SSDI Attorney Guide: Appeals in Colorado, Colorado

SSDI Denial and Appeal Guide for Colorado, Colorado

If you live in Colorado, Colorado and received a Social Security Disability Insurance (SSDI) denial, you are not alone—and you are not out of options. SSDI is a federal program, so the rules are the same nationwide, but where you live affects which Social Security offices handle your claim and where your hearing may occur. Colorado claimants are served by Social Security’s Denver Region (Region VIII), and many steps in the process can be completed online or at a local field office. This guide explains your rights, deadlines, and practical steps for filing an SSDI denial appeal in Colorado, Colorado, with a slight emphasis on protecting claimants’ interests while staying strictly within the law and reliable sources.

This resource focuses on the federal rules that govern SSDI, including the Code of Federal Regulations (20 CFR), the Social Security Act (42 U.S.C.), and official Social Security Administration (SSA) guidance. We explain the four main appeal levels—reconsideration, hearing before an Administrative Law Judge (ALJ), Appeals Council review, and federal court—along with the critical 60‑day deadlines that apply at each stage. We also cover what evidence SSA looks for, how to strengthen your file under the five-step disability evaluation framework, and when to consider hiring a representative or a Colorado disability attorney. For local logistics, we outline how Colorado residents can locate and contact their nearest Social Security office safely and accurately.

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Understanding Your SSDI Rights

What SSDI Is—and Who Qualifies

SSDI provides monthly disability benefits to insured workers who cannot engage in substantial gainful activity (SGA) due to a medically determinable impairment expected to last at least 12 months or result in death. The statutory definition of disability for SSDI appears at Section 223(d) of the Social Security Act (42 U.S.C. § 423(d)). SSA applies your work credits, medical evidence, and vocational factors to determine whether you qualify.

Your Core Rights in the SSDI Process

• Right to a fair determination under the five-step sequential evaluation (20 CFR 404.1520). SSA will consider SGA, severity, medical listings, residual functional capacity (RFC), and your ability to perform past work or other work.
• Right to representation. You may appoint a qualified representative (attorney or eligible non-attorney) to help you at any stage (20 CFR 404.1705). SSA must approve fees, and fees are typically contingent on winning and limited to a portion of back benefits under the Social Security Act (42 U.S.C. § 406). The exact dollar maximum is set by SSA and may change; the statute provides a 25% cap of past-due benefits subject to an SSA-set maximum.
• Right to submit evidence. You must submit all evidence known to you that relates to your disability claim (20 CFR 404.1512). At the hearing level, SSA applies a five-business-day evidence rule (20 CFR 404.935) requiring you to submit or inform SSA about evidence no later than five business days before the hearing, subject to good-cause exceptions.
• Right to a hearing and to examine the evidence. If reconsideration is denied, you can request a de novo hearing before an ALJ (42 U.S.C. § 405(b)(1); 20 CFR 404.929–404.961). You can review your file, submit additional evidence, and present witnesses, including vocational or medical experts.
• Right to appeal adverse decisions. If you disagree with an initial determination, reconsideration result, ALJ decision, or Appeals Council action, you can appeal within the timeframe set by regulation (20 CFR 404.909, 404.933, 404.968; and 20 CFR 422.210 for judicial review).

Colorado and the Federal System

Because SSDI is federal, the same eligibility rules apply in Colorado as in every other state. However, claimants in Colorado interact with SSA field offices located in the state and hearing offices that serve Colorado counties. The SSA Denver Region oversees these services. You can file appeals online or through your local SSA office. Hearing location and format (in-person, telephone, or video) are governed by federal rules and SSA scheduling (see 20 CFR 404.936 regarding time and place of hearing and the ability to appear by video/telephone in some circumstances).

Common Reasons SSA Denies SSDI Claims

Understanding why claims get denied helps you target the evidence SSA needs to approve your case.

1) Working Above SGA Level

At Step 1 of the sequential evaluation, SSA assesses whether you are engaging in substantial gainful activity (SGA). If your earnings are above the SGA threshold, SSA generally finds you not disabled (20 CFR 404.1520(b) and 20 CFR 404.1571–404.1574). The specific monthly dollar threshold is set by SSA and typically changes yearly; check current amounts on SSA’s official website before filing.

2) Insufficient Medical Evidence or Lack of Objective Findings

SSA requires objective medical evidence from acceptable medical sources to establish a medically determinable impairment (20 CFR 404.1502 and 404.1513). If your records lack diagnostic tests, clinical signs, or longitudinal treatment notes that support your allegations, SSA may deny your claim. Consistent treatment, relevant specialist records, and test results can be crucial.

3) Impairment Not “Severe” or Not Lasting 12 Months

At Step 2, SSA determines whether your impairments are “severe”—i.e., they significantly limit your ability to perform basic work activities (20 CFR 404.1520(c); see also 20 CFR 404.1522). SSA also enforces the duration requirement: your impairment must be expected to last at least 12 months or result in death (20 CFR 404.1509). If SSA cannot confirm duration or severity, a denial may follow.

4) Not Meeting or Equaling a Listing

At Step 3, SSA compares your impairment to the Listing of Impairments (20 CFR Part 404, Subpart P, Appendix 1). If your documented signs, symptoms, and lab findings do not meet or medically equal a listing, your claim proceeds to the RFC and vocational steps. Many denials occur here because records do not include the exact criteria specified in the Listings.

5) Residual Functional Capacity (RFC) Allows Other Work

At Steps 4 and 5, SSA assesses your RFC—what you can still do despite your impairments (20 CFR 404.1545)—and determines whether you can perform past relevant work or, considering your age, education, and work experience, adjust to other work in the national economy (20 CFR 404.1520(f)–(g)). Denials often hinge on vocational findings supported by a vocational expert’s testimony at the hearing stage.

6) Noncompliance, Missed Exams, or Gaps in Treatment

• Failure to follow prescribed treatment without good reason can undermine your claim (20 CFR 404.1530).
• Missing a consultative examination scheduled by SSA can lead to a decision based on the existing record (20 CFR 404.1517–404.1519f), which may be insufficient.
• Failure to cooperate or provide requested information can also result in denial (20 CFR 404.1518).

7) Medical Opinion Persuasiveness

For claims filed on or after March 27, 2017, SSA evaluates medical opinions and prior administrative medical findings based on supportability and consistency, rather than giving controlling weight to treating physicians (20 CFR 404.1520c). If your providers’ opinions lack detailed objective support or conflict with the overall record, SSA may find them unpersuasive.

Federal Legal Protections & Regulations You Should Know

Five-Step Sequential Evaluation

SSA must evaluate disability using the five-step process in 20 CFR 404.1520:

• Step 1: Are you engaging in SGA?
• Step 2: Do you have a severe impairment?
• Step 3: Does your impairment meet or equal a listing?
• Step 4: Can you perform your past relevant work?
• Step 5: Can you adjust to other work in the national economy?

This structure shapes evidence needs and arguments throughout your appeal.

Key Procedural Rights

• Right to a hearing with an impartial ALJ if reconsideration is denied (42 U.S.C. § 405(b)(1)).
• Right to submit evidence and be heard; you must inform SSA about or submit evidence at least five business days before the hearing, absent good cause (20 CFR 404.935).
• Right to representation at all stages, with fee approval rules in 20 CFR 404.1720–404.1725 and statutory limits in 42 U.S.C. § 406.
• Right to judicial review after the Appeals Council’s final action, under 42 U.S.C. § 405(g), implemented in regulation at 20 CFR 422.210.

Appeal Deadlines (Statute of Limitations in SSA Proceedings)

• Reconsideration: Generally 60 days from receipt of the initial determination to request reconsideration (20 CFR 404.909(a)(1)). SSA presumes you receive notices 5 days after the date on the notice unless you show otherwise.
• ALJ Hearing: Generally 60 days from receipt of the reconsideration determination to request a hearing (20 CFR 404.933(b)(1)).
• Appeals Council: Generally 60 days from receipt of the ALJ decision to request review (20 CFR 404.968(a)(1)).
• Federal Court: Generally 60 days from receipt of the Appeals Council’s notice to file a civil action in U.S. District Court (20 CFR 422.210(c); 42 U.S.C. § 405(g)).

SSA may extend deadlines for good cause based on specific circumstances, such as serious illness or not receiving the notice timely (20 CFR 404.911). Always request extensions in writing, with supporting documentation.

Evidence, Symptoms, and RFC

• Duty to submit all relevant evidence: 20 CFR 404.1512.
• Symptom evaluation (including pain): 20 CFR 404.1529 focuses on consistency with objective medical evidence and other evidence.
• RFC determination: 20 CFR 404.1545 requires assessment of your maximum sustained work capability, considering physical and mental limitations.

Steps to Take After an SSDI Denial

1) Read the Denial Letter Carefully

Your notice identifies the medical and vocational reasons for denial and includes instructions for appeal. Note the decision date to calculate your 60‑day appeal window. SSA presumes you receive the notice five days after the date on the letter unless you can prove a later receipt.

2) Decide Whether to Appeal or Refile

Appealing keeps your protective filing date and allows you to build on your existing record. Filing a new application may be appropriate in some cases, but it can sacrifice back-benefit potential. If unsure, consult a qualified representative promptly to avoid missing appeal deadlines.

3) Request Reconsideration (First Appeal Level)

Most SSDI denials begin at the initial determination. You typically have 60 days from receipt of the notice to request reconsideration (20 CFR 404.909(a)(1)). You can appeal online, by mail, or at a local SSA office. Include new medical evidence and updated provider information. If you miss the deadline, you can ask SSA to accept a late appeal for good cause (20 CFR 404.911), but do not rely on this; file on time whenever possible.

SSA: How to Appeal a Decision### 4) Prepare for the ALJ Hearing (Second Appeal Level)

If reconsideration is denied, request a hearing within 60 days (20 CFR 404.933(b)(1)). The ALJ will review your case de novo (new look) and may hear testimony from you, vocational experts, and sometimes medical experts. Your rights include submitting evidence and making arguments; however, you should follow the five-business-day evidence rule (20 CFR 404.935). If you discover critical evidence late, explain good cause promptly.

• Strengthen your medical record: Add specialty evaluations, imaging, test results, and function-by-function assessments relevant to your conditions.
• Document symptoms and limitations: Use detailed statements consistent with 20 CFR 404.1529, noting frequency, duration, and intensity of symptoms and their impact on daily activities.
• Address opinions: Ask your treating providers to support findings with objective references, improving supportability and consistency under 20 CFR 404.1520c.
• Consider vocational evidence: If possible, obtain work-preclusive RFC opinions, carefully explaining postural, environmental, mental, and exertional limits.

5) Appeals Council Review (Third Appeal Level)

If the ALJ denies your claim, you generally have 60 days to request Appeals Council review (20 CFR 404.968(a)(1)). The Appeals Council may deny review, remand to the ALJ for another hearing, or, rarely, issue a favorable decision. You can argue legal errors (e.g., misapplication of 20 CFR 404.1520c), failure to consider material evidence, or unsupported findings. Submit any new and material evidence that relates to the period on or before the ALJ decision, following SSA’s timing rules.

6) Federal Court (Fourth Level)

If the Appeals Council denies review or issues an unfavorable decision, you can file a civil action in the U.S. District Court within 60 days of receiving the Appeals Council notice (42 U.S.C. § 405(g); 20 CFR 422.210(c)). The court reviews the administrative record to determine whether the decision is supported by substantial evidence and whether correct legal standards were applied. No new evidence is typically introduced at this stage; the case is decided based on the record from SSA.

When to Seek Legal Help for SSDI Appeals

Why Representation Helps

SSDI appeals often turn on technical issues—sequential evaluation analysis (20 CFR 404.1520), opinion evidence factors (20 CFR 404.1520c), compliance with the five-day rule (20 CFR 404.935), and legal standards for RFC and symptom consistency (20 CFR 404.1545 and 404.1529). An experienced representative can identify gaps in the record, obtain key medical opinions, question vocational experts effectively, and preserve issues for higher appeals or federal court.

Attorney and Representative Rules

• Right to representation: You may appoint a representative at any time (20 CFR 404.1705). Attorneys and qualified non-attorney representatives can practice before SSA nationwide if they meet SSA’s criteria.
• Fees: Fees must be approved by SSA, typically through a fee agreement or fee petition (20 CFR 404.1720–404.1725). By statute, SSDI fee agreements commonly limit fees to 25% of past-due benefits, subject to a maximum set by SSA (42 U.S.C. § 406).
• Colorado licensing: To provide legal services as an attorney in Colorado state courts, a lawyer must be licensed by the Colorado Supreme Court (through its attorney regulation and admission system). For SSA administrative proceedings, attorneys licensed in any U.S. jurisdiction may represent claimants if they comply with SSA representation rules.

When to Call a Colorado Disability Attorney

• You are near a deadline and need to file a complete appeal with supporting evidence.
• Your case involves complex medical issues or multiple impairments.
• An ALJ decision cites inconsistencies, and you need to develop a targeted record for Appeals Council or federal court review.
• You want guidance on RFC opinions, Listings arguments, or challenging vocational expert testimony.

Local Resources & Next Steps for Colorado Claimants

Finding a Local SSA Office in Colorado

Colorado residents can file appeals online or through a local SSA field office. Because office locations and hours can change, use SSA’s official Office Locator to confirm the correct address and contact information for your ZIP code:

SSA Office Locator (Find Your Local Field Office)After you enter your ZIP code, the locator will display the nearest office, mailing address, phone numbers, and hours. You can also confirm which office handles replacement Social Security cards or other services, if needed.

Hearing Offices Serving Colorado

Hearings are scheduled and conducted by SSA’s Office of Hearings Operations (OHO). The specific OHO that serves you depends on your county and SSA’s scheduling. SSA will notify you of the hearing details. You may request to appear by video or telephone under applicable rules (see 20 CFR 404.936). If you move within Colorado, promptly update your address to avoid missed notices.

Medical and Vocational Evidence in Colorado

To strengthen your case, coordinate with your Colorado treatment providers for complete, updated records, including diagnostic imaging, specialist reports, mental health treatment notes, and function-by-function assessments. If you have engaged with Colorado’s vocational rehabilitation resources, obtain relevant records showing job placement barriers and functional limitations. Comprehensive, timely Colorado-based evidence can clarify severity, duration, and work-related restrictions under 20 CFR 404.1509, 404.1520, and 404.1545.

Action Plan Checklist for Colorado Claimants

• Mark deadlines: Calculate the 60-day appeal window from the date you receive SSA’s notice. Keep envelopes and document received dates.
• File online when possible: Use SSA’s online appeals to avoid mailing delays. Confirm submission and print receipts.
• Request records immediately: Ask Colorado providers for complete records and objective testing; follow up on consultative exams.
• Address evidence gaps: Obtain opinions that explain specific limitations aligned to RFC factors (20 CFR 404.1545).
• Prepare testimony: Be ready to explain symptom frequency, intensity, and functional impact consistent with 20 CFR 404.1529.
• Consider representation: A representative can manage filings, evidence deadlines, and hearing strategy (20 CFR 404.1705, 404.935).

Frequently Cited Federal Rules (Quick Reference)

• Definition of disability: Social Security Act § 223(d) (42 U.S.C. § 423(d)). Five-step evaluation: 20 CFR 404.1520. eCFR: 20 CFR 404.1520- Evidence submission duty: 20 CFR 404.1512.
• Symptom evaluation: 20 CFR 404.1529.
• RFC: 20 CFR 404.1545. Reconsideration deadline: 20 CFR 404.909. eCFR: 20 CFR 404.909- Hearing request deadline: 20 CFR 404.933(b)(1).
• Appeals Council deadline: 20 CFR 404.968(a)(1).
• Five-day evidence rule: 20 CFR 404.935. Judicial review: 42 U.S.C. § 405(g); 20 CFR 422.210. eCFR: 20 CFR 422.210

Building a Stronger SSDI Appeal in Colorado

Medical Evidence Strategy

• Longitudinal records: Demonstrate ongoing treatment that documents symptoms, response to treatment, side effects, and functional impact.
• Objective testing: Imaging, labs, pulmonary function tests, neuropsychological evaluations, and other objective findings matching Listing or RFC elements.
• Provider opinions: Ask for detailed function-by-function opinions (sitting, standing, lifting, concentration, pace, attendance) tied to clinical findings to enhance supportability and consistency (20 CFR 404.1520c).

Vocational and Daily Function Evidence

• Work history: Provide accurate job titles, dates, and exertional levels to support Step 4 analysis.
• Daily activities: Document how symptoms limit tasks like cooking, cleaning, shopping, and social interaction without overstating abilities.
• Adherence and side effects: Explain medically necessary limitations, including medication side effects, consistent with 20 CFR 404.1529 considerations.

Handling Consultative Exams (CEs)

SSA may schedule a CE if evidence is insufficient (20 CFR 404.1517–404.1519f). Attend the exam, bring ID, and be honest and specific. If the report is inaccurate, you or your representative can submit a rebuttal, citing contrary records.

Colorado Logistics: Filing, Contact, and Hearing Tips

How to File Your Appeal

• Online: The fastest and most reliable option for most claimants. Keep submission confirmations. Local office: Use the Office Locator to find your nearest Colorado field office for in-person or mail filing. Search SSA Offices- Phone: You can call SSA’s national number or your local office to initiate an appeal; confirm all deadlines in writing.

Scheduling and Appearance Format

SSA decides the time and place of the hearing and may schedule in-person, telephone, or video appearances (20 CFR 404.936). If you have a strong preference, request it early. Always open and read notices quickly and verify the address and format, especially if you move within Colorado.

Good Cause for Late Appeals

If you miss a deadline, you can request an extension for good cause (20 CFR 404.911). Examples include serious illness, records destroyed by accident, or not receiving the notice. Provide a detailed statement and supporting proof. SSA decides good cause based on the specific facts and circumstances.

Appeals Council and Federal Court: Colorado Considerations

Appeals Council Strategy

Successful Appeals Council arguments typically focus on legal error or lack of substantial evidence. Common issues include:

• Failure to evaluate opinion evidence under 20 CFR 404.1520c (missing supportability/consistency rationale).
• Improper Step 3 analysis (insufficient discussion of whether criteria meet or equal a Listing).
• RFC unsupported by substantial evidence (omitting material limitations documented in the record).
• Five-day rule errors (excluding late evidence despite good cause) contrary to 20 CFR 404.935.

When submitting new evidence, explain how it is new, material, and relates to the period on or before the ALJ decision. Cite why it could change the outcome.

Federal Court in Colorado

If you seek judicial review, you file in the U.S. District Court with jurisdiction over your residence in Colorado under 42 U.S.C. § 405(g) and 20 CFR 422.210. The court reviews the administrative record and the ALJ’s application of law; it does not reweigh evidence anew. Remedies include remand for further proceedings or, rarely, reversal with award. Federal court practice is technical; many claimants retain counsel for this stage.

Frequently Asked Questions for Colorado SSDI Appeals

How long do I have to appeal my SSDI denial?

Generally 60 days from receipt of the notice for each stage: reconsideration (20 CFR 404.909), ALJ hearing (20 CFR 404.933), Appeals Council (20 CFR 404.968), and federal court (20 CFR 422.210(c)). SSA presumes you receive notices within five days of the date on the letter unless you show otherwise.

Can I keep working while I appeal?

You may work, but earnings at or above SGA may lead to a non-disability finding (20 CFR 404.1520(b); 404.1571–404.1574). If you attempt part-time or low-earning work, document hours, duties, and pay carefully.

Do I need a Colorado disability attorney?

You are not required to have one, but many claimants benefit from representation. Attorneys must be licensed by a U.S. jurisdiction; to practice law in Colorado courts, a lawyer must be licensed by the Colorado Supreme Court. Representatives before SSA must comply with SSA’s rules (20 CFR 404.1705). Fees are subject to SSA approval and statutory limits (42 U.S.C. § 406; 20 CFR 404.1720–404.1725).

Where do I go in Colorado for my hearing?

SSA will notify you of the hearing details. Hearings are scheduled by the SSA Office of Hearings Operations serving your county; location may be in-person or by telephone/video under 20 CFR 404.936. Always confirm the address and format on your notice and keep your contact information updated with SSA.

How do I find my local SSA office?

Use the official SSA Office Locator and enter your ZIP code to get the correct Colorado office, current address, and hours: SSA Office Locator.## Authoritative Resources

SSA: Appeal a DecisioneCFR: 20 CFR 404.1520 (Five-Step Sequential Evaluation)eCFR: 20 CFR 404.909 (Reconsideration Deadline)eCFR: 20 CFR 422.210 (Judicial Review in Federal Court)SSA Office Locator (Colorado)

Legal Disclaimer

Disclaimer: This guide is for informational purposes only and does not constitute legal advice. SSDI cases are fact-specific. Laws and regulations can change. For advice about your situation, consult a licensed Colorado attorney or qualified representative.

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