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Consultative Examiner, how are they paid?

Why would the SSA send me to the disability examiner?

Recently on our disability forum we had a disability applicant ask, “If the Social Security Administration (SSA) sends me to a disability examiner will they pay for the examination?”

If you have applied for Social Security Disability Insurance (SSDI) the SSA will review your medical records from your treating sources. Acceptable medical sources include medical and osteopathic doctors (including psychiatrists), psychologists, optometrists, podiatrists and speech-language pathologists.

Information the SSA will gather will include medical reports including information about your medical history, clinical reports, laboratory reports, your diagnosis, treatment history and your medical prognosis.

If you have insufficient medical records to determine if you are disabled the SSA will request that you see a consultative examiner (CE). Although many people assume these are “SSA doctors” they are really consultants who are hired by the SSA and not governmental employees.

How is the Consultative Examiner paid?

The good news is if the Social Security Administration requests that you go to the consultative examiner (C.E.) they will pay for the cost of the examination. There will be no expense to you.

Now this may seem like the perfect solution. You didn’t have money to go see a doctor and the SSA will send you to one of their doctors for free and voila, you will win SSDI benefits. Unfortunately, this seldom happens.

Why the Consultative Examination may not help your SSDI case

Although the Consultative Examiner is tasked with determining your residual functional capacity to work including your ability to complete work-related activities such as sitting, standing, walking, lifting, carrying, handling objects, hearing, speaking, and traveling, they generally will find most claimants not disabled.

This could be because many consultative examiners spend as little as five minutes with claimants or because they do not have the benefit of developing a relationship with their patient and may not understand the full extent of their health condition.

How do I improve my chances to win SSDI?

If you do not have sufficient medical evidence to prove you are disabled do not rely on a consultative examiner. It is time to be proactive. Find a great medical doctor who believes that you do not have the ability to work. Talk to them about what information they are willing to provide to the Social Security Administration.

Although most doctors will not fill out forms they may be willing to complete what is called a residual functional capacity form which can be downloaded from the internet and printed out. This form will specifically outline what limitations you have to work and can be a great addition to your medical records.

Bottom Line

It’s great that you can see the consultative examiner for free, but what good will it do if their testimony does not help you win your SSDI case? Do not rely on the consultative examination to win Social Security Disability Insurance or Supplemental Security Income (SSI) benefits get your own medical care and good medical information to win your case.
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