Social Security Administration Medical Exams

Over the past few years, I've probably heard hundreds of complaints from disability claimants about their consultative exam experiences. For anyone who is unaware, a consultative examination, a.k.a. a CE exam, is what social security disability and SSI disability claimants are sometimes sent to as part of the processing of their disability application. Typically, CE exams are ordered by disability examiners, though ALJs (administrative law judges) will sometimes send claimants out for consults as well.

Social security medical exams are performed by independent medical doctors who have contracted to provide this service in exchange for compensation. These physicians are not employees of the social security administration (SSA does employee doctors but these individuals work with disability examiners in DDS units and provide consultation on examiner writeups) and their role is not to provide medical treatment. For the most part, they serve the purpose of providing a "recent snapshot" of a claimant's medical condition when it is apparent, from the medical record, that a claimant has not been to a doctor recently. In some instances, of course, a CE will be ordered when it seems apparent that a claimant has never been treated for a condition they may have (for instance, depression). In other instances, a claimant may simply be sent to a radiological exam, i.e. xray.

What are the common complaints voiced by disability applicants with regard to these exams? Here's a short list:

1. "I have a back problem and they sent me to a gynecologist" (yes, this happens, simply because the specialty of the CE physician is not an issue for SSA. They simply want the standard medical exam performed in most cases).

2. "The doctor was very rude" (unfortunately, this is fairly common)

3. "I couldn't understand a thing the doctor said" (unfortunately, as well, this is fairly common, too)

4. "The doctor didn't even spend five minutes with me" (well, in all honesty, CE exams probably shouldn't last too long, but five minutes does seem brief)

5. "The doctor didn't know anything about my medical history" (Examiners often send some records to update the CE physician as to the medical background of the claimant, but this doesn't always happen, and, sometimes, the CE doctor may simply not take the time to read this information if it has been sent).

Should you get stressed out over a CE exam? Certainly not. If you have to go to one, just keep in mind that it is just part of processing your claim and, sadly, in most case, it will have little bearing on the actual outcome of your case. If it has little bearing, you might ask, why bother going? Best answer---because they tell you to. Not going to a social security medical exam can result in a case denial for failure to cooperate.




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