When Is a Consultative Examination Performed During an SSD Claim?

 Posted on February 10, 2022 in Uncategorized

When a person has a significant disability that prevents them from working at a level that will allow them to support themselves, they may be able to receive disability benefits through Social Security. However, the process of applying for these benefits can be complicated, and multiple types of information will need to be provided to demonstrate that the person has what is considered a “total” disability. During the Social Security disability (SSD) claims process, a person may be required to receive an examination from a medical provider that will be used to determine whether their health condition meets the qualifications for disability. This is known as a consultative examination or CE, and an applicant will need to understand how this type of exam may affect their claim.

When Will Social Security Order a CE?

In some cases, the information a person provides when applying for disability benefits will be sufficient for Social Security to make a determination. However, there are many cases where Social Security will seek out additional information about a person’s diagnosis and treatment plan and the effects their condition has had on their ability to work. A consultative examination may be ordered if:

• There is an inconsistency in the evidence provided by an applicant, such as contradicting opinions from multiple medical providers.

• A person’s medical records do not contain enough information to make a determination of whether they are disabled.

• Information about a person’s condition is unavailable for reasons that are out of their control, such as the death of a doctor that had previously provided treatment.

• Specialized information is needed to make a determination of whether a person is disabled, and this information is not available from their current or previous medical providers.

• An applicant has experienced a change in their health that has affected their ability to work, and additional information is needed to establish the severity of their condition.

What Happens During a CE?

Social Security will pay for a consultative examination that will be performed by a qualified doctor or medical provider. In some cases, a CE may be performed by a person’s current doctor or a provider that has treated them in the past (known as a “treating source”). However, these examinations will often be performed by other qualified medical professionals.

During a CE, the doctor will review a person’s medical history by examining their previous medical records and discussing this history with the patient. They will look at the history of a person’s condition and the treatments they have received in the past, as well as any medications they are taking or have taken and other factors that may affect them. They will also perform a physical examination, looking at specific issues related to the ways their condition affects their ability to perform work-related tasks, such as sitting, standing, walking, lifting, carrying, and reaching, while also addressing issues related to a person’s vision, hearing, and speech. If necessary, a provider may order diagnostic tests such as blood work or X-rays to gain information that will inform their medical opinions about the person’s condition.

Contact Our Collin County Social Security Disability Application Lawyers

While a consultative examination may not be the final word on whether a person is or is not disabled, a doctor’s report will play a significant role in Social Security’s decision to grant or deny disability benefits. If you are planning to apply for SSD benefits, The Law Offices of Coats & Todd can help you take the necessary steps to protect your interests and ensure that you provide the necessary information to demonstrate that you are disabled. To learn how we can help you receive the proper disability benefits, contact our Plano SSD claim attorneys at 972-671-9922 and set up a complimentary case evaluation today.

Sources:

https://www.ssa.gov/OP_Home/cfr20/404/404-1519a.htm

https://www.ssa.gov/disability/professionals/greenbook/ce-adult.htm