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Understanding Your SSDI Consultative Medical Exam

A large part of getting approved for Social Security Disability Insurance (SSDI) is getting past the medical requirement. In some cases, applicants for benefits are asked to undergo a special type of medical exam called a consultative exam. To find out more, read on.

1. Consultative exams are sometimes in order when an applicant appears not to have had recent medical care. If you are applying for SSDI benefits, it's vital that you seek treatment, keep your appointments, follow your doctor's advice, take prescribed medications, and more. When the Social Security Administration (SSA) needs recent information about your medical condition, they may ask you to have a consultative exam.

Applicants cannot have the exam performed just anywhere – they must go to the doctor the SSA sends them to. These doctors work under contract with the SSA and applicants are not charged any money for the exam.

2. Consultative exams are more diagnostic than most are used to. Rather than get treatment, this exam consists of the doctor focusing on the medical condition the applicant mentioned when they applied for benefits. For example, if the applicant has a heart condition, the doctor will ask questions about previous treatment for the condition and the effect it had. They may also listen to the heart, check for other related conditions, and order diagnostic tests like a stress test or echocardiogram. You cannot expect to leave this exam with any advice or a prescription, however.

After the exam is complete, the doctor will prepare a report about the finding and send it to the SSA. This exam will confirm not only whether or not you have a qualifying disability but how much work you can be expected to do given the affliction. For example, if you have a heart condition, the SSA might ascertain that you could still perform some sedentary work.

3. Unfortunately, the fact that the SSA requested you to have this exam performed could be a clue that you are going to be denied benefits. Often, the consultative exam is the last step in the disability determination phase and very few who undergo exams get approved for benefits.

It's important to keep in mind that almost all SSDI applicants get turned down for benefits when they first apply and that you are expected to continue the process by appearing at an appeal hearing. It's advised that you speak to a Social Security attorney about your case and the reasons for your denial before you appear at the appeal. An attorney can help you prove your medical condition and your inability to work at the appeal. Speak to a social security attorney to find out more.