Step 1: Initial Application

The process starts when you file an SSDI application, either online, over the phone, or at a local SSA office. You’ll need to provide:

• Medical records
• Work history
• Details about how your condition affects daily activities

SSA then forwards your file to Rhode Island’s DDS office, which is responsible for making the medical determination.

Step 2: Review by DDS

Rhode Island DDS assigns a disability examiner to your case. This person gathers and evaluates:

• All relevant medical records
• Treatment notes and diagnoses
• Results of any lab tests, scans, or procedures

If needed, DDS may schedule a consultative exam with an SSA-contracted doctor to get more information.

Step 3: Five-Step Evaluation Process

DDS uses a five-step process to determine disability:

1. Are you working?
   If you’re earning above the Substantial Gainful Activity (SGA) level, your claim may be denied.
2. Is your condition severe?
   It must significantly limit your ability to perform basic work functions.
3. Does your condition meet a Listing?
   SSA has a "Blue Book" of listed impairments. If yours matches, you may qualify automatically.
4. Can you do your past work?
   DDS will assess if your condition prevents you from performing your previous jobs.
5. Can you do other work?
   If not, based on age, education, and limitations, you may be considered disabled.
   

Step 4: Initial Decision

Once DDS completes the evaluation, they send a decision back to the SSA. You’ll receive a letter stating:

• Whether you’re approved or denied
• The reasoning behind the decision
• Your right to appeal, if denied

The average processing time for this stage in Rhode Island is about 7 to 8 months, though this can vary based on caseload and medical record availability.

Step 5: If Denied – Reconsideration and Beyond

If your claim is denied:

• Reconsideration: You have 60 days to file. A different examiner reviews your file.
• Hearing: If reconsideration is also denied, you can request a hearing with an Administrative Law Judge (ALJ).
• Further Appeals: If the ALJ denies your claim, you can request review by the Appeals Council and even file in federal court.

Each step follows a similar process of record review, medical evidence analysis, and functional evaluation.