A consultative examination (CE) is a medical exam ordered by Social Security when they need more information about your disability. Here's what to expect.
In this article, we'll cover:
- What a consultative exam is
- Why SSA orders them
- What to expect during the exam
- Tips for your appointment
1. What a Consultative Exam Is
Definition: A medical or psychological examination arranged and paid for by SSA to gather additional evidence for your disability claim.
Who performs it:
- Independent medical providers
- Contracted by SSA
- Usually not your own doctors
- Licensed professionals
Types of exams:
- Physical examinations
- Mental health evaluations
- Specialty exams (orthopedic, cardiac, etc.)
- Intelligence or cognitive testing
Cost:
- SSA pays for the exam
- No cost to you
- Including transportation (sometimes)
- No insurance needed
2. Why SSA Orders Them
Common reasons:
- Your medical records are incomplete
- Need current evaluation
- Records don't address specific issues
- Specialist opinion needed
What SSA is looking for:
- Objective medical findings
- Functional limitations
- Current status of condition
- How disability affects ability to work
When it happens:
- During initial application
- During appeal
- During continuing disability review
- When more info is needed
Important: A CE doesn't mean your claim is being denied. It means SSA needs more information.
3. What to Expect During the Exam
Before the exam:
- SSA sends appointment notice
- Location and time specified
- Instructions included
- Make sure to attend
During a physical exam:
- Medical history questions
- Physical examination
- Possibly X-rays or tests
- Usually 15-30 minutes
During mental health exam:
- Questions about history
- Current symptoms
- Cognitive testing
- May be longer (1-2 hours)
What to bring:
- ID
- List of medications
- Medical records (if you have them)
- List of doctors
What to do:
- Be honest
- Describe your worst days
- Don't minimize symptoms
- Don't exaggerate either
4. Tips for Your Appointment
Attend the exam:
- Missing can hurt your claim
- Reschedule if absolutely necessary
- Transportation assistance may be available
- Confirm appointment
Be on time:
- Arrive early
- Know the location
- Allow extra time
- Contact if running late
Be honest:
- Describe symptoms accurately
- Explain your limitations
- Don't try to appear more disabled
- Don't appear less disabled
Describe your worst days:
- Exams happen on random days
- May be a "good day"
- Explain typical days
- And your worst days
Don't minimize:
- Common tendency
- Hurts your claim
- Be accurate about struggles
- Explain how disability affects life
Remember what happens:
- Length of exam
- What was done
- Questions asked
- Your own observations
After the Exam
What happens next:
- Examiner sends report to SSA
- Becomes part of your file
- Used in decision
- You can request a copy
Getting a copy:
- Request from SSA
- Part of your file
- Review for accuracy
- Understand what was said
If you disagree:
- Your doctor can provide contrary opinion
- Additional evidence helps
- Part of appeal if needed
- Document your concerns
Common Concerns
"The exam was very short":
- CEs are often brief
- Doesn't mean incomplete
- Examiner has specific questions
- May be sufficient for SSA
"The examiner was unfriendly":
- Examiners must be objective
- Not there to advocate for you
- Professional relationship
- Report facts to SSA
"I was having a good day":
- Explain this to examiner
- Describe typical and worst days
- Medical records show pattern
- One day doesn't tell whole story
How Purple Helps
Purple supports you during the disability process:
- Manage finances while waiting
- Track medical expenses
- Be ready when approved
- Early access to benefits
- Simple banking