Applying for Social Security Disability Insurance (SSDI) benefits is seldom an easy process. Many claimants end up being asked to undergo a consultative exam (CE).
Consultative exams are evaluations performed by (supposedly) unbiased medical professionals in order to provide clarity about a claimant’s condition. If you’ve recently been contacted and asked to go to one or more consultative examinations, here’s what you need to know.
This doesn’t mean that your claim is about to be denied
It’s a bit far-fetched to think that the CE physician is really as independent and unbiased as the Social Security Administration (SSA) would have people believe – especially if they derive a lot of their income from the CEs. However, that doesn’t mean the CE will automatically be used to deny your claim. SSA is at least considering an approval, or they wouldn’t be paying for the CE.
If you don’t attend the CE, you can probably expect a denial
If you don’t agree to the CE, SSA probably will deny your claim because there is something in your file that’s unclear. CEs may be ordered when there is conflicting information in your medical records or one of your primary treating providers fails to provide their records. They’re also sometimes used when you haven’t seen a doctor in a while (or ever) for one or more of your conditions. If you force the decision to be made without the CE, you’ll likely regret it.
Consultative exams can be scary, but it’s important to approach them calmly. Review your own medical records carefully before you go, consider taking someone with you (as a witness to how thorough the CE actually was) and be clear and direct with the doctor – without exaggerating.
You should never do or say anything that could throw doubt on your claim. If your SSDI claim is denied, you do have appeal rights – and there is legal help available.