What is a “Consultative Exam”?

What is a “Consultative Exam” and why is Social Security asking that I attend one?

Consultative exam (CE) are either physical and/or mental health appointments you are required to attend as part of your Social Security Disability application process. These exams are not conducted by doctors who work for the Social Security Administration (SSA). The doctors who perform consultative examinations for the SSA are independent physicians who have been contracted to perform such services for the SSA.

SSA will purchase a CE if they cannot get the information they need from medical sources alone. Before purchasing a CE, SSA will consider not only existing medical reports but also the disability interview form containing your allegations as well as other pertinent evidence in your file. SSA may purchase a CE if they need to secure needed medical evidence, such as clinical findings, laboratory tests, a diagnosis, or prognosis.

SSA may also purchase a Consultative Exam if they need to resolve inconsistencies in the evidence in your file, or when the evidence as a whole is insufficient to allow them to make a determination or decision on your claim.

Additional reasons for requiring a Consultative Exam include, but are not limited to:

  1. The additional evidence needed is not contained in the records of your medical sources;
  2. The evidence that may have been available from your treating or other medical sources cannot be obtained for reasons beyond your control, such as death or noncooperation of a medical source;
  3. Highly technical or specialized medical evidence that SSA needs is not available from your treating or other medical sources; or
  4. There is an indication of a change in your condition is likely to affect your ability to work, but the current severity of your impairment is not established.

§ 416.919a. When we will purchase a consultative examination and how we will use it.

At Disability Specialists, we may request a Consultative Exam is scheduled if it is in your best interest. If one is scheduled, we will be notified and will remind you of the date and time of your scheduled Consultative Exam.

Written by: Representative Kelly Blad

Additional information:

More information about Consultative Examinations
Common acronyms used in SSA disability claims