What is a Consultative Exam?

Consultative ExamA Consultative Exam (CE) is a medical examination. Some people who have applied for social security disability benefits are asked to have a consultative exam by the DDS examiner who is handling their claim. You will receive a letter asking for a consultative exam if one is needed.

If your medical records do not have enough documentation, if your application is missing a recent x-ray, or if you have not been seen by your doctor recently, then the DDS examiner may ask for a CE. This is his/her way of gathering more information regarding your condition and limitations which will further help in determining your case.

The CE will not be performed by your own doctor but by a doctor who is contracted by the Social Security Administration. The DDS examiner will request the information or tests that are needed from the physician. Your exam may include a physical, psychiatric or psychological evaluation and may or may not include blood work, x-rays or an eye exam. The examining physician will not prescribe any medication or treatment for you.

Be sure that you attend the CE if you are asked to go. If you do not attend, it may give the examiner a reason to dismiss your claim. If you are unable to attend a scheduled exam, contact your DDS examiner or the CE physician to reschedule as soon as you know you will not be able to make your appointment.
If you have applied for Social Security disability benefits, then the process will be handled by Disability Determination Services who assigns an examiner to the case. If you meet the criteria, including providing accepted medical records, then you will qualify for the benefits. However, if the DDS examiner determines that you do not qualify, your claim will be rejected.

There is a middle ground in which the DDS examiner may find that a Consultative Exam (CE) is in order and will recommend one to ensure that your application receives the full consideration before a final decision is rendered.

If you are applying for disability benefits from Social Security and need assistance, the Disability Help Center San Diego is here for you. Our phone number is (619) 282-1761 or you can visit our offices at 1833 Fourth Avenue, San Diego, CA 92101. Our friendly, courteous staff will take your call, explain our services, answer all your questions, and provide the assistance needed for you to proceed with your application for disability benefits with the SSA.

How a Consultative Exam Works

CE exam letterYou will receive a letter from the DDS examiner explaining that a CE is needed. The CE will usually be required if your medical records lack the following information;

  • Not Enough Documentation
  • Recent X-ray Needed
  • Too Much Time has Passed Since Your Last Visit to the Doctor

The DDS examiner may also have a question about the records that you provide in which a CE will be necessary to provide the answer. The CE will be conducted by a doctor apart from the one you used in acquiring the medical records. The doctor will be contracted by the Social Security Administration, so you will not have to pay for the examination.

The DDS examiner will provide the criteria to the doctor in terms of what questions will be asked and what tests will be performed. The examination itself may require having to undergo a full physical, psychiatric examination or psychological evaluation. Such tests may include the following;

  • Eye examination
  • X-rays
  • Blood Work
  • Mobility Tests and More

There will not be any treatment or medication provided as a result of the new testing, though the doctor may recommend that you be examined by your doctor in which they can make that determination. The point of the exam is to provide accurate information to the DDS examiner, so they can make the final determination about your application for disability benefits.

If you decide not to undergo the CE, that will almost certainly cause the DDS examiner to reject your disability claim. If the appointment is something that you cannot meet, be sure to contact the DDS examiner or the CE physician to reschedule and have it performed at a time that you can be there.

How Disability Help Center San Diego Can Help

Disability Help Center San DiegoWe can help you during the process of the application by applying our knowledge and experience, so that issues such as the Consultative Exam may be avoided. Our experienced professionals understand what is required by the DDS examiner to make their determination, so we can help you fill out your forms accurate and submit recent information which may avoid the CE altogether.

Keep in mind that the CE is not necessary for those who have provided recent, accurate, and complete information. That’s where our services can really help in speeding along the process of approval. By submitting all relevant information, including a recent examination, and updated medical records which include new x-rays if applicable, the DDS examiner will have no reason to order a CE and instead will base their determination on what you provide.

Please call the Disability Help Center San Diego at (619) 282-1761 today if you need assistance with filing your application for disability benefits and if you need representation during the process. You can find our offices at 1833 Fourth Avenue, San Diego, CA, 92101. Don’t delay, call today and get the process of filing for disability claims off to a smooth start.