Will Social Security send you to one of their doctors?

Social Security sends many individuals who apply for disability to what are called consultative medical exams, or CEs for short. These exams can be for a mental impairment or a physical impairment. And they are performed by doctors who do not actually work for the Social Security Administration. Instead, they are private practice physicians who contract to provide examination services for disability claimants.

In other words, when you to go to a Social Security medical exam, you are going to a private doctor's office. The doctor performing the exam will, after the examination, write up a report and then submit the report to SSA (usually to a disability examiner, but sometimes a judge if the case is at the hearing level).

Will the exam have much effect on the outcome of the case? Will the exam be long or short, or be thorough or superficial? These pages address these questions.

1. Why does Social Security send people to medical exams?
2. What should you say if you go to a Social Security Exam?
3. What is the Purpose of the Social Security Disability SSI Medical Exam, or CE?
4. Social Security Psychological Exam results
5. Will an SSI or Social Security Exam help with the Decision?

Are Social Security Medical Exams done by Doctors who are Specialists?

This is where more people would probably have a problem with the system, when claimants are sent to consultative exams performed by private physicians who practice in a medical area that is unrelated to the claimant's impairment(s). But the truth is, most physical consultative examinations would, realistically, only require the doctor to have an M.D.

In an ideal world, would it be optimal to send every claimant who lists angina or tachycardia to a cardiologist? Or every claimant who lists fibromyalgia to a pain specialist? Perhaps. But you probably wouldn't get a much better return in terms of the type of information that these exams record. A CE, or consultative exam, is basically a physical and the information that is obtained is fairly general.

Any competent doctor should be able to do one, regardless of their area of specialty, right? Also, the examining physician is not tasked with trying to sleuth anything out. He or she is simply providing a recent snapshot of a claimant's condition. Which goes to the heart of why consultative exams are scheduled in the first place. Usually, it is simply because the claimant's medical records do not contain recent documentation (meaning within the last 90 days). Recent documentation is required for social security to determine that the claimant is currently disabled and, thus, award, benefits.

Even if the social security administration came to the conclusion that it would be better to send all claimants to doctors practicing in specialized areas for consultative exams, how would this be afforded? There's no doubt that you'd have to pay more to get specialists to perform such exams. As it is now, DDS agencies are constantly recruiting new physicians to perform consultative exams because other physicians are continually dropping out of the program.

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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