As part of your application for disability benefits, the Social Security Administration (SSA) might ask you for a ‘consultative exam.’
That means you’ll meet with a doctor they’ve contracted, sometimes called a ‘disability doctor,’ who can independently assess your condition.
Being asked to do a consultative exam can feel a bit nerve-wracking. Why do you need a whole new exam, with an entirely different doctor?
But it’s a totally normal part of the application process. Consultative exams are just a way for the SSA to get a little more information. They’re meant to supplement, not replace, information from your own doctor — so as long as you go in with realistic expectations, there’s nothing to be concerned about.
Here’s exactly what you can expect to happen after you meet with a disability doctor for your consultative exam.
Why do I need to get a consultative exam?
If the SSA has asked you to take a consultative exam, it just means they need more information.
To gather more evidence because the evidence obtained is not enough to make a disability determination;
To obtain more detailed medical findings about your impairment(s);
To obtain technical or specialized medical information;
To resolve conflicts or differences in medical findings in the evidence already in file; or
To resolve the issue of your ability to do substantial gainful activity, if you are an adult; or, if you are a child under age 18, your ability to function like other children your age who do not have impairments.
If the SSA requests a consultative exam, they’ll set up (and pay for) an appointment with one of their contracted doctors. The doctor will do an exam to assess your level of functionality, and share that information with the SSA — specifically, your local Disability Determinations Services (DDS) office.
Then, the DDS office will approve or deny your benefits application, based on both the consultative exam and the rest of the information in your application.
Is a consultative exam a good or a bad thing?
Many disability applicants find these exams a little intimidating, Medical appointments are never fun, especially with a doctor you’ve never met before.
But it might help to think about your consultative exam as more of a formality.
In practice, it’s uncommon for these exams to turn up information that will actually help your case. After all, this doctor works for the SSA, and they’re only just meeting you for the first time — they don’t have the context and background knowledge that your own doctors would have.
But that’s not actually a big deal. Just don’t approach this exam as a chance to prove your disability, or rely on it for medical information.
After you see a disability doctor, the examiner will complete a report of their findings, and send it to the DDS. If you like, you can ask them to share your findings with your own doctor, too.
But be aware that the application process is far from over after your consultative exam.
It could still take months for the DDS office to process your case and make a decision — and remember, most people’s first disability claim is denied (even if they’re eligible).
If your application is denied, you’ll want to have as much information from your own doctors as possible to help you (and your lawyer) make your case.This is why it’s so important to work with a disability lawyer throughout the process, whether or not you need to attend a consultative exam.
One good strategy is to book an exam with your own doctor, who understands and is treating your condition, around the same time as your appointment with the SSA’s doctor. If you disagree with the DDS’s decision or findings, this information will make it much easier for you and your lawyer to effectively appeal your case. (In general getting regular treatment, and having updated medical records, goes a long way towards a successful application).
How do I know if my consultative exam went well?
If you aren’t sure how your consultative exam went, you aren’t alone.
These exams usually aren’t as in-depth as they could be — remember, they’re more of a formality on the SSA’s side, not a way for you to get professional insights into your condition.
But that’s okay. This doctor isn’t the one deciding whether you get benefits; that’s up to the SSA and your local DDS office.
Even if you didn’t have a good feeling about your exam, or didn’t feel heard by your doctor, it doesn’t mean your application will be denied. And even if it is, you have plenty of chances to appeal and change your decision.
The most powerful way to improve your chances of getting disability benefits is to work with your own lawyer and doctor, not stress about the outcome of your consultative exam.
How to get help with your consultative exam — and your whole disability application
Support is available to help you get disability benefits. You don’t need to pay out of pocket to hire a lawyer, and your claim is three times more likely to be successful if you have legal representation.
This guide is a great place to start, but a disability lawyer will give you more personalized guidance; not just before your consultative exam, but throughout the whole application process.
If you’re not sure whether you’re ready for a lawyer, take our two-minute quiz. It will give you a sense of where you are in the process, whether you might qualify for benefits, and how much assistance you might get.
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