When a Consultative Examination Is Required
Social Security will only send you to a doctor for a Consultative Examination if the medical records and other information you submit when applying for disability are not enough to make a decision on your claim.
Your Responsibility to Prove Your Disability
If you are asked to go for an examination, you will receive a letter from the Disability Determination Services, which is the agency responsible for reviewing your claim. The letter will give you the name and contact information of the examining doctor, the time of the appointment, and how to confirm that you will attend. It is very important to your claim to confirm the appointment by the date given and to attend the examination on time and cooperate fully. If you fail to do so, your claim is likely to be denied.
When a Psychological Examination Is Required
Sometimes people who are applying for benefits based on a physical condition ask, “Why am I being asked to see a psychiatrist? I’ve never been treated for an emotional problem.” Certainly, that situation can be confusing, but Social Security has a reason for asking you to attend a psychiatric evaluation. Here it is: If the information in your claim file doesn’t support the physical disability you claimed and your reported physical symptoms could be caused by a psychiatric illness, then Social Security wants to find out whether you qualify for benefits based on a mental illness. For more information on how Social Security evaluates your disability application, please visit our article “How Does the Social Security Administration Apply Social Security Disability Laws to Determine If I Am Disabled?” and “Who Decides If I Am Disabled? If Both My Doctor and the Social Security Disability Doctors Say I Am Unable to Work, Will I Be Approved?”
The Doctor, the Purpose, and the Cost for the Examination
Just as an aside, the doctor to whom you are sent is not actually an employee of the Social Security Administration. Social Security asks a qualified doctor as close as possible to your home to perform the examination. Your own attending physician may even be asked to perform the consultative examination if he is qualified to do independent exams and is willing. A final note: the appointment has been set because you applying for disability and it is for evaluation only, not for treatment.