The Consultative Examination

People seeking Social Security disability benefits are sometimes asked to attend a consultative examination. A consultative examination is a physical or mental examination or test purchased at Social Security’s expense. The examination will be performed by an independent doctor or psychologist in private practice under contract with the Social Security Administration.

When is a consultative examination required?

Generally, there are only limited circumstances which will prompt the scheduling of a consultative examination. If there is an inconsistency contained in a Social Security applicant’s medical records, then an appointment will be scheduled to resolve the inconsistency. Sometimes a treating doctor may offhandedly remark that a patient is depressed or anxious, and if that individual isn’t treating with a mental health professional, then a consultative examination may be required to assess the patient’s mental condition. A consultative examination is also helpful if someone stops treating due to lack of insurance.

Claimant’s Responsibility to Attend an Examination

Failure to attend a consultative examination is problematic to a Social Security disability case. A Social Security claimant must provide proof of his or her inability to work and if he or she misses the appointment, the claim will be denied for a lack of evidence. Moreover, an Administrative Law Judge considering the case at the hearing level can find that the non-cooperation was an effort to hide the true nature of the medical condition.

A lack of transportation will not impede a consultative examination. The Social Security claims examiner will make every effort to schedule the appointment with someone nearby. If the office is not accessible by public transportation, the claims examiner can arrange for taxi service to and from the appointment upon request.

Why the Consultative Examination is Important to Your Case

While it may be unrealistic to expect much from a one-time visit, the consultative examination can be responsible for the approval of a Social Security claim. It is important for the person attending a consultative examination to be as thorough as possible when discussing his or her impairments. It’s best to try to help the doctor understand specifically the symptoms you experience that prevent you from working.

The Social Security regulations require that all individuals and entities who perform consultative examinations be licensed and in good standing with applicable Federal medical programs. Someone who attends a consultative examination and is dissatisfied with the way the exam was conducted should contact the Social Security Administration with a letter listing his or her impressions. Timely documentation related to the visit can help an adjudicator better understand the impressions and conclusions of the visit.

If you have received notice that a consultative examination has been scheduled, contact Rob Levine & Associates today and we can help you get the Social Security disability benefits you deserve.