Monday, November 19, 2007

What to Expect at a Social Security Disability Medical Exam

I came across a very interesting thread on a forum and the topic of discussion was CEs, or consultative exams. Some of the individuals posting were scheduled for a CE (the technical term for a physical or mental examination scheduled for and paid for by the social security administration) and some had already been to one and were relating the experience.

All of the posters made statements that I've heard many times over the years and which only confirms that the experience of going to a social security examination is pretty much the same in every single state.

Here are some things to keep in mind if you have a claim for social security disability or SSI benefits.

1. You may or may not be scheduled to go a consultative medical exam. In other words, the standard routine for processing disability cases does not require the scheduling of examinations. However, you are more likely to be sent to such an examination if one of the following applies:

a) You have not been seen by a doctor in a long time.
b) You have a condition, either indicated by you on your application, or indicated somewhere somewhere in your records, that you have not received treatment for.

How could you have a condition that is listed in your medical records that you have not received treatmen for? Here's a good example, one that happens often. If a claimant decides to apply for disability based on fibromyalgia or decides to apply for disability based on MS (or any other condition) and has never been treated for depression, yet a doctor has indicated somewhere in the medical notes that the claimant is depressed, this may cause the scheduling of a mental exam.

Very often, claimants who do not consider themselves to have depression or who did not cite depression on their disability applications will find themselves going to a mental status exam or a psychiatric exam simply because their family doctor indicated a single word in the treatment notes: "depression". And, often as well, these claimants are aggravated and irritated by being required to do this. Why does social security do this? To make sure that a claimant receives full consideration for their impairments, even impairments they may "possibly have".

2. If you are scheduled for a social security disability medical exam, you must go. Going to a CE is not optional and, in fact, a failure to attend a scheduled exam can potentially be grounds for a denial of a claim due to a failure to cooperate. If, of course, you are unable to make your appointment, due to a transportation issue or sickness, you may ask for a rescheduled appointment.

3. If you go to a social security disability medical exam, it may last as short as ten minutes. Yes, they can be very short. Many claimants are surprised when they go to a doctor's office and find that the "social security medical exam" can be this brief. Even more are surprised when the examining physician does not ask them about their condition or medical history. But the reason for a consultative exam is not to A) provide medical treatment or B) make, prove, or disprove a medical diagnosis. Most physical disability exams are simply for the purpose of allowing a disability examiner to gather "recent medical evidence" so that a case may be closed. Yes, in most instances, a physical exam is scheduled only because a claimant has not been to a doctor in the last 60 days and, usually, the purpose of going to such an exam is nothing more than that.

4. Some disability exams are not really exams. Sometimes a disability exam is actually testing. For example, individuals with respiratory complaints (such as COPD or asthma may be sent to spirometry, also known as a pulmonary function test or breathing test. And, sometimes, claimants are sent for xrays if they have degenerative conditions such as arthritis.

5. Be prepared for the possibility that your examining doctor may be rude. As a disability examiner, I literally heard hundreds of complaints from claimants who had gone to social security medical exams and had been treated rudely. One would have to wonder why it is that medical professionals who have elected to provide examination services to social security would behave this way. But, right or wrong, it seems fairly common.

In later posts, I will describe things not to do when going to a physical or mental social security examination.

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