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Wednesday, January 7, 2009

Disability Benefit Tip: Social Security Consultative Exams

If your Social Security caseworker does not have enough medical information to make a decision on your claim, he or she will usually order a consultative examination ("CE") at Social Security's expense. The exam may be needed because the caseworker did not receive copies of your medical records, your doctor's notes were illegible, or because the written records simply did not have enough information about your condition and work restrictions. The case workers sometimes request additional information from your doctors, but they can only wait a limited amount of time for a response before needing to move the claim forward.

You will be notified of the examination date and time in writing. If you have a conflict or cannot make the appointment, contact your caseworker immediately to reschedule. Do not wait until the last minute - it can delay your claim significantly or result in a denial. You can also refuse to go to the exam, but your claim will likely be denied because of it.

A few points to remember when at the exam:
  • Cooperate with the doctor. Do not exaggerate your symptoms, but do not minimize them either. The doctor has access to your medical records and may be able to tell how truthful you are. The doctor will probably ask you to do something that is difficult or painful (like testing your range of motion). Do the best you can, and if something hurts, explain that. If you don't try or refuse outright to do something, the doctor may view you unfavorably or conclude that you are lying about your condition.
  • The exam probably will not be very thorough or in depth. When you are done, you should immediately write down what occurred, including the amount of time that you actually saw the doctor. Note also how much the doctor relied on your own statements and how much observation was made of your condition. For example, if one of your symptoms was knee pain, did the doctor have you flex and extend your knee while watching you, or did he just take a brief look and start writing?
  • You can take someone with you to the appointment. They are not usually allowed in the exam room, but they can also write a statement attesting to the amount of time your appointment lasted.
  • Also remember that you may be observed from the time you step out of your car to the time you get back in. Doctors will report if they observed you walk to the office with no problem but start limping as soon as you walk in the door. Again, do not exaggerate or fake anything, but be aware that other staff besides the doctor could be watching.
  • Make sure to take an acceptable form of identification, a list of medications that you take and the bottles they come in, and any glasses, canes, or other assistive devices that have been prescribed by a doctor.

Copyright (c) 2008 by John V. Tucker and Tucker & Ludin, P.A. All rights reserved. For assistance with your Long Term Disability claim, ERISA Disability benefit claim, Social Security Disability claim, or Veterans Disability compensation or pension claim, call Disability Lawyer John Tucker at (866) 282-5260.

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