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When does the SSA schedule my SSD evaluation?

Many Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI) claimants want to know if or when the Social Security Administration will send them to a doctor or to an “evaluation” to determine if they are disabled.

It is important to understand there is no “evaluation” exam to determine disability for all claimants. The Social Security Administration (SSA) instead focuses on a claimant’s medical records from qualifying medical sources to make their disability determination for Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI).

Qualifying medical sources include:

• Licensed physicians (medical or osteopathic doctors)
• Licensed or certified psychologists.
• Licensed optometrists
• Licensed podiatrists
• Qualified speech-language pathologists
• Medical Reports

Medical reports can include the medical history of a claimant, clinical findings (such as the results of physical or mental status examinations), laboratory findings (such as blood pressure, x-rays), diagnosis (statement of disease or injury based on its signs and symptoms), treatment prescribed with response, and prognosis and statements about what the claimant can still do despite their impairment.

When does the SSA send a claimant to an evaluation?

Claimants are sent to a consultative examiner (C.E.) only if the SSA does not have enough information to make a disability determination, the treating physician is not a specialist for the claimant’s medical condition or the claimant’s treating sources have failed to send the claimant’s medical records.

What does a C.E. do? They simply perform a cursory medical review of the claimant’s mental or physical health status and offer a professional opinion to the Social Security Administration about the claimant’s mental or physical limitations. The C.E. does not offer an opinion about whether the claimant is disabled or have the authority to approve benefits.

Does the Consultative Examiner help my disability claim?

Some claimants will benefit from the Consultative examination, especially those who have disabilities that are easily diagnosed and obvious to an observer in a short examination. Others, who have conditions which are not so readily apparent, may not benefit for a C.E. exam.

Remember, a C.E. is not employed by the Federal Government and they are supposed to provide “objective” information to the SSA, but unfortunately, a one time, cursory exam cannot possibly replace medical documentation provided by a physician who has an ongoing relationship with a claimant.

Consultation examiners are not a very good substitute for thorough, comprehensive treatment from a doctor. In fact, according to Social Security Administration, they must consider the claimant’s treating physician as the primary source of information about their mental or physical health condition.

So when is the SSA going to send you to a disability examination? Hopefully, they do not have to. If they do send you to an exam it is because they do not have enough information to find you disabled.

Hiring a Disability Lawyer

If you would like a Social Security Disability attorney to review your Supplemental Security Income or Social Security Disability claim, 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.