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December 12, 2014

Consultative Exams: What Are They And Should You Go?

Many disability claimants are caught off guard when they receive a notice from the Social Security Administration (SSA) for a scheduled doctor’s appointment.   These doctor appointments are called consultative examinations (CE’s).  The SSA will sometimes send SSDI and/or SSI claimants to these examinations if they feel like more information is needed to determine a disabling condition.  It is important that the claimants attend these CE’s.  Failure to appear at a CE may result in the SSA denying the claim. Who are the doctors? The doctors that perform the CE’s are not employed directly by Social Security, but are private doctors that are contracted out by the SSA.  In my experience, this can be good and bad.  The good part is that since the doctors are independent physicians, they should be evaluating the claimant’s condition objectively.  The flip side of this is that since these physicians only see the claimants for a single short visit, (usually around 15 minutes) a thorough evaluation may not be performed. What is the purpose of these exams? The most likely purpose that a claimant is sent to a consultative examination is because of a lack of medical records.  If a claimant is claiming a disability, but there are not any or enough medical records to back it up, or the records are from a long time ago, the claimant’s case reviewer will most likely send the claimant out for a CE.  Hopefully the SSA will attempt to give the claimant a fair shot despite the lack of medical records, but it is usually best not to rely on a consultative examination to prove your disability.  Another scenario that my office sees is when the case reviewer or the judge wants a specific test done that they think could prove or disprove the claimant’s case. … Continued

Filed under: Appeals Process, Claims Process, Evaluation Process, Hearings Process, Medical Treatment, Social Security Disability Benefits Claims Process || Tagged under:
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October 22, 2013

The Social Security Administration scheduled me for a consultative exam. What is it, and do I have to go?

If you are an Indiana resident who has filed a claim for disability benefits, the Social Security Administration (SSA) may schedule you for a consultative exam.   As a disability attorney in Indianapolis, I get many calls from my clients asking about the consultative exam. The consultative examination is a physical or mental exam performed by a medical source at the SSA’s request and expense.  As the SSA reviews your claim, they want as much information as possible about your medical conditions in order to make a decision.The medical evidence may be insufficient to determine if you are disabled.  In some cases, claimant’s physicians do not furnish the required medical records. The SSA will send you a letter with information such as date, time and location of the exam.  It is very important that the SSA has your correct mailing address so that you get this information as soon as possible. The exam itself will likely be performed by a medical professional you have never seen before.  You can expect the exam to take between 20 and 60 minutes.   I have heard people complain that their consultative examinations were very short, or the doctor did not address all of their impairments, or the doctor was rude and did not seem to take them seriously.  The consultative doctors are supposed to evaluate your physical or mental abilities; they are not entering into a treatment relationship with you.  While the doctors are paid by the SSA for their time, they are supposed to give an unbiased opinion.  Therefore, when you go to your appointment, make sure you bring up all of your impairments to the doctor.  Answer all of the doctor’s questions truthfully and completely.  Remember, too, that the doctor is not just listening to your answers to those questions; he or she is also observing your behavior, speech, and movement and will include those observations in the … Continued

Filed under: Evaluation Process, Social Security Disability Attorney || Tagged under:
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