Thursday, March 5, 2009

Consultative Examinations

When the Social Security Administration (the “SSA”) tells a claimant to be examined by one of its doctors it is called a consultative examination (“CE”). The Social Security regulations provide very limited circumstances when the SSA can require a claimant to attend a CE. Nonetheless, the SSA directs virtually every claimant to attend a CE.

Anyone familiar with the SSA doctors knows to expect a report indicating that there is little to nothing wrong with the claimant. If a claimant fails to attend a CE, the SSA frequently denies the application on the grounds that the claimant refused to cooperate.

I regularly advise my clients not to attend CEs. I provide a detailed explanation to the SSA citing the legal reasons why a CE would be inappropriate under the circumstances. Additionally, I offer to provide whatever medical information the SSA specifies, and to facilitate a CE with a treating physician. When the SSA refuses to identify any particular medical information, and ignores my offer to arrange a CE with a treating physician, I can show that it was the SSA, not my client, who failed to cooperate.

I represent 45 year old nurse whose Social Security Disability (“SSD”) application was approved today despite two demands that she attend a CE. I strongly doubt that the claimant’s SSD application would have been approved if file contained the typical adverse CE report from an SSA doctor.

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