What is the Application Process for Social Security Disability and SSI?
How do you Win Benefits under Social Security Disability or SSI?
If I am determined disabled, how far back will Social Security pay benefits?
How do you prove your disability case if you have a mental condition?
What Can I Do to Improve My Chances of Winning Disability Benefits
Common Mistakes after Receiving a Denial of Social Security Disability or SSI Benefits
How to File for Disability - Tips for Filing
If You Get Approved For SSDI Will You Also Get Medicare?
How much does a Social Security disability attorney get paid?
Social Security Disability SSI Criteria and the Evaluation Process
How long does it take to be approved for SSI or Social Security disability?
What do you Need to Prove to Qualify for Disability Benefits?
Social Security Disability SSI and Fibromyalgia
Social Security Disability SSI and Degenerative Disc Disease
Can I Qualify For Disability and Receive Benefits based on Depression?
Answers to questions about SSD and SSI disability
What Disabilities Qualify for SSI and Social Security Disability Benefits?
Social Security Disability Status
Social Security Disability Tips — how a claim gets worked on
Social Security Disability, SSI Disability - Terms, Definitions, Concepts
If Social Security Disability sends you to an Exam, will it be done by your doctor?
How to prove you are disabled
and win disability benefits
It is rare that a claimant for social security disability or SSI disability goes to a consultative medical exam (CE) that is conducted by his or her treating physician, although this is the stated preference of the Social Security Administration (SSA). In fact, the social security official list of impairments, or blue book, states that “The treating source (i.e. the claimant's doctor) is the preferred source for a CE if he or she is qualified, equipped, and willing to perform the examination for the authorized fee.”
It is also probably in the claimant’s best interest to have the CE done by his or her treating physician, as the exams paid for by the social security administration are notoriously brief (10 to 15 minutes), and are usually treated as a mere formality. Your own doctor is far more likely to understand the prognosis (expected progression) of your medical condition, as well as any limitations it imposes on your ability to perform daily living activities or work activities.
However, most claimants don’t ever get the opportunity to be seen by their own doctors when it comes to consultative exams. In part, this is because there are relatively few doctors who are interested in performing them for the SSA.
Despite the fact that the state Disability Determination Services agency (DDS) has a professional relations office (PRO) charged with recruitment and retention of independent physicians to conduct CEs, most physicians either refuse to participate up front or eventually drop out of the pool altogether.
Why is this the case? Most likely because doctors who perform medical exams for disability applicants usually receive payment that is substantially lower than their regular fee, and they also have to deal with those disability applicants who regularly miss appointments without giving notice or rescheduling.
Note: As a disability examiner, I routinely had to have disability exams rescheduled for claimants who missed their appointments, sometimes more than once. Social Security is fairly understanding when it comes missed appointments provided that the claimant has a legitimate reason for missing the appointment. However, from the doctor's viewpoint, it simply may not be worth it to keep holding out appointment slots for individuals who repeatedly fail to show up.
If you are scheduled for a CE and you want your own doctor to do it, first ask him or her if that is a possibility. If the answer is yes, then you should notify the disability examiner in your case that, per your request, this would be your preference. That may not guarantee that your own doctor will be performing the exam, however.
Regardless of who is to perform your social security medical exam, if you are scheduled for one, do your very best to show up for it. If you absolutely can’t make it, call the disability examiner in your case as soon as you are aware of a conflict to reschedule the appointment. Failure to do this will only delay matters, and repeated no-shows for consultative examinations can actually be used by a disability examiner as a reason to deny disability benefits.
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Individual Questions and Answers
SSD and SSI are Federal Programs
The title II Social Security Disability and title 16 SSI Disability programs operate under federal guidelines and, therefore, the program requirements--medical and non-medical--apply to all states:
Alabama, Alaska, Arizona, Arkansas, California, Colorado, Connecticut, Delaware, Florida, Georgia, Hawaii, Idaho, Indiana, Illinois, Iowa, Kansas, Kentucky, Louisiana, Maine, Maryland, Massachusetts, Michigan, Minnesota, Mississippi, Missouri, Montana, Nebraska, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Carolina, North Dakota, Ohio, Oklahoma, Oregon, Pennsylvania, Rhode Island, South Carolina, South Dakota, Tennessee, Texas, Utah, Vermont, Virginia, Washington, West Virginia, Wisconsin, Wyoming
Recent approval and denial statistics for various states can be viewed here:
Social Security Disability, SSI Approval and Denial Statistics by state
Special Section: Disability Lawyers and unnecessary claim denials