Should I go to my Consultative Examination with Social Security?

by Vaughn Clauson on February 21, 2012



The simple answer is yes!

Most of my clients, when being evaluated for disability, receive a notice that Social Security is scheduling them for a “Consultative Examination.”  Many times, my clients receive more than one such notice.  Some of these clients call my office and ask whether they should attend these examinations.  Almost universally, I advise my clients to go to the examination, to arrive on time, and to bring a list of all your symptoms and medical problems, both physical and mental.

Many of my clients tell me that these examinations scheduled by Social Security are extremely superficial, even unprofessional.  I believe that if that is true, it is because Social Security pays so little for their examination reports, which forces the examining consultant to put as little time as possible into the reports.  Some of these reports contain errors, and are needlessly damaging to my clients’ cases.  So:  why do I advise clients to attend these consultative examinations?  Very simply, I do so because if clients do not attend the examinations, then Social Security will deny the claim based upon “failure to cooperate.” Additionally, there are some cases in which these examinations help my client’s case.  I have many clients who do not have health insurance and are unable to pay for regular medical treatment. In some of these cases, particularly when my client is over 55 years old or of borderline intellectual functioning, these “CE” examinations can provide additional documentation of their health conditions and in some cases a new diagnosis.

There is another way to go, however, if the lawyer and client are willing to spend a little more time in communicating and preparing your treating physician to render an opinion about your health and your inability to work.  Social Security’s rules specify that “When in our judgment your treating source is qualified, equipped, and willing to perform the additional examination or tests for the fee schedule payment, and generally furnishes complete and timely reports, your treating source will be the preferred source to do the purchased examination. Even if only a supplemental test is required, your treating source is ordinarily the preferred source.”

This means that IF you have a treating physician who is willing to be an advocate for you; and IF the physician and your attorney can work together in order to craft a medical opinion form or, better yet, a detailed letter; and IF Social Security determines that the treating physician or other professional is qualified, equipped, and willing to perform the additional examination or tests, then the treating physician should be considered the preferred source.

The benefits of having your physician (guided by your lawyer, who can ensure that the physician addresses all the matters that Social Security thinks is important) write an opinion letter or complete a form are many:  a treating physician (one hopes) has a treatment history consisting of regular visits over a year or more, which makes his opinion worthy of credit; a treating physician’s commitment to his patient may be enhanced; and the treating physician may be willing to respond to questions from Social Security or Administrative Law Judges.

About

Vaughn Clauson represents disabled men and women throughout North Carolina in claims brought before the Social Security Administration.

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