The Consultative Examination
Once all of the medical records accompanying your application have been evaluated by the SSA, they may require additional information to be submitted before they can make a determination regarding your claim. The SSA will typically ask you to be evaluated by a medical professional with whom they have a contract. This is what is referred to as the "Consultative Examination." Depending upon the type of disability you are suffering from, the SSA may request that you consult a physician, psychiatrist, psychologist, or specialist of their choosing.

The medical practitioner chosen by the SSA is not contracted to treat your condition, only to evaluate the validity of your disability claim on the basis of medical examination. The SSA chooses the medical practitioner to either validate or dispute the medical opinion of your primary physician. Following the examination, the medical practitioner will file a Disability Determination Evaluation. The report will be added to your claim file and will be used in conjunction with the other files in your disability benefits application to determine your eligibility.

The SSA pays all cost related to the consultative examination. It is essential that you and your doctor comply with requests made by the SSA with regard to your consultative examination. If the SSA is unable to independently verify your claims and the diagnosis of your doctor, they may determine that you are ineligible for benefits. The SSA does not usually allow your own doctor to perform the consultative examination. However, you may request he or she be allowed to do so. Should you be able to demonstrate that you have good reason to object to the medical practitioner the SSA has selected, you may request another physician.

There are specific guidelines related to the consultative examination outlined by the SSA intended to gain specific information related to your claim. The evaluating examiner will only cover those areas specified by the SSA as issues specific to your disability claim. As a result the consultative examination may not seem very thorough.

Despite the process of the consultative examination, the SSA places greater importance upon the opinions of the treating physician, especially if he or she is a specialist in the field of your condition.

Questions on how to properly prepare for the Consultative Examination can be reviewed by our expert advocates and attorneys. This free evaluation can provide comfort that your medical information is being portrayed properly.


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