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

By / The Claims Process / 681 Comments

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.

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

A psychological consultative examination may be ordered even when your own psychiatric records are sufficient for approval of your claim. This occurs when more information is needed to determine whether your mental illness will keep you from using your benefits to take care of yourself by paying for your basic needs of shelter, food, and basic clothing before other expenditures or whether you need to have a representative payee to manage your benefits for you.

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 are a couple of them: If the information in your claim file doesn’t support the physical disability you claimed and you reported physical symptoms that could be caused by a psychiatric illness, then Social Security wants to find out whether you qualify for benefits based on a mental illness. This most especially will occur if your chart notes mention, even in passing, that you are depressed or anxious. 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

Social Security arranges and pays for the consultative examination. 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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