Comprehensive SSDI Denial Guide | Colorado, CO

Introduction: Why This Guide Matters to Coloradans

Receiving a Social Security Disability Insurance (SSDI) denial can feel overwhelming—especially when you rely on those benefits to cover basic living expenses, medical care, and housing here in Colorado (CO). In 2023, the Social Security Administration (SSA) reported that nearly two-thirds of initial SSDI applications nationwide were denied. Colorado residents are no exception: the Denver Regional Office—which oversees all SSA field offices in the state—consistently echoes these national statistics. This guide leans slightly in favor of protecting claimants’ rights but remains strictly factual, relying on authoritative federal regulations and publicly available SSA data. Whether you live in Denver, Colorado Springs, Aurora, Fort Collins, or Grand Junction, the information below will help you understand why claims get denied, how to appeal, and when a Colorado disability attorney can make the difference.

Understanding Your SSDI Rights

Eligibility Basics Under Federal Law

SSDI is a federal insurance program funded through payroll taxes and administered under Title II of the Social Security Act. To qualify, you must:

• Have earned enough work credits in covered employment (generally 20 credits in the 10 years preceding disability for most adults).

• Demonstrate a medically determinable impairment expected to last at least 12 months or result in death, per 20 C.F.R. §404.1505.

• Be unable to engage in Substantial Gainful Activity (SGA) according to monthly earnings limits set annually by SSA.

Once you meet these criteria, you have a statutory right to apply for SSDI and, if denied, to pursue multiple layers of appeal. Section 205(b) of the Social Security Act guarantees due process, meaning the SSA must provide written notice of its decision and an opportunity for a hearing.

Key Protections for Colorado Claimants

• Non-discrimination: SSA must evaluate your claim without bias, including against veterans, Native populations on Colorado’s reservations, or bilingual applicants.

• Representative choice: Under 20 C.F.R. §404.1705, you may appoint a licensed Colorado attorney or qualified non-attorney to help with your appeal.

• No up-front attorney fees: Fees are generally capped at 25% of past-due benefits or $7,200 (2024 limit) and must be approved by SSA.

Common Reasons SSA Denies SSDI Claims

Understanding why claims fail is the first step in crafting a successful SSDI denial appeal colorado colorado (primary SEO phrase). The most common denial reasons reflected in Colorado cases are:

Insufficient Medical Evidence SSA may conclude that objective tests, treatment notes, or imaging do not support the claimed limitations. For example, applicants citing severe back pain often lack recent MRI results showing nerve impingement. Failure to Follow Prescribed Treatment Under 20 C.F.R. §404.1530, you generally must follow your doctor’s treatment plan unless you have a justifiable reason (e.g., financial constraints, religious beliefs). Earnings Above SGA In 2024, the SGA limit is $1,550 per month for non-blind claimants and $2,590 for blind claimants. Working above these thresholds leads to technical denials. Short-Duration Impairments Conditions expected to improve within 12 months—such as many post-operative recoveries—usually fail to meet the duration requirement. Previous Denials Without New Evidence Submitting a repeat application identical to a prior denial often triggers the same outcome unless you add new medical records or diagnoses.

Federal Legal Protections & Regulations

The Four-Step Administrative Appeals Process

The appeals framework is set out in 20 C.F.R. §404.900. Each step must be completed in sequence unless SSA allows you to skip to federal court.

• Reconsideration (60-day deadline). A new examiner and medical consultant reevaluate your file. In Colorado, reconsiderations are processed by Disability Determination Services (DDS) in Denver.

• Administrative Law Judge (ALJ) Hearing (60-day deadline after reconsideration denial). Hearings for Colorado residents occur via video or in-person before ALJs based in the Office of Hearings Operations (OHO) in Denver and Colorado Springs.

• Appeals Council Review (60-day deadline). Located in Falls Church, VA, the Appeals Council may deny review, remand, or issue a decision.

• Federal District Court Filing (60 days). Colorado claimants file suit in the U.S. District Court for the District of Colorado, typically in Denver’s Alfred A. Arraj Courthouse.

Statute of Limitations & Timelines

• Initial determination: Appeal within 60 days of the date you receive your denial letter (SSA assumes receipt 5 days after the mailing date).

• Late appeals: You may request an extension for good cause per 20 C.F.R. §404.911.

• Federal court: File your civil action within 60 days after the Appeals Council decision, naming the Commissioner of Social Security as defendant.

Key Federal Court Precedents Affecting Colorado

• Thompson v. Sullivan, 987 F.2d 1482 (10th Cir. 1993) – Requires ALJs in the Tenth Circuit (which includes Colorado) to consider the combined impact of multiple impairments.

• Lax v. Astrue, 489 F.3d 1080 (10th Cir. 2007) – Reiterates claimant-friendly standard that ALJ decisions must be supported by substantial evidence.

Steps to Take After an SSDI Denial

1. Scrutinize the Denial Letter

The denial notice will identify (a) medical/vocational grounds or (b) technical grounds. Mark every stated reason in writing to build a targeted response.

2. Gather Missing Medical Evidence

• Request treatment records from UCHealth, Centura Health, Denver Health, or the VA Eastern Colorado Health Care System.

• Consult specialists: neurologists, orthopedic surgeons, or mental health providers who can offer objective findings.

• Obtain functional capacity evaluations and statements of limitations using SSA Form RFC – (Physical/ Mental).

3. File for Reconsideration (Form SSA-561)

You can submit online via the SSA iAppeals portal or file paper forms at your local office (see addresses below). Attach new evidence, updated medications, and any worsening symptoms.

4. Prepare for the ALJ Hearing

• Timeline: Average wait times in Colorado are nine to twelve months but vary by docket backlog.

• Witnesses: Vocational experts (VEs) and medical experts (MEs) testify. Cross-examination can be crucial—an experienced Colorado disability attorney is often beneficial here.

• Hearing locations: Denver OHO – 1244 Speer Blvd., Suite 600, Denver, CO 80204; Colorado Springs OHO – 2864 South Circle Drive, Colorado Springs, CO 80906.

5. Pursue Appeals Council & Federal Court Review

If the ALJ rules against you, submit a written brief to the Appeals Council highlighting ALJ legal errors. Should the Council deny review, your last remedy is a federal lawsuit. While you may proceed pro se, federal practice rules and filing fees (currently $402) make attorney representation advisable.

When to Seek Legal Help for SSDI Appeals

Although claimants can represent themselves before SSA, multiple studies—including SSA’s own 2017 Appeals Council Report—show higher success rates with representation, particularly at the ALJ stage.

Benefits of a Colorado Disability Attorney

• Evidence curation: Attorneys understand which medical records satisfy the Listings in 20 C.F.R. Part 404, Subpart P, Appendix 1.

• Hearing advocacy: Cross-examine VEs, object to hypothetical questions that misstate your limitations, and ensure the ALJ develops the record per 20 C.F.R. §404.944.

• Contingency fees: No fee unless you win. SSA directly withholds and pays approved fees from back-pay.

• Local knowledge: Familiarity with Colorado ALJs’ preferences and medical providers improves strategic presentation.

Attorney Licensing Rules in Colorado

Any lawyer representing SSDI claimants in Colorado federal court must be admitted to the U.S. District Court for the District of Colorado and remain in good standing with the Colorado Supreme Court’s Office of Attorney Regulation Counsel. Non-attorney representatives must meet SSA’s eligibility criteria and pass a criminal background check.

Local Resources & Next Steps

SSA Field Offices in Major Colorado Cities

• Denver Downtown – 1500 Champa St. Suite 200, Denver, CO 80202

• Colorado Springs – 2306 East Pikes Peak Ave., Colorado Springs, CO 80909

• Aurora – 14280 East Jewell Ave. Suite 250, Aurora, CO 80012

• Grand Junction – 825 North Crest Drive, Grand Junction, CO 81506

State and Community Assistance

Colorado Department of Human Services (CDHS) – Offers SNAP, Medicaid, and energy assistance while your SSDI appeal is pending. Colorado Legal Services – Provides free or low-cost representation to qualifying low-income residents for disability benefits appeals.

• Community health centers such as Denver Health’s Federico F. Peña Southwest Family Health Center can supply sliding-scale medical care and documentation essential for your claim.

Free Workshops and Clinics

Several public libraries—including the Denver Public Library Central Branch—host quarterly “SSDI 101” clinics in partnership with local nonprofits. Check the library events calendar for upcoming sessions.

Legal Disclaimer

This guide is for informational purposes only and is not legal advice. Laws and SSA policies change. Consult a licensed Colorado attorney for advice 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.