Consultative Exam For Social Security Disability

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A Consultative Examination: What to Expect

A consultative examination (CE) is not conducted in order to give medical advice, as with other conventional medical examinations. This medical exam is instructed by Disability Determination Services (DDS) to reckon the level of disability of the claimant. They outline the type of test that will be performed and what must be included in each report. People should review what will be covered in the CE and how they’ll accomplish it before taking one. 

What is a Consultative Examination?

When you apply for Social Security Disability Insurance (SSDI) benefits, because of a disability, you may need to appear for a consultative exam (CE). A notice for appearing in a disability consultative exam is requested when there is not enough medical evidence in your file to determine the severity of your disability. To get financial assistance from SSA, you would need to apply at a local Social Security field office. After that, your claim is sent to a federally-funded state agency called the DDS. 

Consultative Exam For Social Security DisabilityThe DDS makes a preliminary determination whether or not a claimant is disabled after obtaining all the necessary medical evidence. Assume that the DDS needs more medical information in order to make a decision. In that instance, it may contact the source of treatment for further information or clarification, or a CE may be requested to you via notice.

The purpose of a CE is not to give medical treatment or advice. Rather, its purpose is to give DDS more information about an applicant’s disabling condition so that a decision can be made about whether the person meets Social Security’s definition of disabled.

The treating source, not DDS, is responsible for your regular medical care. This means that you will continue to see your own doctor for treatment.

However, as per SSA rules, an independent source may be used for a CE or diagnostic study if the treating source is unable to perform the consultative examination for social security disability, there are conflict or insufficient information in the file that cannot be resolved by treating the source, or the claimant has a good reason for choosing another. 

The examination may be physical or psychological. The CE might include additional tests such as PFS, x-rays, or EKGs, but the medical source must take approval from the DDS before performing additional tests.

Who can perform the Disability Consultative Examination?

The CE must be conducted by a licensed medical or psychological professional who is neither the applicant’s treating source nor an employee of the DDS. The consultant should have enough experience in the field to make a determination about your disabling impairment(s).

For a physical examination, this generally means that the doctor should be a licensed physician (MD or DO), although in some cases, a licensed nurse practitioner (NP) or physician assistant (PA) may be used. For a psychological evaluation, the consultant should generally be a licensed psychologist, although in some cases, a psychiatrist (a medical doctor with specialized training in mental health conditions) may be used.

The medical source must participate in SSA’s program. It’s not necessary that the source be on a list of approved medical sources. However, he should have all the requisite qualifications to perform the examination and be willing to provide all the needed information to the DDS.

The medical source should submit through reports in a specific structure following the examination. If you wish to be approved for SSDI after a consultative examination, you must adhere to all of the rules.

All documents should be checked and signed by the healthcare professional

The doctor performing the medical or psychological examination must review and sign the reports. Generally, medical sources or treating sources are selected based on appointment availability, ability to perform examinations, tests, and the distance between the claimant’s home and their location.

During the appointment, you should give concise and accurate answers to the questions that are asked. You should not panic and try to communicate clearly. The medical professional who will perform the disability consultative exam is instructed to spend a considerable amount of time with the beneficiary, depending on the nature of the exam, as many things go into the consultative exam process.

If you feel that your disability prevents you from living independently and you want to explore your options for support, it is best to talk about your needs with a disability attorney. An experienced lawyer can make sure that you are making informed decisions and help you understand your rights under the law.


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