Boise Social Security Attorney

Consultative Examinations–A Review

This article discuses the consultative examination. Your Boise Social Security Attorney can help you understand how this examination affects your disability application and its interplay with your own doctors records and statements.  If you have questions about your consultative examination, contact a Social Security Attorney in our Boise Idaho office.

Consultative Examinations

It is not uncommon for Social Security to send you to one of their doctors if they feel you do not have sufficient medical records to determine the extent of your limitations.  This is called a consultative examination.  But sometimes Social Security will seek to send you to one of their doctors for no apparent reason other than as an attempt to create substantial evidence to justify denying a claim for disability benefits. If this is the case, your disability lawyer should object to this consultative examination.  This is also a reason to choose a local Social Security attorney who is familiar with which doctors tend to be unfair in their reporting of claimant’s symptoms.  Social Security should not request a consultative examination until “every reasonable effort” has been made to obtain evidence from the claimant’s own medical sources.

…we will make an initial request for evidence from your medical source and, at any time between 10 and 20 calendar days after the initial request, if the evidence has not been received, we will make one follow-up request to obtain the medical evidence necessary to make a determination. The medical source will have a minimum of 10 calendar days from the date of our follow-up request to reply, unless our experience with that source indicates that a longer period is advisable in a particular case.  (20 C.F.R. ßß 404.1512 (d)(1)).

 If you have a treating physician, your Social Security disability attorney may want to ask that this doctor be used by Social Security for your consultative examination.  Your own doctors are generally supposed to be Social Security’s preferred source for disability examinations.  (20 C.F.R. ßß 404.1519h).  So if a consultative examination is required, after every reasonable effort has been made to obtain from your doctors the needed information your disability lawyer should insist that Social Security send you to one of your own doctors, provided that doctor is willing and able to provide such an examination.  Social Security may deny your request for examination by one of your doctors if they know from prior experience that your doctor is not be a productive source, e.g., he or she has consistently failed to provide complete or timely reports. If the agency states that your doctor is not an acceptable source for an examination, your disability lawyers should demand proof.  (20 C.F.R. ßß 404.1519i)

If your Social Security Attorney is not able to get Social Security to send you to one of your own doctors for an examination, they should object to any doctor that they have reason to believe does not provide adequate examinations.  Your disability attorney can object to a consultative examination for the following reasons:

Social Security Attorneys for Boise, ID(1)        If the medical source Social Secuirty designated had previously represented an interest adverse to you. For example, the medical source may have represented your employer in a workers’ compensation case.

(2)        The presence of a language barrier.

(3)        The medical source’s office location (e.g., 2nd floor, no elevator).

(4)       Travel restrictions.

(5)        The medical source had examined you in connection with a previous disability determination or decision that was unfavorable to you.

(6)        If your objection is that a medical source allegedly lacks objectivity in general, but not in relation to you personally, we will review the allegations. See 20 C.F.R ß 404.1519s.

To avoid a delay in processing your claim, the consultative examination in your case will be changed to another medical source while a review is being conducted. (20 C.F.R. ßß 404.1519j)

If SSA refuses to change your examination and asserts that the agency had previously conducted such a review and found that the reports of the medical source in question conformed to agency guidelines, your disability lawyer may want to file a FOIA request to ascertain the validity of the review.

If there is any conflict in the evidence in the record, Social Security must first contact and then re-contact the medical sources responsible for creating the conflicts and ambiguities. SSA may not first resolve those conflicts and ambiguities by engaging a third party expert to create his or her own additional conflicts.

 Be sure to ask a Boise Social Security Attorney in our office about getting a medical source statement to your doctors.

Originally posted 2014-09-12 23:57:26.