Consultative Examinations

Friday, February 1st, 2008

The rules and regulations of the Social Security Administration (the “SSA”) limit the situations when a claimant should be asked to attend a consultative examination (“CE”) by a non-treating doctor. Nonetheless, the SSA very rarely processes a disability application without sending the claimant a notice for a CE. There is nothing wrong with the SSA asking the claimant to attend a CE. What is wrong is that the CE notice asks the claimant to be examined by a doctor who is not treating the claimant.

I usually object to CE notices. When doing so, I offer provide whatever medical information the SSA requests. I advise the SSA that as long as they specify what medical information they claim is needed to evaluate the application I will get it for them. I also offer to facilitate a CE with a treating physician because he or she is the “preferred source” for any CE according to the regulations. The goal is to show that while I am objecting to the CE notice, the claimant could not possibly be more cooperative.

I had an application approved today where the SSA sent four CE demands. In response to my letters, the SSA failed to specify any additional information that was purportedly needed to evaluate the application. My letters showed that the claimant was cooperating while the SSA was not. The regulations do not permit the SSA to have a CE simply because they want a second opinion

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