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When will the SSA send me to the doctor for a disability 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.

If the Social Security Administration does not have enough medical evidence to make a Social Security Disability decision for a SSDI or SSI claimant, their primary care doctor has not sent the requested medical files to the Social Security Administration, or their treating physician is not a specialist in their medical condition, the Social Security Administration may send them to a Consultative Examiner (CE) who will perform a cursory mental or physical health review and make a disability determination for either Supplemental Security Income or Social Security Disability Insurance benefits.

Many disability claimants assume that a consultative examiner or CE works for the Social Security Administration, but they do not. They are an objective,  non-governmental, medical professional who reviews a claimant’s medical records and performs a cursory medical evaluation. They are also responsible for completing documentation from the exam and reporting back to the Social Security Administration.

If you have not seen a doctor for your mental or physical health condition and you are waiting for the SSA to send you to the doctor, stop waiting. It is not the responsibility of the Social Security Administration to send you to a doctor.

If a consultative examination is needed, this generally means your medical records are not sufficient to decide your Social Security Disability claim, and unfortunately, these examines are generally not helpful to a claimant’s Social Security Disability case. Consultation examiners are not a very good substitute for an ongoing relationship with a doctor who is sympathetic to your situation and who is familiar with the mental or physical limitations you may have to complete work.

According to Social Security Administration’s policy, they must consider your treating physician as the primary source of information about your disabling mental or physical health condition. With this in mind, you may be able to request that your physician perform the consultative medical examination. Many physicians will not do these exams, however, because the SSA requires extensive paperwork and does not reimburse much money for the examination.

If you have been waiting for the Social Security Administration to send you to the doctor, it is time to stop waiting and get the medical documentation you need to win your SSI or SSDI claim.

If you would like a Social Security Disability attorney to review your 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 at1-800-641-3759 to talk to someone now.