Receiving a notice from the Social Security Administration (SSA) requiring you to attend a Consultative Examination (CE) can be stressful. Many disability applicants wonder whether the exam means their claim is in trouble or whether it will determine if they are approved for benefits.
The reality is that a consultative examination is often requested because Disability Determination Services (DDS) needs additional medical information before making a decision. The exam is paid for by Social Security and is intended to help fill gaps in the medical evidence. It is not treatment, and the examiner’s role is not to decide your case.
One of the most common reasons that people get sent for consultative examinations is because Social Security’s examiners “speak the language”. This means that they directly attempt to link medical diagnoses with functional impairments. All too frequently, treating physicians do not discuss how the diagnoses they make effects an individual’s ability to sit, stand, walk, bend, focus, concentrate, etc. Enter Social Security’s contracted examiners. Please be aware that these folks are contracted physicians and psychologists, and in the experience of this attorney, they tend to understate the subjective impact of one’s diagnoses. For this reason, I have specifically included a Bonus Tip at the bottom of this article to help navigate potential bias.
If you have been scheduled for a Social Security consultative examination, the following tips can help you prepare and avoid common pitfalls.
1. Be there…
The most important thing you can do is show up for your scheduled examination or make a concerted attempt to reschedule before simply missing the date. Missing a consultative exam without a valid reason can negatively impact your disability claim because Social Security may make a decision based on the evidence already in your file.
If an emergency arises, contact your disability examiner as soon as possible to discuss rescheduling.
2. …on time
Plan to arrive 15 to 20 minutes before your scheduled appointment time. This allows you sufficient time for check-in procedures, paperwork, and unexpected delays.
When you arrive, assume that you are being observed from the parking lot all the way to the examination table. Many consultative examination reports describe how comfortably one was seated in the waiting room, how walking down the hallway went, and the ease (or lack thereof) getting on and off the examination table. All of these features may be described by the practitioner that is evaluating you.
3. Bring your Valid Photo ID
Social Security advises claimants to bring a current government-issued identification card, preferably one with a photograph. Failure to bring proper identification could delay or even cancel your appointment.
4. Bring your List of Medications
Be prepared to discuss all medications you take, including dosage amounts and prescribing providers. If possible, bring your medications in their original containers.
This information helps the examiner understand your treatment history and the severity of your medical conditions.
5. Bring Any Medical Devices You Use
If you regularly use a cane, walker, brace, hearing aid, eyeglasses, oxygen equipment, or any other assistive device, bring it with you to the appointment.
Social Security specifically recommends bringing any medical aids you normally use.
6. Review Your Medical History Before the Exam
Before presenting to the consultative examination it is not a bad idea to take time and reflect on your medical history. This could include:
- Diagnoses
- Surgeries
- Hospitalizations
- Treating physicians
- Specialists
- Major medical tests
The examiner may ask detailed questions about your medical history, and having accurate information can help ensure a complete report.
7. Think About Your Daily Activities
Many consultative examiners ask about daily functioning.
Before your appointment, think about how your medical conditions affect your ability to:
- Cook meals
- Shop
- Clean
- Drive
- Handle personal care
- Perform household chores
- Participate in hobbies
Be prepared to explain not only what you do, but also what you are unable to do, how long activities take and whether you require assistance.
8. Be Honest About Your Symptoms
One of the biggest mistakes claimants make is either minimizing or exaggerating their symptoms.
Your goal is simply to provide an accurate picture of your condition. Describe your symptoms or other limitations honestly and consistently.
The examiner is evaluating your functioning—not your ability to convince them of anything.
At most mental health consultative examinations, the practitioner will evaluate your truthfulness by administering the Rey 15-item malingering test, or similar test. They will then share the results of this particular test with their assessment as to whether their report is likely accurate or perhaps made less accurate by Claimant responses.
9. Focus on Functional Limitations
Social Security is often more interested in what you can and cannot do than in the name of your medical condition.
For example, instead of saying: “I have degenerative disc disease.”
Explain: “I can only stand for about ten minutes before I need to sit down because of severe back pain.”
Functional limitations frequently play a key role in disability determinations.
10. Explain Good Days and Bad Days
Many disabling conditions fluctuate over time.
If you experience both good days and bad days, explain:
- How often symptom flare-ups occur
- How long they last
- What limitations you experience during those periods
- What triggers the flare-ups
- How do you treat the flare-ups
Because the consultative examination provides only a snapshot of your condition, this information can help provide additional context.
11. Discuss Limitations Over Time
The ability to perform a task once does not necessarily mean you can perform it repeatedly throughout a workday.
Be sure to explain if:
- You need frequent breaks
- Symptoms worsen throughout the day
- Fatigue limits your endurance
- Pain increases with prolonged activity
Endurance and persistence are often just as important as physical ability.
12. Do Not Assume the Examiner Knows Your Entire Case
Although the examiner may review certain records before your appointment, they often do not have a comprehensive understanding of your entire medical history.
Provide complete and accurate answers regarding your conditions, symptoms, treatment, and limitations rather than assuming information is already known.
13. Remain Courteous and Cooperative
Even if the disability process feels frustrating, approach the examination professionally.
Answer questions honestly, follow instructions during testing, and cooperate throughout the examination process.
A professional demeanor helps ensure the examiner has the information needed to complete the report accurately.
14. Understand That This Is Not a Regular Doctor’s Appointment
Many claimants are surprised by how brief consultative examinations can be.
The examiner is not acting as your treating physician and generally will not provide treatment recommendations or ongoing medical care. Their role is to conduct an evaluation and prepare a report for Disability Determination Services.
Understanding this can help set realistic expectations.
15. Keep the Examination in Perspective
Perhaps the most important thing to remember is that the consultative examiner does not decide your disability claim.
The examiner submits a report that becomes one piece of evidence considered by Disability Determination Services along with:
- Medical records
- Treatment history
- Employment history
- Function reports
- Other supporting documentation
The final determination is based on the totality of the evidence, not solely on the consultative examination.
Bonus Tip: Have your physician document your functional limitations.
Rather than let Social Security examiners have the final say about how your diagnoses affect your ability to function, it is strongly recommended to seek similar statements from your treating physical and mental health practitioners. Those would be the folks most acquainted with your health over a longer period of time, and in many cases can provide a greater level of insight than a single visit with a Social Security examiner. Ask your attorney to provide forms to support this effort.
Final Thoughts
A Social Security consultative examination can feel intimidating, but preparation can make the process much easier. By arriving on time, bringing the necessary documentation, answering questions honestly, and focusing on how your medical conditions affect your day-to-day functioning, you can help ensure that the examiner has an accurate understanding of your limitations.
Remember, the purpose of the examination is not to prove that you are disabled. Your responsibility is simply to provide truthful and accurate information about your medical conditions and how they impact your ability to function and work.
Disclaimer: This article is intended for educational purposes only and should not be considered legal advice. Individuals with questions regarding a Social Security Disability claim should consult with a qualified representative like Attorney Thomas O’Brien at OBFlegal.com regarding the specific facts of their case.