Colorado SSDI Denial Guide: Appeal Steps & Rights

Introduction: Why a Colorado-Specific SSDI Guide Matters

Each year thousands of Colorado residents—from Pueblo’s steelworkers to Denver’s tech professionals and Grand Junction’s ranchers—turn to Social Security Disability Insurance (SSDI) after injury or illness ends their ability to work. According to Social Security Administration (SSA) data, only about one in three Coloradans who apply are approved at the initial level, closely mirroring the national rate. If you recently opened a brown SSA envelope and found a Notice of Disapproved Claim, you are not alone—and you are not out of options. This comprehensive guide explains the federal rules, state-specific considerations, and practical steps you can take to protect your rights, strengthen your evidence, and move your claim forward.

All facts are drawn from authoritative sources, including the Social Security Act, the Code of Federal Regulations, SSA Program Operations Manual System (POMS), and published federal court decisions. Where Colorado-specific information is provided—such as addresses for SSA field offices, statistics, or attorney-licensing requirements—it is taken from official state or federal websites. This article favors claimants by highlighting common pitfalls the agency may not explain in plain language, while remaining strictly accurate and evidence-based.

Understanding Your SSDI Rights Under Federal Law

Who Qualifies for SSDI?

SSDI is a federal insurance program funded by payroll taxes. To qualify, you must:

• Be insured—generally at least 20 quarters of coverage in the 40-quarter period before disability onset (see 42 U.S.C. §423(c)).

• Have a medically determinable impairment expected to last 12 months or result in death (20 CFR 404.1505).

• Prove inability to perform substantial gainful activity (SGA)—in 2024, that means earning less than $1,550 per month for non-blind claimants (20 CFR 404.1574).

Key Procedural Protections

The Social Security Act guarantees you “reasonable notice and opportunity for a hearing” before benefits are permanently denied (42 U.S.C. §405(b)). Under 20 CFR 404.900, you have four appeal stages:

• Request for Reconsideration

• Hearing before an Administrative Law Judge (ALJ)

• Appeals Council review

• Federal court review

At each stage you may submit new evidence, obtain representation, and request the agency’s complete file.

Common Reasons SSA Denies Colorado SSDI Claims

1. Technical (Non-Medical) Denials

• Insufficient work credits—common among gig-economy workers in Denver or seasonal employees in ski resorts who had self-employment earnings but failed to pay FICA.

• Exceeding SGA—some claimants attempt part-time work in Boulder startups but inadvertently earn over the monthly limit.

2. Medical Denials

• Lack of objective evidence—SSA rarely accepts subjective pain complaints without diagnostic imaging or specialist notes.

• Failure to meet or equal a Listing—for example, Listing 1.15 for spinal disorders requires specific clinical findings many family physicians do not document.

• Residual Functional Capacity (RFC) underestimated—Disability Determination Services (DDS) doctors in Aurora may conclude you can perform light work, even though your treating orthopedist imposes stricter limits.

3. Procedural Errors

• Missing deadlines (discussed below).

• Non-compliance with consultative examinations (CEs).

• Incomplete work history reports (Form SSA-3369).

Federal Legal Protections & Regulations Every Coloradan Should Know

Appeal Deadlines

• 60 days from receipt of any adverse SSA decision to file the next appeal level (20 CFR 404.909, 404.933, 422.210). SSA presumes you received the notice five days after the date on the letter unless you prove otherwise.

• 45 days to request a review of an ALJ dismissal (20 CFR 404.960).

• Federal court: You have 60 days after Appeals Council denial to file a civil action in U.S. District Court for the District of Colorado (28 U.S.C. §405(g)).

Right to Representation

Under 20 CFR 404.1700, you may appoint an attorney or qualified non-attorney representative. Representatives are typically paid 25% of past-due benefits, capped at $7,200 unless a fee petition is approved for more.

Evidence Rules

The ALJ must consider all evidence in the record (20 CFR 404.1512). Medical opinions from treating physicians are evaluated under 20 CFR 404.1520c; persuasive value depends on supportability and consistency. The SSA’s Medical-Vocational Guidelines—known as the “Grid Rules”—may direct a finding of disability for claimants over age 50 with limited education.

Bias Prohibition

SSA adjudicators must evaluate claims impartially. If you suspect bias, 20 CFR 404.940 allows you to move for ALJ recusal by filing a written statement explaining your reasons.

Steps to Take After an SSDI Denial in Colorado

1. Carefully Read Your Notice

The denial letter lists the “technical” or “medical” reasons. Highlight missing evidence and take note of the date printed on the notice to calculate the 60-day deadline.

2. File a Timely Request for Reconsideration

You can submit Form SSA-561 online, by mail, or in person at any Colorado SSA field office. For example, the Denver Downtown SSA Office is located at 1500 Champa St, Suite 200, Denver, CO 80202. Telephone: 1-800-772-1213. Keep a date-stamped copy or USPS certified mail receipt.

3. Strengthen Your Medical Record

• Specialist referrals—Orthopedic, neurological, or psychiatric specialists at University of Colorado Hospital or UCHealth Poudre Valley can provide detailed narratives.

• Diagnostic tests—MRIs, EMGs, or neuropsychological exams often carry more weight than primary care notes.

4. Track Functional Limitations

Maintain a daily journal of pain levels, medication side effects, and tasks you can no longer perform. Present this alongside work-history forms.

5. Obtain Statements from Employers and Family

Under 20 CFR 404.1513(a)(4), non-medical sources such as former supervisors in Colorado Springs can corroborate reduced productivity or work absences.

6. Prepare for the Administrative Law Judge (ALJ) Hearing

• Request your electronic claims file (e-Folders) through mySocialSecurity or by written request.

• Submit all evidence at least five business days before the hearing (20 CFR 405.331).

• Review vocational expert (VE) testimony—be ready to challenge hypothetical jobs that do not exist in meaningful numbers in Colorado’s labor market, such as “silver wrapper.”

When to Seek Legal Help for SSDI Appeals

Benefits of Representation

A Colorado disability attorney understands SSA’s complex rules and local medical resources. A 2019 Government Accountability Office (GAO) study found claimants with representation were nearly three times more likely to be approved at the ALJ level. Attorneys cross-examine vocational experts, draft legal briefs citing 20 CFR 404.1520, and ensure deadlines are met.

Attorney Licensing in Colorado

All lawyers must be admitted to the Colorado Supreme Court and remain in good standing with the Office of Attorney Regulation Counsel. You can verify a lawyer’s status online or by calling 303-457-5800.

Fee Structure

Most Colorado SSDI attorneys work on contingency. Fees are capped by the SSA as discussed above, so you pay nothing up front. Costs (e.g., medical record fees) are typically billed separately, so request an itemized statement.

Local Resources & Next Steps

Key Colorado SSA Offices

• Denver Downtown: 1500 Champa St, Suite 200, Denver, CO 80202

• Colorado Springs: 2306 E Pikes Peak Ave, Colorado Springs, CO 80909

• Grand Junction: 825 N Crest Dr, Grand Junction, CO 81506

Hours: Monday–Friday, 9 a.m.–4 p.m. (except federal holidays). Always call 1-800-772-1213 for updates, as hours can change.

Medical Facilities Familiar with Disability Documentation

• UCHealth University of Colorado Hospital (Aurora)

• National Jewish Health (Denver) for pulmonary claims

• Craig Hospital (Englewood) for spinal cord and traumatic brain injuries

Community Organizations

Disability Law Colorado – statewide protection & advocacy agency DRMAC – transportation assistance for medical appointments in the Denver metro

Further Reading

SSA Official Appeals Portal SSA POMS: Disability Determination Services 20 CFR 404.900 – Administrative Review Process

Legal Disclaimer

This article is for informational purposes only and does not constitute legal advice. For advice on your specific situation, consult a licensed Colorado attorney.

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