Consultative Examinations

Saturday, April 23rd, 2011

If you apply for Social Security Disability (“SSD”) benefits in the New York metropolitan area, you will probably be sent to a doctor from Industrial Medicine Associates for a consultative examination (“CE”). Although the regulations actually provide very limited circumstances when a CE is appropriate, Social Security requires them in the vast majority of cases. CE’s are a single exam, and as the courts have ruled, provide opinions that are vague.

A CE’s opinion is usually unreliable compared to a treating doctor’s opinion. A CE frequently takes insufficient time to perform an adequate exam. Many claimants have testified that their CE lasted less than five minutes, and one examiner was even removed from CE eligibility after admitting he lacked the time to perform valid exams.

I represent a former dry wall apprentice, janitor-custodian, and tow truck operator whose on-the-record request for a fully favorable decision (“OTR”) was approved today by an Attorney Advisor. In granting the OTR, the Attorney Advisor explained that he gave less weight to the CE’s opinion because it was based on only one exam, and was vague.

The five Queens Administrative Law Judges (the “Queens Five”) who are the subject of the class action alleging that they are biased against claimants, constantly deny claims by elevating the opinions of CEs over treating physicians. If an Attorney Advisor understands that it is improper to give greater weight to a CE than a treating physician, then shouldn’t the Queens Five be able to understand that too, especially since their decisions have been rejected by federal court judges for that very reason?

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