Relying on a Consultative Exam for Proof of Your Disability

Many Social Security Disability claimants assume that their consultative exam (CE) will be enough to qualify them for Social Security Disability benefits. After a CE, the SSA will still need to make a decision on if you qualify for SSDI and/or SSI. Many think even if the doctor says you’re disabled, the Social Security Administration ought to agree with their assessment. Unfortunately, that’s not often the case.

Further Reading: What Is SSI?

To qualify for Social Security Disability benefits, you need to clearly demonstrate that you are disabled to the point that you can no longer reasonably be expected to continue doing any type of work that you have ever done (especially during the past 15 years). Beyond that, the Social Security Administration must determine that you could not reasonably be expected to learn any kind of job that is available to people of your educational and experience level anywhere in the country.

This isn't the only difficulty, of course. The process itself can get complicated and frustrating. This is why it can be very helpful to hire a Social Security Disability attorney to walk you through this process and help you get the benefits you deserve.

Further Reading: What Conditions Qualify For Disability?

Will I Be Approved for Disability Benefits After a CE exam?

There are several potential reasons why the Social Security Administration (SSA) will request a consultative exam (CE). These reasons typically can include the following:

  • a need for more detail about medical findings related to your medical condition;
  • a need for more specialized medical information provided by a specialist in your medical condition;
  • information is needed about whether you can perform substantial gainful activity (SGA).

When they believe that taking part in a consultative exam (CE), many disability people who apply for SSDI or SSI make the mistake of thinking that the CE will be sufficient to qualify for social security disability benefits. However, the SSA doesn’t always agree.

As such, it is of the utmost importance that you are able to show how your disability does, and will, prevent from doing any kind of work and that your mental and physical state prevents you from learning any new skills.

The best way to be sure that you have the right medical documents—as well as ensuring that they are filled out correctly—so that you could have higher chances of the SSA approving your claim, is to work with an experienced social security disability attorney to review your claim before it is submitted to the SSA.

Taking part in a consultative exam (CE) is not a guarantee that you will be approved for disability benefits. However, a consultative exam (CE) it may improve your chances. This is because, after your examination is performed, its results will provide more details about the medical findings related to your medical condition from a doctor. This medical information typically supports the fact that you cannot earn enough money from working. This is one of the key reasons for being eligible to receive disability benefits.

Is It a Good Sign When the Social Security Administration (SSA) Sends You to a Doctor?

It might not be, but no there is no need to panic as the most likely reason is that the SSA needs more evidence to decide if you will be approved or denied for disability benefits. You will most likely be asked to see one of their doctors rather than your own doctor. If you fail to get consistent medical treatment, this is one of the top reasons you could lose your disability benefits claim.

The length of the doctor’s examination depends on the medical condition. A general medical exam should last at least 30 minutes, a musculoskeletal or neurological exam should last at least 20 minutes, a psychiatric exam should last at least 40 minutes, a psychological exam should last at least 60 minutes while other tests may be required to last for at least 30 minutes.

When you arrive at the doctor’s appointment you need at least to bring suitable identification. It is also preferable to bring a copy of your treating doctor’s assessment form if he or she has been completed. If you provide medical records you shouldn’t provide more than 15 pages. A well-written disability report from your treating doctor should state your diagnosis, summarize your medical history, includes a description of your ability to perform physical and mental tasks and a list of both objective and subjective findings which support the opinions. If all this information is made available to the examining doctor at the same time it will increase your chances of winning disability benefits.

How Long After a SSD Exam Will I Get a Decision?

Oftentimes, people hear back about a decision around a month after the CE has taken place. However, some people may have to wait to hear back for up to 3 months after their exam.

After the consultative examination, you will have to wait before you receive an answer from the Disability Determination Services (DDS). Usually, the doctor who conducted the exam will send their evaluation results to the DDS within 10 business days of the examination taking place. However, sometimes more tests are required which will lengthen the waiting time. If a new medical condition has developed, this will also slow down the decision-making time.

Sometimes, you will be asked to provide more information about your medical condition. If this happens, you should do this as soon as possible. Otherwise, you may face more delays until a final decision regarding your eligibility for disability benefits is made.

Unfortunately, the doctor who performs a consultative exam for the SSA doesn’t always support the claimant. This means the findings may not support your claim that you are unable to work. If the DDS denies your claim after a CE, you will need to lodge an appeal which will lengthen your wait to hear if your claim for disability benefits is successful.


Your consultation with a doctor, whether your own doctor or one who is appointed by the Social Security Administration, will give a proper medical opinion on your disabling condition. However, the problem that many claimants face is that a medical prognosis usually fails to outline exactly what kinds of activities you can or cannot continue to do with your particular condition.

In some cases, your medical evaluation will provide a diagnosis that meets a Social Security Disability listing by itself. In such cases, the consultative examination may prove sufficient.

However, more often than not, the medical evaluation will not provide the kinds of details the SSA adjudicators need to see before they can approve your Social Security Disability claim.

Remember, Social Security adjudicators are not doctors. They don’t make real judgment calls unless their guidelines specifically address that situation. What they need to see is how your condition limits your ability to walk, stand, sit, push, pull, lift, interact with others, and perform other activities that are important in the workplace.

Why Documentation Matters

When it comes to medical documentation for your Social Security Disability claim, more is definitely better. You will want as much information about your disabling conditions as you can put together, complete with a full analysis of how these conditions limit you.

It’s also a good idea to be able to demonstrate that you have been following a doctor’s orders and that your condition has failed to improve sufficiently enough to allow you to perform meaningful work. In many cases, SSA adjudicators can’t approve claims if the disabled person has not complied with a doctor’s instructions.

The best way to make sure that you have sufficient medical documentation and to ensure that the documentation is filled out in such a way that the Social Security Administration will approve your claim is to have an experienced Social Security Disability attorney or advocate review your claim before you turn it in to the Social Security Administration.

How Disability Attorneys Can Help

Disability lawyers work with disability claims on a regular basis, and are thoroughly familiar with the SSA’s procedures and requirements. In many cases, they can communicate directly with your doctor to make sure that your diagnosis is stated in a manner that will satisfy the SSA’s requirements for approving disability benefits.

In some cases, the SSA may require proof of some diagnoses. Often, there are specific test results that must accompany a disability claim in order for the SSA to approve benefits based on a particular condition. Again, your Social Security Disability lawyer will be familiar with these requirements and can make sure that everything is in order before you file your claim, potentially saving you several months of frustration.

Don’t make the mistake of assuming that your consultative exam will give you enough proof of your disability. Have a professional look your claim over and advise you regarding whether you will need more or different kinds of medical proof before you file. They can also tell you about other common disability mistakes and help you avoid them or help fix any you may have made.

Contact An Attorney Today

Having an attorney on your side can make this part of the process easier to navigate and may be more likely to result in you getting the benefits that you need. Contact an attorney today to find someone who will advocate on your behalf and give you some peace of mind during this confusing, exhausting time.

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