What Is a Consultative Examination & How Do I Prepare?

July 5, 2022


Claimants who apply for Social Security Disability benefits may be asked by the Disability Determination Services (DDS) adjudicator, who is evaluating their claim, to appear for a consultative examination.

There are two main reasons why these are typically scheduled:

  1. There is not enough medical evidence to support your claim
  2. The claimant hasn’t been evaluated by a physician for a long time.

While this may sound like a concerning ask from an adjudicator, it is actually a very common occurrence and is relatively straightforward. The Social Security Administration pays for the appointments, too, which means it is of no cost to you.

Keep reading for more information on how to prepare for a consultative examination.

What Is a Consultative Examination?

Unlike a visit to a primary care doctor or a specialist, a consultative exam (CE) is not scheduled to provide treatment. Instead, it is used to assess your current medical condition.

A consultative exam may be scheduled to assess a physical medical condition, such as

  • Diabetes
  • Degenerative Disc Disease
  • Macular Degeneration

It may also be scheduled to assess a psychological condition, such as

  • Depression
  • PTSD

You should go to your exam prepared with your medical history, regarding the condition being assessed, as well as your subjective complaints and symptoms. The physician you’re scheduled with may perform imaging, bloodwork, or other procedures—along with a physical and/or mental evaluation.

Next, the examiner will send a report to DDS that contains your medical history, the results of their evaluation with any findings, and their opinions on your ability to perform general work functions.

Who Performs the Consultative Exam?

Sometimes, if your treating doctor agrees, a physician you have seen before will perform the exam. Oftentimes, however, treating physicians decline, and DDS will schedule an appointment with a contracted physician that has a thorough understanding and history of treating your impairment.

Your evaluation will always be performed by a licensed physician. DDS also tries to make sure the provider is relatively close to where you live, so you don’t need to travel too far to make the appointment.

Do You Have to Go to Your Consultative Exam?

No. It is not “required.” However, if you want to win your claim, you should attend these appointments. If you miss these appointments without a valid reason, they will make a decision based on the information they have on hand, which oftentimes, is not enough, and your application will be denied.

If you do miss an appointment, you can call DDS and reschedule, which we would highly recommend.

How Can I Prepare for My Consultative Examination?

First and foremost, double and triple-check the date, time, and location of your consultative examination. You want to ensure you have a means of reliable transport to and from the exam, as well.

Additionally, you’ll need to create a list of important information, as well as gather relevant records and documents to have ready at your exam.

For example, you should plan to bring a list of the following information relevant to your claim:

  • Any medications you are taking
  • Treatments you have tried in regards to your impairment
  • Specialists you’ve seen
  • Recurring symptoms and their severity
  • Previous testing and imaging, such as bloodwork or X-rays.

Having this information at the ready can help give the provider a clearer understanding of your impairments, thus leading to a more accurate exam with better insight into your conditions.

You can also take notes during the exam. There are oftentimes many aspects to the exams and a lot of questions that are asked. Take notes regarding what they talk about with you and what kinds of procedures they perform.

Need a Disability Attorney?

There is a lot to consider during the CE process. Our experienced attorneys at Kapor Davis & Associates, LLC, have years of experience guiding clients through their consultative examinations. Our team can help you navigate the process and will make sure you’re doing everything you can to reach a positive result.

Contact us today for a free consultation!