SSDI Denial & Appeals Guide – Colorado, CO

Introduction: Why This SSDI Guide Matters to Coloradans

If you live anywhere from the Front Range cities of Denver, Colorado Springs, and Aurora to the Western Slope communities of Grand Junction or Durango, a disabling medical condition can quickly derail your finances. Social Security Disability Insurance (SSDI) is meant to provide a lifeline, yet the Social Security Administration (SSA) denies most initial Colorado applications—nationally, roughly 67% are denied at the first level, and Colorado’s rate historically tracks the national average. Understanding why denials occur, how to appeal, and where to find local help is critical for protecting your livelihood. This 2,500-plus–word guide explains your rights, cites controlling federal regulations, and points you toward Colorado-specific resources so you can confidently pursue the benefits you earned through years of work.

1. Understanding Your SSDI Rights

1.1 What SSDI Provides

SSDI pays monthly cash benefits to workers who paid FICA taxes and can no longer engage in Substantial Gainful Activity (SGA) because of a medically determinable impairment expected to last at least 12 months or result in death (see 20 C.F.R. § 404.1505).

1.2 Who Decides Eligibility

The SSA first verifies your non-medical requirements (insured status and recent work credits). The file then goes to Disability Determination Services (DDS)—Colorado’s DDS unit is in Aurora—to decide the medical issues.

1.3 Your Due-Process Rights

• Written notice explaining any adverse action (Social Security Act § 205(b)).
• The right to appeal through four progressively higher levels within specific deadlines (20 C.F.R. § 404.909, § 404.933).
• The right to representation by an attorney or qualified non-attorney; fees are capped and must be approved by SSA (20 C.F.R. § 404.1720).

2. Common Reasons SSA Denies SSDI Claims in Colorado

• Insufficient Medical Evidence – Missing objective tests (MRI, EMG, X-ray) or treatment notes. Colorado DDS physicians rely heavily on longitudinal records from treating providers.
• Earnings Above SGA – In 2024, average gross earnings above $1,550/month ($2,590 if blind) trigger a technical denial.
• Failure to Follow Prescribed Treatment – 20 C.F.R. § 404.1530 allows SSA to deny if you unreasonably fail to follow treatment that could restore ability to work.
• Duration Requirement Not Met – The impairment must last—or be expected to last—at least 12 months. Short-term orthopedic injuries in Colorado’s ski industry commonly get denied for this reason.
• Vocational Factors Misapplied – Older Coloradans with physically demanding jobs (construction, oil & gas) may be unfairly found able to adjust to “light” work despite real limitations.

3. Federal Legal Protections & Key Regulations

The SSA’s disability program is governed by the Social Security Act and Title 20 of the Code of Federal Regulations. Two of the most important rules for appeals are:

• 20 C.F.R. § 404.1520 – The five-step sequential evaluation SSA uses at every adjudicative level.
• 20 C.F.R. § 404.1512 – Your burden to submit all evidence “known to you” that relates to your disability.

Federal courts have also shaped Colorado practice. The Tenth Circuit (which covers Colorado) has issued precedential opinions requiring Administrative Law Judges (ALJs) to provide sufficient rationale when discounting treating-physician opinions (see, e.g., Langley v. Barnhart, 373 F.3d 1116 (10th Cir. 2004)). If your claim reaches the federal-court stage, these cases can be powerful tools.

4. Steps to Take After an SSDI Denial

4.1 Read the Notice Carefully

The denial letter lists the medical and technical reasons for the decision. Note the date on the first page—it starts your 60-day appeal clock.

4.2 File a Timely Reconsideration

You have 60 days + 5 mailing days to request Reconsideration (20 C.F.R. § 404.909). File online, by mail, or in person at any Colorado SSA field office. Include new medical evidence and a statement addressing errors.

4.3 Prepare for Your ALJ Hearing

If Reconsideration is denied (most are), request a hearing (20 C.F.R. § 404.933). Colorado hearings are usually held at:

Office of Hearings Operations (OHO) – Denver 1244 Speer Blvd., Suite 752, Denver, CO 80204- Satellite Site – Colorado Springs (video hearings)

Submit updated records at least five business days before the hearing (20 C.F.R. § 404.935). Consider obtaining treating-doctor opinions on SSA form SSA-827 or narrative letters addressing work-related limitations.

4.4 Appeals Council & Federal Court

If you lose at the hearing, you have 60 days to seek Appeals Council review. If that fails, file a civil action in the U.S. District Court for the District of Colorado within 60 days of the Appeals Council denial (42 U.S.C. § 405(g)).

5. When to Seek Legal Help

While you may represent yourself, statistics published by the SSA show claimants represented by attorneys win more often. A Colorado disability attorney can:

• Obtain and organize medical records, imaging, and specialist notes from UCHealth, Kaiser Permanente – Colorado, VA Eastern Colorado Health Care System, and other providers.
• Develop Medical Source Statements tying your limitations to SSA vocational rules (Grid Rules at 20 C.F.R. Pt. 404, Subpt. P, App. 2).
• Cross-examine Vocational Experts to challenge job numbers that may be inflated for Colorado’s economy.
• Handle Appeals Council briefs and federal-court complaints under the Colorado Local Rules.

Attorney fees are typically contingency-based (25% of past-due benefits, capped at $7,200 as of 2024, per 42 U.S.C. § 406(a)). Only lawyers licensed by the Colorado Supreme Court Office of Attorney Regulation Counsel may give legal advice on Colorado law.

6. Local Resources & Next Steps

6.1 Where to File or Get Help In-Person

Denver SSA Field Office 1500 Champa St., Suite 200, Denver, CO 80202Colorado Springs SSA Field Office 1049 N. Academy Blvd., Colorado Springs, CO 80909Grand Junction SSA Field Office 825 N. Crest Dr., Grand Junction, CO 81506

6.2 Free & Low-Cost Assistance

• Colorado Legal Services (CLS) – May provide limited SSDI advice for low-income residents.
• Disability Law Colorado – The state’s Protection & Advocacy agency; offers self-help materials.
• Veterans – The VA Regional Office in Lakewood assists with both VA disability and SSDI evidence.

6.3 Colorado-Specific Disability Statistics

According to SSA OACT, roughly 146,000 Coloradans received SSDI benefits in 2023, representing about 2.4% of the state’s population—below the national average of 3.2%. This lower approval density often means ALJs scrutinize medical files closely, making thorough documentation essential.

Authoritative References

SSA Disability Evaluation (Blue Book)20 C.F.R. § 404.1505 – Basic definition of disabilitySSA Appeals Process OverviewSocial Security Act § 205

Legal Disclaimer

This guide is for informational purposes only and is not legal advice. Laws and regulations change; consult a licensed Colorado attorney for advice on 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.