Consultative Examinations for Mental Impairments

If you’re applying for disability due to a mental health disorder, Social Security may ask you to attend a consultative examination (CE) with a psychologist or psychiatrist to better understand your condition. CEs are a very common step in the disability determination process, and are typically scheduled after you first submit your application for benefits (or after you’ve appealed a denial).

Social Security can schedule you for a mental CE even if your application only lists physical conditions. Because your mental health can affect the types of tasks you’re able to do or how you interact with others, the agency needs to know if you have any cognitive or emotional limitations that would keep you from performing certain jobs. Therefore, when you go to a mental CE, it’s important to be forthcoming about any symptoms of depression, anxiety, or related disorders you’re experiencing. 

Your mental CE should take roughly one hour. The psychologist or psychiatrist conducting the exam will likely start by asking you about your medical history and any mental health issues you’re experiencing. The doctor will also ask about any therapy, counseling, or medications you’ve taken in the past, and whether these treatments worked for you. Finally, the doctor will ask about the ways in which your mental health interferes with your daily routines, such as grocery shopping, paying bills, and cleaning the house. 

Depending on your specific condition, the doctor is also likely to administer a mental status examination. Mental status exams involve several simple questions designed to evaluate your memory, mood, and reasoning abilities. The doctor may ask you to count backwards from 100 by threes, recall basic objects after five minutes, or interpret a set of pictures. 

The mental status examination will be included in the psychiatrist or psychologist’s report to Social Security, along with their observations about your behavior. It’s common for the doctor to describe your appearance, speech, and “affect” (how your emotions appear to others). For example, somebody with few to no symptoms of a mental impairment may be described as well-groomed, speaking at a normal volume and rate, with a “broad affect” (healthy range of emotional responses). But somebody with severe depression may be described as disheveled in appearance, speaking very slowly and softly, with a “flat affect” (limited emotional responsiveness). 

It’s normal to be nervous during the CE, especially if you haven’t had any formal mental health evaluations before. You might be worried about messing up or saying the wrong thing, but the CE isn’t a pass or fail event. Answering the questions honestly and with specific details is the best way to approach a mental CE.