A Consultative Exam Request for a Social Security Disability Case
Q: Does everyone who files a social security disability claim have to do another medical examination?
A: During the review process, some social security disability claims will be required to have a consultative exam before a decision on the case can be rendered. A consultative examination is requested because of one of two things. If there is not enough information provided by medical files to allow the disability case manager to make a decision on an application, then an exam will be needed. The other reason an exam will be required is to provide current medical information regarding the condition of the claimant. Do not panic if a consultative exam has been requested for your case. Your attendance is mandatory and your application cannot be approved or denied without the exam, once it has been requested. If you intentionally miss the consultative exam and do not try to reschedule, your social security disability claim could be denied due to your failure to cooperate. The exam is paid for by the Social Security Administration.
Q: Will my doctor conduct a requested consultative examination?
A: The disability manager for your case will typically not request that your physician conduct the CE. The examination is normally conducted by a physician who has not treated you for the current injury or condition. Speak with the social security disability examiner assigned to your case if you believe you have not been treated fairly by the doctor who provided your CE. If that doctor provided an exam for a previous case of yours that was not approved, for instance, you can request a different physician. The physicians who provide CEs for social security disability claims are not Social Security doctors. The physicians who conduct the exams are independent physicians that have a contract to provide such services to the agency.
Q: Is it possible to get retroactive benefit payments for social security disability?
A: A fair number of applicants approved for social security disability benefits receive back payments. The main reason for this is because the review process for claims can take a considerable amount of time. Applicants can accrue benefits retroactively from the date of application and, in some cases, up to a year prior. The 5 month waiting period after the date of onset will not be included in back pay.