What is a Consultative Exam?

When a Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI) claim is filed and Social Security confirms that the applicant meets the technical requirements for at least one of the disability programs, Social Security will send the file to a state agency for disability determination purposes.

The agency that determines whether an applicant is disabled is known as Disability Determination Services (DDS). This agency considers a number of different factors in determining if an applicant is disabled. One tool DDS sometimes uses in determining disability is a Consultative Exam (CE).

A CE can be either a physical or mental health examination performed by medical professionals, often times a medical doctor, psychiatrist or psychologist. This type of exam is scheduled when DDS concludes that there’s not enough medical evidence available about an applicant to determine whether or not the applicant is disabled. The exam is provided at no cost to the applicant, but it is the applicant’s responsibility to provide their own transportation to a CE.

If you attend a CE you want to make sure you provide the medical professional conducting the exam with all the necessary information about your disabilities. You MUST inform the medical professional of ALL problems, both mental and physical, you are dealing with associated with your disabilities and how those disabilities limit your ability to work. Make sure to bring all of your prescribed medications, in their prescribed containers, to the CE and it’s especially important that you are on time or even a little early for your CE.

At completion of the exam the medical professional will issue a report and send the findings to DDS, it could take several weeks before this report is sent to DDS. This report, along with an applicant’s medical records, past work experience, detailed information about how impairments impact an applicant’s ability to manage daily activities and the opinions of the applicant’s own medical treating sources are all considered in determining disability.
It is important to know that when a CE is ordered YOU MUST ATTEND. It is very important for an applicant to show-up on time for the CE and to cooperate with the medical professional. Failure to attend an ordered CE will certainly result in the DENIAL of a Social Security disability claim.

Keep in mind, the medical professional conducting the CE is not your own doctor, but an INDEPENDENT MEDICAL SOURCE THAT HAS HIS OR HER FEES PAID BY SOCIAL SECURITY. Your behavior and actions will be observed by this medical professional from the moment you arrive at your CE appointment until the minute you leave.

For more information about CEs visit: http://www.socialsecurity.gov/OP_Home/hallex/I-02/I-2-5-20.html