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What is a consultative examination?

If you've filed for Social Security Disability (SSD) benefits, you may not have enough medical evidence to prove your case -- but that doesn't mean that you aren't disabled.

In order to try to get the proof that they need to either deny or approve your claim, the claims examiner may decide to send your for one or more consultative examinations.

What is it?

A consultative examination is performed by a doctor you've never seen before. He or she will likely have some extra experience or training in the medical area that causes you the largest part of your disability. That's why it isn't uncommon to see more than one -- especially if you have both a physical and mental condition affecting you.

For example, if you have chronic pain from rheumatoid arthritis that causes depression, you may be asked to see both a rheumatologist regarding the arthritis and a psychologist or psychiatrist regarding your depression.

What will the doctor do?

He or she won't be asked to treat your condition. Instead, the doctor will be asked to perform an exam and run any tests necessary to evaluate your condition.

Then he will send the Social Security claims examiner a detailed report of the examination, his or her tests, what evidence he or she found to confirm or deny your condition, a diagnosis and a statement that indicates if you are impaired from working -- and to what degree.

What is important to know about these exams?

While these exams are technically performed by an independent doctor -- meaning that the bill for your exam is paid for by the government but the doctor does not work directly for the government in any official capacity -- some of the consultative doctors only see a few patients for Social Security and some derive most of their income from Social Security consultations.

Unfortunately, you have no idea which is which. That makes it important to be on your guard in case the doctor is more concerned about protecting his or her income source than providing a truly fair report.

If you've been scheduled to go to a consultative exam, talk to your Social Security Disability attorney promptly -- he or she may want you to follow specific advice or take someone with you as a witness.

Source: Social Security Administration, "Disability Evaluation Under Social Security," accessed Sep. 28, 2017

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