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If Social Security Disability sends you to an Exam, will it be done by your doctor?



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

Can you get temporary Social Security Disability or SSI benefits?

Permanent Social Security Disability

What is the difference between Social Security Disability and SSI?

Who is eligible for SSI disability?

Can I Be Eligible For SSI And Social Security Disability At The Same Time?

What makes a person eligible to receive disability benefits?

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?









For the sake of clarity, SSDRC.com is not the Social Security Administration, nor is it associated or affiliated with SSA. This site is a personal, private website that is published, edited, and maintained by former caseworker and former disability claims examiner, Tim Moore, who was interviewed by the New York Times on the topic of Social Security Disability and SSI benefits in an article entitled "The Disability Mess" and also by the Los Angeles Times on the subject of political attempts to weaken the Social Security Disability system.

The goal of the site is to provide information about how Social Security Disability and SSI work, the idea being that qualified information may help claimants pursue their claims and appeals, potentially avoiding time-consuming mistakes. If you find the information on this site helpful and believe it would be helpful to others, feel free to share links to its homepage or other pages on website resource pages, blogs, or social media. Copying of this material, however, is prohibited.

To learn more about the author, please visit the SSDRC.com homepage and view the "about this site" link near the bottom of the page.