When you apply for Social Security Disability Insurance (SSDI) benefits, the Social Security Administration (SSA) will use your medical records to make a decision on your claim.
Unfortunately, not all medical records have enough information in them to make the decision clear. Sometimes doctors don’t take good notes, while others simply don’t provide SSA with the requested information. Other times, people simply haven’t had much recent medical treatment when they file, either because they lack insurance or their conditions are stable.
In those situations, SSA may order a consultative exam, at their expense.
Be conscious of what is really going on
The consultative examination is supposed to be performed by an independent physician – but some of the physicians aren’t really as independent as they should be. If a physician makes a significant portion of their income from SSA consultative exams, they usually don’t want to be seen as “pro-patient,” since that could put their own future at risk.
With that in mind, here are some tips that can help you through this process:
- Remember that you are not seeing a physician about treatment. The consultative exam is strictly to determine if you meet SSA’s criteria for disability. Expect the visit to be brief, so go in prepared to list off all your conditions, limitations, medications and the treatments you’ve already tried. Do not give out more information than you’re asked.
- Remember that everything you say will be noted. It’s critically important that you do not minimize your symptoms or say anything that can be taken out of context to make it seem like you’re doing better than you are. For example, when the doctor asks how you are doing, a polite, “I’m fine,” can be written down and used to dismiss your claim. It’s better to respond directly about your condition, instead. You can say something like, “I’m struggling today with my pain,” so long as it’s true.
- Remember that you’re being watched. It’s not unusual for disability applicants to be watched as they get out of their vehicles, while they’re in the waiting room and when they go back to their cars. Be conscious of how you may look to a neutral observer and how seemingly harmless things could be used against you. For example, if you’re applying for SSDI for depression or anxiety, merely being chatty and friendly with someone else in the waiting room could be used as “proof” that you’re not really suffering from any mental health issues.
Obtaining SSDI benefits isn’t an easy process, and a consultative exam often feels like it’s designed to make things harder. You may have an easier time navigating your claim with legal assistance.