Many times, after you apply for
Social Security disability, SSA will write you and ask you to report to a
certain doctor for a consultative examination. At this exam, paid for
by Social Security, a doctor working under contract with the SSA, will
perform an examination to determine the extent of your medical
impairments.
Many claimants wrongly assume that this doctor will find evidence of an impairment that will help win their case. Not likely. Unless you are paralyzed, confined to a wheelchair, require oxygen 24/7, or have some other catastrophic, obviously serious impairment, the consulting doctor will probably fail to find any disabling conditions.
Here are some of the factors that I generally assign to explain the fallacy of consultative examinations by Social Security doctors. I say in general because there are exceptions.
I reviewed the consultative report written by a doctor who had examined one of my clients. The doctor wrote the following in her report: "...I walked with the claimant out to the parking lot. He was driving a truck that was pretty high off the ground. He appeared to be able to get into the truck with no difficulty." This, of course, is not medical opinion, it is prejudiced personal opinion--pure and simple!
Let's put this in a little different context. Let's say I am having severe pain in my neck and upper back. It's been getting gradually worse. It's pretty bad now, and I'm having severe headaches with nausea and vomitting. I pay a visit to Dr. Feelbetter. He walks into the room and says, "OK, I have 10 minutes to spend with you, no more. I can't do any lab tests because nobody will pay for them. I also can't do any X-ray, MRI or other tests. If I can't see your problem with my naked eye, I won't be able to help you." How much hope should I have that Dr. Feelbetter will accurately diagnose my medical problems? (I'm more likely to win the lotto and be selected as the next man into space, all on the same day)!
In summary, a Social Security consultative exam is often a waste of time and it more than likely will not help you win your disability benefits. (As I said, there are exceptions). It will very likely hurt your chances, not because it verifies that you have exaggerated your conditions but because the doctor isn't given much opportunity to find your medical problems. I also think, frankly, that the doctor isn't very motivated to find your medical problems due to the nature of the exam and his lack of a treating relationship with you. He sees you one time but sees Social Security patients hundreds of times for pay. Who does he want to keep happy?
Finally, some good news. The law is on your side in the matter of consultative exams. The law requires that more weight be given to a treating doctor's opinion than to a non-treating doctor's, all other things being equal. Therefore, Social Security may commit legal error if they give the consulting doctor's opinion more weight than they give your own treating physician. This can make a great legal argument on appeal and frequently results in the original denial being overturned or remanded (20 CFR 404.1527; POMS DI24515.004, SSR 96-2p, etc.).
If Social Security requests that you attend a consultative exam you should do so. Refusing to attend can result in your claim being dismissed for "non-cooperation" or may get you an automatic denial. Just remember that any denial should be appealed in writing immediately.
If I or my firm may be of assistance to you, please contact us at our office in Huntsville, AL. There is no charge for our service unless you win. There is never a charge to speak with us. And Social Security is the only thing we do.
Many claimants wrongly assume that this doctor will find evidence of an impairment that will help win their case. Not likely. Unless you are paralyzed, confined to a wheelchair, require oxygen 24/7, or have some other catastrophic, obviously serious impairment, the consulting doctor will probably fail to find any disabling conditions.
Here are some of the factors that I generally assign to explain the fallacy of consultative examinations by Social Security doctors. I say in general because there are exceptions.
- The doctor will probably spend 5 to 15 minutes with you. He turns out patients like an assembly line. Unlikely he will find whatever is causing you to be unable to work. Less likely that he will report it.
- This doctor gets paid by Social Security. I'm not suggesting that he will lie, but most normal human beings are influenced by people who write them checks. Doctors are humans.
- This doctor has never seen you before. He's never examined you before. He will probably not be able to take an X-ray, do a lab test or perform any other diagnostic tests. Do we really expect him to be able to find your medical impairments in less than 10 minutes? It would take a miracle.
- This doctor is limited to answering only the questions sent to him by Social Security, or checking off only the items on their form. Nothing else. If there's a tumor the size of a watermelon in your head, he'll never know it (unless he's been asked to find it).
I reviewed the consultative report written by a doctor who had examined one of my clients. The doctor wrote the following in her report: "...I walked with the claimant out to the parking lot. He was driving a truck that was pretty high off the ground. He appeared to be able to get into the truck with no difficulty." This, of course, is not medical opinion, it is prejudiced personal opinion--pure and simple!
Let's put this in a little different context. Let's say I am having severe pain in my neck and upper back. It's been getting gradually worse. It's pretty bad now, and I'm having severe headaches with nausea and vomitting. I pay a visit to Dr. Feelbetter. He walks into the room and says, "OK, I have 10 minutes to spend with you, no more. I can't do any lab tests because nobody will pay for them. I also can't do any X-ray, MRI or other tests. If I can't see your problem with my naked eye, I won't be able to help you." How much hope should I have that Dr. Feelbetter will accurately diagnose my medical problems? (I'm more likely to win the lotto and be selected as the next man into space, all on the same day)!
In summary, a Social Security consultative exam is often a waste of time and it more than likely will not help you win your disability benefits. (As I said, there are exceptions). It will very likely hurt your chances, not because it verifies that you have exaggerated your conditions but because the doctor isn't given much opportunity to find your medical problems. I also think, frankly, that the doctor isn't very motivated to find your medical problems due to the nature of the exam and his lack of a treating relationship with you. He sees you one time but sees Social Security patients hundreds of times for pay. Who does he want to keep happy?
Finally, some good news. The law is on your side in the matter of consultative exams. The law requires that more weight be given to a treating doctor's opinion than to a non-treating doctor's, all other things being equal. Therefore, Social Security may commit legal error if they give the consulting doctor's opinion more weight than they give your own treating physician. This can make a great legal argument on appeal and frequently results in the original denial being overturned or remanded (20 CFR 404.1527; POMS DI24515.004, SSR 96-2p, etc.).
If Social Security requests that you attend a consultative exam you should do so. Refusing to attend can result in your claim being dismissed for "non-cooperation" or may get you an automatic denial. Just remember that any denial should be appealed in writing immediately.
If I or my firm may be of assistance to you, please contact us at our office in Huntsville, AL. There is no charge for our service unless you win. There is never a charge to speak with us. And Social Security is the only thing we do.
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