Obtaining Social Security Disability Insurance (SSDI) benefits isn’t easy. A lot is riding on the medical evidence that’s in your file – and, sometimes, there just isn’t enough there.
In those situations, the Social Security Administration (SSA) may ask you to attend one or more consultative examinations (CEs).
Beware of “hired guns” posing as neutral parties
If SSA asks you to go to a consultative exam, they will schedule the appointment and pay for it – along with any tests that the consultative provider decides are necessary.
While you can technically refuse to go, that’s generally unwise. Typically, consultative exams are done when:
- Your own medical providers haven’t returned requests for information.
- Your medical providers have provided information that was requested but it’s unclear.
- You haven’t been seen by a doctor for your condition for a while and it may have improved.
- There’s conflicting information in your medical files and SSA is looking for a “tie-breaker” opinion.
If you refuse to go to the consultative exam, SSA will make its decision based solely on what is already in your file, and that’s highly unlikely to be favorable.
However, you also need to be cautious when you attend a consultative exam. While some doctors do an occasional consultative exam for SSA and are truly neutral, there are physicians who make a good portion of their living simply doing these kinds of evaluations. If they were to appear too “patient-friendly,” they would be unlikely to keep getting SSA’s referrals.
For that reason, you want to go into a consultative exam with the understanding that you are being scrutinized very carefully. You need to be clear about your condition and concise about why you cannot work. Additionally, you may benefit from seeking legal guidance to help you navigate this situation and get your claim approved.