SSDI Attorney Guide for Colorado, Colorado

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

If you live in Colorado and received a Social Security Disability Insurance (SSDI) denial, you are not alone—and you have the right to appeal. The Social Security Administration (SSA) follows a nationwide, federally regulated process for deciding disability claims. That means your appeal rights and deadlines in Colorado are the same as in other states, but it helps to understand how the process works in practice for Coloradans, where many claimants live in the Front Range urban corridor (Denver–Aurora–Lakewood) while others are spread across mountain and rural communities. Regardless of where you live—from the Denver metro area to Colorado Springs, Fort Collins, Pueblo, the Western Slope, or the Eastern Plains—the same federal rules govern your SSDI appeal.

This guide explains your appeal rights, common reasons for denials, the legal standards SSA applies, and concrete steps to strengthen your case. It also points you to local SSA resources and practical strategies for navigating medical evidence in Colorado. While the SSA aims for consistency, disability decisions turn on the quality and timeliness of evidence. A slight tilt in your favor comes from understanding the rules, meeting deadlines, and supplying complete medical and vocational documentation. When in doubt, consider consulting a Colorado-licensed attorney familiar with Social Security practice and federal court review.

Throughout this guide, we cite controlling federal regulations and provisions of the Social Security Act so you can verify each step. The appeals process has multiple levels—reconsideration, an Administrative Law Judge (ALJ) hearing, Appeals Council review, and federal court—and strict deadlines apply at each stage. Missing a deadline can end your claim unless SSA finds “good cause.” The information below helps you protect your rights and prepare for a strong SSDI denial appeal in Colorado.

Understanding Your SSDI Rights

The federal definition of disability and the five-step process

SSDI is a federal insurance program for workers who paid Social Security taxes and later became unable to 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 appears in Section 223(d) of the Social Security Act (42 U.S.C. § 423(d)). SSA applies a five-step sequential evaluation to determine disability for adults, codified at 20 C.F.R. § 404.1520 and related sections:

• Step 1 (Work Activity): Are you performing substantial gainful activity? If you are working and your earnings are above SSA’s SGA level, you generally will be found not disabled. See 20 C.F.R. §§ 404.1571–404.1574.
• Step 2 (Severity): Do you have a severe impairment (or combination) that significantly limits basic work activities and has lasted or is expected to last at least 12 months? See 20 C.F.R. §§ 404.1509, 404.1520(c).
• Step 3 (Listings): Does your condition meet or medically equal a Listing in Appendix 1 of Subpart P of Part 404? If yes, you are disabled. See 20 C.F.R. pt. 404, subpt. P, app. 1.
• Step 4 (Past Work): Considering your residual functional capacity (RFC), can you perform your past relevant work? If yes, not disabled. See 20 C.F.R. § 404.1545.
• Step 5 (Other Work): Can you adjust to other work that exists in significant numbers in the national economy? If no, disabled. See 20 C.F.R. § 404.1560.

Evidence rules and treating sources

SSA requires objective medical evidence from acceptable medical sources to establish a medically determinable impairment. Post–March 27, 2017 claims are evaluated under the “persuasiveness” framework at 20 C.F.R. § 404.1520c; no single medical source automatically receives controlling weight. The most important factors are supportability and consistency. Functional capacity opinions should cite specific clinical findings, imaging, or testing. Nonmedical evidence—like third-party statements—can be considered but cannot establish an impairment on its own.

Insured status and credits

To qualify for SSDI, you must be “insured,” meaning you have enough recent work credits under 20 C.F.R. §§ 404.130–404.133. If you stop working and wait too long to apply, your date last insured may pass, requiring proof that your disability began on or before that date. Colorado claimants should obtain lifetime earnings records and confirm insured status early to avoid surprises later in the appeal.

Your procedural rights

Every claimant has the right to appeal and present evidence at each stage of administrative review. The overall framework appears in 20 C.F.R. § 404.900 et seq. You can submit new evidence at reconsideration and at the ALJ hearing level (subject to timing rules). You also have the right to representation by an attorney or qualified non-attorney representative, see 20 C.F.R. § 404.1705, and to ask for accommodations if you have communication or other access needs.

Common Reasons SSA Denies SSDI Claims

Understanding why SSA issues initial denials can help you target the gaps in your file before you appeal. Many denials in Colorado mirror national patterns because SSA applies uniform federal standards.

1) Working above SGA

If your earnings exceed SSA’s substantial gainful activity threshold, you will generally be found not disabled at Step 1. See 20 C.F.R. §§ 404.1571–404.1574. Some volunteer or sheltered work may be evaluated differently, but be prepared to document any special conditions, subsidies, or reduced productivity.

2) Not “severe” for 12 months

SSDI requires a severe impairment that lasts (or is expected to last) at least 12 continuous months or result in death, 20 C.F.R. § 404.1509. If your records show improvement within a few months, SSA may find no severe impairment or only a brief period of disability. If you have a fluctuating condition, make sure evidence covers the full period with longitudinal treatment notes.

3) Limited objective evidence

SSA needs objective medical evidence from acceptable sources. Missing diagnostic tests (imaging, labs) or sparse treatment records are common reasons for denials. If costs or access to specialists in parts of Colorado made testing difficult, document those barriers and work with your providers to supply missing data before reconsideration.

4) Missed consultative examinations

When records are insufficient, SSA may schedule a consultative examination (CE). Missing or refusing a CE without good cause can lead to denial. See 20 C.F.R. §§ 404.1517–404.1519t. If you had scheduling or transportation issues, explain them and promptly request rescheduling.

5) Non-compliance with prescribed treatment

Failure to follow prescribed treatment without good cause can lead to denial. See 20 C.F.R. § 404.1530. If you had side effects, contraindications, affordability issues, or access barriers, document them. Good-cause explanations matter.

6) Vocational findings at Step 5

SSA may conclude there are other jobs you can perform given your RFC, age, education, and work experience, applying the Medical–Vocational Guidelines (the “grids”) in Appendix 2 to Subpart P of Part 404. Rebutting Step 5 findings often requires more detailed functional evidence and clarification of transferable skills.

7) Insured status problems

Some denials occur because the claimant’s date last insured has expired. You must prove disability began on or before that date, using medical evidence anchored to the relevant timeframe. Continuous care notes can be critical in these cases.

Federal Legal Protections & Regulations

Your SSDI appeal rights are rooted in the Social Security Act and the Code of Federal Regulations. Key provisions include:

• Administrative review process: 20 C.F.R. § 404.900 et seq. governs the steps from initial determination through Appeals Council review.
• Reconsideration deadline: 20 C.F.R. § 404.909 sets the 60-day time limit to request reconsideration after you receive the initial determination.
• ALJ hearing requests: 20 C.F.R. § 404.933 provides the 60-day deadline to request a hearing after a reconsideration decision.
• Appeals Council review: 20 C.F.R. § 404.968 outlines the 60-day deadline to request Appeals Council review after an ALJ decision.
• Judicial review: Section 205(g) of the Social Security Act (42 U.S.C. § 405(g)) authorizes federal court review after the Appeals Council issues a final action; SSA’s rules are also reflected at 20 C.F.R. § 422.210.
• Timeliness and mailing presumption: 20 C.F.R. § 404.901 establishes that you are presumed to receive SSA notices 5 days after the date on the notice, unless you show otherwise.
• Good cause for late filing: 20 C.F.R. § 404.911 explains when SSA may accept a late appeal for good cause.
• Representation and fees: 20 C.F.R. § 404.1705 (representatives) and § 404.1720 et seq. (fees) govern who may represent you and how fees are approved; § 404.1728 addresses fee agreements.
• Medical evaluation standards: 20 C.F.R. §§ 404.1520 (five-step process), 404.1520c (medical opinion persuasiveness), 404.1545 (RFC), and Appendix 1 to Subpart P (Listings).

Federal court review in Colorado occurs in the U.S. District Court for the District of Colorado. Courts review whether SSA applied the correct legal standards and whether the decision is supported by “substantial evidence” in the record. If the court finds reversible error, it may remand to SSA for a new hearing or, in rare cases, order benefits.

Steps to Take After an SSDI Denial

Act quickly and deliberately. The appeals timeline is short, and thorough evidence wins cases. The primary SEO phrase is included here for clarity for searchers: SSDI denial appeal colorado colorado.

1) Mark your deadlines

• Reconsideration: You generally have 60 days from the date you receive the initial denial to file a Request for Reconsideration. See 20 C.F.R. § 404.909 and § 404.901 (5-day mailing presumption).
• ALJ hearing: If reconsideration is denied, request a hearing within 60 days. See 20 C.F.R. § 404.933.
• Appeals Council: Request review within 60 days of the ALJ decision. See 20 C.F.R. § 404.968.
• Federal court: File a civil action within 60 days after you receive the Appeals Council’s notice of its decision or denial of review. See 42 U.S.C. § 405(g); 20 C.F.R. § 422.210.

If you miss a deadline, you can ask for an extension by showing good cause under 20 C.F.R. § 404.911. Provide a detailed explanation and supporting proof (for example, hospitalization records or mail delivery issues).

2) File your appeal the fastest way

Most Colorado claimants can appeal online using SSA’s secure portal. Online filing timestamps your appeal and helps avoid mailing delays, especially in remote areas or during severe weather. You can also appeal by mail or in person at a local field office.

Start here: SSA: Appeal a Decision (Reconsideration, Hearing, Appeals Council)

3) Identify and fix evidence gaps

Review the denial letter’s rationale (often referencing the five-step analysis). Target the missing items:

• Missing diagnostics: Work with your providers to obtain imaging, labs, or specialty evaluations that corroborate your impairments.
• Functional detail: Ask providers to describe specific work-related limitations—sitting, standing, lifting, reaching, attendance, pace, and social interaction—tied to objective findings. Cite test results and exam findings where possible.
• Longitudinal records: Secure records covering at least 12 continuous months. If care gaps exist due to access or cost, document the reasons.
• Medication effects: Capture side effects and treatment failures. If you had good cause for non-adherence (e.g., side effects, affordability), explain under 20 C.F.R. § 404.1530.

4) Consider a representative

You may appoint a representative at any time. Under 20 C.F.R. § 404.1705, representatives can be attorneys or qualified non-attorneys. Representation fees must be approved by SSA under 20 C.F.R. § 404.1720 et seq., and many representatives use fee agreements reviewed under § 404.1728. In Colorado, an attorney can advise you on both SSA rules and federal court practice if needed.

5) Prepare for reconsideration

Reconsideration is a fresh review by a different adjudicator. Submit new evidence as soon as possible. If SSA orders a consultative exam, confirm attendance promptly and request accommodations as needed. Keep copies of all submissions and confirmations.

6) Request an ALJ hearing if needed

If reconsideration is denied, request a hearing within 60 days (20 C.F.R. § 404.933). Hearings may be held by telephone, by online video, or in person. Use this stage to present a comprehensive medical and vocational narrative:

• Pre-hearing brief: Summarize medical evidence, applicable Listings, RFC, and vocational arguments. Address unfavorable consultative opinions with contrary evidence and rationale under 20 C.F.R. § 404.1520c.
• Witnesses: Consider lay witnesses who can describe your day-to-day limitations. Their testimony can corroborate the severity and functional impact of symptoms.
• Vocational expert (VE): Be prepared to question the VE about job numbers and how your specific limitations affect employability. Reference the Medical–Vocational Guidelines (Appendix 2) when relevant.

7) Appeals Council and federal court

If you receive an unfavorable ALJ decision, you may ask the Appeals Council to review within 60 days (20 C.F.R. § 404.968). The Appeals Council may deny review, remand, or issue a decision. If the Appeals Council denies or issues an unfavorable decision, you can file a civil action in the U.S. District Court for the District of Colorado under 42 U.S.C. § 405(g). In court, legal issues (e.g., misapplication of 20 C.F.R. § 404.1520c, inadequate RFC analysis under § 404.1545, or flawed Step 5 findings) can be central.

When to Seek Legal Help for SSDI Appeals

Choosing a representative

While you can represent yourself, many claimants benefit from experienced help, especially at the ALJ hearing or in federal court. Under 20 C.F.R. § 404.1705, representatives include attorneys and qualified non-attorneys. SSA must authorize fees under 20 C.F.R. § 404.1720 et seq. If you seek legal advice about Colorado-specific issues (e.g., litigation in the District of Colorado), consider a Colorado-licensed attorney familiar with Social Security disability practice.

What a representative can do

• Collect and organize medical records; identify missing diagnostics; obtain detailed functional opinions tied to objective evidence.
• Draft persuasive pre-hearing briefs referencing regulatory standards (e.g., Listings, RFC, and the persuasiveness framework at 20 C.F.R. § 404.1520c).
• Question vocational experts, address job numbers, and raise legal errors such as inadequate evaluation of symptom consistency or improper Step 5 analysis.
• Request on-the-record decisions when the evidence is strong or seek postponements to obtain critical evidence.
• Escalate to Appeals Council and federal court where appropriate, preserving issues under 42 U.S.C. § 405(g).

Fee structures

Most SSDI representatives use a contingency fee approved by SSA, commonly based on a percentage of past-due benefits and subject to a maximum set by SSA. See 20 C.F.R. § 404.1720 and § 404.1728. Fees are not payable unless you win benefits and SSA authorizes the fee. Out-of-pocket costs (e.g., medical records fees) are separate.

Local Resources & Next Steps for Colorado Claimants

Finding your local SSA office in Colorado

Colorado residents can apply for benefits, submit appeals, or get account services online, by phone, or at local Social Security field offices located across the state. To find the nearest office and confirm hours or appointment options, use SSA’s official locator by ZIP code:

SSA Office Locator (Find Your Local Colorado Office) For general questions, you can also call SSA’s national line at 1-800-772-1213 (TTY 1-800-325-0778). When you call or visit, have your Social Security number, the denial notice, and a list of your medical providers handy.

Appeals process overview and Colorado touchpoints

• Reconsideration in Colorado: A different adjudicator reviews your file. Submit any new records promptly and keep proof of submission.
• ALJ Hearings: Hearings for Colorado claimants may be scheduled by telephone, online video, or in person. You will receive a Notice of Hearing with instructions and deadlines to submit evidence. Ensure SSA has updated contact information to avoid missed notices.
• Appeals Council: If you disagree with an ALJ decision, file your request online or by mail within 60 days. Consider citing specific legal and evidentiary errors.
• Federal Court (District of Colorado): If the Appeals Council denies review or issues an unfavorable decision, you generally have 60 days to file a civil action under 42 U.S.C. § 405(g). Many claimants retain counsel at this stage due to the complexity of federal litigation.

Medical records strategy for Colorado

Whether you receive care through large health systems or smaller clinics, the key is completeness and clarity. Ask providers to:

• Include objective findings and testing that support diagnoses.
• Explain how symptoms translate into concrete work-related limitations.
• Describe expected duration and variability (flare-ups, off-task time, absenteeism).
• List side effects of medications and reasons for any treatment changes or gaps.

If you have difficulty accessing specialty care due to geography or wait times, document appointment delays and referral efforts. If costs prevented testing, note affordability issues and explore community services that can help with diagnostic access.

Remote and accessible services

SSA offers options to file and appeal online and may conduct hearings by telephone or online video. These options can be especially helpful if you live far from a field office or have mobility limitations. If you need accommodations (e.g., language services, sign language, large print), alert SSA early so they can assist.

Detailed Guide to Each Appeal Level

Reconsideration (First Appeal)

Deadline: 60 days from the date you receive the denial (20 C.F.R. § 404.909; presumed received 5 days after the date on the notice under § 404.901).

What to submit: New medical evidence, updated treatment notes, objective testing, and detailed functional opinions addressing why you cannot sustain full-time competitive employment. If SSA questioned the severity or duration of your impairments, supply longitudinal documentation covering at least 12 months.

Tip: If you missed a consultative exam for reasons beyond your control, request a new appointment and provide proof for good cause (work conflicts, transportation breakdowns, illness).

ALJ Hearing (Second Appeal)

Deadline: 60 days after the reconsideration decision (20 C.F.R. § 404.933).

Preparation: Review your entire case file. Submit a pre-hearing brief that cites supporting regulations and clarifies how the evidence meets a Listing or, alternatively, shows an RFC preventing sustained work. Identify opinion evidence and analyze its supportability and consistency under 20 C.F.R. § 404.1520c. Ensure you meet SSA’s evidence submission deadlines outlined in your Notice of Hearing.

Hearing format: Telephone, online video, or in-person hearings are possible. You and any representative can question vocational and medical experts. Provide detailed testimony about functional limits—frequency of breaks, off-task time, absenteeism, need to elevate legs, limits on handling/fingering or reaching, mental health symptoms affecting pace and persistence, and how symptoms vary over days and weeks.

Appeals Council (Third Appeal)

Deadline: 60 days after the ALJ decision (20 C.F.R. § 404.968).

Scope: The Appeals Council reviews for abuse of discretion, errors of law, findings not supported by substantial evidence, and broad policy or procedural issues. Specify errors precisely—e.g., failure to evaluate a key medical opinion under § 404.1520c, inadequate symptom evaluation, or improper reliance on vocational evidence without adequate explanation.

Federal Court Review

Deadline: Generally 60 days after you receive the Appeals Council’s action (42 U.S.C. § 405(g); 20 C.F.R. § 422.210).

Standard of review: The court assesses whether SSA applied correct legal standards and whether findings are supported by substantial evidence. The court may remand for a new hearing or, rarely, reverse and award benefits.

Strengthening Your Evidence: Practical Tips for Colorado Claimants

Medical opinions and RFC

Ask your treating providers to address specific work-related limitations: maximum sitting/standing/walking, lifting/carrying, need for unscheduled breaks, use of assistive devices, manipulative limits, environmental limits, and mental-health related limits (e.g., concentration, persistence, social interaction). Opinions that cite exams, imaging, or neuropsychological testing tend to carry more weight under 20 C.F.R. § 404.1520c.

Listings analysis

If your impairment potentially meets a Listing, include a point-by-point analysis against the criteria in Appendix 1. Make sure the required test results or clinical signs are present and dated. If you do not meet a Listing, address why your combined impairments still preclude sustained employment.

Symptom consistency and daily activities

Explain how your daily activities are performed—frequency, duration, and the need for assistance—to avoid misunderstandings. Clarify if activities are sporadic or require extended recovery. Consistency across medical records and personal statements is key.

Vocational strategy at Step 5

For claimants over age 50 or 55, the Medical–Vocational Guidelines may favor a finding of disability when limited to certain exertional levels with no transferable skills. Build the record around exertional and non-exertional limitations, erosion of the job base, and conflicts between vocational testimony and the Dictionary of Occupational Titles when they arise.

Your Right to Representation and Fee Approval

Representation can clarify complex rules and ensure key issues are preserved for appeal. Under 20 C.F.R. § 404.1705, you may choose an attorney or qualified non-attorney. Any fee must be authorized by SSA (20 C.F.R. § 404.1720 et seq.); many cases proceed under the fee agreement process (20 C.F.R. § 404.1728), with fees typically contingent on winning past-due benefits and subject to SSA’s cap. Representatives must keep client information confidential and follow SSA’s rules of conduct.

Colorado-Focused Logistics

Getting and organizing records

Request records early and follow up frequently. Keep a master list of all providers, facilities, and diagnostic tests. If a provider charges for records, ask about patient portals or summaries that may be quicker to obtain while you wait for complete files.

Access considerations in Colorado

If distance, weather, or transportation complicate in-person visits, prioritize telehealth appointments when medically appropriate and permitted, and document any delays in obtaining care or testing. If SSA questions care gaps, supply your explanation and any proof (e.g., scheduling confirmations, referrals, or provider notes acknowledging delays).

Local SSA contact options

• Online: File appeals and upload evidence through your my Social Security account or the online appeals portal.
• Phone: SSA at 1-800-772-1213 (TTY 1-800-325-0778). In person: Use the official locator to identify a Colorado field office and confirm appointment options: SSA Office Locator.

Frequently Asked Questions for Colorado SSDI Claimants

How long do I have to appeal?

Generally, 60 days from the date you receive the decision to move to each next level: reconsideration (20 C.F.R. § 404.909), ALJ hearing (20 C.F.R. § 404.933), Appeals Council (20 C.F.R. § 404.968), and federal court (42 U.S.C. § 405(g); 20 C.F.R. § 422.210). SSA presumes you receive notices 5 days after the date on the notice (20 C.F.R. § 404.901).

Can I submit new evidence after a denial?

Yes. The administrative review process allows submission of new, material evidence at reconsideration and the ALJ hearing, subject to evidence submission rules and deadlines. Cite why the evidence was not submitted earlier and how it relates to the relevant time period.

Do I need a Colorado attorney?

You may represent yourself or use a representative under 20 C.F.R. § 404.1705. Many claimants seek a Colorado-licensed attorney for hearings and any federal court filing in the District of Colorado. Fees must be approved by SSA (20 C.F.R. § 404.1720 et seq.).

What if I missed a deadline?

Request an extension and explain good cause under 20 C.F.R. § 404.911, providing documentation (hospitalization records, mail issues, or other circumstances beyond your control).

What if SSA says I can do other work?

Challenge vocational assumptions with detailed functional evidence, cross-examination of the vocational expert, and citations to the Medical–Vocational Guidelines (Appendix 2) and relevant RFC rules (20 C.F.R. § 404.1545).

Authoritative Resources

SSA: How to Appeal a Disability Decision20 C.F.R. § 404.900: Administrative Review Process20 C.F.R. § 404.909: Reconsideration—Time and Place20 C.F.R. § 404.1705: Who May Be Your RepresentativeSSA Office Locator (Find a Local Office in Colorado)

Legal Disclaimer

This guide provides general information for Colorado residents regarding SSDI denials and appeals. It is not legal advice. Laws and regulations can change, and outcomes depend on specific facts. Consult a licensed Colorado attorney about your situation.

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