Social Security Lawyers Near Me: SSDI — Colorado, Colorado

Colorado, Colorado SSDI Denial and Appeal Guide: What Social Security Disability Claimants Need to Know

When a Social Security Disability Insurance (SSDI) claim is denied, Colorado residents face not only the challenge of medical recovery but also the pressure of navigating a federal appeals system. Whether you live along the Front Range, on the Western Slope, or in the Eastern Plains, the core rules for SSDI are federal and apply uniformly across the state. Still, process details—like where your hearing is held and which local offices can accept your filings—have a Colorado-specific footprint. This guide explains your appeal rights, critical deadlines, and practical steps to strengthen your case, with a slight tilt toward protecting claimants while adhering strictly to authoritative sources.

SSDI is a federal insurance benefit for workers who paid Social Security taxes and can no longer engage in substantial work because of a medically determinable impairment that has lasted or is expected to last at least 12 months or result in death. The Social Security Administration (SSA) adjudicates eligibility under federal statutes and regulations. Colorado disability claimants most often interact with SSA field offices for filing and updates, state Disability Determination Services (DDS) for medical decisions at the initial and reconsideration stages, and an SSA hearing office (Office of Hearings Operations, or OHO) in the state for hearings before an Administrative Law Judge (ALJ). While the process is national, local logistics—like your nearest SSA office and the Denver-area ALJ hearing office—are Colorado-specific.

If you received a denial notice, the appeals clock is already running. The reconsideration deadline is 60 days from receipt of the notice (SSA presumes you receive notices five days after the date on the notice), and subsequent appeals have the same 60-day window. Missing a deadline can jeopardize your benefits, though SSA recognizes “good cause” to excuse late filings in some circumstances. Below, you’ll find step-by-step guidance grounded in the Social Security Act and the Code of Federal Regulations (CFR), so you can move forward with confidence.

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Understanding Your SSDI Rights in Colorado

Your rights in an SSDI case are defined by federal law, which applies in Colorado just as it does in every other state. The foundation comes from the Social Security Act and SSA regulations in Title 20 of the Code of Federal Regulations (20 CFR). Here are the bedrock concepts:

• Definition of Disability: For Title II (SSDI) claims, disability means the inability to engage in any substantial gainful activity (SGA) due to a medically determinable physical or mental impairment that can be expected to result in death or has lasted or can be expected to last at least 12 months. See 42 U.S.C. § 423(d)(1)(A); 20 CFR 404.1505.
• Insured Status: SSDI requires you to have sufficient work credits, typically earned by paying Social Security taxes over a set period. See 20 CFR 404.130 (insured status rules). The exact number of credits depends on your age and work history.
• Sequential Evaluation: SSA decides adult disability using a five-step process: (1) Are you working at the SGA level? (2) Do you have a severe impairment? (3) Does your condition meet or equal a listing? (4) Can you perform past relevant work? (5) Can you do other work in the national economy? See 20 CFR 404.1520.
• Listings (“Blue Book”): SSA maintains a list of impairments that, if met or medically equaled, qualify you for disability without further vocational analysis. See the adult listings in SSA’s “Blue Book.”
• Residual Functional Capacity (RFC): If your condition does not meet a listing, SSA assesses your remaining functional abilities (sitting, standing, lifting, concentrating, interacting, etc.) and uses medical-vocational rules (the “grids”) to determine disability. See 20 CFR 404.1545 (RFC) and 20 CFR Part 404, Subpart P, Appendix 2 (Medical-Vocational Guidelines).
• Right to Appeal: You have the right to appeal an adverse determination at four levels: reconsideration, hearing before an ALJ, Appeals Council review, and federal court review. See 20 CFR 404.900(a).
• Representation: You may appoint a representative (attorney or eligible non-attorney) to help at any stage. See 20 CFR 404.1705 (who may be a representative) and 20 CFR 404.1707 (appointment of representative).

These rights apply equally to claimants in Colorado. Colorado’s field offices and hearing operations are there to administer these federal rights locally, but your entitlement is anchored in the federal rules summarized above.

Common Reasons SSA Denies SSDI Claims

Understanding why claims are denied helps you fix the record on appeal. The most common reasons, directly tied to the federal rules, include:

• Earnings over SGA: If you are working and earning over the SGA threshold (set annually by SSA), you generally will not be found disabled, regardless of medical issues. See 20 CFR 404.1572–404.1574.
• Lack of a “severe” impairment: SSA may find your medical impairment(s) cause little functional limitation, resulting in a “not severe” finding at step 2. See 20 CFR 404.1520(c).
• Does not meet/equal a listing: The record may not document the specific objective findings required by a listing (e.g., imaging results, clinical signs, or standardized testing). See 20 CFR 404.1526 (medical equivalence).
• Insufficient medical evidence: SSA needs objective medical evidence from acceptable medical sources. If records are missing or sparse, the claim may be denied. See 20 CFR 404.1513 (evidence) and 404.1519a (consultative examinations).
• Ability to perform past work: SSA may determine your RFC still permits your past relevant work. See 20 CFR 404.1560(b).
• Ability to perform other work: Even if you cannot do past work, SSA may identify other jobs existing in significant numbers that match your RFC, age, education, and work experience using the Medical-Vocational Guidelines. See 20 CFR 404.1569 and Appendix 2.
• Duration requirement not met: If your impairment is not expected to last 12 continuous months or result in death, the claim can be denied. See 42 U.S.C. § 423(d)(1)(A); 20 CFR 404.1509.
• Failure to follow prescribed treatment (without good reason): A claim may be denied if you do not follow prescribed treatment that could restore ability to work, unless you have a good reason. See 20 CFR 404.1530.
• Non-cooperation or missed deadlines: Missing consultative exams, failing to return SSA forms, or missing the appeal deadline can result in an unfavorable outcome. See 20 CFR 404.1518; 20 CFR 404.909(a)(1) (time to appeal).

Even if one or more of these applies to your initial determination, the appeals process is designed to correct errors, build a more complete record, and allow you to explain or document “good cause” where appropriate.

Federal Legal Protections & Regulations That Control Your Case

Here are the core federal authorities you can rely on—and cite—during your SSDI appeal in Colorado:

• Social Security Act: The fundamental statute governing SSDI. Key sections include 42 U.S.C. § 423 (definition of disability) and 42 U.S.C. § 405(b), (g) (administrative hearings and judicial review). 20 CFR Part 404 (Subpart J and related provisions): These regulations set out filing, evidence, hearing rights, and appeal deadlines for Title II (SSDI). For example:

• Initial appeal to reconsideration: 20 CFR 404.909(a)(1) (60 days).

• Request for ALJ hearing: 20 CFR 404.933(b)(1) (60 days).

• Appeals Council review: 20 CFR 404.968(a)(1) (60 days).

• Evidence submission at ALJ level: 20 CFR 404.935 (5‑day rule).

• Good cause for late filing: 20 CFR 404.911.

• 20 CFR Part 422: General administrative procedures, including filing a civil action in federal court. See 20 CFR 422.210(c) (60 days from receipt of the Appeals Council decision to file a civil action).

• Disability standard and evaluation: 20 CFR 404.1505 (definition of disability), 404.1520 (five‑step sequential evaluation), 404.1545 (RFC), 404.1560–404.1569 (past work and other work analysis), and Part 404, Subpart P, Appendix 2 (Medical-Vocational Guidelines).

• Representation and fees: 20 CFR 404.1705–404.1715 (representation), 404.1720 and 404.1725 (fee authorization and fee agreements). Under 42 U.S.C. § 406(a), SSA must approve representative fees, and fee agreements in most cases are limited to a percentage of past-due benefits and a maximum dollar cap set by SSA.

Because these sources are controlling, citing them in written appeals, at hearings, or in supporting memos helps maintain accuracy and credibility in your Colorado claim.

Steps to Take After an SSDI Denial in Colorado

1) Read the denial carefully and calendar deadlines

Your notice explains the decision and your next steps. You usually have 60 days to appeal from the date you receive the notice, and SSA presumes you receive it five days after the date on the notice. See 20 CFR 404.909(a)(1), 404.901 (mailing presumption). Missing the deadline risks dismissal, though SSA can accept late appeals for “good cause.” See 20 CFR 404.911.

2) Request reconsideration (first appeal level)

File online, by mail, or in person at a Colorado SSA field office. Reconsideration is a fresh review by someone who did not participate in the initial decision. Use the denial rationale to identify what evidence is missing and supply it promptly. You can and should submit updated medical records, test results, medication lists, and statements from treating providers. If SSA schedules a consultative examination, attend it and cooperate fully.

3) Request a hearing with an Administrative Law Judge (second appeal level)

If reconsideration is denied, request a hearing within 60 days of receipt. See 20 CFR 404.933(b)(1). Hearings are typically held in person or by video, and Colorado cases are generally scheduled through the SSA hearing office serving the state. Before the hearing, submit all written evidence no later than five business days before the hearing, unless an exception applies. See 20 CFR 404.935.

At the hearing, the ALJ may take testimony from you, a vocational expert, and sometimes a medical expert. You or your representative can question these experts. Focus on objective evidence and functional limitations relevant to the five-step process, especially RFC findings and how your impairments preclude both past work and other work. If you are 50 or older, the Medical-Vocational Guidelines can be particularly important.

4) Appeals Council review (third appeal level)

If the ALJ denies your claim, you can request review by the Appeals Council within 60 days. See 20 CFR 404.968(a)(1). The Appeals Council may deny review, remand the case to the ALJ, or issue a decision. Grounds include legal error, findings unsupported by substantial evidence, abuse of discretion, or a broad policy issue. See 20 CFR 404.970.

5) Federal court review (fourth appeal level)

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 judicial district where you reside—typically the U.S. District Court for the District of Colorado—within 60 days of receiving the final decision. See 42 U.S.C. § 405(g); 20 CFR 422.210(c). The court reviews the administrative record for legal error and whether the decision is supported by substantial evidence. No new evidence is typically admitted at this stage.

6) Keep your evidence current throughout

The record must document your impairments and functional limitations over time. In Colorado, as elsewhere, common gaps include missing imaging, outdated clinic notes, and inadequate mental health documentation. Ask your providers to submit detailed treatment notes, objective findings, and functional opinions that address your work-related limitations (e.g., sitting, standing, lifting, attendance, concentration, social interaction). If you miss appointments due to transportation, finances, or exacerbations, document those barriers—this may support “good cause” for gaps in care or missed deadlines when applicable.

When to Seek Legal Help for SSDI Appeals in Colorado

Although claimants can handle appeals on their own, representation can help with deadlines, evidence development, and hearing strategy. Representatives can:

• Analyze your denial under the five-step framework and identify missing evidence.
• Obtain medical records and supportive opinions from treating providers tailored to SSA’s standards.
• Prepare you for testimony and cross-examine vocational or medical experts.
• Submit persuasive briefs citing controlling regulations such as 20 CFR 404.1520 (five-step evaluation) and 20 CFR 404.1545 (RFC).

Fees: Representatives must have fees approved by SSA. Fee agreements are generally limited to the lesser of a percentage of past-due benefits or a dollar cap set by SSA, and no fee is paid unless you win past-due benefits. See 42 U.S.C. § 406(a); 20 CFR 404.1720 and 404.1725. Ask your representative to explain costs for obtaining medical records, which are separate from fees.

Colorado attorney licensing: Legal advice about Colorado law should be provided by a lawyer licensed by the Colorado Supreme Court (administered through the Office of Attorney Regulation Counsel). For federal SSDI matters, attorneys can represent you before SSA nationwide, but if your case proceeds to federal court in Colorado, your lawyer must be admitted to the U.S. District Court for the District of Colorado or associated with counsel who is. Always verify your representative’s credentials.

Local Resources & Next Steps for Colorado Claimants

Colorado SSA offices and hearing operations

Colorado residents can file applications and appeals online or at local SSA field offices, including in major population centers such as Denver and Colorado Springs. The SSA also operates a hearing office (OHO) serving Colorado, where ALJ hearings are scheduled. For the most current locations, hours, and contact details, use the SSA Office Locator:

Find Your Colorado SSA Field Office Tip: If in-person access is difficult due to distance, weather, or health, consider filing online or calling SSA’s national number: 800-772-1213 (TTY 800-325-0778).

Colorado’s Disability Determination Services (DDS)

The initial and reconsideration medical determinations for Colorado claimants are made by Disability Determination Services (DDS) under federal standards. DDS may request additional information from you or your medical providers and may schedule a consultative examination if necessary. Cooperating with these requests helps avoid avoidable denials.

Medical documentation in Colorado

Whether you receive care through large health systems, community clinics, or rural providers, prioritize complete, consistent records. Ask providers to reference objective testing (imaging, labs, standardized assessments) and describe how symptoms limit work functions. For mental health claims, treatment notes describing persistence, treatment response, and functional limitations (e.g., pace, persistence, social interaction) are critical.

Community and vocational supports

Colorado residents may seek help with job loss and disability-related work barriers through state vocational rehabilitation services. While separate from SSA, these supports can complement medical care and help document functional limitations over time.

Evidence and Strategy: Strengthening a Colorado SSDI Appeal

Documenting your impairment

SSA requires objective medical evidence from acceptable medical sources. See 20 CFR 404.1513. In practice, that means:

• Diagnostic tests that substantiate your diagnosis (e.g., MRIs for spinal disorders, echocardiograms for cardiac issues, neuropsychological testing for cognitive impairments as appropriate).
• Longitudinal treatment notes showing symptoms, frequency of exacerbations, side effects, and functional limitations.
• Medication and therapy adherence, or documented good reasons for non-adherence (e.g., severe side effects, unaffordable cost, or contraindications). See 20 CFR 404.1530.

Linking evidence to function

SSA’s decision-makers assess how impairments translate into specific work-related limitations. An effective record connects objective findings to functional losses, such as:

• Need to alternate sitting and standing more frequently than standard breaks.
• Unscheduled absences or off-task time due to symptoms or treatment side effects.
• Limitations in stooping, climbing, or handling/fingering that would preclude past work or other jobs.
• Mental limitations affecting task completion, pace, adaptation, or social interaction.

Targeting the listings and RFC

Review SSA’s Blue Book listings to see whether your evidence meets or equals criteria. If not, focus on RFC limitations and the medical-vocational “grid” rules in Part 404, Subpart P, Appendix 2. Older age categories can shift outcomes. Vocational expert testimony often hinges on precise RFC language—tighten your record accordingly.

Meeting the 5‑day evidence rule

At the ALJ level, submit evidence at least five business days before the hearing or explain why an exception applies. See 20 CFR 404.935. Don’t assume the judge has everything—confirm receipt of key records and consider a pre-hearing brief citing 20 CFR 404.1520, 404.1545, and any listing sections that apply.

Deadlines and “Good Cause” in Colorado SSDI Appeals

• Reconsideration: 60 days from receipt of the initial denial. See 20 CFR 404.909(a)(1).
• ALJ hearing request: 60 days from receipt of the reconsideration denial. See 20 CFR 404.933(b)(1).
• Appeals Council: 60 days from receipt of the ALJ decision. See 20 CFR 404.968(a)(1); review criteria in 20 CFR 404.970.
• Federal court: 60 days from receipt of the Appeals Council’s notice. See 42 U.S.C. § 405(g); 20 CFR 422.210(c).
• Mailing presumption: You are presumed to receive SSA notices five days after the date on the notice unless you show otherwise. See 20 CFR 404.901.
• Good cause for late filing: SSA may accept late appeals if you have good cause, such as serious illness, records lost in the mail, or misunderstanding due to language limitations. See 20 CFR 404.911.

Colorado-specific considerations like winter travel or rural access can support a good cause argument when supported by facts and documentation.

Working With a Colorado Disability Attorney

A knowledgeable Colorado disability attorney can align your case with federal standards and local practice realities (for example, typical scheduling patterns at the hearing office serving Colorado). When selecting counsel, consider:

• Experience with 20 CFR and the five-step evaluation: Ask how the attorney approaches RFC and vocational expert testimony.
• Evidence strategy: How will they obtain provider opinions that address functional limitations relevant to work?
• Hearing preparation: Will they conduct mock Q&A and discuss how to handle symptom credibility and daily activities?
• Fees and costs: Confirm the SSA-approved fee structure under 42 U.S.C. § 406(a) and 20 CFR 404.1720/404.1725, and how medical record costs are handled.
• Licensing: Confirm the attorney is licensed by the Colorado Supreme Court if you want Colorado-specific legal advice and, if needed, admitted (or associating with counsel) to the U.S. District Court for the District of Colorado.

Filing and Contact Options for Colorado Residents

• Online: File appeals through your my Social Security account or SSA’s online appeals portal.
• By phone: Call SSA at 800-772-1213 (TTY 800-325-0778).
• In person: Visit a Colorado SSA field office. Confirm locations and hours via the SSA Office Locator.

Keep copies of everything you submit, note the date and method of filing, and request a stamped receipt when filing in person.

Frequently Asked Questions from Colorado Claimants

Do I need to stop all work to qualify?

No. You cannot engage in substantial gainful activity (SGA), but minimal or part-time work below SSA’s SGA threshold does not automatically disqualify you. See 20 CFR 404.1572–404.1574. Still, work activity can complicate your case—speak with a representative about how to document unsuccessful work attempts or special conditions.

What if I can’t afford treatment?

SSA evaluates your case based on medical evidence. If cost prevents treatment or testing, document the barriers. In some cases, lack of treatment may be excused if you have good reason. See 20 CFR 404.1530. Seek community clinics or sliding-fee providers where possible and keep detailed records of efforts to obtain care.

What happens at an ALJ hearing in Colorado?

Hearings are non-adversarial. The judge may ask questions about your limitations and daily activities. A vocational expert often testifies about jobs consistent with various RFCs. You or your representative can question the expert and address conflicts with the Dictionary of Occupational Titles or job numbers, all framed under 20 CFR 404.1520 and related provisions.

If I lose at the Appeals Council, where do I file in court?

Most Colorado residents file suit in the U.S. District Court for the District of Colorado within 60 days of receiving the Appeals Council’s decision. See 42 U.S.C. § 405(g); 20 CFR 422.210(c). Federal court review is based on the administrative record and legal briefs; new evidence is generally not considered at this stage.

Action Plan: Your Next 30–90 Days in a Colorado SSDI Appeal

• Within 7 days: Read the denial, list the reasons SSA gave, and calendar the 60-day deadline (plus the five-day mailing presumption). Request copies of all medical records from the relevant period.
• Within 14–21 days: File the reconsideration (or the next appeal level), submit new records, and update SSA on any new diagnoses, tests, or provider visits.
• Within 30–45 days: Ask treating providers for detailed functional assessments that align with SSA’s work-related categories (sitting, standing, lifting, attendance, concentration, social interaction). Ensure clarity on objective findings and consistency over time.
• Within 60–90 days: If you progress to the hearing stage, organize your exhibits, submit them under the 5‑day rule (20 CFR 404.935), and prepare testimony that connects symptoms to specific work limitations.

Authoritative Resources

SSA: Appeal a Decision (Overview of Levels and Deadlines)eCFR: 20 CFR Part 404 (Disability Insurance Benefits)eCFR: 20 CFR Part 422 (Administrative Procedure, including Federal Court)SSA Listing of Impairments (Blue Book)SSA Office Locator (Find Colorado Field Offices)

Legal Disclaimer

This guide is for informational purposes only and is not legal advice. Laws and regulations change, and outcomes depend on specific facts. If you need advice about your situation, consult a licensed Colorado attorney.

Next Step

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