The Consultative ExaminationPosted April 30, 2015 by Premier Disability Services, LLC® The Social Security Administration (SSA) may schedule a claimant for what is called a consultative examination (CE) during their claim. This examination is performed by an independent physician who is contracted by SSA to perform an evaluation of a claimant’s physical or mental impairments. Often, these examinations are scheduled when a claimant’s medical file is out of date, the file lacks imaging or other objective findings, and/or the file lacks evidence of a specific impairment, such as a psychological condition.
A consultative examination may entail multiple different methods of evaluation; including x-rays or other imaging, cognitive testing, a physical examination, or a psychiatric evaluation. They may also entail laboratory testing or blood work. These examinations are not meant to be construed as treatment and many CE Physicians will clarify this point prior to the examination. Consultative examinations are often brief in comparison to an appointment with a treating physician.
There are inherent deficiencies in the accuracy of a consultative examination. First, the CE Physician has likely never seen the claimant they are examining. It is difficult to accurately assess the severity of a condition after only one examination and this often leads to the physician assessing the claimant with unrealistic functional abilities. Further, these physicians do not always have access to the claimant’s medical file prior to performing the examination. As a result, they are given only a snapshot of the claimant’s conditions rather than the entire medical history to put the severity of the claimant’s conditions into perspective.
If you are scheduled for a consultative examination, it is important that you do not miss your appointment unless you have good reason. Failure to attend this examination may result in SSA denying your claim due to lack of evidence or failure to cooperate. While these examination reports can sometimes be inaccurate or unsupportive, there are methods of getting around this issue. For example, a supportive statement from a treating physician that contradicts the CE findings can be extremely beneficial to a claim. Hiring an experienced Representative is also very beneficial to overcoming this problem. An experienced Representative will know the rules and regulations that deal with non-treating medical sources, and they will be able to craft a strong argument as to why these opinions should be given little weight.
If you are considering filing for disability benefits, or you have already filed, please contact our office for a free evaluation of your claim.
By: Thomas A. Klint of Premier Disability Services, LLC®