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What Social Security considers disabling

Medical Evidence and Disability

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Why Will You be Sent to a Social Security Doctor for your disability case?




 
Sometimes in the course of evaluating a claim, a disability examiner (examiners work for the state disability determination services agencies in charge of deciding all initial applications and first appeals for Social Security) will schedule the claimant for a consultative exam (CE).

CEs are not performed by physicians who are employed by DDS; rather Social Security contracts with independent physicians, psychologists or psychiatrists to perform these exams as needed.

In general, those who have recently been seen by their physician (within the past 60 days) will not have to attend a CE, but this is not always the case. You could be sent for a CE even if you have seen your doctor recently, particularly if the disability examiner feels more information is needed before he can close a case.

For instance, a CE could be needed to obtain testing that is not in the claimant’s medical records, such as spirometry testing for asthma or COPD, X-rays for fractures or degenerative disc disease, or hearing tests if you are filing on the basis of hearing loss.

CEs can also be used to gather information about the claimant’s mental condition through IQ tests, memory exams, or a full psychiatric workup.

In some cases the disability examiner will schedule a CE if a medical condition is indicated in your medical records, but you have not mentioned it on your initial application.

For instance, if your family doctor has prescribed antidepressants, you could be sent for a mental CE to provide the examiner with a clear picture of your level of depression and the limitations this could impose on your ability to work.

The most common reason a disability examiner schedules a CE is so that the examiner can receive a written opinion from the consultative examiner about your current state of physical or mental health. Without recent (within the past 60 days) medical documentation, the examiner cannot close a case.

In fact, it is rare that a CE will have any great impact on the approval or denial of a claim. Medical records from a treating physician that establish a date of onset (when your symptoms began), specific limitations imposed by your impairment (activities you can or cannot do), and a prognosis (how your impairment is expected to progress over time) carry more weight in the examiner’s decision-making process than the opinion of a physician hired to perform a CE.

This is why it is so important for those whose impairments compromise their ability to work to immediately seek medical attention from a physician with whom they have enough rapport to establish a long-term doctor-patient relationship.

In the end, all disability decisions are based on information contained in medical records—-if you have not sought regular medical treatment for your impairment, it is unlikely that a consultative exam will supply a disability examiner with enough proof to approve your claim for disability.















Return to:  Social Security Disability Resource Center, or read answers to Questions





























Related pages:

When Social Security Disability Sends You To A Doctor, What Kind Is It?
Who is The Doctor for a Social Security Disability Claim or SSI Case?
What should you get from your doctor to file for disability benefits?
Why Will You be Sent to a Social Security Doctor for your disability case?
Will Social Security Grant Disability If I Have Not Been To the Doctor?
If I apply for disability and my doctor says I am disabled, is there a waiting period to receive benefits?
SSA Medical Exam and your own Physician
How Important is the Treating Physician to a Social Security Disability or SSI case?
How to go back on disability after trying to work again



Information on the following topics can be found here: Social Security Disability Questions and in these subsections:

Frequently asked questions about getting Denied for Disability Benefits | FAQ on Disability Claim Representation | Info about Social Security Disability Approvals and Being Approved | FAQ on Social Security Disability SSI decisions | The SSD SSI Decision Process and what gets taken into consideration | Disability hearings before Judges | Medical exams for disability claims | Applying for Disability in various states | Selecting and hiring Disability Lawyers | Applying for Disability in North Carolina | Recent articles and answers to questions about SSD and SSI


These pages answer some of the most basic questions for individuals who are considering filing a claim.

Filing for disability - How to file for SSD or SSI and the Information that is needed by Social Security
How to Apply for Disability - What medical conditions can you apply and qualify for?
Applying for Disability - How long does it take to get Social Security Disability or SSI benefits?
What happens if I file a disability application and it is denied by a disability examiner or Judge?
How to Prove you are disabled and qualify to win disability benefits
How do you prove your disability case if you have a mental condition or impairment?
Social Security Disability Back pay and How Long it Takes to Qualify for it and receive it
Social Security Disability SSI - Eligibility Requirements and Qualifications Criteria