What Now? Doctor Refused to Perform Disability Examination.

What Now? Doctor Refused to Perform Disability Examination.

Consultative Examination for SSDI Benefits
What to Expect if Your Physician Refuses to Perform the Disability Examination

To qualify for Social Security Disability Insurance, you will need to prove that you have a condition that is disabling. This requires that you submit the proper paperwork, such as:

  • Medical records that include your medical history;
  • Any treatments or surgeries you’ve undergone;
  • History of your prescribed medications;
  • An official diagnosis;
  • And, more.

If the Social Security Administration (SSA) deems that the information you’ve provided is insufficient for proving your condition, they will require that you undergo a consultative examination.

What is a Consultative Examination?

A consultative examination is a medical exam performed by a physician chosen by the SSA. The results of the exam will help the SSA determine validity of your claim. These exams become required if you haven’t submitted the proper medical information.

The SSA will often contact your doctor to request your medical records. If your doctor refuses or does not respond, then you will need to get a consultative examination.

If your disability is obvious then you shouldn’t have to worry about a consultative examination. For example, you’re bound to a wheelchair due to a serious physical condition. A doctor will identify with relative ease that you do, in fact, have a disabling condition.

Unfortunately, not all conditions are obviously disabling upon first sight. This can make it difficult for a doctor to make a proper prognosis in just a single visit; this is especially true with mental conditions.

Using Your Own Doctor

One thing that a lot of people don’t realize when they get a notification telling them that they must get a consultative examination is that they can get their doctor to perform it. Your doctor will be much more familiar with your medical history, which means that you should feel much more comfortable with them performing your exam instead of someone contracted through the SSA.

However, to get your doctor to do the exam, you will need to ask them. Not all doctors are willing to perform exams on the behalf of the SSA since it requires a lot of paperwork and the reimbursement from the SSA is minimal.

If you have a willing doctor who agrees to perform the exam, you will need to inform the disability analyst listed on your consultative exam notice. They will have to send the proper paperwork to your doctor to fill out. They are required to do this in accordance with Social Security regulations.

Undergoing a Consultative Exam

If you have a willing primary doctor that agrees to perform a consultative exam, you will need to go to a doctor chosen by the SSA. Here are a few tips that you should follow to help ensure that the exam goes well:

  • Bring a witness.

    Ask a friend or family member to come with you for your exam. You can have someone with you and they should pay attention to how long the exam takes and how thorough the doctor is. This way, if you receive a rejections notice after a doctor only spent 15 minutes with you, you can provide proof that the doctor did not spend an adequate amount of time examining you.

  • Record the exam if possible.

    Bring a tape recorder (or download a recording app on your smartphone) and ask the doctor if they mind if you record the exam. This will give you proof of whether the exam was properly conducted should you receive a rejections notice. For example, the medical examiner may not ask enough questions or the right questions to truly determine whether you have a qualifying disability.

  • Write everything down.

    If the doctor refuses to be recorded, then make sure to note that you asked and that the doctor refused. Then, try to write down every question that they ask you. You can even have your witness write down the questions they ask.

If your application is rejected and you believe the consultative examination wasn’t properly conducted, you’ll want to take your notes to a professional for assistance in appealing the decision. Here at Social Security Disability Advocates USA, we can also help you prepare for a consultative examination. Be sure to call us at (602) 952-3200 today for a free consultation.

 

The information on this blog is for general information purposes only. Nothing herein should be taken as legal advice for any individual case or situation. This information is not intended to create, and receipt or viewing does not constitute, an attorney-client relationship.

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