A Consultative Exam Request for a Social Security Disability Case

Q: Does everyone who files a social security disability claim have to do another medical examination?
A: Not everyone who applies for social security disability benefits has to undergo a consultative exam (CE.) A consultative examination is requested because of one of two things. If there is not enough information provided by medical files to allow the disability case manager to make a decision on an application, then an exam will be needed. The other reason an exam will be required is to provide current medical information regarding the condition of the claimant. If a CE is required for your claim, try not to worry. Your attendance is mandatory and your application cannot be approved or denied without the exam, once it has been requested. If you cannot attend the scheduled examination, contact your social security disability examiner and reschedule. The exam is paid for by the Social Security Administration.
Q: Who will perform a CE requested by the Social Security Administration?
A: The disability manager for your case will typically not request that your physician conduct the CE. A doctor who has not previously treated you will most likely provide the scheduled exam. If you have any concerns regarding the particular physician scheduled to provide your exam, you can contact your social security disability examiner. You may object, for example, if the physician has examined you before for an insurance or work related claim. The Social Security Administration does not necessarily have a staff of doctors on the payroll to handle consultative exams. The physicians who conduct the exams are independent physicians that have a contract to provide such services to the agency.
Q: Who receives back pay for social security disability?
A: A fair number of applicants approved for social security disability benefits receive back payments. The main reason for this is because the review process for claims can take a considerable amount of time. It is possible to receive back pay from the date of application and, if the condition was present prior to application, from up to 12 months before. The 5 month waiting period after the date of onset will not be included in back pay.

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