A Consultative Examination (CE) is a doctor’s exam that the Social Security Administration (SSA) or state Disability Determination Service (DDS) agency is paying for, and scheduling you for so that they have more medical evidence to evaluate your claim. If the DDS or SSA has scheduled you for a CE it is essential that you go to the exam. Failure to go to a CE could get your claim denied due to insufficient evidence.
A CE Will Add More Evidence to Your File
Disability cases are largely decided based on the medical evidence records. If you do not have insurance, or regular healthcare then you may not have many medical records for the SSA or DDS agencies to evaluate. A CE is your chance to get another doctor to examine you, and report back to the agency on your condition. Even if you have insurance and good medical records more evidence is usually going to be better for your case. If your condition is not that severe, a CE doctor could however draw conclusions which may not help your case.
Even though not every CE will result in helpful records to add to your file you still need to go. Some Administrative Law Judges (ALJs), the judges that conduct the Social Security Disability hearings, get irritated when people miss exams that the agency sets up and pays for. If you are a no show at a CE the agency still has to pay the doctor a fee for the time slot.
If a CE comes back with a report that does not help your case then you or your legal representative will be able to argue to the ALJ that the opinion of this consultative examiner is not as important as the opinion of your own treating doctor who has seen you many times over several years. The laws of the SSA include guidance to the ALJs on how to weigh different medical opinions, and doctors with a treating relationship with claimants will have more weight than the CE doctor.
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