Social Security Disability, SSI Medical Exams For Physical Problems

medical treatment records within ninety days of the application date. Disability examiners are not required to have a twelve-month medical history of an individual's alleged medical or mental impairment but they are required to have current medical information about all alleged disabling impairments.

Many disability applicants have been out of work for quite some time; consequently they have lost their health insurance and they have no money. Therefore they may not have any recent medical treatment with which the disability examiner can make a decision.

Social Security Disability examiners are obligated to have a current status of an individual's physical problems prior to making their medical determination, so the social security administration has to provide the disability applicant with a medical examination (a CE, or consultative examination) to address their alleged disabling physical problems.

Who performs a Social Security Disability or SSI Medical Exam?

Contrary to what many people believe, Social Security doctors do not perform consultative examinations. The doctors that perform consultative examinations are usually doctors who practice in a locality who are willing to perform consultative examinations for Social Security for an agreed upon fee per examination. Unfortunately, these examinations are often performed by physicians whose medical specialty may have nothing whatsoever to do with the disability applicant's physical problem or problems.

Although Social Security guidelines state that consultative examinations should be performed by a physician whose specialty addresses the disability applicant's physical or mental condition, it is rare that an individual sees a physician whose specialty actually addresses their physical impairment.

This is due to the that there are so few physicians in many areas and, of those doctors, many are not willing to perform consultative examinations. So that leaves disability applicants in the position of going to any doctor who simply agrees to perform consultative examination in their area, no matter what their medical specialty is.

By their very nature, consultative examinations usually do not help a disability applicant win disability benefits. Consultative examinations are short basic evaluations performed just to meet the requirement of SSA having current medical information. Many times these examinations are not even ten minutes long and are not very thorough.

Consultative examinations are not meant to provide any kind of treatment or an in-depth look at an individual's physical problems. This is why it is so difficult for an individual to win their disability benefits without recent treatment notes from a treating medical source who is familiar with their physical problems. It is hard to determine the severity of an individual's physical problems and their residual functional capacity (what they are able to do despite the limitations of their physical or mental problem) in a ten-minute examination with a physician who knows nothing about them.

About the Author: Tim Moore is a former Social Security Disability Examiner in North Carolina, has been interviewed by the NY Times and the LA Times on the disability system, and is an Accredited Disability Representative (ADR) in North Carolina. For assistance on a disability application or Appeal in NC, click here.

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