SSD: What You Need to Know Before Your Consultative Exam

consultative exam

If you apply for Social Security disability (SSD) benefits, you may get a letter from the SSA. This letter likely tells you the SSA scheduled your consultative exam with a Disability Determination Services (DDS) medical examiner. But don’t worry! We’ll explain how to prepare, what to expect and share tips to help you pass in our FAQs below.

FAQ #3: “Will This Consultative Exam Cost Me Money?”

Nope, the SSA pays for it. You’ll owe no money at all (unless you pay for transportation to get there). And the SSA should pay you back any qualified travel costs for getting to and from your consultative exam.

FAQ #4: “Can My Own Doctor Do This Consultative Exam For Me?”

Almost certainly not. The SSA updated their medical evidence rules for disability claims on March 27, 2017. That rule says the SSA must respect your one-time consultative exam doctor’s assessment more than your own physician’s opinion. In other words, if your doctor says you’re disabled but your DDS physician disagrees, the second opinion wins. So, again, it’s really important to show up to your scheduled consultative exam on time and be prepared. The doctor you see won’t know your medical history, but may perform some laboratory tests. Just try to relax and follow the doctor’s instructions.

FAQ #5: “How Long Does This Exam Usually Take?”

The appointment’s usually pretty short, lasting around 10 to 15 minutes. But if your consultative exam is to confirm a mental health issue, it may last up to four hours. This means your exam will only include tests the SSA ordered directly to support your disability claim. In other words, they may fall short in determining your condition’s physical or psychological limitations. Remember, the DDS examiner’s just trying to get acceptable medical evidence the SSA requested while reviewing your claim. This isn’t about treating your condition, or proving you’re sicker or worse off than anyone else.

FAQ #6: “What Else Should I Know Before Going In?”

The DDS examiner won’t know you personally, and neither will the nursing staff. But these people will start watching you the second you arrive for your consultative exam. Observation starts the moment you leave transportation or step into the waiting room for your appointment. Anything they see may hurt or help your disability claim, so watch what you do and say. Here are a few more tips:

  1. Don’t exaggerate or minimize your symptoms. Get your consultative exam over quickly. Talk only about how your health limits your ability to work and avoid asking too many questions. This person has a specific job and a short time to do it, so dragging things out only hurts your case.
  2. Make your answers short, direct and to the point. Nervous people often ramble or get emotional discussing health problems with strangers. If that describes you, complete #3 before you arrive!
  3. One week before your exam, write down all your current symptoms and how often they affect your daily life. Give yourself all seven days to finish and add or delete things that don’t affect you regularly. Some things that may help prove your case: Can you prepare your own food daily yourself? Can you stand, sit, walk up or down stairs, or 10 steps in a straight line without help? If you drop a pencil, can you pick it back up? If not, tell (or show) your DDS examiner!
  4. Bring copies of your medical records with you, if possible. They should cover the last year of treatments prior to your consultative exam. You don’t have to go over these in detail at your appointment. Just ensure the DDS examiner has your most current medical records for reviewing your case.

FAQ #7: “Does the Consultative Exam Doctor Approve or Deny My Disability Claim?”

Once your exam’s over, the DDS examiner submits a detailed medical report to the SSA. This report will include your assessment along with any laboratory test results. The SSA will then review these and your most recent medical records (along with any notes from your consultative exam doctor). Once that’s done, Disability Determination Services will either approve or deny your benefits application.

You May Qualify for Legal Assistance

If the DDS claims examiner denies your application, you can always appeal that decision within 60 days. The best way to avoid that problem is getting a Social Security attorney to help file your claim. Already applied and got a denial letter in the mail? You can get a lawyer to review your benefits application for mistakes free of charge. These lawyers always work on contingency, so you’ll pay nothing for professional help unless they help you win benefits. And if your case wins, you’ll only pay a small, one-time fee.

Ready to see if you may qualify? Click the button below to start your free online benefits evaluation now!

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