Overview of Disability
Disability Back Pay
Requirements for Disability
Applications for disability
Tips and Advice for Disability Claims
How long does Disability take?
Winning Disability Benefits
Common Mistakes after a Denial
Mental Disability Benefits
Denials for Disability
Appeals for denied claims
Disability Benefits from SSA
Child Disability Benefits
Qualifications and How to Qualify
Working and Disability
Disability Awards and Notices
Disability Lawyers, Hiring Attorneys
Social Security List of Conditions
What Social Security considers disabling
Medical Evidence and Disability
Filing for Disability Benefits
Eligibility for Disability Benefits
SSD SSI Definitions
SSDRC authored by Tim Moore
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Will an SSI or Social Security Exam help with the Decision?
A disability exam may help with the decision a case. Or it may not. However, it really depends on what a person means by "help". To answer that, we should discuss why it is that social security sends claimants to examinations in the first place.
The social security medical exam is actually something called a CE, or consultative examination. These exams are sometimes ordered by administrative law judges who hold disability hearings. But probably 95 percent of the time they are scheduled by disability examiners who are trying to make decisions on disability applications and reconsideration appeals.
A CE is ordered by a disability examiner in just a couple of scenarios:
1) When the person filing for disability benefits has alleged on their application for disability that they have a certain physical or mental condition, but there is no evidence of them ever having received treatment for the condition. Depression is a condition that often fits this category. An individual will list depression when they file for disability; yet they have never received counseling, been prescribed medication, or even mentioned to a psychiatrist, or even their family doctor, that they are experiencing, or have experienced, depression.
In some cases, claimants will allege that they have carpal tunnel syndrome or a back condition but have not been officially diagnosed or treated by a doctor.
2. When the person applying for disability has received a diagnosis for their condition and has received medical treatment in the past, but has not received recent medical treatment. For SSA, recent medical treatment means treatment received in the last 90 days.
How important is recent medical treatment and having documentation of this? The social security administration takes the position that a person cannot be considered disabled as of the here and now (and, thus, cannot qualify for disability), if they do not have medical proof that is recent.
Now that we've gone over why a social security exam is usually scheduled, we can state that consultative examinations definitely help in the sense that they allow a disability examiner to make a decision on a social security disability or SSI case.
However, this does not mean that it, in any way, shape or form, pushes the case toward an approval. Speaking as a former disability examiner, I can state that in most instances the results of a consultative medical examination has little positive effect on a case. As was said, it usually just allows a decision to be made since it provides a small amount of recent evidence when it is lacking.
Having said this, however, there are many cases that are already in the position of being approved for disability benefits based on the cumulative record but which are lacking recent records. In these cases, getting the results of a CE, i.e. a social security medical exam, will facilitate a case being approved.
In other words, when a claimant is in the position of qualifying for disability, getting the report from a CE can simply tie up the loose lends and make the approval happen.
Finally, there are cases in which the results of a CE do substantially provide evidence that results in the awarding of benefits. For example, when claimants are sent to a mental consultative exam, this is often to have memory or IQ testing done. And in cases for which memory impairment or low IQ are alleged, the results of this testing can provide a basis for approval.
Also, in some cases, a physical CE will be a neurological exam or an appointment to have an XRAY done (at the government's expense, of course) and the medical information provided can also provide a needed basis for approval.
Return to: Social Security Disability Resource Center, or read answers to Questions
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