What is a consultative exam?

consultative exam
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A consultative exam is ordered when Social Security believes that they need more medical information to make a decision in your case. This exam is scheduled by and paid for by Social Security. It is only an exam. The doctor will not provide any treatment and will not prescribe medication for you.

If you are scheduled for an exam, Social Security will send you a letter about the appointment. If you cannot keep the appointment, you need to let Social Security know immediately so that it can be rescheduled.

Many of our clients call these a social security doctor. Although the doctor is paid by Social Security, they do not work for Social Security.  Your examining doctor may be very understanding and care about your situation. However, they really have no control over the decision in your case. 

What happens during a consultative exam?


The exam may be for a physical exam for medical problems such as back pain or tremors. A psychological exam can be ordered for people who have depression, bi-polar disorder or other mental health issues. 
Depending on the type of disability you have, x-rays or bloodwork may be performed. These exams may also be ordered for children who have applied for Child’s SSI benefits.

You need to be honest with the examiner about your health and not try to put on a brave front. If you are hurting, then you need to say so. If you go in and tell the doctor that you are “fine” or “ok”, that will also be noted in the report.

What is a consultative exam report?


The doctor is paid to perform a physical or mental health exam and file a report with Social Security. The report does not include an opinion about whether or not you are disabled. The report usually includes your diagnosis any anything the doctor noted about your limitations. For example, they might give an opinion about how long you can be on your feet or might say that you cannot lift heavy objects. A psychologist or psychiatrist might say that you would have trouble working with a lot of people. 

The exam report will be reviewed by the staff at Disability Determination Services (or the judge if your exam was ordered by the hearing office) once it is placed in your file. The consultative exam report is only one of the things that will be looked at before a decision is made in your disability claim.

It is very important that you attend the exam. You are being sent for the exam because Social Security needs more information about your condition. If you do not attend the exam, it is likely that your claim will be denied.

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Established in 2011, Lunn & Forro, PLLC, is a client-focused firm recognized for excellence in providing top-level legal services. We assist the sick, injured and disabled in obtaining the benefits that they are entitled to receive.

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