SSDI & SSI Denial Guide — Colorado, Colorado

SSDI and SSI Denial Guide for Colorado, Colorado: Your Rights, Deadlines, and How to Appeal

If you live in Colorado and your Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI) claim was denied, you are not alone—and you have the right to appeal. The Social Security Administration (SSA) operates under federal law, so Colorado claimants follow the same national rules for disability determinations and appeals. However, there are Colorado-specific practical considerations, including where hearings are typically scheduled and how to access nearby SSA field offices and local support services. This guide explains the federal legal framework, strict appeal deadlines, and step-by-step actions Colorado residents can take to protect their claims.

SSDI is a federal program for workers who have paid Social Security taxes and can no longer engage in substantial gainful activity because of a medically determinable impairment expected to last at least 12 months or result in death. SSI is a separate, needs-based program that considers limited income and resources. Because both programs share a common appeals structure but have different eligibility requirements, this guide highlights SSDI rules while noting key SSI differences where helpful.

Colorado claimants access SSA services online, by phone, and through field offices located throughout the state. Hearings for Colorado residents are generally administered by SSA’s Office of Hearings Operations (OHO), often out of Denver or via telephone or video, depending on SSA scheduling and your preferences when available. While initial denials can be discouraging, many Colorado claimants ultimately succeed on appeal by submitting stronger medical evidence, clarifying work limitations, and following the SSA’s procedural rules and deadlines.

The information below is strictly grounded in federal statutes and regulations, including the Social Security Act and the Code of Federal Regulations (CFR). It slightly favors protecting claimants’ rights—because knowing and using those rights can make a meaningful difference—while remaining evidence-based and professional.

Who This Guide Helps

• Colorado workers denied SSDI at the initial or reconsideration level
• Colorado residents preparing for a hearing before an Administrative Law Judge (ALJ)
• Claimants deciding whether to request Appeals Council review or file a federal court case
• Family members assisting a Colorado claimant

Understanding Your SSDI Rights in Colorado

Federal law defines “disability” for SSDI purposes. Under the Social Security Act, disability means the inability to engage in substantial gainful activity due to a medically determinable physical or mental impairment that has lasted or is expected to last at least 12 months or result in death. See 42 U.S.C. § 423(d)(1)(A). SSA’s regulations at 20 C.F.R. § 404.1505 restate this definition and explain that your impairment must be established by objective medical evidence from acceptable medical sources.

SSA uses a five-step sequential evaluation process to determine disability. See 20 C.F.R. § 404.1520. In brief, SSA evaluates: (1) whether you are working at the level of substantial gainful activity; (2) whether you have a severe impairment; (3) whether your impairment meets or equals a listed impairment in the Listing of Impairments (Appendix 1 to Subpart P of Part 404); (4) whether you can perform your past relevant work; and (5) whether you can adjust to other work considering your residual functional capacity, age, education, and work experience. If you meet or equal a listed impairment at step three, you are generally found disabled without needing to proceed to steps four and five.

Your Core Procedural Rights

• Right to appeal each denial: You can appeal an unfavorable decision at every level within set time limits. See 20 C.F.R. §§ 404.909 (reconsideration), 404.933 (hearing before an ALJ), and 404.968 (Appeals Council review).
• Right to representation: You may appoint an attorney or qualified non-attorney representative to assist with forms, evidence, hearings, and appeals. See 20 C.F.R. § 404.1705; 42 U.S.C. § 406 (fee approval).
• Right to examine your file and submit evidence: SSA must consider all relevant evidence. See 20 C.F.R. § 404.1512. You can review your file and submit additional medical and non-medical evidence supporting your limitations.
• Right to a fair hearing and to present witnesses: At the ALJ hearing, you can present testimony, question witnesses (including vocational experts), and submit medical opinions. See 20 C.F.R. §§ 404.929–404.961 (hearing procedures).
• Right to request more time (good cause): If you miss a deadline for reasons beyond your control, you may request an extension for “good cause.” See 20 C.F.R. § 404.911.

Colorado claimants have the same rights as claimants in other states, but exercising these rights effectively often requires careful evidence development and attention to deadlines. The SSA presumes you receive decisions five days after the date on the notice unless you show otherwise. That presumption matters when calculating appeal deadlines.

Common Reasons SSA Denies SSDI Claims

While each case is unique, the most common reasons for initial SSDI denials include evidentiary and procedural issues. Understanding these can help you avoid repeat denials on appeal.

1) Working Above Substantial Gainful Activity (SGA)

If you are working and earning above SSA’s SGA level at the time of your claim, SSA will usually deny at step one. SGA amounts are set annually by SSA. Even part-time work can affect your claim if earnings exceed SGA thresholds, or if the nature of the work suggests the ability to perform competitive employment. See step-one rules in 20 C.F.R. § 404.1520(a)(4)(i).

2) Insufficient Medical Evidence

SSA requires objective medical evidence from acceptable medical sources to establish the existence and severity of a medically determinable impairment. See 20 C.F.R. § 404.1513 and § 404.1512. Denials often occur when there are gaps in treatment, missing imaging or lab results, or when medical opinions do not explain specific functional limitations (e.g., lifting, standing, concentration, pace).

3) Impairment Not Severe or Not Lasting Long Enough

To be “severe,” an impairment must significantly limit your ability to perform basic work activities and be expected to last at least 12 months or result in death. See 42 U.S.C. § 423(d)(1)(A); 20 C.F.R. § 404.1520(a)(4)(ii). Denials occur when SSA finds the impairment is not severe, is well-controlled with treatment, or is expected to resolve in less than 12 months.

4) Does Not Meet or Equal a Listing

SSA’s Listing of Impairments describes medical criteria that are severe enough to prevent any gainful activity. If your impairment does not meet or medically equal a Listing at step three, SSA proceeds to evaluate your remaining ability to work. Many denials occur because the record lacks the specific clinical findings required by the Listings.

5) Ability to Do Past Work or Other Work

At steps four and five, SSA evaluates your residual functional capacity (RFC) and compares it with demands of your past work and other jobs that exist in the national economy. If the evidence suggests you can still perform your past work or adjust to other work, SSA will deny. See 20 C.F.R. § 404.1520(a)(4)(iv)-(v).

6) Procedural Issues

Missing consultative examinations, not responding to SSA requests, or failing to submit evidence in time can lead to unfavorable outcomes. While SSA must develop the record, claimants bear a responsibility to inform SSA about or submit all known evidence. See 20 C.F.R. § 404.1512.

Federal Legal Protections and Key Regulations

Colorado claimants benefit from the same federal legal protections that apply nationwide. The following statutes and regulations are central to SSDI and SSI denials and appeals:

• Definition of Disability: 42 U.S.C. § 423(d); 20 C.F.R. § 404.1505.
• Five-Step Sequential Evaluation: 20 C.F.R. § 404.1520; Listings at Appendix 1 to Subpart P of Part 404; Medical-Vocational Guidelines at Appendix 2.
• Evidence Requirements: 20 C.F.R. § 404.1512 (duty to submit evidence) and § 404.1513 (acceptable medical sources and evidence categories).
• Appeal Deadlines and Levels: 20 C.F.R. § 404.909 (reconsideration), § 404.933 (hearing), § 404.968 (Appeals Council). Federal court deadline: 42 U.S.C. § 405(g); see also 20 C.F.R. § 422.210.
• Five-Day Evidence Rule (Hearings): Generally submit evidence at least 5 business days before the hearing; good-cause exceptions may apply. See 20 C.F.R. § 404.935.
• Good Cause for Missing Deadlines: 20 C.F.R. § 404.911.
• Representation and Fees: 20 C.F.R. § 404.1705 (who may serve as a representative); fee approvals governed by 42 U.S.C. § 406 and 20 C.F.R. §§ 404.1720–404.1730.

These rules protect your right to a fair process, ensure you can appoint a representative, require SSA to consider all relevant evidence, and set deadlines and procedures to keep cases moving. In addition, for SSI claims under Title XVI, parallel regulations apply in Part 416 of Title 20 C.F.R., and the statutory framework is found at 42 U.S.C. § 1381 et seq. While this guide centers on SSDI, many procedural points apply to both programs.

Steps to Take After an SSDI Denial in Colorado

Act quickly. The SSA generally gives you 60 days from the date you receive your denial notice to appeal to the next level. SSA presumes you receive the notice five days after the date on the letter, unless you can show otherwise. See 20 C.F.R. §§ 404.909(a)(1), 404.933(b)(1), 404.968(a)(1). Missing a deadline can force you to restart the process, unless SSA grants an extension for good cause under 20 C.F.R. § 404.911.

1) Understand Why You Were Denied

Carefully read the denial notice. It explains the medical and vocational rationale for the decision and cites the evidence SSA considered. Identifying the exact reasons for denial helps you and your representative target the weaknesses in your record—whether that’s missing imaging, limited specialty care, or gaps in treatment history.

2) File a Reconsideration Request (First Appeal)

If your initial SSDI application is denied, your next step in Colorado is to request reconsideration within 60 days. A different disability examiner and medical consultant review your file. Use this time to submit missing records, updated clinic notes, imaging and lab results, and detailed opinions from your treating providers addressing your functional limitations (sitting, standing, lifting, attention, pace, social interaction, etc.). See 20 C.F.R. § 404.909.

3) Request a Hearing Before an ALJ (Second Appeal)

If reconsideration is denied, you may request a hearing before an Administrative Law Judge. See 20 C.F.R. § 404.933. Hearings for Colorado claimants are commonly scheduled by SSA’s OHO and may be conducted by telephone, by video, or in person as available. The hearing is your best opportunity to explain your symptoms, treatment course, and work history directly to a judge, and to respond to testimony from a vocational expert. Submit evidence at least five business days before the hearing or ask for good-cause exceptions if needed. See 20 C.F.R. § 404.935.

4) Appeals Council Review (Third Appeal)

If the ALJ’s decision is unfavorable, request Appeals Council review within 60 days. See 20 C.F.R. § 404.968. The Appeals Council may deny review, remand the case to the ALJ, or less commonly issue a new decision. Arguments often focus on legal error, failure to follow the regulations, inadequate evaluation of key medical opinions, or insufficient analysis at steps four and five. Keep building the record and point to specific regulatory criteria where the decision fell short.

5) Federal Court (Civil Action)

After the Appeals Council denies review or issues an unfavorable decision, you can file a civil action within 60 days in the U.S. District Court for the District of Colorado. See 42 U.S.C. § 405(g); 20 C.F.R. § 422.210. At this stage, the court reviews the administrative record for legal error and whether the decision is supported by substantial evidence. Strict filing deadlines apply, and you generally must serve the complaint according to federal rules. Many claimants seek attorney representation here, as federal court practice has specific procedural requirements.

Strengthening Your Evidence at Every Stage

• Comprehensive medical records: Ensure SSA receives all relevant treatment notes, imaging, labs, and specialist assessments. See 20 C.F.R. § 404.1512.
• Treating source opinions: Ask your doctors to provide detailed function-by-function opinions (e.g., how long you can sit, stand, lift; off-task time; absences). Opinions tied to objective findings carry more weight.
• Consistency: Keep your statements consistent across forms, exams, and testimony. Inconsistencies can undermine credibility.
• Follow prescribed treatment where appropriate: If you cannot follow treatment, document why (e.g., side effects, contraindications, access issues). SSA considers reasons for nonadherence when evaluating your claim.
• Daily activities: Clarify how you perform daily tasks and at what pace, with what assistance, and how symptoms fluctuate. Context matters.

When to Seek Legal Help for SSDI Appeals

While you can appeal on your own, many Colorado claimants choose to work with a representative—especially at the hearing, Appeals Council, and federal court stages. Representatives can identify missing evidence, prepare focused medical opinions, question vocational experts, and ensure compliance with key regulations like the five-day evidence rule. See 20 C.F.R. §§ 404.1705 and 404.935.

Representation and Fees

SSA must approve representative fees in SSDI and SSI cases. See 42 U.S.C. § 406; 20 C.F.R. §§ 404.1720–404.1730. Most representatives use a fee agreement subject to SSA approval; fees are typically contingent on past-due benefits and capped by SSA regulation or order. You should receive a written fee agreement and SSA approval before payment is processed. You also have the right to change representatives or proceed without one.

Colorado Attorney Licensing and Federal Practice

• Colorado licensing: Legal advice on Colorado law must be provided by an attorney licensed to practice in Colorado, under the authority of the Colorado Supreme Court.
• SSA administrative representation: Attorneys licensed in any U.S. jurisdiction and qualified non-attorney representatives may represent claimants before SSA if they meet SSA’s eligibility rules. See 20 C.F.R. § 404.1705.
• Federal court in Colorado: To represent you in the U.S. District Court for the District of Colorado, an attorney must be admitted to that federal court’s bar (or admitted pro hac vice under local rules).

Local Resources and Next Steps for Colorado Claimants

SSA field offices in Colorado: Colorado residents can get in-person assistance at SSA field offices located across the state. Use SSA’s Office Locator to find the nearest office, confirm hours, and verify appointment options. SSA also offers robust online services that allow you to file appeals, upload documents, and review your records from home.

Hearings in Colorado: SSA’s Office of Hearings Operations schedules hearings for Colorado claimants, often through the Denver hearing office, with availability for telephone or video hearings statewide depending on SSA policy and claimant preferences when offered. Check your hearing notice for the exact format and instructions.

Colorado Disability Determination Services (DDS): At the initial and reconsideration levels, SSA relies on Colorado’s DDS to evaluate medical evidence and make determinations. DDS may schedule consultative examinations if needed to complete the record. Attend any scheduled examinations and inform DDS of all treating sources so records can be obtained.

Colorado employment and rehabilitation supports: Some claimants work with vocational rehabilitation during or after the disability process. Colorado’s Division of Vocational Rehabilitation (DVR) provides services designed to help individuals with disabilities prepare for and obtain employment suited to their limitations. Participation is voluntary and may help document your functional abilities and treatment course over time.

How to Contact SSA and Verify Local Information

• Use SSA’s online appeals portal to file reconsiderations and hearing requests.
• Call SSA’s national number to ask questions about deadlines and document submissions.
• For in-person help, verify your local Colorado office using the SSA Office Locator before visiting.

Detailed Timeline: Deadlines and What to File

Appeal deadlines are strict. Missing them can lead to dismissal of your appeal unless you show good cause under 20 C.F.R. § 404.911. Here is the standard timeline under federal rules:

• Initial Denial → Reconsideration: File within 60 days of receiving the notice. See 20 C.F.R. § 404.909(a)(1).
• Reconsideration Denial → ALJ Hearing: File within 60 days of receiving the reconsideration denial. See 20 C.F.R. § 404.933(b)(1).
• Unfavorable ALJ Decision → Appeals Council: File within 60 days of receiving the ALJ decision. See 20 C.F.R. § 404.968(a)(1).
• Appeals Council Denial or Unfavorable Decision → Federal Court: File civil action within 60 days. See 42 U.S.C. § 405(g); 20 C.F.R. § 422.210(c).

SSA presumes you receive each notice five days after the date on the letter. Keep envelopes and correspondence to rebut the presumption if mail delays occur.

Building a Strong Colorado SSDI Appeal Record

Medical Evidence Essentials

• Objective proof: Imaging, labs, and specialized testing (e.g., EMG, echocardiogram, pulmonary function tests) that support your diagnosis and limitations.
• Longitudinal treatment: Consistent care over time can show persistence and severity of symptoms.
• Functional opinions: Detailed capacity assessments from treating providers addressing exertional and non-exertional limits.
• Mental health records: Therapy notes, psychological testing, and psychiatric evaluations are critical for mental impairments.

Non-Medical Evidence

• Work history and job demands: Accurate job titles, exertional levels, skill levels, and task descriptions help SSA and vocational experts evaluate transferability of skills and step-four/step-five issues.
• Activities of daily living: Provide realistic, detailed explanations that reflect the frequency, duration, and assistance required to complete tasks.
• Third-party statements: Statements from family or coworkers may corroborate the severity and functional impact of your impairments.

Colorado-Specific Practical Tips

• Travel and access: If you live far from a field office or medical provider in rural Colorado, note transportation barriers and their impact on consistent care.
• Telehealth: When using telehealth, ensure visit summaries and diagnoses are documented in your medical records, just as with in-person care.
• Specialty care: If specialists are concentrated in metro areas, document referral efforts and wait times so the record reflects access constraints.

FAQs for Colorado SSDI Denials

Is SSDI different from SSI?

Yes. SSDI is based on insured status from your work history and payroll contributions, while SSI is needs-based with strict income and resource limits. Both use the same disability standard for medical eligibility, but financial eligibility differs. SSDI is governed by Title II of the Social Security Act; SSI by Title XVI.

Can I work while appealing?

You can work during an appeal, but earnings at or above substantial gainful activity may affect eligibility. If you attempt part-time or accommodated work, keep detailed records and consult with a representative to avoid jeopardizing your case.

What happens at an ALJ hearing?

You and your representative (if any) present testimony. A vocational expert may testify. The ALJ asks questions about your impairments, treatment, symptoms, and work history. Provide clear, specific answers and avoid guessing.

How long do appeals take?

Timelines vary by case complexity and SSA workload, which can change over time. Focus on meeting deadlines and submitting complete records; this is the part you can control.

How to Find and Use Colorado SSA Offices

SSA maintains field offices across Colorado to assist with claims, appeals, and questions. To ensure accurate, current information for your nearest Colorado office—such as address, contact numbers, and hours—use the SSA Office Locator and verify details before traveling. Many services, including filing reconsiderations and hearing requests, are available online and by phone.

• Online: File appeals, upload documents, and check claim status through SSA’s secure online services.
• Phone: SSA’s national line can provide general guidance and schedule appointments.
• In person: Field offices in major Colorado communities provide assistance; bring identification and your denial notice.

Appeal Strategies That Help Colorado Claimants

• Map the denial to the law: Match each denial reason to specific regulatory requirements (e.g., why your evidence satisfies 20 C.F.R. § 404.1520 steps).
• Close evidence gaps fast: Request missing records as soon as a denial arrives; follow up on specialist referrals.
• Obtain detailed provider opinions: Ask providers to give function-by-function limitations rather than broad conclusions.
• Prepare for the vocational expert: Understand how your past work is classified and be ready to explain why you cannot perform it or other jobs.
• Meet every deadline: If in doubt, file the appeal promptly and continue developing the record.

Colorado, Colorado Next Steps Checklist

• Calendar your 60-day deadline based on the date of your denial letter.
• Request reconsideration or a hearing online promptly and confirm SSA received it.
• Gather and submit updated medical records, including imaging, labs, and specialist notes.
• Seek treating source opinions tied to objective findings and consistent with your records.
• Consider representation to protect your rights and manage hearing strategy.
• Use the SSA Office Locator to verify your closest Colorado field office and available services.
• Keep copies of all submissions, SSA notices, and mailing receipts.

Important SEO Note for Searchers

If you are looking online for help, you may find resources by searching phrases like “SSDI denial appeal colorado colorado,” “social security disability,” “colorado disability attorney,” and “SSDI appeals.” While search terms can be awkward, focus on sources that cite the Social Security Act, 20 C.F.R. Part 404, or official SSA guidance.

Authoritative Resources

SSA: How to Appeal a DecisioneCFR: 20 C.F.R. Part 404 (Disability Insurance)SSA Office Locator (Find Colorado Field Offices)Colorado Division of Vocational Rehabilitation (DVR)42 U.S.C. § 405(g) (Judicial Review)

Legal Disclaimer

This guide provides general information for Colorado residents and is not legal advice. Laws and regulations change, and your facts matter. Consult a licensed Colorado attorney 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.