Getting seen by a doctor for Social Security Disability in Texas

The term "Social Security Doctor" can be a little confusing to individuals who file for disability in Texas. This is because the phrase actually applies to two different types of doctors.

Only one of them, however, actually works for social security. This is the ME, or medical examiner, who works with the disability examiner (at a state agency that renders disability determinations for the social security administration) on either a disability application or a disability reconsideration (the first appeal).

The second type of doctor, the one that does not actually work for social security, is the doctor who conducts the independent medical exam (usually referred to as a social security medical exam, or a consultative medical exam). Though this doctor is actually a private physician who has contracted to provide examination services for Social Security Disability and SSI cases, he is usually referred to as a "social security doctor" by claimants.

Now that we have the defintion of a social security doctor out of the way, what are the examinations conducted by these doctors like? As I have written several times, the examinations are as follows:

1. The exams are short. As a disability examiner, I was frequently told by claimants that their exam only lasted ten minutes and sometimes not even that long. This is despite the fact that social security administration rules actually require a doctor to provide a minimum of thirty minutes for examinations.

2. Very often the social security doctor conducting the consultative exam knows little to nothing about the claimant's medical history. This happens even when the disability examiner who has scheduled the exam has sent some of the claimant's medical records to the examining physician.

3. Too often, independent physicians performing such exams are somewhat rude to the claimants they see.

So, what should an applicant for Social Security Disability or SSI in Texas prepare themselves for in the event they are scheduled to be seen by a "social security doctor"?

First of all, the claimant should remember that these exams are not for the purpose of providing medical treatment. In fact, in most cases, they are scheduled for only one reason, which is for the disability examiner or disability judge (if the case is at the hearing level) to obtain a recent medical record snapshot of the claimant.

Very often, this becomes necessary to the processing of a case when a claimant has not been to a doctor in more than two months or when a claimant has not received treatment for a condition that they have listed on a disability application. Secondly, of course, the claimant should keep in mind the things I've discussed in this post, which is that the exam may be incredibly short and the doctor may be suprisingly detached or even rude.

However, despite this, a person who has been scheduled for an exam should always go to their appointment. A failure to attend a CE (consultative exam) will mean that the exam will need to be rescheduled, which can waste several weeks of valuable time (especially valuable for claimants whose financial situations are deteriorating). And a repeated failure to attend a social security medical exam can actually provide the basis for a denial (for failure to cooperate).

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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