SSDI, social security lawyers near me—Colorado, Colorado

SSDI Denials and Appeals in Colorado, Colorado: A Practical Guide for Claimants

Facing a Social Security Disability Insurance (SSDI) denial can feel overwhelming, especially when your health and livelihood are on the line. If you live anywhere in Colorado, Colorado—from the Denver metro area to the Western Slope—the federal SSDI rules governing your case are the same nationwide, but how you access local Social Security resources and prepare your evidence can make a meaningful difference. This guide explains your rights, deadlines, and options after a denial, with a slight claimant-protective lens while staying strictly grounded in federal law and authoritative Social Security Administration (SSA) guidance.

SSDI is a federal program administered by the SSA. Colorado claimants interact with their local SSA field offices for applications and certain notices, but appeals proceed under the same federal framework that applies in every state. Colorado is served by the SSA’s Denver Region, which provides regional oversight and information for residents and local offices. You can locate your nearest field office, confirm hours, and plan your next steps online before visiting a location in person.

This guide focuses on what to do after a denial, how the four-level appeal structure works, what federal regulations govern the process, and how to strengthen your case at each stage. We also include specific references to the Code of Federal Regulations (CFR) and the Social Security Act so you can verify each step and requirement independently. While many people pursue appeals on their own, representation by a qualified representative can help organize medical evidence, track deadlines, and present arguments aligned with SSA’s rules. Whatever path you choose, knowing the process and your rights is central to a fair outcome.

Understanding Your SSDI Rights

When you apply for SSDI, you have the right to a full and fair determination of your claim under the Social Security Act and the SSA’s regulations. The SSA uses the “sequential evaluation” process to decide disability, which considers whether you are working at a level considered substantial, whether you have a severe medically determinable impairment, whether your condition meets or equals a listed impairment, and whether you can perform past work or other work in the national economy. This process is detailed in 20 CFR 404.1520 and related sections, with medical Listings of Impairments in 20 CFR Part 404, Subpart P, Appendix 1.

If your initial claim is denied, you have the right to seek further review through a multi-step appeal process laid out in 20 CFR 404.900. Generally, you must complete each level in order: reconsideration, hearing before an Administrative Law Judge (ALJ), Appeals Council review, and federal court review under Section 205(g) of the Social Security Act, 42 U.S.C. § 405(g). Each step has deadlines and specific procedures, and you are entitled to submit additional evidence and legal argument at various points, subject to rules about timeliness and “good cause” for late submissions (see 20 CFR 404.911 and 20 CFR 404.935).

You also have the right to representation. The SSA permits claimants to appoint a representative, which may be an attorney in good standing or a qualified non-attorney, as outlined in 20 CFR 404.1705. Representatives can help you collect medical records, prepare written briefs, question witnesses, and manage deadlines. Fees for representatives must be approved by the SSA and are governed by 42 U.S.C. § 406(a) and 20 CFR 404.1720–404.1725. If you choose to hire an attorney in Colorado, confirm that the attorney is in good standing with the highest court of a state or territory, as required by SSA regulations for attorney representatives.

Importantly, due process protections under the Social Security Act include timely notice of decisions and an opportunity to be heard (see 42 U.S.C. § 405(b)). If you disagree with a denial, you are entitled to appeal and present your case. Missing a deadline can end your appeal, but the SSA may extend deadlines if you have “good cause” under 20 CFR 404.911—so do not give up without exploring whether your circumstances meet that standard.

Common Reasons SSA Denies SSDI Claims

Understanding why claims are denied can help you focus your appeal. Denials typically fall into two broad categories: technical (non-medical) and medical.

Technical (Non-Medical) Denials

• Insufficient insured status: SSDI requires sufficient work credits. If you lack enough recent covered work, the SSA may deny the claim technically.
• Work activity above substantial gainful activity (SGA): If earnings exceed SGA, you may be found not disabled at step one of the evaluation. SGA concepts are described in 20 CFR 404.1571–404.1576. The specific dollar threshold changes periodically, so verify the current amount directly with SSA.
• Failure to cooperate or provide information: If the SSA cannot contact you or obtain necessary forms or authorizations, it may deny the claim. See 20 CFR 404.1518.

Medical Denials

• Insufficient objective evidence: The SSA generally requires medical evidence from acceptable medical sources to establish a medically determinable impairment and functional limitations. See 20 CFR 404.1513 and 404.1521.
• Impairment not severe or not of 12-month duration: To qualify, your impairments must be severe and expected to last at least 12 months or result in death. See 20 CFR 404.1509 and 404.1520(c).
• Does not meet or equal a listing: If your condition does not meet or equal a listed impairment in 20 CFR Part 404, Subpart P, Appendix 1, the SSA will assess residual functional capacity and consider past work and other work.
• Failure to follow prescribed treatment without good cause: This can lead to denial. See 20 CFR 404.1530.
• Missed consultative examination: If you miss an SSA-scheduled exam without good reason, the claim may be decided unfavorably. See 20 CFR 404.1517.

In Colorado, many denials ultimately hinge on documentation—how clearly your record shows diagnosis, objective findings, longitudinal treatment, and specific functional limitations. On appeal, a focused strategy to fill gaps is often decisive.

Federal Legal Protections & Regulations You Should Know

The SSDI appeals system is governed by federal law. Key authorities include:

• Social Security Act: Section 223 (42 U.S.C. § 423) governs disability insurance benefits. Section 205(b)–(g) (42 U.S.C. § 405(b)–(g)) provides for notice, hearings, Appeals Council review, and judicial review.
• Administrative Review Process: 20 CFR 404.900 explains the levels of administrative review.
• Reconsideration: 20 CFR 404.909 outlines the reconsideration process and filing timelines.
• ALJ Hearing: 20 CFR 404.929 through 404.961 address hearing rights, procedures, and decisions; 20 CFR 404.933 covers filing a request for hearing.
• Appeals Council: 20 CFR 404.967–404.983 cover Appeals Council review; 20 CFR 404.968 addresses deadlines to request review.
• Evidence Submission: 20 CFR 404.1512 details evidence requirements. The nationwide “five-day rule” for hearing submissions is in 20 CFR 404.935 (with exceptions for good cause).
• Representation & Fees: 20 CFR 404.1705 (who may represent you), 20 CFR 404.1720–404.1725 (fees and fee approval). Attorney fees are also addressed in 42 U.S.C. § 406(a).
• Work and SGA: 20 CFR 404.1571–404.1576 define substantial gainful activity.

These regulations protect your right to seek review, submit medical and non-medical evidence, appear at a hearing (including by telephone or online video if approved), and obtain a written decision. The SSA’s hearing and Appeals Council levels are non-adversarial, but presenting a clear, rule-based argument—grounded in objective medical evidence and vocational analysis—substantially improves your odds of success.

Steps to Take After an SSDI Denial

Appeals are time-sensitive. In general, you must act within 60 days after you receive the notice of denial. The SSA presumes you receive notices 5 days after the date on the notice, unless you can show you received it later (see 20 CFR 404.901 for the “date you receive notice” definition and timelines; see also 20 CFR 404.909, 404.933, and 404.968 for specific levels). If you miss a deadline, you can ask for more time by showing “good cause” under 20 CFR 404.911. Below is a step-by-step overview.

1) Read Your Denial Notice Carefully

• Identify whether the denial is technical or medical.
• Note the date on the notice and the deadline to appeal (typically 60 days from receipt).
• List the reasons given for denial; this guides what new evidence or arguments are needed.

2) File a Reconsideration Request

• Deadline: 60 days from receipt of your initial denial (20 CFR 404.909).
• How: You can request reconsideration online through the SSA’s appeals portal or by submitting the SSA-561 Request for Reconsideration, along with updated medical records and forms requested by SSA.
• Tip: Address each reason for denial with targeted evidence (e.g., objective imaging, specialist notes, function reports). Keep copies of everything you submit.

3) Request an ALJ Hearing if Reconsideration Is Denied

• Deadline: 60 days from receipt of the reconsideration denial to file a hearing request (20 CFR 404.933).
• How: File online or submit form HA-501 (Request for Hearing by Administrative Law Judge). Indicate any witnesses (e.g., family or former employer) and whether you prefer in-person, telephone, or online video hearing options, as available through SSA.
• Evidence Timing: Submit all evidence no later than 5 business days before the hearing, unless you can show good cause under 20 CFR 404.935.
• Prepare: Organize a “hearing brief” that ties medical findings and symptoms to functional limits, citing 20 CFR 404.1520 and any relevant Listings. Be ready to discuss treatment history, side effects, and reasons for any gaps in care.

4) Seek Appeals Council Review if You Disagree with the ALJ

• Deadline: 60 days from receipt of the ALJ decision to request Appeals Council review (20 CFR 404.968).
• Grounds: The Appeals Council reviews for errors of law, abuse of discretion, lack of substantial evidence, or new and material evidence with good cause for not submitting it earlier.
• Outcome: The Appeals Council may deny review, remand to the ALJ, or issue its own decision.

5) Federal Court Review

• Statute: File a civil action in federal district court under 42 U.S.C. § 405(g) if the Appeals Council denies review or issues an unfavorable decision.
• Deadline: Typically 60 days from receipt of the Appeals Council decision.
• Scope: The court reviews whether the SSA’s decision is supported by substantial evidence and free from legal error. New evidence is generally limited at this stage.

Proving Disability: Evidence That Carries Weight

• Objective medical evidence: Imaging, lab results, and clinical findings from acceptable medical sources (20 CFR 404.1513).
• Longitudinal treatment records: Demonstrate persistence and severity of symptoms over time, as well as compliance with prescribed treatment when feasible (20 CFR 404.1530).
• Functional assessments: Residual Functional Capacity (RFC) opinions from treating specialists addressing sitting/standing tolerance, lifting, use of hands, postural limits, and mental functional areas (concentration, persistence, pace, social interaction, adaptation).
• Work history and vocational evidence: Job demands, transferable skills, and how symptoms affect ability to perform past work or other work (20 CFR 404.1560–404.1569a).

When to Seek Legal Help for SSDI Appeals

While you can appeal on your own, consider consulting a representative if:

• Your case involves complex medical conditions or multiple impairments (physical and mental), requiring careful coordination of evidence and Listings arguments.
• You have a history of denials and need to build a more robust record with opinion evidence and function-based documentation.
• You are approaching a hearing and must comply with the five-day evidence rule (20 CFR 404.935) and frame issues for the ALJ.
• You need help eliciting detailed testimony and cross-examining vocational experts at hearing.
• You want assistance with Appeals Council briefing or federal court review under 42 U.S.C. § 405(g).

Attorney and non-attorney representatives must meet SSA’s requirements (20 CFR 404.1705). Fee agreements and fee petitions are subject to SSA approval and statutory limits (42 U.S.C. § 406(a); 20 CFR 404.1720–404.1725). Many representatives work on a contingency basis requiring no upfront attorney fee, but confirm all terms in writing and ask how costs (e.g., medical record fees) are handled.

Local Resources & Next Steps for Colorado Residents

Colorado is served by the SSA’s Denver Region. You can locate your nearest field office, check hours, and see service updates using the SSA’s official tools. Hearings for Colorado claimants are conducted by SSA’s Office of Hearings Operations; depending on availability and your preferences, hearings may be held in person, by telephone, or by online video as permitted by the SSA. Always rely on your official SSA notices for scheduling details and instructions.

Find Your Local SSA Office (Colorado)

• Use the SSA Office Locator to find the closest field office by ZIP code, confirm hours, and check accessibility information.
• You can handle many tasks online, including appeals filings and status checks, to avoid unnecessary travel.
• SSA National Phone Line: 1-800-772-1213 (TTY 1-800-325-0778) for general questions and appointment assistance.

Colorado Context: Practical Tips

• Medical records access: Ask your providers for complete records, including objective testing and functional assessments. In larger metro areas in Colorado, specialists often maintain detailed electronic records that can be obtained efficiently—submit them directly to SSA using the designated portals or by following submission instructions on your notices.
• Travel and weather considerations: If you live in high-altitude or rural parts of Colorado and face travel barriers, promptly inform SSA if in-person attendance is difficult. The SSA can consider remote hearing options where available.
• Keep SSA updated: If you move within Colorado or change phone numbers, update SSA immediately to avoid missed communications that could affect deadlines (see 20 CFR 404.1518).

Frequently Asked Questions (Colorado, Colorado)

What are my deadlines after a denial?

At each administrative level (reconsideration, hearing, Appeals Council), you generally have 60 days from receipt of the decision to appeal (presuming receipt 5 days after the date on the notice), per 20 CFR 404.909, 404.933, and 404.968. If you miss a deadline, request an extension and explain your “good cause” under 20 CFR 404.911.

What if I kept working?

Work above the SGA level can result in a denial at step one (20 CFR 404.1571–404.1576). If your work was brief or ended because of your condition, the SSA may consider whether it was an unsuccessful work attempt, subject to SSA rules. Provide pay records and a statement explaining why you stopped.

How do I strengthen my medical evidence?

Focus on objective findings, specialist opinions on functional limits, and consistent treatment history. If SSA schedules a consultative exam, attend and cooperate fully (20 CFR 404.1517). If you cannot attend, promptly notify SSA and reschedule with an explanation.

Do I need a lawyer in Colorado to appeal?

Representation is optional. Under 20 CFR 404.1705, you can appoint an attorney in good standing or certain qualified non-attorney representatives. Many claimants seek help when preparing for an ALJ hearing or Appeals Council review to comply with procedural rules like the five-day evidence rule (20 CFR 404.935).

What happens at the hearing?

An ALJ will question you about your limitations and may take testimony from a vocational expert. You can present witnesses and additional evidence. The process is non-adversarial, but organized evidence and clear testimony are crucial.

Detailed Checklist After an SSDI Denial

• Calendar your deadline: Count 60 days from the date you are presumed to have received the notice. Add reminders to gather records and file your appeal ahead of time.
• Request reconsideration: File online or with SSA-561. Attach new medical records, medication lists, and updated provider statements.
• Track and submit evidence: Keep a running list of outstanding records. Ask providers for RFC opinions tied to work-related functions.
• If reconsideration is denied, request a hearing: File HA-501. Decide on in-person, phone, or online video format as allowed by SSA and your circumstances.
• Meet the five-day rule: Submit evidence at least five business days before the hearing or explain good cause (20 CFR 404.935).
• Prepare testimony: Describe your worst days, typical fluctuations, and functional limits (sitting, standing, lifting, concentrating) with concrete examples.
• Consider representation: Appoint a representative under 20 CFR 404.1705, and confirm fee arrangements per 42 U.S.C. § 406(a) and 20 CFR 404.1720–404.1725.
• After the ALJ decision: If unfavorable, weigh Appeals Council review within 60 days (20 CFR 404.968). Consider legal briefing focused on errors of law or gaps in substantial evidence.
• Federal court option: If necessary, consult counsel regarding a civil action under 42 U.S.C. § 405(g).

Key Rights to Assert in Your Appeal

• Right to submit evidence and be heard: 42 U.S.C. § 405(b) and 20 CFR 404.900 et seq.
• Right to representation: 20 CFR 404.1705; fee control under 42 U.S.C. § 406(a) and 20 CFR 404.1720–404.1725.
• Right to good-cause extensions: 20 CFR 404.911.
• Right to a fair hearing with evidence rules and timelines: 20 CFR 404.929–404.961 and 20 CFR 404.935.

How Colorado Residents Can Engage SSA Locally

Although SSDI rules are federal, local logistics matter. Colorado residents can:

• Use online services first: File appeals, upload documents, and track case status through SSA’s online portals to reduce delays.
• Call before visiting: Confirm hours and any appointment requirements using the national number (1-800-772-1213) or the online office locator.
• Keep copies: Retain proof of every submission and note the date, method (upload, mail, in-person), and what was sent. This is essential if a document is later missing.
• Request accommodations: If you need language or disability-related accommodations for a hearing, tell SSA as early as possible so arrangements can be made.

Authoritative Resources

SSA: How to Appeal a Decision20 CFR 404.900: Administrative Review Process20 CFR 404.935: Five-Day Evidence RuleSSA Office Locator (Find Your Colorado Field Office)SSA Denver Region (Colorado Information)

SEO Notes for Colorado Claimants

Primary phrase included for relevance: SSDI denial appeal colorado colorado. Secondary phrases integrated: social security disability, colorado disability attorney, SSDI appeals.

Legal Disclaimer

This guide is for informational purposes only and is not legal advice. Laws and regulations change, and application to your facts may differ. Consult a licensed Colorado attorney or qualified representative for advice about 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.