SO SOCIAL SECURITY WANTS A CONSULTATIVE EXAMINATION!

Many times, after you apply for Social Security disability, SSA will write you and ask you to report to a certain doctor for a consultative examination.  At this exam, paid for by Social Security, a doctor working under contract with the SSA, will perform an examination to determine the extent of your medical impairments.

Many claimants wrongly assume that this doctor will find evidence of an impairment that will help win their case.  Not likely.  Unless you are paralyzed, confined to a wheelchair, require oxygen 24/7, or have some other catastrophic, obviously serious impairment, the consulting doctor will probably fail to find any disabling conditions.

Here are some of the factors that I generally assign to explain the fallacy of consultative examinations by Social Security doctors.  I say in general because there are exceptions.  

  • The doctor will probably spend 5 to 15 minutes with you.  He turns out patients like an assembly line.  Unlikely he will find whatever is causing you to be unable to work.  Less likely that he will report it.
  • This doctor gets paid by Social Security.  I'm not suggesting that he will lie, but most normal human beings are influenced by who pays them.
  •  This doctor has never seen you before.  He's never examined you before.  He will probably not be able to take an X-ray, do a lab test or perform any other diagnostic tests.  Do we really expect him to be able to find your medical impairments in less than 10 minutes?
  • This doctor is limited to answering only the questions sent to him by Social Security, or checking off only the items on their form.  Nothing else.  If there's a tumor the size of a watermelon in your head, he'll never know it (unless he's been asked to find it).
The fact is, the report from consulting doctors are often quoted in Social Security denial letters.  "Doctor Feelbetter noted that the patient can get on and off the exam table without assistance.  The doctor noted the patient walks without a limp.  Dr. Feelbetter states that he can find no reason for the claimant's alleged back pain."  Of course he can't; he can't take an X-ray, let alone an MRI.  Do we expect him to have X-ray vision?

Let's put this in a little different context.  Let's say I am having severe pain in my neck and upper back.  It's been getting gradually worse.  It's pretty bad now, and I'm having severe headaches with nausea and vomitting.  I pay a visit to Dr. Feelbetter.  He walks into the room and says, "OK, I have 10 minutes to spend with you, no more.  I can't do any lab tests because nobody will pay for them.  I also can't do any X-ray, MRI or other tests.  If I can't see your problem with my naked eye, I won't be able to help you."  How much hope should I have that Dr. Feelbetter will accurately diagnose my medical problems?  (I'm more likely to win the lotto and Publishers Clearing House sweepstakes all on the same day).

In summary, a Social Security consultative exam is pretty much a waste of time and it more than likely will not help you win your disability benefits.  It will very likely hurt your chances, not because it verifies that you have exaggerated your conditions but because the doctor isn't given much opportunity to find your medical problems.  I also think, frankly, that the doctor isn't very motivated to find your medical problems due to the nature of the exam and the lack of a treating relationship with you.

Finally, the law is on your side in the matter of consultative exams.  The law requires that more weight be given to a treating doctor's opinion than to a non-treating doctor's, all things being equal.  Therefore, Social Security will commit legal error if they give the consulting doctor's opinion more weight than they give your own treating physician. This can make a great legal argument on appeal and frequently results in the original denial being overturned.  (20 CFR 404.1527; POMS DI24515.004, SSR 96-2p, etc.).

 If Social Security requests that you attend a consultative exam you should do so.  Refusing to attend can result in your claim being dismissed for "non-cooperation" or may get you an automatic denial.  Just remember that any denial should be appealed in writing immediately.

 If I or my firm may be of assistance to you, please contact us at our office in Huntsville, AL.  There is no charge for our service unless you win.  There is never a charge to speak with us.

 

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