Consultative Examinations

Monday, August 11th, 2008

People filing applications for Social Security Disability (“SSD”) benefits in the metropolitan area are led to believe that they must be examined by a doctor from IMA Disability Services. The Social Security Administration (the “SSA”) call that a Consultative Examination (“CE”). The truth is that CEs are permitted only in very limited situations.

There are many SSA regulations that govern CEs. The regulations specify the circumstances when a CE is permitted. The regulations also provide that the preferred source for a CE is the treating physician. I usually advise my clients not to attend a CE unless the SSA agrees to have the treating physician perform it. When the claimant refuses to go to the CE, the SSA usually threatens to deny the application for lack of cooperation.

One of two things can happen if the claimant does not go to IMA. One possibility is that the application gets denied on the ground of lack of cooperation. However, that argument always gets reversed on appeal because I document the fact that the claimant is ready, willing and able to attend a CE, as long as it complies with the SSA’s own regulations.

The other possibility is that the claim will still be approved. I represent a baker’s assistant whose SSD claim was approved in four months even though he did not attend the CE. Had he allowed IMA to examine him, his claim probably would have been denied because IMA never finds anyone disabled.

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