Wednesday, January 2, 2013

State Agency Exam Notices

Whenever a Social Security Disability (“SSD”) claimant in New York applies for benefits, regardless of his or her diagnosis, the State agency sends a notice stating that, “It will be necessary for you to be examined by” IMA Disability Services (“IMA”).  Unsuspecting claimants think that they have no choice about going to the consultative examination (“CE”) because the State agency notice says it is “necessary."

The State agency notice is misleading.  The Social Security regulations state when it is necessary to attend a CE.  There are actually very few situations where a CE is “necessary,” and in the majority of those cases, the regulations provide that the CE should be performed by the claimant’s treating doctor.

I represent a 49 year old former public safety officer with a back problem.  As is usual, the State agency sent her letters that said it was necessary for her to be examined by IMA for her back.  For various reasons the claimant declined the CE.  Today, I received the claimant’s Notice of Award.

The State agency knows that its notice is misleading.  I send the State agency a lengthy, detailed letter explaining why the CE is not necessary, and asking if they asked the treating doctor to supply the same information that they asked IMA to supply.  Not surprisingly, the State agency fails to respond to my letters, and instead, simply sends another notice, which says that the CE is “necessary.”

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