Consultative Examinations Process for Disability Claims
What is a Consultative Examination?
Consultative Examinations for SSD Claims are generally ordered by the Social Security Administration when it is determined that the applicant’s own medical sources are inadequate to accurately determine a disability. Roughly half of all initial applications can require a consultative examination before making a determination.
There are two types of consultative examinations—physical and mental. A physical consultative examination can take twenty minutes or so, while a mental CE exam can take up to 45 minutes. If the SSA wants you to undergo a consultative examination, they will send you a letter (from Disability Determination Services) asking you to see a specific doctor, along with the date, time, and location of the examination.
It’s important to be aware that a consultative examination is not a sign that the SSA is assuming responsibility for securing the medical evidence required for your claim. In other words, you still have the burden of proof to provide strong medical evidence of your disability. Depending on your disability, you may be asked to see a general practitioner for your consultative examination or a specialist. For example, if your claimed disability is Lupus, you may be asked to see a specialist like a rheumatologist, but this is more the exception rather than the rule.
In any case, the consultative examination is a very important piece of information that can carry weight and may be referred to many times throughout the SSD process. Having a strong SSD attorney from Carmichael Law Group, LLC is an important step to take in this process. Hiring a nationwide disability lawyer from Carmichael Law Group can help ensure your application is submitted in a complete, professional manner. If your initial application is denied, our attorneys will ensure your appeals are filed in a timely manner, always advocating zealously on your behalf.
Are Consultative Examinations for SSD Claims Mandatory?
The answer to this question is a resounding “yes.” If the SSA sends you a letter, asking that you attend a consultative examination, failure to show up without an explanation will likely be seen as a lack of cooperation. As such, this lack of cooperation could be grounds for denying your SSD claim. The exam is usually scheduled with a doctor in your area, so you won’t have to travel far.
If your consultative examination is with a doctor an hour or more away—and you don’t think you can make the appointment—contact your attorney as well as your DDS specialist as soon as possible. It may be possible to find a doctor closer or re-schedule your examination. If you are unable to make the appointment for any reason, contact your DDS specialist and your attorney.
Your Voice in the Fight for the Justice You Deserve
Here's What Sets Our Team Apart
Carmichael Law Group guides you through every step, from applications to appeals, with clear communication and strategic advocacy.
-
Focused on Results
We fight tirelessly to secure the benefits you deserve, using strategic legal expertise to achieve the best possible outcome.
-
Honest GuidanceWe prioritize clear communication, ethical advocacy, and transparency, ensuring you understand your rights and options.
-
Proven Track Record
With years of experience and thousands of successful cases, we provide skilled representation at every stage of your claim.
-
Compassionate Advocates
We treat every client with respect, empathy, and personalized attention, guiding you through the SSD process with care.
What Do I Need to Know Before I Attend My SSD Consultative Examination?
Perhaps even more important than what you bring to the consultative examination is what you do and say during the examination. Your goal is for this consultative examination to be helpful to your SSD application for benefits. When you file an application for SSD benefits, you are, in effect, saying that your medical condition prevents you from doing any type of job for eight hours a day, five days a week. This means you are having adverse medical symptoms every day and/or frequent ‘bad days’ where your functioning is significantly limited – i.e., bed bound days. It’s important that you express all your medical problems and symptoms to the consultative examination doctor. Remember the following:
- If pain is a part of your disabling medical condition—and it usually is—you need to authentically describe, in your own words, how your pain feels. Simply saying you have “bad” pain, or your pain is a “level 8” is not enough. If your pain makes you feel as though your legs are on fire, relay that to the doctor. In other words, let the doctor know how your pain feels to you on a daily basis.
- Explain to the doctor how your pain places limitations on your life—on your work, on how you care for your children or home, on your work, and even on your social life. For some, the pain they experience can be so severe that it keeps them from even being able to focus or concentrate. That’s a big thing that the doctor needs to know.
- If your pain is so severe that you must lie down during the day to get some measure of relief—say so.
- If your disabling condition is mental, clearly detail how your anxiety, depression, PTSD, or other mental disability affects your everyday life. If your anxiety is so bad you are unable to leave your home, state that fact. If you are unable to concentrate or focus for extended periods of time due to nervousness or depression, overtly tell such to the consultative examiner.
- While you can’t control what’s in the consultative examination report, you can be very assertive when highlighting your disabling symptoms and problems. If you feel like the doctor is rushing you, be even more overt about your disabling condition—do your best to make sure the doctor really hears you.
- If you feel like a specific test would clearly support your disabling condition, don’t be afraid to ask the doctor. While the doctor does not have to agree to a test, it might prod them into asking DDS to also order an x-ray, CT scan, or another type of test done.
- Ask the consultative examination doctor whether he or she reviewed your medical records. The doctor must mention in the report which medical records (sent by your DDS specialist) were reviewed prior to your examination. In some cases, however, the doctor may fail to do this.
- Even if the doctor did review your medical records, be thorough in your descriptions of your disabling condition.
- If there is important medical information you believe is critical to proving your disabling condition, bring a copy of that information with you, whether it’s a doctor’s report, a test result, or any other medical information. While sometimes the consultative examiner may not review such information, sometimes they will.
- Even if the doctor is rushing you or otherwise angering you, make sure your responses are polite. Annoying the doctor—even when deserved—can cause the doctor to be less than forthcoming about your disabling condition in the report.
- While you should always clearly detail all your disabling symptoms, don’t over-exaggerate—and don’t assume no one is watching you before you see the doctor. Perhaps a staff member saw you walking across the parking lot with no assistance, yet once you were inside, you hobbled around with a cane. Such a tactic can definitely backfire—you never want the doctor to put in your report that you are “faking” your disability.
