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 "he 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.

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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