Under the law, Social Security has an obligation to help claimants “develop their medical records” as part of the disability decision making process. Some disability claimants have no money and no insurance and the courts have ruled that SSA has to make some effort to evaluate these claims.
Since Social Security has no way of knowing which disability claimants are uninsured or low income they tend to schedule consultative evaluations (CE) for almost every disability applicant.
Social Security May Send You to a Psychological CE, a Physical Medicine CE or Both
Your local State Agency office maintains a list of providers who have been approved to provide consultative evaluations. Like an IME (independent medical exam) used by insurance companies, the CE provider will make it clear that he/she is not your doctor and that no physician/patient relationship exists.
Generally speaking, CE providers are paid a flat fee for a limited consult. They will not run expensive diagnostic tests nor will they schedule follow-up appointments.
Psychological Consultatives
My experience has been that psychological consultative examinations are not likely to hurt your case and may actually provide some benefit. This is because the psychologists on the CE panel are in private practice and they do not rely on Social Security for a large part of their income.
While it is rare for a psychological consultative report to be enough to support an approval, many times these reports do document some level of mental health impairment and we can use these reports to ask the judge to eliminate entire categories of jobs from consideration.
For example, if you suffer from even a mild level of PTSD, depression or anxiety, the psychologist may conclude that you could only perform in a work setting requiring simple, one or two step tasks, limited interaction with co-workers, supervisors or the general public and minimal changes in the work setting.
This level of impairment will not eliminate all jobs but it may eliminate from consideration your past work and reduce the potential job base to simple, entry-level work. In combination with other physical or mental impairments, we may have enough to convince your judge that you are not able to reliably perform the duties of any job.
Physical Medicine Consultatives
By contrast, physical medicine consultative evaluations are rarely helpful, often damaging and frequently irrelevant. Most of the doctors used by SSA for physical CE’s are “industrial clinic” doctors who mostly work for insurance companies who pay them to help deny claims.
As such these doctors rarely find anything wrong with anyone and are likely to minimize your allegations of pain and discomfort. The good news is that many of these physical medicine doctors do not have any idea that Social Security disability focuses on work limitations and their reports often say nothing about this threshold issue.
Most Social Security judges recognize that these physical consultatives are worthless and they treat them as such, although I do not hesitate to point out the deficiencies of these reports in a pre-hearing brief or opening statement.
You Will Be Observed Entering and Exiting the Building
One important point to note about consultative evaluations – many times the CE doctor will observe you walking in and out of his/her office, as well as your behavior in the waiting room. If your presentation or functioning is different outside the exam room than inside, that fact may make it into the doctor’s report.
Do Not Rely on Consultative Evaluations to Win Your Case
Social Security uses consultative evaluations to meet what the courts consider a minimum requirement to develop a claimant’s record. With rare exception the report from a consultative physician or psychologist will not be enough to convince your judge to approve your case. Your ongoing treatment records from long time treating doctors is much more important and relevant.
On the other hand, a damaging consultative report can be used by your judge to deny your claim.
You should always be truthful and forthcoming with the consultative doctor and cooperate as best you can. If you have records from long time treatment, or reports from objective testing like MRIs, CT scans or EMG tests, bring them. Make a list of your medications and bring that as well.
Consultative evaluations are part of SSA’s process. If you would like to know more or want to speak with me about your case, please call me at 770-393-4985.