If you’ve been scheduled for a Consultative Exam (CE) by the Social Security Administration (SSA), you might wonder what happens next and how the results of that exam will impact your disability claim. The CE is a critical step, and understanding what to expect after the exam is key to maintaining control over your case.
Understanding the Purpose of the Consultative Exam
A Consultative Exam is ordered by SSA when they need more information to make a decision on your disability claim. This could happen if your medical records are incomplete, outdated, or if there’s conflicting information about your condition. The CE is conducted by an independent doctor, not your regular physician.
The purpose of the CE is not to provide treatment but to offer an unbiased evaluation of your physical or mental limitations. While many claimants worry about this step, it’s important to view it as an opportunity to further substantiate your disability claim.
After your CE, the doctor will send a report to SSA detailing their findings. SSA will then consider this report along with your medical records to make a decision about your eligibility for benefits.
How the Results Are Used
Once SSA receives the CE report, they will review it in conjunction with your existing medical records. If the findings align with your medical history and symptoms, the exam can help confirm the severity of your disability. However, if the report contradicts your medical records or downplays your symptoms, it could negatively impact your claim.
For example, if you’ve reported chronic back pain that limits your ability to sit or stand for long periods, but the CE report suggests you had no difficulty during the exam, SSA might question the credibility of your claim. This is why it’s important to be honest about your symptoms during the exam, even if you feel better than usual on the day of the CE.
What Happens After the Exam?
- SSA reviews the report: After the doctor submits their findings, SSA will review the CE report along with all other medical evidence in your file.
- Additional requests: In some cases, SSA may request more information, such as updated medical records or clarification from your doctor. Stay in touch with SSA to ensure all requested documents are provided promptly.
- Decision-making: SSA will make a decision based on the totality of the evidence. It’s important to remember that the CE is just one piece of the puzzle, and a single exam won’t automatically determine the outcome.
- Decision notification: Once SSA has made their decision, you will receive a letter in the mail. If approved, you’ll be informed of your benefits start date and payment amounts. If denied, you’ll be provided with an explanation and instructions on how to appeal the decision.
Common Mistakes to Avoid After a Consultative Exam
- Not following up: Some claimants assume that the CE alone is enough. Make sure to follow up with SSA if they request additional documentation or clarification from your treating doctors.
- Ignoring contradictions: If the CE report contradicts your medical records, address it immediately. You or your attorney can submit additional medical evidence to refute any inaccuracies.
- Failing to keep your doctors informed: Ensure your treating physician is aware of the CE findings. They may be able to provide additional context or documentation to counter any discrepancies.
How an Experienced Attorney Can Help
Navigating the CE process can be complex, especially if the exam results aren’t in your favor. An experienced disability attorney, like those at DLG, can review the CE report and compare it with your existing medical records to ensure SSA has a clear and accurate picture of your condition. If the CE report contains errors or downplays your symptoms, an attorney can help submit additional medical evidence or appeal the decision if necessary.
Consultative Exams are an important part of the disability determination process, but they don’t have to be stressful. If you need help managing the next steps after your exam, Disability Law Group can provide guidance, ensuring your claim remains strong and consistent. Contact their experienced team today for help with any questions or concerns you have about your CE and the claims process.
