As part of the application process for Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI), you might have to undergo a consultative exam (CE). The purpose of a CE [In Progress: link to https://www.socialsecuritylawcenter.info/frequently-asked-questions/what-is-the-purpose-of-the-social-security-disability-ssi-medical-exam-or-ce/], which a private doctor or psychologist contracted through the Social Security Administration (SSA) performs, is simply to obtain recent medical information.
It is not a sign that the SSA doubts the information on your application, nor is it a sign the SSA is on the cusp of approving you for benefits. Rather, it is one of many steps the SSA has at its disposal to determine if your medical condition qualifies for disability benefits.
Social Security consultative medical exams affect disability claims. If the results of the exam corroborate information on your application and make it clear you suffer from a disabling condition, the exam can help you receive approval. On the other hand, if you made statements on your application that the CE results deem false, the SSA may issue a denial.
If you received notification of a CE and are unsure of its implications, a disability attorney can help. Contact the Disability Advantage Group, for a free consultation to review your disability application. Call 865-566-0800.
Why Did the SSA Select Me for a CE?
The most common reason that an SSDI or SSI applicant must take a CE is that the applicant has not had a recent medical evaluation for a condition listed on the application. The SSA requires recent medical information for any condition before it will decide on whether you qualify for disability benefits.
Imagine, for example, you have chronic joint pain that prevents you from doing any job you have the experience and qualifications to perform. Unable to work and earn an income, you apply for disability benefits. When the SSA reviews your application, it sees that your last check-up with an orthopedist or other specialist was six months ago.
Chances are, the information on your application is still accurate—especially if you were honest in filling it out. By rule, though, the SSA cannot decide on it without more recent medical information. In this scenario, you would be a prime candidate for a CE.
Can I Decline to Attend a CE?
You certainly can—but it will result in the SSA denying your application for benefits. Once the SSA selects you for an exam, the CE is not a suggestion or optional. It is something you must attend to receive disability.
That said, you have the option to reschedule your exam, even more than once, as long as you have a valid reason. The SSA can work with you to reschedule if you have an illness, prior obligation, or even if you get lost on the way to the appointment.
However, if you consistently fail to show up and miss appointments or you disregard your notice to attend a CE to begin with, you can expect the SSA to respond by denying your application.
What Will Happen During My Examination?
The structure of the examination largely depends on the condition for which you are applying for benefits. For most physical conditions, a medical doctor conducts the exam. If your condition is mental or cognitive, you might see a licensed psychologist instead. Either way, the person conducting the exam does not work for the SSA. You will see a private practice professional contracted to perform the CE.
There is no guarantee, though, that you will see a doctor who specializes in your condition. Many applicants have complained about seeing doctors who seemed to have no familiarity with the medical condition in question. Other common complaints have mentioned rude, condescending doctors and overly cursory evaluations.
Unfortunately, you do not have much control over who performs your CE or what happens at the appointment. If you have any concerns about the process, it is a good idea to work with a disability lawyer. Many of our clients have attended one of these medical exams as part of the application process. We can answer any questions you have and help you prepare for the appointment so you have the best chance of a successful outcome.
How Can I Discuss My Case With a Disability Lawyer?
The attorneys at the Disability Advantage Group, are here to help. We can answer your questions, address your concerns, and help you get the benefits you deserve. Call 865-566-0800 for a free consultation.