What's a Consultative Examination?

Social Security may request that you undergo a consultative exam (CE) as part of the disability application review process. Here's what to expect.

When you apply for Social Security disability benefits, there may be a number of different components to the review of your application. Typically, the process of qualifying for benefits involves submitting your work history and details about your disability and making sure your doctor submits extensive medical information and records.

Sometimes, however, you may be asked to also undergo a consultative examination (CE). Such examinations are generally requested when the SSA wants to get a little bit more medical information about you in order to determine if you are legitimately entitled to benefits or not - usually due to missing or conflicting medical records. There's nothing to be afraid of if you are asked to undergo a consultative examination, but you should understand what it is and how to prepare for it.

What Is This Exam?

A consultative examination is an examination conducted by a third-party physician that is chosen by the SSA. Among other reasons, the examination may be requested if:

  • The SSA does not have enough medical information about your disability.
  • The SSA is not confident of your doctor's reports for some reason, such as a belief that your doctor may be biased or not fully qualified to diagnose your condition.
  • Your disability is a difficult one to diagnose and/or is based on subjective standards rather than empirical measurements. For example, if you are applying for benefits on the basis of PTSD, anxiety, or depression, there may only be anecdotal evidence in your file regarding your symptoms. The SSA may want another physician to perform an examination and testing to determine if that doctor comes to the same conclusion as your first doctor, that your disability is real and severe.

Essentially, this all means that the SSA wants to make sure that you are disabled severely enough that you should be granted benefits.

What You Can Do To Prepare

The only real way to prepare for your examination is to list your symptoms ahead of time and keep records of how the disability interferes with your life. The SSA is primarily concerned with two different things when it comes to assessing your disability, including:

At your examination, you want to make it clear that your disability has a marked or severe impact on your life and that your residual functional capacity is too low to allow you to do work. You should not exaggerate your symptoms, but you should have details about the problems your condition causes you. Keeping a pain journal or another type of daily journal about how your disability affects you can be helpful as this will allow you to remember exactly what you want to discuss with the doctor.

At the examination, you should provide information that the doctor requests that will help your case. Answer questions when asked, be straightforward and honest, and be cognizant of the fact that information you volunteer unnecessarily could hurt your case.

If You Want Help

If you are asked to undergo a consultative examination for the SSA when you believe there is already enough medical evidence in your file, you may wish to speak with a lawyer who specializes in disability cases. A disability attorney can help you understand what to expect in the examination, based on what your specific disability is, and can assist you in providing the examining doctor the best information on your functional limitations to make sure you get benefits.

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