Social Security Disability Exam - What Should You Expect?

If you are filing for social security disability (SSD) or supplemental security income (SSI) benefits, you may have to submit to a consultative exam (CE), which is a physical or mental exam scheduled by the social security administration.

Not all individuals filing for SSD or SSI are required to go to a CE, but for those who have not been to a doctor within the last 60 days, or who have other medical conditions listed in their medical records for which they have not received prior treatment, a CE will in all likelihood be required before a disability examiner can render a decision on your claim.

A consultative medical exam is not scheduled for the purpose of prescribing medical treatment, nor is it a means to arrive at a diagnosis that will prove or disprove a medical disability. In fact, most CEs are fairly brief, and may last as little as 10 minutes, because their sole purpose is to meet the requirement that a disability examiner consider "recent medical evidence" before closing a case. In other words, it's more of a formality, and will not overrule the other medical evidence which a claimant has supplied to the social security administration in his or her medical history.

However, sometimes doctors' notes make reference to secondary medical conditions for which the claimant is not seeking benefits, such as depression, or insomnia, etc., fairly common complaints for those who are under the stress of dealing with chronic pain or fatigue, or for anyone who must consider leaving the workforce for that matter. If your physician has noted that you seem depressed or are suffering other mental symptoms for which you have not had treatment, your CE may consist of a mental exam, and yes, you must attend. Not only is not attending a scheduled CE grounds for denial of your disability claim, but it could also mean that you short yourself from receiving full compensation for any other impairments you might have. Either attend the scheduled CE or reschedule it if you are unable to make it that day.

Not all CEs are medical exams; some may require that a patient have recent medical tests to provide the disability examiner with a snapshot of their physical state as it is now. New X-rays, MRIs, or spirometry testing of pulmonary function may be required before a case is closed to show how your condition has improved, worsened, or if it remains stable.

One thing that you should prepare yourself for if you are scheduled for a consultative exam, and this is really word of mouth from those who have attended them before-many of the physicians who conduct CEs do not come off as the most caring individuals. While this is not true of all of them, to be sure, many social security disability claimants leave these exams feeling defensive, and that the doctor performing the exam doesn't really care about them, or even believe that they are disabled. If this is your experience, do not put to much stock into what the physician performing the CE thinks or doesn't think, because in the end it is really your treating physician's opinion that will be given the most weight by the disability examiner.