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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.

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

Related pages:

Social Security Disability Claims and Medical Exams
What is the Purpose of the Social Security Disability SSI Medical Exam, or CE?
Social Security Medical Exam - the purpose of the Consultative Examination
Social Security Consultative Medical Exams and How they affect Disability Claims
The Social Security Disability Doctor Appointment is Called a CE
If Social Security Disability sends you to an Exam, will it be done by your doctor?
Social Security Disability, SSI Medical Exams For Physical Problems
Social Security Administration Physical Consultative Exam (CE)
Social Security Disability, SSI, and Mental Testing
Do the Results of the Social Security Psychological Exam have any Bearing on Being Approved?
Will an SSI or Social Security Exam help with the Decision?

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