The doctor will conduct an exam that will assess your functionality level. After the exam, they will share the exam details with the Social Security Administration (SSA) and the local Disability Determination Service (DDS) office. The DDS office will review the application and other information to provide its decision. 

A consultative exam is a part of the disability application that you are filing to seek SSDI or SSI benefits. The SSA will suggest a doctor known as a “disability doctor” who will assess your medical condition independently. Some applicants may think that is why they need to take this exam. 

However, this is normal and one of the parts of the application procedure they must follow. Moreover, consultative exams are one of the ways that help the SSA to get a better scenario of your impairment.   

What Is The Need To Give The Consultative Exam?

The SSA has various reasons why they are conducting the consultative exams. Some of them are as follows:

  • To collect sufficient evidence. This is because the evidence submitted is not enough to determine the disability;
  • To collect descriptive medical records about the severity of your medical situation;
  • To gather additional medical information relating to your disability;
  • To find out if there are any differences in the medical findings and resolve them or
  • To determine whether your disability prevents you from doing substantial gainful activity if the applicant is an adult. In case the claimant is a child who is less than 18 years of age, the SSA will review their ability to work that other children of their age who do not have disabilities are working.

Is a Consultative Exam Beneficial Or Not?

The perception of a consultative exam can vary depending on the individual’s perspective and the specific circumstances. 

Positive Aspects:

  • Additional Medical Evidence: A consultative exam allows additional medical evidence to be gathered. This can be particularly helpful if the existing medical records are incomplete or insufficient to make a precise determination of the extent of the disability.
  • Objective Evaluation: The exam is usually conducted by an independent healthcare professional chosen by the SSA. This impartiality can contribute to a more accurate evaluation of the individual’s medical condition, providing a fresh perspective.
  • Clarification of Medical Issues: In some cases, the consultative exam can help clarify any ambiguities or uncertainties in the medical evidence presented. This clarity can aid in the decision-making process for the disability claim.

Challenges:

  • Limited Time for Evaluation: Consultative exams are often brief, and the examiner may not have the same level of familiarity with the individual’s medical history as their primary healthcare provider. This limited time may affect the thoroughness of the evaluation.
  • Potential for Inconsistency: The findings of consultative exams may not always align with the individual’s regular healthcare providers’ assessments. This inconsistency can create challenges in reaching a consensus on the severity of the disability.
  • Stress for Claimants: For some individuals, the prospect of a consultative exam may be stressful. They may feel pressure to adequately convey the impact of their disability within the limited time of the examination.

What Happens After Your Consultative Exam?

After undergoing a consultative exam, the next steps in the disability claims process involve evaluating the additional medical evidence gathered during the examination. The findings from the consultative exam are added to the individual’s overall disability claim file, which is then reviewed by the Disability Determination Services (DDS) office. 

DDS, in collaboration with the Social Security Administration (SSA), assesses the collective medical evidence to determine the individual’s eligibility for disability benefits. The outcome of this evaluation will be communicated to the claimant through a formal notification outlining whether their claim has been approved or denied or if further information is required.

If the initial determination is unfavorable, the individual must stay informed and be prepared for potential next steps, such as the appeals process. Seeking guidance from a disability attorney can also be beneficial during this stage to navigate any complexities and ensure the best possible outcome for the claimant.

How Do You Know If Your Consultative Exam Went Well?

Determining if your consultative exam went well can be gauged by a few indicators. Positive signs include thoroughness in addressing your medical condition, clear communication with the examiner, and a sense that your concerns were considered. 

If the examiner takes the time to understand how your disability affects your daily life and work capabilities, it suggests a more comprehensive evaluation. However, it’s essential to remember that the ultimate assessment of the exam’s success lies in the resulting impact on your disability claim, which will be communicated to you through the SSA’s determination. (Get detailed insights on reasons for denial of your social security disability)

Need Legal Help With Your Consultative Exams? Contact a lawyer

A Social Security disability lawyer can be crucial in supporting you during consultative exams in various ways. Firstly, they can help you prepare for the exam by advising you on what to expect and guiding you on how to communicate the impact of your disability effectively. They can also ensure that you provide the necessary information to the examiner to strengthen your case.