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Why do I need a Consultative Examination?

By Christina April 4, 2018

When you are applying for Social Security Disability (SSDI) benefits, the disability examiners who will make a decision on your claim may schedule you for a Consultative Examination. This examination is an extremely important part of the process and can also be frustrating or confusing, so we want to answer some common questions about Consultative Exams, in hopes that we can help you or someone you know who is going through the Social Security disability process.

What is a Consultative Exam?

A Consultative Examination is a type of exam or test that is scheduled by a disability examiner (at no cost to you) for further evaluation of your disabling medical condition. When an examiner finds inconsistent information in your medical records or does not feel that they have sufficient evidence from your medical records to make a determination on your claim, they might then schedule you for this appointment. It’s important to note that this does not mean that your medical records are not sufficient enough for Social Security, this just means that there are various guidelines that Social Security must abide by before they can make a favorable or unfavorable decision on the claim.

If a Consultative Examination is scheduled for you, you will receive a letter in the mail from Disability Determination Services (DDS) with the date, time and location of the exam. It is important that you confirm that you are able to attend this exam or let your DDS office know right away if you are unable to make the scheduled time. Not responding or not showing up for your Consultative Exam could cause delays in the processing of your Social Security disability application, and could potentially even lead to an unfavorable decision.

Confirming the date, time, and location of your Consultative Exam is step one. Step two is being prepared when you attend.

What do I need to bring to my Consultative Exam?

It is important to bring your photo ID (such as your driver’s license) and a list of the current medications you are taking to your Consultative Exam. Once you arrive at the examination the doctor or other medical provider will conduct the requested exam or test. Following your exam, it may take a few weeks before your disability examiner has received your results. The information they receive from the doctor will then help them make a decision to award or deny your Social Security disability claim.

Can my doctor perform my Consultative Exam?

Potentially, yes. When a Consultative Exam is requested, it typically means that your Social Security disability examiner is looking for something specific, such as a test or evaluation that you have not had—or one that you have not had recently enough to help them make their determination. If your Consultative Exam is scheduled for you to have a specific test like an x-ray, you can schedule the same test with your doctor and then send the results to your disability examiner.  However, if a physical or psychological evaluation is being requested, we suggest checking with the disability examiner to see if this evaluation can be performed by your doctor. Oftentimes the examiner wants to have a different doctor do an evaluation, but in certain circumstances they will allow this information to be gathered by your doctor.

Overall, Consultative Examinations may seem overwhelming when you first receive the letter in the mail, but rest assured that this is a very common piece of the process when applying for SSDI benefits.  If this examination is scheduled for you, please confirm your ability to attend and if you have any questions or concerns, please contact our office. It is important to be sure the request is handled and responded to properly, and we are here to help you with all of that!


This post was written by a Client Advocate, Melissa.

Nothing in this post is intended as advice or a suggestion to elect or not elect to claim benefits of any kind, including Social Security benefits, nor is it intended as financial advice in any way.  The decision to claim benefits is a personal one that is contingent upon each individual’s unique circumstances.

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