Consultative Examinations and SSDI Claims
Author: Jonathan Ginsberg
Published: 2010-05-18 : (Rev. 2013-06-08)
Synopsis and Key Points:
Be aware that not every disability case will require the services of a CE.
Main DigestBe aware that not every disability case will require the services of a CE
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 MS 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.
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:
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 he or she can make the best decision possible.
Jonathan Ginsberg has been practicing Social Security Disability law in the Atlanta, Georgia area for over 20 years. His website can be found at www.atlantasocialsecuritydisabilityattorney.net
- 1: Disability Bias in AI Hiring Tools and Legal Protection : Juyoun Han and Patrick Lin (2020/11/25)
- 2: Can School Districts Carve Out a Placement from the IDEA's Stay-Put Provision? : David Greco : RMO LLP (2020/05/01)
- 3: U.S. Jails Hold More Mentally Ill Persons Than Hospitals : Joe D. Gonzales Law Office (2010/08/21)
- 4: Ambulance Chasing Lawsuits : Litigation, Extortion and Lawyer Complaints : Emma Johnson (2013/12/28)
- 5: Lawsuit Alleging Disability Discrimination by Owners and Developers of Apartment Complexes in 13 States : U.S. Department of Justice Office of Public Affairs (2019/05/10)
- 6: Crowdfunding Legal Expenses Such as Litigation, Court or Trial Defense : Disabled World (2015/01/13)
- 7: U.S. Justice Department Files Lawsuit Alleging Disability-Based Housing Discrimination : The U.S. Justice Department (2019/02/21)
• Disabled World is strictly a news and information website provided for general informational purpose only and does not constitute medical advice. Materials presented are in no way meant to be a substitute for professional medical care by a qualified practitioner, nor should they be construed as such. Any 3rd party offering or advertising on disabled-world.com does not constitute endorsement by Disabled World. Please report outdated or inaccurate information to us.