SSDI Claims: Consultative Examinations
Ian C. Langtree - Writer/Editor for Disabled World (DW)
Published: 2010/05/18 - Updated: 2024/06/05
Publication Type: Informative
Topic: Lawyers and Rights - Publications List
Page Content: Synopsis - Introduction - Main
Synopsis: Consultative examinations are sometimes requested in an effort to obtain the opinions of outside medical professionals in order to evaluate disability claims. Depending on the nature of the claim, the claimant may be referred to a psychiatrist, a psychologist, or regular physician in order to obtain an independent opinion.
Introduction
What Are Consultative Examinations?
Where social security disability (SSDI) hearings are concerned, consultative examinations are oftentimes requested in an effort to obtain the opinions of outside medical professionals in order to evaluate disability claims. Although the SSA will always evaluate and take into consideration all of your treating physician's and specialist's records, they may also require you to submit additional evaluations by an independent medical professional. This is done in order to obtain additional substantiating evidence on your behalf.
Focus
The Function of the Consultative Examiner
The SSA will select the CE who is ordered to examine the claimant.
Depending on the nature of the claim, the claimant may be referred to a psychiatrist, a psychologist, or regular physician in order to obtain an independent opinion. The claimant is not going to be treated by the professional who performs the consultative examination. Their function in your Social Security Disability hearing is to conduct an examination, prepare documentation relative to their findings, and then submit that documentation to the ALJ hearing your case.
As the claimant, you are allowed to read their report, called a Disability Determination Evaluation (or DDE) prior to the hearing. The DDE will be considered by the SSA in order to determine whether or not they are going to award you any benefits. Just be aware that not every disability case will require the services of a CE. Based on the individual facts involved in the case, some cases will already have several evaluations documented.
Additional Considerations With CE's
Should a claimant be suffering with more than one medical or psychological condition, the SSA may order additional CE's from several different specialists such as neurologists or orthopedists for example. The SSA determines whether or not a CE is needed and their decision will typically be based upon certain factors relative to additional medical evidence that is needed above and beyond the current documentation on hand.
This required information includes:
- Lab tests
- Prognosis
- Diagnosis
- Clinical findings
- Other clinical reports
Additionally, the SSA pays for the consultative examination and when one is requested, the claimant is obligated by law to participate.
Consequences of Not Showing Up for Your CE
There is a good possibility that the SSA will deny your benefits if you do not participate in a CE. Remember that it is important to always cooperate with the demands of the hearing. Typically, that CE is requested based on a need for further information relative to your case. It is not requested in order to deny you the SSDI benefits you deserve and need. The judge just needs further information so they can make the best decision possible.
Author Credentials: Ian is an Australian-born writer, editor, and advocate who currently resides in Montreal, Canada. He is the founder and Editor-in-Chief of Disabled World, a leading resource for news and information on disability issues. With a global perspective shaped by years of travel and lived experience, Ian is a committed proponent of the Social Model of Disability-a transformative framework developed by disabled activists in the 1970s that emphasizes dismantling societal barriers rather than focusing solely on individual impairments. His work reflects a deep commitment to disability rights, accessibility, and social inclusion. To learn more about Ian's background, expertise, and accomplishments, visit his full biography.