SSD: What You Need to Know Before Your Consultative Exam

consultative exam

If you’ve recently filed for Social Security disability (SSD) benefits, you may have received a letter from the SSA. This letter likely asked you to partake in a consultative exam to verify your medical condition meets their definition of a disability. These tests are usually ordered by a Disability Determination Services Medical Examiner because there isn’t enough evidence yet to support your claim. Here are a few things you need to know before you head to the doctor’s office:



If you receive a consultative exam request from the SSA, the worst thing you can do is ignore it. To many people, the consultative exam may seem superfluous. However, that letter indicates the state’s reviewing your claim and needs more evidence to approve it. Skipping your appointment tells the SSA you may be avoiding the consultative exam or that your disability already subsided. The good news: You can reschedule your consultative exam if needed, as long as it’s done far enough in advance. The sooner you make your appointment, the better!

The SSA Will Pay For It

Medical care is typically expensive, but you shouldn’t have to pay for your consultative exam. You will need to see a doctor as soon as you receive the request. Fortunately, the SSA should pay for it (along with certain qualifying travel costs, if applicable).

Your Consultative Exam Will Probably Be Performed By a Different Doctor

A few lucky people have their exam done performed by their current doctor, but most do not.

Independent physicians contracted with the SSA will perform your exam, but most won’t have treated you before. While the consultative exam should properly provide evidence of your disability, some people get frustrated with the lack of insight into their personal health. You can usually ask your doctor to release certain portions of your medical history to the examiner beforehand. Doing so can help provide a more comprehensive report from your consultative exam.

You Will Be Under Observation Before Your Appointment Officially Begins

Because the examiners aren’t already familiar with you personally, they will often observe you moving around in areas outside of the exam area. Be cognizant of getting out of your car, walking around the waiting room and sitting down prior to your appointment. Your examiners will take note of any additional evidence that may help (or hinder) your disability claim.

The Appointment is For Confirmation of Your Disability, Not Its Treatment

While the doctors will perform certain tests to confirm your disability, you won’t be offered treatment. They will, however, fill out a detailed report indicating your results. In addition, your consultative exam doctor may add notes aligning with your primary care physician’s medical records.

Your Consultative Exam Will Be Short

The appointment’s usually very brief, lasting around 10 to 15 minutes. This means your appointment will only touch on tests ordered directly by the SSA. In other words, they may fall short in terms of determining any physical or psychological limitations.

You Can Request That They Send Your Results to Your Primary Care Physician

Whether the doctor uncovered something new or you’d simply like to keep them as updated as possible, you can request that the SSA send your consultative exam results to your regular physician. You will have to ask, though, and it’s best to do so promptly.

The SSA Ultimately Decides Whether to Approve or Deny Your Claim

While the examiner performs tests and fills out your report, he or she does not make the final decision on your claim. The SSA state agency will review your report. After that, Disability Determination Services will either approve or deny your claim.

If Denied, You Can Always Appeal Their Decision

If the state agency denies your disability claim, you can always file an appeal. This is a good time to seek help from a qualified Social Security attorney or advocate. Legal professionals are quite familiar with the nature of consultative exams. You can get a free claim evaluation immediately simply by clicking the button below.

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