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Should you go to the SSA doctors?

The first mistake claimants make is to assume if they are required to see a consultative examiner that they are seeing a “SSA doctor.” The CE or consultative doctor is an independent contractor. They are not a government employee, and they are required to give an objective opinion about a claimant’s mental or physical health conditions.

When will the Social Security Administration (SSA) request that a claimant go to see a consultative examiner? A consultative examination will only be required if the SSA does not have enough information to make a disability determination for a claimant. This could happen if the treating physicians have not sent the patient’s medical records to the SSA as requested, the claimant has not seen the appropriate specialists, or the patient does not have sufficient medical evidence to support their claim of disability and the SSA disability examiner needs more information to make a disability determination.

One of the biggest mistakes Social Security Disability claimants make is to assume that they can use the consultative examination to prove their claim and they do not have to go see their own doctor or worry about their medical file.

The consultative examiner is not providing medical care. They are only tasked with evaluating a claimant’s mental or physical health status and documenting the claimant's functional limitations which may hinder their ability to perform substantial gainful activity.

Do these consultative examinations generally support the claimant’s claim for disability? No, they do not.  The consultative examination generally does not offer sufficient medical evidence to prove disability and should not be used as a substitute for an on-going doctor/patient relationship.

Many claimants, in fact, complain about the CE examinations which can last as little as 5 to 10 minutes. This is not enough time to accurately examine and diagnosis a patient, regardless of their mental or physical health condition.

What should you do at a Consultative Examination? 

  1. If the Social Security Administration asks you to go to a consultative examination, it is important that you attend. Claimants who repeatedly refuse to attend their consultative examinations may be denied Social Security Disability Insurance or Supplemental Security Income benefits. The C.E. is supposed to provide an objective opinion to the SSA.

  2. If you are unable to attend your consultative examination, reschedule as soon as possible. If you have hired a disability lawyer, they can work with the SSA to help you reschedule your examination. If you are at the application level, call the Social Security Administration and talk to a disability examiner.

  3. Do not keep the consultative examiner waiting. Be on time and be courteous. Remember, the doctor is trying to do their job, and it is important to make their job as easy as possible. Do not give them any reason to give you a bad review.

  4. Keep notes about the visit. How long was the visit? What did the C.E. ask you? Did you think the examination was thorough? Was the C.E. rude or condescending? Detailed records may be presented at the Administrative Hearing if necessary to prove that the C.E. did not spend enough time with you to accurately diagnose your medical issues.

What not to do at a Consultative Examination 

  1. Do not overstate or try to convince the doctor that you are disabled. Do not intentionally try to fail any type of test. The C.E. will document if they believe you intentionally failed or overstated your conditions and this information will be permanently attached to your Social Security Disability file, potentially making all of your statements seem potentially false.

  2. Do not hide any physical or mental limitations or pain. This is not the time to push through or try to be a hero. If you feel pain, let the C.E. know. Always be honest about your conditions and your resulting symptoms.

  3. We all know doctors are overscheduled. The C.E. may have a busy schedule and you may have to wait awhile to see them. Give yourself enough time for the visit and expect to wait. Understand that the doctor may spend very little time evaluating your condition and do not rely on their evaluation. This is why you have your own primary care doctor who has provided their own assessment of your ability to work.  

How do you avoid the consultative examination? Review your medical records. Are they clear? Do they provide specific information about your diagnosis, your symptoms and the job responsibilities that you cannot perform? Have you found a good doctor and specialists who are on your side and willing to help you win disability benefits?

If your doctor is not supportive or refuses to provide any help or if they have stated either verbally or in your medical record that you are not disabled, it may be time to find another doctor.

One of the most common questions on our Social Security Disability forum is about a claimant’s inability to afford medical care. Many claimants have been out of work for months and do not have medical insurance. How do you get the medical records you need to win a Social Security Disability claim if you cannot see a doctor?

This is a great question and for some claimants their only hope will be the consultative examiner and convincing them they are disabled.

If you would like a disability attorney to review your claim you can fill out the FREE evaluation form and a disability advocate will call you to review your claim or you can call our office at 1-800-641-3759 to talk to someone now.