Knowing what to expect during a disability consultative exam provides peace of mind by mentally preparing you for the process of qualifying for Social Security Disability (SSDI) benefits. If you are navigating a complex disability claim, consult a local Social Security lawyer to help prepare you for your consultative exam and interpret your results.
What Is a Disability Consultative Examination?
A disability consultative exam (CE) is a medical evaluation performed by a physician to assess your medical condition and limitations. The Social Security Administration (SSA) sometimes requests that your primary care doctor (if you have one) perform the CE—provided your doctor has the necessary skills and equipment to complete the exam.
However, your doctor reserves the right to refuse, and many do. If your doctor refuses or isn’t qualified to perform your CE, the Disability Determination Service (DDS) agency will direct you to a doctor they assign. The disability consultative exam will include the following:
- Medical History: The physician will ask you a curated list of questions about your medical history. Asking for as much detail as possible, they will inquire about current medications, surgeries, past illnesses, and symptoms you’re experiencing due to your disability.
- Physical Examination: The doctor will conduct a physical medical evaluation based on your claimed disability(s). They may include neurological checks, strength testing, and range of motion assessments.
- Specific Tests: Depending on your disability, the physician may order specific tests, such as imaging (X-rays, MRIs, CT scans) and blood work, to discover further information about your condition or conditions.
- Functional Limitations: The doctor will ask designated questions about how your disability impacts your daily life, including everyday and work-related tasks.
Your CE is strictly medical assessment only. That means the examining doctor will not provide or prescribe you any treatment. They also will not provide their opinion about whether you should qualify for SSDI benefits.
How to Prepare for Your Disability Consultative Exam
Preparing for your disability consultative exam helps ensure a smoother process. Start by listing your disabilities and symptoms to ensure you voice your most critical concerns. Here are seven vital steps for adequate preparation for your CE:
- Consult a Disability Lawyer: Chances are, if the SSA schedules a consultative exam, they’re searching for a way to close your case. An experienced SSDI lawyer representing you gives you the best chance of being heard and approved.
- Gather Pertinent Information: Collect all relevant medical test results (imaging and bloodwork), current medications, doctors and specialists you’ve seen, and past medical treatments.
- Bring Medical Documentation: Bring relevant medical documentation, including recent exam results. There is no need to bring your complete medical records. Your lawyer would advise you against this because they may try to dismiss current disability symptoms as being associated with pre-existing injuries.
- Bring Assistive Devices: Bring your medical devices and equipment to your consultative exam to verify your mobility limitations. For example, braces, canes, walkers, orthotic devices, prosthetic devices, powered scooters, and wheelchairs.
- Prepare Your Verbal Explanation: Consider your condition(s) and how it affects your life. Carefully articulate what you plan to tell your physician and rehearse it so you’re confident you won’t stumble over words or forget important details. Explain the severity of your symptoms and how they affect daily activities, such as eating, bathing, getting dressed, doing household chores, and driving.
- Bring a Support Person: Having a support person drive you to and from the appointment may be beneficial to avoid exhaustion and overwhelm. A support person is also ideal for helping you remember details and advocating for your disability needs during your CE.
Be prepared with any questions about the disability consultative exam process or what to expect. Bring a pen and notepad to jot down relevant notes to help you remember the doctor’s words and assessment. You may need it to testify later.
Also, you must be honest about your symptoms and conditions during your CE. They will look and listen for signs of exaggeration, resulting in valid claim denial. You mustn’t exaggerate or downplay the severity of your disability.
The Doctor’s Disability Consultative Exam Report
After completing your CE, the physician will write and submit a report to DDS. Their report will include your medical history and the results of your exams and tests. The doctor will also report their opinion on your ability to return to work and continue working. Never downplay or exaggerate your symptoms.
What Happens After a Disability Consultative Exam?
After your CE, determining your disability claim usually goes relatively quickly. When the SSA schedules your consultative exam, it has already reviewed most, if not all, of your documented medical information. The CE report is the SSA’s final step in determining your disability benefits.
You should expect to discover your claim results within a few weeks following your CE. You may also check with your disability claims examiner after two to three weeks or ask your Social Security lawyer to check for you after that time frame has passed.
What Happens If You Miss Your Social Security CE Exam?
Missing your disability consultative exam appointment may result in denying your disability benefits. If you need to miss your appointment due to unforeseen and extraordinary circumstances—you must call to reschedule it.
Missing it without any communication or late communication could get your claim denied. If you have a legitimate reason for needing to miss your exam, DDS will reschedule it and inform you of where it will occur. Examples of viable reasons DDS will accept for rescheduling a CE include:
- Being ill
- Being injured
- Your vehicle broke down
- Your transportation fell through at the last minute
- A death in the family
Other circumstances outside your control will be considered on a case-by-case basis. However, rescheduling your appointment pushes back your approval process. So it is best to avoid cancellations.
Schedule a Consultation With a Disability Lawyer
Schedule a free consultation with a disability lawyer to help navigate your SSDI claims process. If you have been denied and disagree with the disability claims examiner’s report, you’ll want to contact a local attorney immediately.
