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When applying for disability benefits will I have to see a Social Security doctor?

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Learn when applying for disability benefits means that Social Security will send you to a doctor for evaluation and find out who will pay for the exam.

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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.

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43 Comments

  1. Kim says:

    Hi Kay
    I have a head injury and memory problems. Ssa sent me to a psychiatrist for a memory test. I just received a letter now they are sending me to a psychologist for a more formal memory/ iq test t. Is this a good sign?

    • Kay Derochie says:

      Dear Kim,

      It is a good sign that they are carefully investigating your claim. It is not, however, an indication of whether or not you will be approved.

      Best regards,

      Kay

      • shon says:

        I had a doctor appt and a physc appt two weeks apt for my mental and physical claim its only been three weeks and I checked yesterday and they said my case was closed and ill get a letter ive been applying off and on for five years they said it’s been reviewed and now closed does that mean they have denied me

        • Kay Derochie says:

          Dear Shon,

          It is likely that your claim has been denied. If it were approved medically and wer pending non-medical factors, it would say “pending.”
          If you really believe you are disabled–unable to perform substantial gainful activity, that is, earn $1,070 gross per month–and have not appealed before, you should request your claim file and read the reasons for the denial. If you still disagree, then you should appeal.

          Sincerely,

          Kay

        • Lupita says:

          I have a same exams coming up. What does these exams entail? Is the physical exam with blood work too?

          • Kay Derochie says:

            Dear Lupita,

            The consultative examinations requested by the Social Security Administration are for evaluation purposes only, not for treatment. They usually do not involve blood tests.

            Sincerely,

            Kay

  2. Laurie says:

    Hi Kay. This is my 1st time applying for PTSD,ADHD, and memory loss. They sent me to their phycologist in December and today when I checked my online status it said I need a amended application. What does that mean and is it a good sign? Thanks so much!!

    • Kay Derochie says:

      Dear Laurie,

      I am not familiar with the term “amended application.” I suggest that you call your local Social Security office and talk with the claims representative who is handling your claim to get an explanation and find out what you need to do.

      Sincerely,

      Kay

      Sincerely,

      Kay

  3. Shawna says:

    I was asked to do a psychological exam however no medical exam was needed. I applied sept 2013 and when I called today (feb 10, 2014) was told I would have answer in next 30 days. I have severe rheumatoid arthritis.
    Is it bad that they do not want me to get a medical exam?

    • Kay Derochie says:

      Dear Shawna,

      They did not request a medical examination because they believe that your medical records provide an adequate picture of your physical condition. It is likely that the medical information was insufficient to approve your claim based on your arthritis alone and that they are investigating to see if you have mental health limitations as well. If the mental health limitations alone or in combination with your physical limitations indicate that you are disabled as defined by Social Security law, your claim will be approved.

      Sincerely,

      Kay

  4. Ronnie says:

    I reapplied after denial from judge in jan 2013. I was ask to go see SS doctors. When I inquired to SS I found out they did not have any of my medical records and as a matter of fact had not received any updated medical information on me since August 2012. I guess my other attorney was not forwarding my medical records, hence one of many reasons for my denial. Anyway, Ss has now received my records pertaining to my Bi polar yet they still want me to go for a physical exam. Is this a good or bad sign? What should I expect? I have medical records of my bi polar since 2009 and have not worked since then. This is my last chance at SS as my insurability date is March 2014. It is very important that I do everything possible to win. Suggestions?

    • Kay Derochie says:

      Dear Ronnie,

      My suggestions are that you be sure that Social Security has all the medical information that could support your claim (which you apparently have done) and that you attend the examination. Also, if statements have not been obtained from your family and friends, ask them to write observations that they have on how your condition(s) affect your ability to function in daily life. If you have former work colleagues or supervisors who observed you having problems on the job, get statements about what they observed from them too. Lastly, be sure that you have provided a full list of your duties in occupations that you have performed and list which duties you couldn’t perform because of your conditions and why.

      Sincerely,

      Kay

  5. apryl says:

    Hi,
    I am a above the knee amputee and half of my right lung removed. My question is I was approved for ssi 8yrs ago but while I worked I was not advised to switch to ssdi,so my benifits were stopped. I am reapplying and they sent me to a chiropractor and he flat said he dont know why they chose him.

  6. sue says:

    I got a letter from ssi saying they are sending me to s dr.to see how bad my arthritis is…..i had other medical issues wrong with me too….mentally issues …wby didnt they say i need to see a pjyschiatrist? And if they dont think myy arthritis is real bd….can i still get ssi for my other medical issues??

    • Kay Derochie says:

      Dear Sue,

      Apparently, Social Security finds that your psychiatric condition alone is not disabling. You could still be approved if they find either that your arthritis is disabling in and of itself or that you have limitations from each condition–arthritis and your mental health diagnosis–that when combined are disabling.

      Sincerely,

      Kay

  7. Ruth bennett says:

    I have applied for disibility in Jan-2014. I received a phone call yesterday 3-20 about an appointment to see a social security dr. I have ms & why do I have to see this dr?

    • Kay Derochie says:

      Dear Ruth,

      Apparently, the Disability Determination Services (DDS) claims examiner didn’t find enough information in your medical records to determine the severity of your MS symptoms and the limitations stemming from them. It is important that you attend the examination and cooperate fully. If you do not, your claim may be denied.

      Sincerely,

      Kay

  8. Kathy says:

    Hello, I have been seeing a dr for right hip pain since june 2013, as when the pain started, I applied for ssd/ssi on the same day in oct of 2013. I was denied the end of dec, and I moved and did a reconsideration, I then have been seeing another ortho who is also saying the same as my original dr 5 states away. I also have terrible mood swings and GAD. I got a letter from the ss office with a dr’s name and number and appointment date and time. So I called and verified the appointment, also found out that I will also be seeing a psychiatrist for the mental part, which I have been and also a counselor. I found out this dr they are sending me to is a pediatrician. Why would they send me to a pediatrician for osteoarthritis, and labral tear? I’m beginning to think this is all a joke and a waste of time, I have all my documentations from the doctors and behavioral health center. So is this a sign that they are just making me do more work just to get denied again? And my current ortho wont prescribe meds and I havent found a family dr that will take my ins. Plus not working I cant afford anything as I have no funds. What do you think?

    • Kay Derochie says:

      Dear Kathy,

      First, be sure that you should attend the consultative examinations. Failure to do so, could result in a denial I suggest that you also call the Disability Determination Services (SSD) examiner to double check that there is no error in your being sent to pediatrician. Mistakes do occur. If it is not a mistake, as for an explanation for the choice of specialists.

      Best regards,

      Kay

  9. Jason says:

    Hello I am 70% disabled through the Va. I had a l4 l5 fusion in 09 its not any better and MRI doesn’t show signs of improvement just normal wear and tear from age. I
    I have a plate and screws in my back. They sent me for a examine that lasted 45 min. Also I have PTSD from war. I was sent to a phys doctor. Also surgery on my right knee. I have a off set knee cap. I need a brace for my back and knee. I don’t take meds makes me sick and never helped. Also cronix migrainsm.y forward flrxstion was 5% side was 10% any chance of winning my case 1st time or 2nd time with a lawyer? Thanks.

    • Kay Derochie says:

      Dear Jason,

      You have multiple conditions that may qualify you for Social Security Disability; however, if you are denied, get an attorney for your first appeal. You can obtain an excellent Social Security attorney by calling Disability Advisor at 1-888-393-1010. You do not have to pay any legal fees up front and you will pay attorney fees only if you are approved for benefits. Social Security law sets the amount your attorney can charge and the Social Security Administration pays the attorney directly from your retroactive award at the time they send your back pay to you. So, it’s all very easy and risk-free.

      Sincerely,

      Kay

  10. shaunda johnson says:

    I have been applying for Social Security since the beginning of 2012 and was denied 3 times already. I have some physical, but more mental illness issues. I have been being treated for my issues for a very long time. I suffer from severe depression, severe anxiety and social anxiety disorder, sleep apnea and insomnia. which I take medicine for to sleep. well after fighting again for the 3rd time, I hope they are finally listening to me. I had questioned, why did they have me go to their independent Psychologist. so I went about 2weeks ago. do you think I have a better chance now to be approved? I will be devastated if they deny me again.

    • Kay Derochie says:

      Dear Shaunda,

      I do not know whether you will be approved this time; but apparently the examiner thinks there are some questions about your conditions that were not answered in your claim file and is trying to gather more information for a decision.

      Sincerely,

      Kay

  11. Nija Johnson says:

    I applied for my son for adhd and a speach impairment he was deniedv feb 28 2011 i apealed went in front of alj judge he was sent to a psychological evaluation were the man said nothing was wrong basically but I had notes from teachers,principal,preacher etc supporting our facts along with his doc records so alj said he needed to send him back out so he was sent to a mental exam were he was given wechsler lntelligence test for children forth addition diagnostic impression was Adhd/ borderline intellectual functioning and out of six domains four were marked. Im confuse why would the first person said nothing wrong was allowed to be by video when his findings were two years ago be the expert interpreter for the judge who was still negative. Instead of the mental expert three months ago? I did have an attorney who did get him to say, he sounds like a mild case of adhd with behavior problems he then said no futher questions. I then ask the judge what aboutthe new evidence. Judge said I am who sent you there ITS BEEN 3YEARS WHAT NOW!judge said id have a decision in 1 to 11/2 month. What does sound like

    • Kay Derochie says:

      Dear Nija,

      I can’t say for sure what the judge meant, but I would expect him to consider the evidence that he himself requested. I am not sure what you meant by the judge still being negative; however, if the claim is denied, you can request an Appeals Council review.

      Best regards,

      Kay

  12. blaze gilman says:

    Hi I Need to know if you filed for SSI because you have anexity so bad that you don’t leave the house and Don’t associate with the public. and you have mild Bone degenerative disorder. Can you get approved for SSI even If SSI does not requsted you to see their Doctor’s. And I have Limited Doctors records Due to Not leaving my House. And I have No work History at all. And I’m 40 Years Old.

    • Kay Derochie says:

      Dear Blaze,

      To be approved for Social Security or Supplemental Security income, you must present proof of disability either from your medical and psychiatric records or by a consultative examination. It is important to let Social Security know that part of your disability is so much anxiety that you do not go out of your house and that is a reason for few medical records. You may be asked to attend an examination and failure to do so may result in your claim being denied. I suggest that you consider asking one or more family members to support you in getting to such an examination by their going with you.

      Sincerely,

      Kay

  13. Beverly says:

    I applied for disability in March of 2014, they first sent me a letter wanting me to provide more of my physicians addresses and numbers and I complied. This happened in April. Then in June they sent me to a physical exam doctor and I was waiting on the results from that exam which was on June 16th. Today June 28th I received a letter instructing me I have a mental exam scheduled for July 8th. I thought the reason for being sent to their doctors was not receive medical information. I have been to some form of doctor in the last two years around 50 times or more. I see a neurologist because Its been suspected MS for 10 years. I see a Rheutologist for fibromyailgia ,I have chronic back pain that I get very little help with because doctors simply do not give anything for pain for anymore because of the new laws. I have chronic headaches. I have blood disease. I have third stage kidney disease.And many other things going on. I have not received any denials yet. But my question is why sent me for a mental exam? I do have some memory problems and when I am stressed I have difficulty speaking at time but I do not consider myself depressed, anxiety at times but not depressed. Why would they send me for a mental exam?

    • Kay Derochie says:

      Dear Beverly,

      It would appear that Social Security wants to know more about your cognitive (memory and speech) problems.

      Sincerely,

      Kay

  14. Kris says:

    Hi Kay,

    I have 4 herniated disks in Lumbars 3,4,5 & S1. Been to two neurologist, both agree they cannot guarantee surgery to alleviate my pain. I completed 6 weeks of physical therapy, only relief I found was it eliminated all the stiff muscles. Nothing alleviates my pain, except 5-6 times a day laying flat on heat pad. I am currently with a pain management doctor . I have also been diagnosis from my psychiatrist of almost three years with major depression with agoraphobia, panic disorder, and panic attacks. I went for my CE exam today and was pleasantly surprised at the empathy from this complete stranger. At the end of the session, she said “You did good”. Praying this means she supports the Mdd and I see an approval soon. It will be a year in August.

  15. melissa mckinney says:

    Hi my husban has been trying to get ssi for years now. This is the 2nd time he is trying for his heart condition. He appealed their decision because they left out a lot of his medical history. So now they have it but they sent him to a mental exam and the woman he saw said she was seeing if he could handle his own money. I’m just wondering what this means. Did he get approved?

    • Kay Derochie says:

      Dear Melissa,

      If the only reason for the mental examination was to evaluate his capability to handle money, then you can expect that his claim will be approved.

      Sincerely,

      Kay

  16. monica flen says:

    Hello,

    I wanted to know for a 6yr old that has been diagnosed with adhd and is receiving medication for this disability in school she is receiving a 504 plan and should she also receive an iep? Also, I want to know if i can apply for ssi for her as well? If so what information would I need?

    • Kay Derochie says:

      Dear Monica,

      I am not qualified to comment on whether your child qualifies for an independent educational plan. I suggest that you check with the school district. You can apply for Supplemental Security Income (SSI) to see if she is disabled as defined by Social Security. I suggest that you review the information under the “SSI” tab on the http://www.disabilityadvisor.com website for information about SSI, including the criteria for childhood disability. Submit medical information, mental testing, and any documentation the school district has.

      Sincerely,

      Kay

  17. stephanie says:

    I applied in April and have not been rasked to see a Dr my attorney said I should have been weeks ago if I am not sent to a Dr what does this mean?

    • Kay Derochie says:

      Dear Stephanie,

      Not all claimants are sent to a doctor. If you have submitted enough information for Social Security to make a decision, they will not ask you to attend an examination. The delay may be that your claim is waiting in line to be reviewed. Sometimes due to large workloads there is a delay before the review begins.

      Sincerely,
      Kay

  18. Chan says:

    SSI is sending me to a psychiatrist and a medical doctor, both in the same week.why is this? I suffer from a thoracic herniated disc, which I have been receiving epidural injections from, severe carpal tunnel in both hands which I had surgery on my dominant which made my problems worse, hypertension, IbS-c, severe anxiety, depression, chronic back, leg, hip and foot pain.i am also being referred to a rheumatologist by my neurologist for suspicion of auto immune arthritis. Can you give me some insight on this?? Thanks!! I can’t work due to all this I am so depressed…

    • Kay Derochie says:

      Dear Chan,

      Social Security is sending you to medical and psychiatric examinations to gather information that did not find in your claim file. Be sure to let the claims examiner know that you are going to be evaluated for an autoimmune disorder and that you will give her the date of the appointment as soon as you have it. Then arrange to get a copy of the report to send to the examiner after you see the rheumatologist.

      Sincerely,
      Kay

  19. Vickie Owens says:

    5 years ago I had a major surgery on right rotator cuff and collar bone and received SSD and after 18 months of healing, I went back to work and went off of SSD. I am now more critical with numerous conditions, Crohn’s Disease, A tear in the same shoulder, an ulcerated esophagus, fibromyalgia and arthritis. I have submitted all medical and had to quit work on June 5, 2014. SSD is sending me to a psychiatrist and a DO doctor. Will they take into consideration my age, (57) and my previous claim for SSD along with my medical conditions?

    • Kay Derochie says:

      Dear Vicki,

      Your age will be taken into consideration. Specifically, because you are over age fifty, you only have to be disabled from occupations you have performed in the past. You should state that you received Social Security in the past, but your claim will be based on all your current conditions and you must submit all your medical history. Information in your prior claim file will not be accessed if it has been five years or more since you were last eligible for benefits. If it has been less than five years, you might qualify for expedited reinstatement because of the tear in the same shoulder. If so, the five-month unpaid waiting period is waived. If it’s been less than five years since benefits were terminated, contact Social Security and say that you should have applied for expedited reinstatement.

      Sincerely,
      Kay

  20. Tamika Homesly says:

    Hi I just recently applied for ssd and was stabbed all the way down to the bone with no meat left inside of my arm and caused nerve damage . the area where this happened was right over a tattoo which is kinda good because I took pictures of the injury so they won’t just think its some pictures I’ve stolen or isn’t mine. The tatoo proves it is will it be good to take the pictures to the medical examiner if asked too see one ?

    • Kay Derochie says:

      Dear Tamika,

      You can take the picture to an independent medical examiner if you are asked to go to one, but the examiner will probably be more focused on any loss of function you currently have.

      Sincerely,
      Kay

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