A consultative exam (CE) is a medical appointment with a doctor who is contracted by the Social Security Administration (SSA). The SSA requests a consultative exam if it feels the medical information from your application isn’t enough to make a decision. The SSA will pay for your exam, including significant travel costs, if required. Getting an appointment letter for a Social Security medical examination means, at the very least, that a claim is actively being worked on. In some cases, it may be that a claims examiner who is leaning toward making an approval needs to obtain additional evidence, such as an x-ray.
- In some
situations, we pay travel expenses relating to a medical examination
required in connection with a disability determination. - When you make this request, it must go through your disability examiner, who works at Disability Determination Services.
- After you apply for Social Security Disability (SSD), the Social Security Administration (SSA) may request that you participate in a consultative examination.
- The selection of test approaches is a powerful factor in the success of the test effort and the accuracy of the test plans and recipe estimation.
- Keep in mind, though, that whether to review or accept the information you’ve brought with you is up to the examiner.
- Consultative exams are needed when the SSA needs more information to make a decision on your application.
If a supplementary test (e.g., X-ray) will furnish the additional evidence needed, Social Security will not request or authorize a more comprehensive examination. A big challenge with having your own doctor conduct the exam is timing. They must be willing and able to quickly complete the required testing and send in a report with their findings. It might be easier to have your own doctor conduct the CE if the SSA is only requesting a certain kind of test instead of a full physical exam. Don’t bring new medical documentation with you for the doctor to review – that isn’t part of your exam.
What is in the final Consultative Exam report?
Another reason your doctor may not want to do the exam is that the SSA will pay a set fee and your doctor may normally charge more for that service. In that case, it may be possible for you to pay the difference between what the SSA offers and what your doctor https://www.globalcloudteam.com/ will accept. Make sure that you’re completely honest about your condition and how you’re managing it. Tell the doctor what symptoms you’ve been experiencing and answer based on how you feel on your worst days – even if you feel good on that specific day.
On the other hand, if your impairment is one of a mental nature, a psychiatrist or psychologist will conduct a series of psychological tests. They’re experts in the disability process and can advise you on the best way to strengthen your claim. Applicants with lawyers are also three times more likely to win benefits. Many people who go through consultative exams have their applications denied — the SSA denies about 70% of all initial applications — but people who work with a lawyer are three times more likely to win benefits in the end. If you have questions about the consultative exam, consider working with a disability lawyer. It may sound strange to get a lawyer involved, but they know the ins-and-outs of the disability process, so they can help increase your chance of winning benefits.
Nevada COVID-19 Testing Information
The CE should never be your sole source of medical records and you shouldn’t rely on it to win your claim. This exam isn’t usually the most thorough and it will be most helpful when it comes on top of records from your usual doctors. The final consultative exam report will include the results from the medical examination. This includes the results of any requested tests and any positive or negative findings from the exam. Keep in mind that your doctor must agree to accept payment from the Social Security Administration, perform the requested exam, and send the SSA a formal report.
You may be asked to participate in a consultative examination if SSA reviewers determine that the medical documentation included with your disability claim is insufficient. Many times, this occurs because the claimant isn’t currently receiving medical treatment for the disability or hasn’t seen a physician in quite some time. When this happens, the SSA asks the examiner to provide additional information. For example, you may be asked to participate in a consultative examination if your submitted medical records are more than 90 days old. Consultative exams (CEs) are not conducted by doctors who work for the Social Security Administration (SSA). (In fact, there is no such thing as an SSA doctor), although there are physicians in each DDS (Disability Determination Services) who assist the DDS disability examiners in their decision-making duties.
It involves automating the functional test before the release of the function, in which case it requires early testing. Sometimes, testing focuses primarily on functions that have already been released, which can be considered a form of post-release testing environment. For example, you might try to automate all the functional test cases so that whenever the requirements or anything changes, you can rerun every test case to ensure the system’s functionality. Health centers provide free or low-cost COVID-19 tests to people who meet criteria for testing. If there are costs to the patient, health centers may provide sliding fee discounts based on income and family size.
With that said, if you need a CE, it probably means your medical records aren’t enough for Social Security to make a decision on your application. Sometimes consultative exams are enough to answer lingering questions, but often it isn’t. The examiner will ask you specific questions about your medical condition and carry out any appropriate medical tests that have been requested. Keep in mind that your consultative examiner does not make a recommendation about your Social Security disability claim.
Generally, the CE is required where Social Security does not have enough evidence to make an accurate determination as to disability. Since you may never know the reason for scheduling an exam, don’t be overly concerned about having to go to an exam. If you’re physically impaired, the physician may conduct a comprehensive examination that includes looking at your complete medical history plus additional laboratory and physical testing.
A consultative exam isn’t strictly a good or bad sign for your disability application, but it probably means you’re more likely to get denied than approved. Additionally, Social Security medical exams tend to be fairly brief. It is a common complaint among claimants who have gone to such examinations that the duration of the exam was only 5-10 minutes. Though this may not be true for every CE, it is probably true for a large percentage of them.
This can help your exam go smoothly and provide valuable and accurate medical information related to your claim. If you refuse a consultative examination without good cause,
we make a decision based only on the evidence in your file. In some cases, the SSA doesn’t have enough proof that you have the condition you say you have. It’s also possible there are inconsistencies in your medical history or the SSA wants more detailed information about something. Regardless, the doctor will likely ask about your functionality or how you handle certain daily activities. Specific tests — like blood work — may also be necessary to show you meet certain technical requirements for your condition.
But for many applicants, they are a vital part of making a compelling case for disability benefits and are an opportunity for you to have additional evidence in your case about your condition. Nevertheless, it’s recommended to have a disability lawyer who can assist you from the very start, and prepare you for what to expect along the way. If you’ve been asked to take a CE or you need other assistance with your claim, schedule a consultation with Disability Law Group today. The doctor will ask you about your recent medical complaints and about your medical history. In performing the examination, the doctor will also conduct any tests specifically requested by DDS. It’s important to understand that the CE is merely for the purposes of assessing your medical condition and specific limitations you may have.
Consultative medical examinations are not necessarily the best way to get evidence to decide a disability claim. For one thing, a doctor who conducts a consultative exam has typically never seen a claimant. In any case, a CE can be a poor substitute for an established doctor-patient relationship. However, a CE appointment can also mean that a claimant has very little in the way of medical records. The CE Baseline Study analyzed and documented the quality of CEs used in the initial level of disability determination; assessed if CEs were requested in compliance with SSA regulations; and established a baseline for CE quality. The consultative exam isn’t necessarily a good or a bad sign for your disability claim.
Your consultative examination might not be a comprehensive one, however. The first is carrying out the specific examination requested by the SSA. The second duty is to complete and submit a report to the SSA outlining the examiner’s findings. You must remember that the examining physician is not there to treat your medical condition but to objectively evaluate your alleged disability and report to the SSA. In most cases, the consultative exam will be performed by a licensed medical or mental health professional who is under contract with the Disability Determination Service (DDS) for your state. The DDS is the agency that makes disability decisions on behalf of the Social Security Administration.
A consultative exam (CE) is a medical exam or test you’ll receive while applying for SSI or SSDI if your health records aren’t enough to prove your eligibility. The CE happens after you submit your disability application, though exact timing varies. You may receive a general physical exam, a psychological evaluation, or only a specific test, like an X-ray. If the Social Security Administration assigns your consultative exam to a doctor that you have seen in the past or dislike based on past history, you may be able to object. For example, if this physician has seen you as part of a prior consultative exam or was involved in a previous insurance or legal case that was unfavorable to you, you may be able to get an alternate examiner assigned.
