SSDI Denial & Appeal Guide – Colorado, CO

Introduction: Why This SSDI Denial Appeal Guide Matters to Colorado Claimants

If you live in Colorado and your application for Social Security Disability Insurance (SSDI) was denied, you are not alone. According to the Social Security Administration (SSA), approximately 154,000 Colorado residents received disabled-worker benefits in 2022, yet more than half of first-time applications are denied nationwide. The good news is that federal law provides a structured, multi-level appeals process, and claimants who persist—especially those who obtain qualified legal help—often succeed at later stages. This guide walks Colorado claimants through every stage of an SSDI denial appeal, explains the governing federal regulations, and points you to local resources from Denver to Grand Junction. Our goal is to give you clear, factual information so you can protect your right to benefits.

Understanding Your SSDI Rights

The Legal Basis of SSDI

SSDI is a federal insurance program authorized by Title II of the Social Security Act. Workers earn coverage by paying FICA taxes. If you develop a medically determinable impairment that prevents substantial gainful activity (SGA) for at least 12 months—or is expected to result in death—you have a right to file for benefits under 42 U.S.C. § 423.

Core Rights for Colorado Claimants

• Right to Notice: Under 20 C.F.R. § 404.904, SSA must give written notice of any determination, including specific reasons for denial and your appeal options.

• Right to Representation: You may appoint an attorney or qualified non-attorney representative. In Colorado, attorneys must be licensed by the Colorado Supreme Court and in good standing with the bar.

• Right to a Fair Hearing: Per 20 C.F.R. § 404.929, you are entitled to an impartial hearing before an Administrative Law Judge (ALJ) if reconsideration is denied.

• Right to Timely Appeal: Federal regulations (discussed below) give you 60 days from receipt of a denial notice—plus a 5-day mailing presumption—to request the next appeal level.

Common Reasons SSA Denies SSDI Claims

The SSA denies Colorado SSDI applications for multiple reasons. Knowing these issues can guide you in strengthening an appeal.

• Insufficient Medical Evidence – The medical records do not establish a “severe” impairment under 20 C.F.R. § 404.1520(c).

• Earnings Above SGA Level – In 2024, earning more than $1,550 per month (non-blind) generally disqualifies you.

• Failure to Follow Prescribed Treatment – Under 20 C.F.R. § 404.1530, benefits can be denied if you do not comply with treatment that could restore your ability to work.

• Duration Requirement Not Met – The impairment must last or be expected to last at least 12 consecutive months.

• Insufficient Work Credits – SSA looks at your “date last insured” (DLI). If you have not worked enough quarters in the relevant period, technical denial follows.

Federal Legal Protections & Regulations

Key Statutes and Regulations

• Social Security Act § 205(b) – Guarantees a hearing and due-process protections.

• 20 C.F.R. Part 404, Subpart J – Governs administrative reviews, inclusive of reconsideration, ALJ hearings, and Appeals Council review.

• 20 C.F.R. § 404.968 – Discusses Appeals Council authority.

Time Limits You Cannot Miss

You generally have 60 days from receipt of any adverse decision (with a statutory 5-day mailing presumption) to file your next appeal. Missing the deadline usually ends your claim unless you show “good cause” under 20 C.F.R. § 404.911.

How Federal Courts Influence Colorado Cases

If you exhaust all SSA administrative steps, you can file a civil action in the U.S. District Court for the District of Colorado. Federal judges review the administrative record and apply the “substantial evidence” standard set out in 42 U.S.C. § 405(g).

Steps to Take After an SSDI Denial

1. Reconsideration

File SSA Form 561 within 60 days. A different examiner will review your file. In Colorado, reconsiderations are processed by Disability Determination Services (DDS) in Englewood.

2. Administrative Law Judge (ALJ) Hearing

If reconsideration is denied, request a hearing using Form HA-501. Colorado ALJ hearings are typically assigned to the Denver Office of Hearing Operations, located at 1244 Speer Blvd, Suite 400, Denver, CO 80204.

3. Appeals Council Review

You must ask the Appeals Council in Falls Church, VA, to review an unfavorable ALJ decision. The Council may uphold, reverse, or remand your case.

4. Federal District Court

File a civil complaint within 60 days of the Appeals Council’s decision. In Colorado, venue is the Alfred A. Arraj United States Courthouse in Denver.

Best Practices for Each Stage

• Submit updated medical evidence—especially imaging, specialist opinions, and functional capacity evaluations.

• Prepare a detailed statement describing how symptoms limit daily activities.

• Meet every deadline; use certified mail or SSA’s online portal for proof.

• Consider requesting an “on‐the‐record” decision if the file is strong.

When to Seek Legal Help for SSDI Appeals

Statistics from SSA’s Annual Report on Representative Payee and Representation show that claimants with representation are nearly three times more likely to win benefits at the ALJ level. A Colorado disability attorney can:

• Analyze vocational evidence and cross-examine SSA medical experts.

• Ensure compliance with 20 C.F.R. § 404.1740 (rules of conduct for representatives).

• Front-load the record to avoid Appeals Council remand.

Attorney fees are contingency-based and capped by statute (currently 25% of past-due benefits or $7,200, whichever is less, per Social Security Act § 206).

Local Resources & Next Steps

Colorado DDS and SSA Offices

Colorado Disability Determination Services P.O. Box 25326, Denver, CO 80225 Denver Downtown SSA Field Office 1500 Champa St, Denver, CO 80202 Colorado Springs SSA Field Office 2306 E Pikes Peak Ave, Colorado Springs, CO 80909

Major Medical Providers Familiar with SSDI Documentation

• UCHealth University of Colorado Hospital, Aurora

• Denver Health Medical Center, Denver

• St. Mary’s Medical Center, Grand Junction

Statewide Disability Advocacy Groups

• Colorado Cross‐Disability Coalition (CCDC)

• Mental Health Colorado

While these organizations do not replace legal counsel, they can help you secure medical records, attend consultative exams, and understand your rights.

Authoritative References

SSA Disability Benefits Overview 20 C.F.R. Part 404 (eCFR) SSA Appeals Process SSA Annual Statistical Supplement

Conclusion

Facing an SSDI denial can feel overwhelming, but Colorado claimants have powerful rights under federal law. By understanding the appeals process, meeting deadlines, and obtaining experienced legal representation, you can significantly improve your chances of success.

Legal Disclaimer: This article provides general information for Colorado residents and is not legal advice. Always consult a licensed Colorado attorney regarding your specific situation.

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