When Social Security Disability Sends You To A Doctor, What Kind Is It?

The kind of doctor that Social Security Disability might send you to depends upon your disabling condition or conditions. Social Security Disability examiners usually send you to a consultative examination (usually called a CE) if your own medical sources are inadequate to determine whether or not you are disabled under Social Security Disability guidelines.

Disability examiners may attempt to get more information by recontacting your medical sources for more information or even clarification, or by scheduling a consultative examination. Social Security prefers to use your medical treatment source (i.e. your personal doctor) to be their consultative doctor if he or she is equipped, qualified, and willing to perform a consultative examination for the authorized fee.

However, Social Security rules give the disability examiner the option to use an independent medical source for the consultative examination or diagnostic test if:

1. Your doctor prefers not to perform the examination;

2. Your doctor does not have the equipment to provide the information needed for your disability determination;

3. You prefer to go to a different doctor and have a good reason for doing so;

4. Your doctor is not a productive source for medical information;

I should point out, at this point, that, in my experience as a disability examiner, very few consultative medical exams were ever performed by a claimant's own physician. Usually, claimants simply go to exams that are conducted by contracted doctors whom they've never met.

If the disability examiner determines that they need more medical information, you may have to attend a consultative examination with a physician, psychiatrist, psychologist, ophthalmologist, neurologist, etc.

The doctor performing the CE may not even specialize in a medical field that deals with their disabling condition (i.e. you may be alleging back pain but your consultative examination doctor might be a allergist), especially if the disability examiner needs information about the limitations of a physical problem (basically, social security sends you to whoever is available in your area to conduct a general exam).

Most individuals who have mental disabling conditions at least see someone who specializes in mental conditions. Typically, this may mean a psychiatrist if a full psychiatric exam is to be performed, but it will usually mean being seen by a psychologist if a memory test or IQ test, or a mental status exam is to be given.

Also, if disability examiners have plenty of general medical information but are in need of some clarification of the records, or a more expert evaluation of an individual's condition or limitations, they may send them to a specialist for clarification. Consequently, some disability claimants receive more thorough evaluations by doctors who specialize in their disabling condition. That is if the disability examiner cannot determine their limitations through regular medical treatment records.

It was my experience as a disability examiner that far more general consultative examinations are performed than consultative examinations with specialists. And, for the most part, these consultative examinations are simply geared to give the disability examiner a general status of your disabling condition. Therefore, most consultative examinations do not lead to an approval for benefits unless they are something like intelligence quotient (IQ) testing or perhaps memory testing to evaluate mental functioning because these are not very subjective by nature.

With such testing, an individual completes the testing and their scores determine the severity of their disabling conditions. Whereas, the evaluation of other physical conditions, such as back pain, can be far more subjective.

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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