The Social Security Consultative Exam

Feb 17, 2016 | Sara Khaki

Tips For Your Consultative Exam:

You’ve submitted your Social Security disability claim, and now they are asking you to get a Consultative Exam (CE). Why? The Disability Determination Services (DDS) is reviewing your claim. There are times when they feel that they need more information regarding your medical status to make a decision on  your claim. When this happens, the SSA requests that you have a Physical or Mental Consultative Exam that the SSA will pay for out of their pocket. Depending on the nature of the exam, you will see either a medical doctor or a psychologist at a time that is determined by the SSA and at a location that is dependent on the type of doctors they have available and how close they are to the claimant.

We often end up with a lot of questions from our clients about the Consultative Exam. The most common is “do I have to go?” We always advise our clients that it is in their best interest to go to the appointment and answer all questions to the best of their knowledge and ability, because this provides the claimant another opportunity to establish medical evidence in support of his or her disability. It is also important to put forth your best effort should a doctor ask you to take any physical or mental tests. The claimant’s level of effort will be recorded by the examiner, and the SSA will use a remark of “good effort” as an indication that the claimant was credible throughout the evaluation; and a remark of “poor effort” or “exaggerated symptoms” can hurt a claimants’ credibility with the SSA adjudicator.

Another question asked is what to do if they can’t make the appointment assigned to them. It is imperative to contact the SSA right away to let them know you would like to reschedule. If a claimant is scheduled for a Consultative Exam and doesn’t show up or communicate with the DDS that the appointment needs to be rescheduled, a decision will be made based solely on the information provided. The reason the DDS requested a CE is because they felt they had inadequate information. If a claimant doesn’t show up to a CE, the DDS will make a decision on this inadequate information and oftentimes it does not turn out favorably.

The third most common question is “what can I expect from the actual appointment?” It’s important to remember to treat it like any other doctors appointment. In order for the doctor to make the best determination of your disability, they need all the information that the claimant can offer. The doctor conducting the examination will only conduct the test or exam and get information specifically requested by the DDS. They will not prescribe medication or a treatment nor will they take part in making a decision on whether you are disabled or not according to the SSA guidelines. They will simply gather the information they need and send the report to the DDS. The report will also include detailed remarks such as whether you arrived on time to your exam, if you were cooperative, and if you carried with you an assistive device or not. If you do not use an assistive device (such as a cane or walker) on a regular basis, then you should not take it with you to the exam. Once the report has been submitted, the DDS will use the information provided by the consultative examiner to make a decision on your claim.

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