Consultative Examinations for Physical Impairments

Many people who apply for Social Security disability benefits will be asked to attend a consultative examination (CE) early on in the disability determination process. Physical consultative examinations are a way for Social Security to get a better idea of your health and what strength-related limitations you have that affect your ability to work.

Social Security may send you to a CE if they don’t have enough information from your medical records to determine if you’re disabled. This can happen if your records are old, incomplete, or unclear. A CE can help fill in the gaps by having a doctor perform a physical examination and send a report about their findings back to Social Security.

If Social Security decides that you need a CE, they’ll schedule an appointment with a doctor who is contracted by the agency to perform examinations. You’ll receive a letter that tells you when and where to go for your CE. If you don’t think you’ll be able to attend the appointment, let Social Security know, and they’ll reschedule it for you. Don’t just not show up—that can be very damaging to your disability claim. 

During the exam, the doctor will ask you about your medical history and current symptoms. Be honest and give complete information. The doctor will likely also do a physical exam and may run tests or take an X-ray, depending on your specific condition. For example, if you have back pain, the doctor might check your range of motion (how far you can bend and twist). If you have carpal tunnel syndrome, the doctor may have you perform exercises that measure your grip strength. 

After the exam, the doctor will write a report about what they found. This report is sent to Disability Determination Services (DDS), a state agency that helps Social Security decide if you qualify for benefits, and added to your file. 

Even though CE doctors are hired by the Social Security Administration, they’re supposed to conduct fair and independent evaluations and are asked to state that they’re not influenced by the agency. Of course, the doctors are human, and biases can unwillingly affect their conclusions. So while CEs can be helpful if you haven’t seen a doctor in a while, a one-time examination is no substitute for care by a regular doctor who knows you well and is familiar with your medical history. If the cost of medical care is prohibitively expensive, check for free or low cost options in your community to establish an ongoing relationship with a doctor near you. 

Social Security Announces Changes to their Overpayment Process

An overpayment occurs when the Social Security Administration (SSA) pays an individual more benefits than what they are eligible to receive.  These overpayments most commonly occur when SSA incorrectly calculates the benefits owed to a claimant.  They can also occur if SSA obtains new information that results in either a reduction in what should have been paid, or renders a claimant ineligible for a period for which they already received benefits. 

These overpayments cause a substantial hardship on claimants who are relying on their benefit payments just to get by.  By law, SSA is required to collect these overpayments back from a claimant.  Unfortunately, in many cases, claimants do not realize they have been paid incorrectly and spend the benefits immediately to avoid foreclosure, pay off credit cards, or pay medical bills.  Once SSA realizes they have overpaid an individual, they will start collecting that money back.  If the claimant cannot pay the full amount immediately, SSA can take a claimant’s entire monthly benefit.  This results in disabled Americans facing the same financial hardship that led to them filing for benefits in the first place. 

We are excited to hear that SSA has now changed their overpayment policies to be much more favorable to claimants.  Instead of withholding a claimant’s entire benefit amount to recover an overpayment, SSA is now defaulting to recovering no more than 10% of a claimant’s monthly benefit.  Their agency is also extending the period they will approve payment plans by an additional two years (from 36 to 60 months).  Finally, claimants who request overpayment waivers no longer have to prove they are not at fault for the overpayment.  That burden is now on the agency. 

There is nothing more frustrating for our firm than to see a disabled person who desperately needs financial support have their benefits taken merely because a calculation error occurred.  The changes to SSA’s overpayment collection process are a welcome change that we are excited to see going forward. 

By: Devon Brady of Premier Disability Services, LLC

The Trial Work Period Before Being found Disabled

In the process of your case for disability, you may think that your impairments have improved. You may feel like you can go back to work, but you are scared to do so. After all, your case for Social Security benefits has lasted this long and you don’t want to go through it all again, so you may find it risky to return to work at all.

            The good news is that the Social Security Administration has a rule that allows you to test your ability to return to work.^[1] A “Trial Work Period” is a time in which you can test your ability to work and still be found disabled.^[2] This test can happen before you get benefits or after you receive benefits.

            There are some limitations with attempting to go back to work. The first is that you cannot work for more than 9 months in a 5-year period.^[3] The months that you do not work do not have to be consecutive, so you could work for 3 months, 4, months, then 2 months and the work would still be considered a “Trial Work Period”.

Another requirement is that you cannot test your ability to perform work within 1 year of the day you became disabled, or your “Alleged Onset Date”.^[4] The reason for this requirement is that the Social Security Administration wants to make sure that your impairments really did last for a full 12 months, as injuries that can heal that quickly are not considered when determining disability. Lastly, you must be eligible to receive ongoing benefits before returning to work.^[5] This requirement means that there is enough medical evidence in the file to prove that you were disabled prior to returning to work. We at Premier Disability Services, LLC will work diligently to make sure this requirement is met, from requesting medical records to writing letters to judges to point out why the medical records show you are disabled. So contact us today if you are interested in having us represent you in your claim for Social Security Disa

^[1] 20 CFR § 404.1592

^[2] 20 CFR § 404.1592(a)

^[3] 20 CFR § 404.1592(e)(2)

^[4] 20 CFR § 404.1592(d)(2)(iii)

^[5] 20 CFR § 404.1592(d)(2)(i)