What Are Consultative Examinations?


Posted by: Chris

Proof is required for much of what we do in life. For example, to claim a lottery prize, you have to show a valid winning ticket. You have to show proof of income to sign a lease or a mortgage. It’s the same with Social Security Disability Insurance claims. Sometimes the proof you need is only obtainable through something called consultative examinations.

Requirements for Disability Benefits

To qualify for Social Security Disability Insurance (SSDI) benefits, you must meet the following requirements:

  • You are unable to work due to a medical condition that limits or prevents you from working; and
  • You have accrued the required number of work credits.

It’s up to the person applying for SSDI to prove they are disabled because of a ‘medically determinable impairment.’ As you might expect, this is determined using medical evidence. SSDI applications and supporting evidence typically are reviewed by state-level agencies called Disability Determination Services (DDS).

However, if the DDS is not sure you are truly disabled, they may seek additional medical evidence. That’s where the consultative examination (CE) comes in.

Proving Disability

DDS caseworkers may contact your own medical providers for additional information about your disability. However, sometimes they set up one or more consultative examinations.

Social Security Administration (SSA) rules require the DDS to try to use the ‘treating source.’ In other words, they will first contact the medical provider who currently treats you or has treated you in the past. If the treating source is unable or unwilling to perform additional tests or physical examinations, an independent source will be found. An independent source is only to be used when:

  • The treating source does not want to perform the CE;
  • Problems with the evidence will not be resolved by further discussions with the treating source;
  • The claimant asks for someone else to perform the tests with good reasons,
  • The treating source has not been helpful in the past.

If you need further consultative examinations, the DDS will arrange for the tests. They typically try to choose medical sources that are as close to the applicant’s home as possible.

Have You Been Injured at Work?

If you are planning to apply for SSDI benefits, there’s a good chance you will undergo consultative examinations at times. Anytime you have to deal with a government agency or program, it’s good to have someone on your side.

If so, contact the experienced attorneys at Armstrong & Vaught, P.L.C. at once. Let our team make the process of applying for Social Security benefits as stress-free as possible so you can focus solely on recovering from your injuries. Call us now at 918-582-2500, toll free at (800) 722-8880, or contact us online for a free consultation with a skilled attorney.