and decisions within specific timeframes, including within four years for good cause in Title II cases (20 CFR 404.988(b)). Reopening is not guaranteed; consult the regulations and consider seeking guidance if you believe reopening may apply.

Connecticut-Specific Practical Tips

Use the SSA Office Locator for Accurate CT Office Details

Office locations and hours can change. For the most accurate Connecticut information, use the SSA Office Locator to confirm the nearest field office to your ZIP code, current operating hours, and appointment options. Major Connecticut cities such as Hartford, New Haven, and Bridgeport have SSA field offices that assist with SSDI and SSI services. If transportation is a barrier, ask SSA about phone or online options for appeals and hearings when available.

Coordinate With Your Local Providers

Connecticut claimants often receive care from a mix of large health systems and independent practices. Ask providers to respond promptly to SSA’s record requests and, where possible, provide function-based medical opinions addressing work-related limitations. Bring any SSA forms to appointments and explain the 12-month duration requirement and functional focus of SSA’s rules.

Prepare for a Video or In-Person Hearing

SSA may schedule video or in-person hearings depending on availability and policy. If technology is a concern, notify the hearing office in advance. Whether in Connecticut or via video, your preparation is the same: comply with 20 CFR 404.935’s evidence rules, practice testimony, and have your records organized.

Frequently Asked Questions for Connecticut SSDI Denials

Is an initial denial the end of my case?

No. The federal appeals process provides multiple levels of review (20 CFR 404.900), culminating in the right to file in federal court under 42 U.S.C. § 405(g). Many claims are won on appeal when the record is fully developed.

Do I need a Connecticut attorney?

You are not required to have an attorney, but representation can help, especially at the ALJ hearing stage. Attorneys who give legal advice about Connecticut law or represent clients in Connecticut state courts must be admitted to the Connecticut bar. For SSA proceedings, both attorneys and qualified non-attorney representatives may represent you (20 CFR 404.1705). Fees require SSA approval (42 U.S.C. § 406; 20 CFR 404.1720).

How do I strengthen my case?

Keep consistent medical treatment, obtain function-focused opinions, correct inconsistencies, and adhere to deadlines. Understand the five-step framework (20 CFR 404.1520) and be prepared to discuss why you cannot sustain full-time work activities on a regular and continuing basis.

What if I missed my appeal deadline?

Request an extension and explain good cause under 20 CFR 404.911. Provide documentation showing why you could not file timely (for example, serious illness or misdirected mail). If SSA does not accept good cause, consult about other options, including a new application or whether reopening rules (20 CFR 404.987–404.989) may apply.

How to Contact SSA and Verify Locations in Connecticut

SSA Office Locator (Find Your CT Field Office) SSA: Appeal a Decision (Official Appeals Portal) 20 CFR 404.900 (Administrative Review Process) Social Security Act § 205 (42 U.S.C. § 405) Connecticut Judicial Branch: Attorney Information

For general assistance, call SSA at 800-772-1213 (TTY 800-325-0778). Use your my Social Security account for online services where available.

Final Checklist for Connecticut SSDI Denial Appeals

• Calendar the Deadline: 60 days to appeal at each level (plus 5-day mailing presumption) unless your notice states otherwise.

• Request Reconsideration Promptly: Use SSA’s online appeal tools or contact your CT field office via the Office Locator.

• Gather Evidence: Obtain complete, up-to-date Connecticut medical records and function-focused opinions.

• Prepare for Hearing: Follow 20 CFR 404.935’s five-day evidence rule; consider representation.

• Keep Contact Info Current: Notify SSA of any Connecticut address or phone changes.

• Consider Higher Appeals: Appeals Council (20 CFR 404.968) and, if needed, federal court under 42 U.S.C. § 405(g).

Legal Disclaimer

This guide provides general information for Connecticut residents about SSDI denials and appeals. It is not legal advice. Laws and regulations change, and outcomes depend on specific facts. Consult a licensed Connecticut attorney or qualified representative about your particular situation.

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