Blogs Main

Medical Exam in Social Security Disability – What Should You Expect

medical exam

SSA disability claims for physical problems can be difficult to win without recent records. When their determinations are made by Social Security disability examiners for a medical exam, they prefer to have a twelve-month medical history that includes some kind of medical treatment records within ninety days of the application date. Disability examiners are not required to have a medical history of individual’s alleged medical or psychological impairment but they are required to have current information about all alleged disabling impairments.

Many disability applicants have been out of work for quite some time; consequently, they have lost their health insurance and they have no money. Therefore they may not have any recent treatment with which the disability examiner may make a decision.

Social Security disability examiners are obligated to have a current status of an individual’s physical issues prior to making their medical determination, so the social security administration has to provide the disability applicant with a medical examination (a CE, or consultative examination) to address their alleged disabling physical problems.

What to Expect at Your Social Security Disability Medical Exam

Your medical exam will help your case examiner gather the evidence needed to support or deny your Social Security Disability claim. The extent of the exam may entail a mental exam, x-rays, blood work and other evaluations and will depend on the nature of your claim. The individual will decide which tests need to be administered and ordered by the physician you go to.

It’s important to understand that the disability medical exam is not intended to treat your disability. Its sole purpose is to determine the extent of your condition and to ensure that your claim meets the guidelines set forth for approval. For example, your Social Security Disability claim might be rock solid but if you haven’t had a recent doctor’s visit (within the last 60 days) your examiner may schedule a Social Security Disability examination to meet this requirement.

As a general rule, Social Security Disability exams are very brief. Some exams may last just ten to fifteen minutes. In most cases, your disability exam will take twenty minutes or less. The exception to this rule is if you are undergoing a comprehensive mental evaluation. In these cases, it’s not uncommon for the medical exam to last forty minutes or an hour or more.

You may encounter an examiner, although your Social Security Disability exam will be brief. There have been several reports of people being treated badly at their Social Security Disability exam, while not all examining doctors are rude. Bear in mind that you only have to endure the treatment for a few minutes and then you will not have to see this doctor if this happens to you. It is never a good idea to become confrontational with your physician.

Understand that while it is not the physician’s job to approve or deny your disability claim, they can make notes as to whether or not they believe you’re healthy and able to work. There have been some reports of physicians. More than one doctor has watched a disability applicant walk back to the car after the visit just to see if that person limped in the parking lot.

You need to see that the doctor you are seeing will be evaluating the specific extent of your condition. Don’t be afraid to speak up if you feel that he or she has not gathered enough evidence during your trip. This does not mean you should be rude to the physician, but you need to explain that you feel they have not asked some critical questions related to your disability case.

Above all else, make sure you show up to your Social Security Disability test. The doctor decides if you miss the exam altogether without good reason or not to see you and if you are late, your claim for Social Security Disability benefits may be denied.

medical examWho performs a Social Security Disability or SSI Medical Exam?

Contrary to what many people believe, Social Security physicians don’t perform consultative examinations. The doctors that perform examinations are usually physicians who practice in a locality who are willing to perform consultative examinations for Social Security for an agreed upon fee per examination. Unfortunately, physicians whose medical specialty may have nothing at all to do with the disability applicant’s physical problem or issues often perform these examinations.

Although Social Security guidelines state that consultative examinations should be performed by a physician whose specialty addresses the disability applicants bodily or psychological condition, it’s rare that an individual sees their physical impairment is actually addressed by a doctor whose specialty.

This is due to the many are not willing to perform examinations, that there are so few doctors in many areas and, of those doctors. So that leaves disability applicants in the position of going to any physician who just agrees to perform a consultative examination in their field.

By their very nature, consultative examinations usually do not help a disability applicant win disability benefits. Consultative examinations are short primary evaluations performed just to meet the requirement of SSA having current information. Many times these examinations are not even ten minutes long and aren’t very thorough.

Examinations are not meant to supply any sort of treatment or an in-depth look at an individual’s physical problems. This is why it is so difficult for an individual to win their disability benefits without recent therapy notes. It is hard to determine the severity of an individual’s physical problems and their residual functional capacity (what they are able to do despite the limitations of their physical or mental problem) at a ten-minute examination with a physician who knows nothing about them.

What Happens in the Medical Exam?

What happens at a physical exam for Social Security disability or SSI? A consultative examination involves all of the elements of a routine physical examination. For instance, heart rate, your blood pressure, weight, and other facets of a typical physical examination will be checked. The physician will also evaluate the part of your impaired body and/or perform evaluations such as an exercise stress test.

What Happens After the Medical Exam?

After the examination, the consultative physician will complete Include the claimant’s main medical complaint, a detailed synopsis of the individual’s major complaint or complaints, a report of the positive and negative findings based on the history, exam, and laboratory findings which were found during the course of the exam, and a diagnosis and prognosis for the claimant.

The consultative doctor will also make a statement with regard to what a claimant is capable of doing in spite of the impairment — that is an opinion as to the claimant’s ability to perform work-related activities like lifting, carrying, standing, walking, handling things, hearing, speaking, and so on.

Can You Pass a Social Security Mental Exam?

It’s a good rule of thumb to be truthful and give any mental health testing (IQ testing, memory scales, etc.) your best effort. It’s unlikely that you can “fool” the mental health examiner who administers the examination. From time to time, An applicant for disability benefits has tried to answer exam questions to try to get approved for disability benefits. I remember one specific individual about whom, on three separate occasions, the psychologist indicated in the CE (consultative examination) report the results of the intelligence testing could not be considered valid because the claimant clearly gave less than his very best effort. The claimant ended up being denied for benefits. However, The claimant’s educational history and medical record documentation pointed to a lifelong history of impaired cognitive function – -something that might have been adequately substantiated by testing had the claimant not attempted to “game the system .”

The doctor will most likely not their suspicions in their CE report if you don’t try your best at an exam. As a disability examiner, I frequently saw reports generated by consultative physicians and psychologists that stated that an individual had not given their best performance or was even malingering (faking).

In short, if you have a health impairment that prevents you from working and you get a consultative examination, give your very best effort with no consideration concerning the outcome of the testing. A great likelihood of being denied stands because of a consultative physician or mental health professional suspects that you’re not giving an honest portrayal of the constraints caused by your mental condition. And once there’s a notation of malingering in your disability case file, it will be hard if you have to use the Social Security disability appeal process, to acquire your disability claim.

Read More: What Medical Conditions That Considered For Disability?