SSDI Attorney Guide: Colorado, Colorado

SSDI Attorney Guide: What Colorado, Colorado Claimants Need to Know After a Denial

If you live in Colorado and your Social Security Disability Insurance (SSDI) claim was denied, you are not alone—and you are not out of options. Most initial SSDI applications are denied nationwide, but federal law gives Colorado residents a structured appeals path and important procedural rights. This comprehensive guide explains your rights, deadlines, strategies, and local resources with a slight bias toward protecting claimants while staying strictly within verified federal rules.

Colorado claimants pursue SSDI under federal law administered by the Social Security Administration (SSA). Appeals follow a nationwide process rooted in the Social Security Act and regulations in Title 20 of the Code of Federal Regulations (CFR). While there is no separate state SSDI system, it helps to understand how the SSA’s Denver Region oversees Colorado cases and how to access your nearest field office. You can handle much of the process online, but many claimants benefit from professional representation, especially at the hearing stage before an Administrative Law Judge (ALJ).

This guide covers: why claims are denied, your federal appeal rights and deadlines, evidence rules that can make or break your case, when to seek legal help, and how to find local SSA information that applies to Colorado residents. It cites authoritative sources only, including SSA publications, the CFR, and the Social Security Act, so you can make informed decisions and avoid avoidable mistakes. If you need immediate next steps, you can file your appeal online or by contacting your local SSA field office for assistance. Details below.

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Understanding Your SSDI Rights in Colorado

SSDI is a federal benefit for workers who have paid into Social Security and who can no longer engage in substantial gainful activity (SGA) due to a medically determinable impairment expected to last at least 12 months or result in death. See 42 U.S.C. § 423(d) for the statutory definition of disability and related eligibility factors. SSA’s regulations at 20 CFR Part 404 govern SSDI claims and appeals.

Key rights and structures for Colorado claimants include:

• Definition of Disability: Federal law defines disability as the inability to engage in SGA due to a severe impairment lasting or expected to last 12 months or result in death (42 U.S.C. § 423(d); 20 CFR 404.1505, 404.1509).
• Five-Step Evaluation: SSA uses a sequential evaluation process to decide disability claims (20 CFR 404.1520). You must establish: (1) no SGA, (2) severe impairment(s), (3) meeting/equaling a listed impairment in Appendix 1, (4) inability to perform past relevant work, and (5) inability to adjust to other work in the national economy considering residual functional capacity (RFC), age, education, and work experience.
• Insured Status and Work Credits: SSDI requires sufficient work credits based on age and recent work (20 CFR 404.130). If you lack insured status, SSA will deny SSDI regardless of medical severity.
• Evidence and Proof: You have the right to submit medical and non-medical evidence from acceptable medical sources (20 CFR 404.1512, 404.1513). Your symptoms are evaluated under SSR 16-3p, and functional limitations are assessed for RFC under SSR 96-8p.
• Representation: You may appoint a representative, including an attorney or qualified non-attorney, to help with evidence, hearings, and appeals (20 CFR 404.1705–404.1715). Fee approvals are strictly regulated (42 U.S.C. § 406; 20 CFR 404.1720).
• Due Process and Appeals: You are entitled to written notice of decisions and the right to appeal in stages: reconsideration, ALJ hearing, Appeals Council review, and federal court (20 CFR 404.900–404.999; 42 U.S.C. § 405(b), (g)).

Because SSDI is federal, the law applies uniformly nationwide, including in Colorado. However, the Denver Region of SSA administers Colorado cases, and your hearing location and field office services are managed regionally. That regional context can affect scheduling and where you submit documents in person.

Common Reasons SSA Denies SSDI Claims

Understanding why claims are denied helps you correct issues on appeal. Typical denial reasons—each addressed by specific federal rules—include:

• Insufficient Work Credits: If SSA finds you are not “insured” under 20 CFR 404.130 for the period at issue, your SSDI claim will be denied regardless of medical severity. This can also involve a “date last insured” problem, where you must prove disability existed on or before that date.
• Substantial Gainful Activity (SGA): Earning above the SGA level can lead to a denial at step one (20 CFR 404.1572–404.1574). SGA thresholds change annually; consult SSA for current amounts.
• Medical Severity and Duration: If your impairment does not meet the 12-month duration requirement (20 CFR 404.1509) or is considered non-severe, denial can occur at steps two or three. SSA relies on objective medical evidence to establish medically determinable impairments (20 CFR 404.1521).
• Not Meeting or Equaling a Listing: Failing to meet Appendix 1 listings (20 CFR Part 404, Subpart P, App. 1) does not end your case, but SSA then evaluates RFC and work capacity at steps four and five. Many cases are denied here without strong functional evidence.
• Ability to Perform Past Work or Other Work: If SSA determines you can do your past relevant work (step four) or other work in the national economy (step five), you may be denied (20 CFR 404.1520(f)–(g)). Vocational expert testimony often plays a role at hearings; the Supreme Court’s decision in Biestek v. Berryhill, 139 S. Ct. 1148 (2019), discusses substantial-evidence standards for such testimony.
• Insufficient Medical Evidence or Gaps in Treatment: SSA may deny if records are incomplete or fail to document functional limitations. You are responsible for submitting evidence (20 CFR 404.1512), though SSA can order consultative exams (20 CFR 404.1517).
• Drug and Alcohol Materiality: If substance use is a material contributing factor to disability, benefits can be denied (20 CFR 404.1535). SSA must assess disability absent substance use.
• Adverse Credibility/Symptom Findings: Under SSR 16-3p, SSA evaluates consistency of your symptoms with the evidence. Without consistent reports and corroboration, denials can follow.
• Prior Denials and Res Judicata: If the same period was already adjudicated, SSA may apply administrative res judicata. New and material evidence or a new period may be needed to proceed (see 20 CFR 404.957(c)(1)).

On appeal, you can fix many of these issues by supplying targeted medical opinions, longitudinal treatment records, and explanatory statements that directly address the step of denial.

Federal Legal Protections & Regulations You Can Use

Colorado claimants rely on federal statutes, regulations, and rulings. These are key authorities that frequently matter in SSDI appeals:

• Social Security Act: The core provisions governing hearings and judicial review are 42 U.S.C. § 405(b) and § 405(g). The statutory definition of disability is in 42 U.S.C. § 423(d).
• Five-Step Sequential Evaluation: 20 CFR 404.1520 sets the decision framework. Listings are in 20 CFR Part 404, Subpart P, Appendix 1.
• Evidence Rules: 20 CFR 404.1512 outlines your duty to submit evidence and the evidence SSA considers. 20 CFR 404.1513 identifies medical sources. For claims filed on or after March 27, 2017, opinion persuasiveness (supportability and consistency) is evaluated under 20 CFR 404.1520c.
• Hearing Procedures and Evidence Deadlines: 20 CFR 404.935 contains the “five-day rule” requiring that evidence be submitted at least 5 business days before the hearing, unless you show good cause for late submission. 20 CFR 404.929 and 404.933 cover requesting a hearing and scheduling.
• Appeals Council Review: 20 CFR 404.967–404.970 sets standards for Appeals Council review, including when new, material, and time-relevant evidence may be considered and when the Council may grant review.
• Appeal Deadlines and Computation of Time: 20 CFR 404.901 presumes you receive SSA notices 5 days after the date on the notice. Specific deadlines include reconsideration (20 CFR 404.909), hearing (20 CFR 404.933(b)), Appeals Council (20 CFR 404.968(a)), and federal court (42 U.S.C. § 405(g); 20 CFR 422.210(c)).
• Representation and Fees: 20 CFR 404.1705–404.1740 govern representatives; fee approvals are under 42 U.S.C. § 406 and 20 CFR 404.1720.
• Case Law: Richardson v. Perales, 402 U.S. 389 (1971), recognizes that written medical reports can constitute substantial evidence. Biestek v. Berryhill (2019) addresses vocational expert testimony and substantial evidence.

These authorities give you leverage to argue procedural rights, evidentiary points, and legal standards in your Colorado SSDI appeal.

Steps to Take After an SSDI Denial (Colorado)

Appeals are time-sensitive. Colorado follows the nationwide process:

Read Your Denial Notice Carefully Deadline awareness: You typically have 60 days from receipt to appeal to the next level, with a presumption that you received the notice 5 days after the date on it (20 CFR 404.901; 404.909; 404.933(b); 404.968(a)). If you miss a deadline, you can request an extension by showing good cause (20 CFR 404.911).Request Reconsideration File a reconsideration within 60 days of receiving the initial denial (20 CFR 404.909). Colorado uses reconsideration before the ALJ hearing stage. Use SSA’s online appeal system or submit forms to your field office. During reconsideration, a new reviewer evaluates your case. Submit any new medical evidence and correct errors you identify in the initial determination.Request an ALJ Hearing If reconsideration is denied, request a hearing before an Administrative Law Judge within 60 days (20 CFR 404.929, 404.933(b)). Hearings may be in person, by telephone, or by online video, subject to SSA rules and your consent preferences (20 CFR 404.936). The hearing is your best chance to present testimony, cross-examine vocational or medical experts, and fully explain your functional limitations.Meet the Five-Day Evidence Rule Submit all evidence you want the ALJ to consider at least 5 business days before the hearing (20 CFR 404.935). If you cannot meet this deadline, you must show good cause for late submission, such as unexpected circumstances or difficulty obtaining records.Appeals Council Review If the ALJ denies your claim, file a request for review with the Appeals Council within 60 days (20 CFR 404.967–404.968). The Council may deny review, grant review, remand the case to an ALJ, or issue a decision. You can also submit new, material, and time-relevant evidence that relates to the period on or before the ALJ decision (20 CFR 404.970(a)(5)).File in Federal Court If the Appeals Council denies review or issues an adverse decision, you have 60 days from when you receive the Council’s notice to file a civil action in U.S. District Court (42 U.S.C. § 405(g); 20 CFR 422.210(c)). The federal court reviews the administrative record for legal errors and whether the decision is supported by substantial evidence. Throughout these steps, continue medical treatment and document your limitations. SSA weighs longitudinal evidence and consistency heavily. If possible, obtain medical source statements that detail specific functional limits—sitting, standing, walking, lifting, postural and mental restrictions—supported by objective findings and clinical observations (20 CFR 404.1520c).

How to Strengthen Your SSDI Appeal

• Target the Sequential Evaluation: Identify at which step your claim was denied and tailor your evidence to that step: SGA (step 1), severity/duration (step 2), listings (step 3), RFC vs. past work (step 4), or vocational adjustment (step 5).
• Use Listing Criteria: If you pursue a Listing argument, match the exact medical criteria in Appendix 1. SSA’s “Blue Book” provides the specifications for many conditions.
• RFC Evidence: If your case hinges on RFC, ask your treating providers for functional capacity forms that tie medical findings to specific work-related restrictions. SSA evaluates persuasiveness by supportability and consistency (20 CFR 404.1520c).
• Address Substance Use if Present: If drug or alcohol use is present, provide evidence showing your impairments would still be disabling absent substance use (20 CFR 404.1535).
• Explain Work Attempts: If you worked after onset, document whether it was an unsuccessful work attempt or accommodated work. SGA rules at 20 CFR 404.1572–404.1574 and policy guidance can help frame this.
• Follow the Five-Day Rule: Track record requests and follow up with providers so your documents arrive before the hearing deadline (20 CFR 404.935). If late, be ready to show good cause.
• Prepare for Hearing Testimony: Be specific, consistent, and concrete about daily limitations. Vocational experts may testify; courts recognize VEs as a source of substantial evidence when their testimony is reliable (see Biestek v. Berryhill, 139 S. Ct. 1148 (2019)).

When to Seek Legal Help for SSDI Appeals in Colorado

Representation can significantly improve how your case is developed and presented. Under SSA rules, you may appoint an attorney or qualified non-attorney representative (20 CFR 404.1705). Representatives can:

• Analyze the initial denial to identify the precise step and evidence gaps;
• Gather and organize medical evidence and opinion statements, ensuring compliance with 20 CFR 404.1512 and 404.935;
• Prepare you for hearing testimony and cross-examine vocational or medical experts;
• Draft persuasive pre-hearing and post-hearing briefs applying 20 CFR 404.1520, 404.1520c, and relevant Social Security Rulings;
• Navigate Appeals Council and federal court review standards.

Fee Regulation: SSA strictly controls representative fees. Generally, fees must be approved by SSA under 42 U.S.C. § 406 and 20 CFR 404.1720. Contingency fees are common and usually come from past-due benefits, subject to statutory caps set by SSA. Ask your representative to explain how fees and costs work in your specific case.

Attorney Licensing in Colorado: Only attorneys licensed to practice law in Colorado may provide legal services as Colorado lawyers. Regardless of where the representative is based, SSA representation must comply with federal regulations (20 CFR 404.1705–404.1715). Before you retain a lawyer for an SSDI appeal in Colorado, verify the lawyer’s active license and good standing through the Colorado Supreme Court’s public attorney records.

Local Resources & Next Steps for Colorado Residents

While SSDI is federal, it helps to know how to access Colorado-specific logistics and services:

• SSA Denver Region (Region 8): Colorado is in SSA’s Denver Region, which oversees field offices and hearings services for the state. This regional context affects hearing scheduling and operations. Visit SSA’s Denver Region information page to learn more about services relevant to Colorado.
• Find Your Local SSA Field Office: Use SSA’s Office Locator to identify your nearest field office by ZIP code and view hours, services, and contact options. This is the best way to obtain up-to-date, location-specific information without risking outdated addresses.
• Contact SSA by Phone: For general help, call SSA at 800-772-1213; TTY 1-800-325-0778. These lines provide assistance with appeals, status updates, and scheduling.
• Online Appeals: Most Colorado claimants can file reconsideration and hearing requests online. This is often the fastest way to meet deadlines and upload evidence.

Colorado claimants commonly travel to hearings or appear by phone/online video. The Office of Hearings Operations serving Colorado holds hearings in the Denver Region, and SSA may offer various remote hearing options consistent with 20 CFR 404.936.

Key Deadlines and How They Apply

• Reconsideration: File within 60 days of receiving the initial denial (20 CFR 404.909; 404.901 presumption of 5-day mail receipt).
• ALJ Hearing: Request within 60 days after reconsideration denial (20 CFR 404.929; 404.933(b)).
• Appeals Council: Request review within 60 days after the ALJ decision (20 CFR 404.968(a), 404.970).
• Federal Court: File a civil action within 60 days after receiving the Appeals Council’s notice (42 U.S.C. § 405(g); 20 CFR 422.210(c)).

Missed a deadline? Ask for an extension and show good cause under 20 CFR 404.911. Provide specifics, such as hospitalization, severe illness, or circumstances beyond your control.

Evidence and Medical Provider Tips for Colorado Claimants

• Coordinate With Providers: Ask your Colorado healthcare providers to include objective findings, imaging, lab results, specialized testing, and detailed functional limitations. SSA assesses persuasiveness based on supportability and consistency (20 CFR 404.1520c).
• Mental Health Documentation: For mental impairments, ensure your records reflect longitudinal treatment, therapy notes, standardized assessments where applicable, and functional effects on concentration, persistence, pace, and social interaction as considered in Appendix 1.
• Consultative Exams (CEs): If SSA schedules a CE, attend it. SSA may order exams when records are insufficient (20 CFR 404.1517). Submit any missing records promptly to avoid unnecessary CE findings filling gaps without context.
• Statements From Non-Medical Sources: Statements from family, friends, or former coworkers may help explain functional limitations, though medical evidence carries the most weight (20 CFR 404.1513(a)(4)).

Practical Hearing Strategies

• Pre-Hearing Brief: If represented, consider a brief outlining the theory of the case, key exhibits, applicable Listings, RFC analysis, and vocational issues.
• Vocational Expert (VE) Testimony: Be ready for hypotheticals and to challenge job numbers or task requirements if inconsistent with your limitations. Courts allow VEs to testify as substantial evidence when their testimony is reliable (Biestek v. Berryhill).
• Medical Expert (ME) Testimony: Where an ME appears, ensure they address durational requirements (20 CFR 404.1509), the Listings, and RFC implications. Cross-examination can clarify assumptions and record gaps.

Avoiding Common Pitfalls

• Evidence Arrives Late: Track your record requests and use the five-day rule (20 CFR 404.935). If records come in late, document your efforts and request good cause consideration.
• Focusing Only on Diagnosis: SSDI hinges on functional limitations, not the diagnosis alone. Anchor claims to measurable restrictions and objective evidence.
• Ignoring Vocational Factors: Age categories, education level, and transferable skills matter at step five. Tailor the case to the Medical-Vocational Guidelines where applicable.
• Underestimating Symptom Consistency: Keep treatment consistent when feasible and explain gaps. SSR 16-3p emphasizes consistency between your statements and the evidence.

Frequently Asked Questions (Colorado SSDI Appeals)

Is Colorado a reconsideration state?

Yes. Colorado follows the standard SSA appeals sequence: reconsideration, ALJ hearing, Appeals Council, and federal court (20 CFR 404.900–404.999).

Can I submit new evidence after the ALJ decision?

Yes, if you request Appeals Council review. The Council considers new, material, time-relevant evidence relating to the period on or before the ALJ decision (20 CFR 404.970(a)(5)).

How do I calculate deadlines?

SSA presumes you receive notices 5 days after the date on them (20 CFR 404.901). Most appeal deadlines are 60 days from receipt (20 CFR 404.909; 404.933(b); 404.968(a); 20 CFR 422.210(c) for court).

What if I worked after my alleged onset date?

Explain the circumstances. Unsuccessful work attempts and accommodated work can be considered under SGA rules (20 CFR 404.1572–404.1574). Provide documentation.

Do VA ratings or other agency decisions control SSA outcomes?

No. SSA is not bound by disability decisions from other agencies, though it considers the underlying evidence (see 20 CFR 404.1504).

How to Contact SSA and Find Colorado Offices

The most reliable way to find your nearest Colorado SSA field office and current hours is to use the SSA Office Locator by ZIP code. Many services—including starting or appealing a claim—can be done online, and phone assistance is available.

• Office Locator: Use the SSA Office Locator to find and confirm your local Colorado field office and available services.
• Phone: 800-772-1213; TTY 1-800-325-0778.
• Denver Region: Colorado is in SSA’s Denver Region, which oversees the state’s field and hearing operations.

Helpful, Authoritative Links

SSA: How to Appeal a DecisionSSA Office Locator (Find Colorado Field Offices)SSA Denver Region (Region 8) InformationeCFR: 20 CFR Part 404 (Disability Insurance)SSA Listing of Impairments (Blue Book)

Summary and Next Steps for Colorado Claimants

Your SSDI appeal rights are strong and time-sensitive. In Colorado, you will proceed through reconsideration, an ALJ hearing, Appeals Council review, and possibly federal court, guided by the Social Security Act and 20 CFR Part 404. Organize your medical evidence around the five-step framework, meet deadlines, and consider experienced representation—especially for hearings where testimony and vocational evidence are critical.

To move forward now, file your appeal online, contact your local Colorado SSA office via the Office Locator, and begin collecting updated medical records and opinion statements that address your functional limitations. Doing these steps quickly helps preserve your rights, improves the record, and increases the chance of a favorable outcome.

Legal Disclaimer

This guide is for informational purposes only and is not legal advice. Laws and regulations can change. For advice on your specific situation, consult a licensed Colorado attorney or qualified representative experienced in Social Security disability law.

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