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What’s a consultative exam for SSDI?

On Behalf of | Jul 12, 2024 | Social Security Appeals

Applying for Social Security Disability Insurance (SSDI) benefits is always a lengthy process – and your application may hit a snag if your medical records are incomplete or contain contradictory information. 

When your medical records aren’t clear for one reason or another, the Social Security Administration (SSA) will most likely ask you to attend a consultative exam. These exams, paid for by the agency, are conducted by independent medical professionals who are supposed to provide SSA with an objective assessment of your condition.

What do you need to know about consultative exams?

It’s important to understand two things about every consultative exam arranged by SSA:

  1. You have to attend the exam if you want to get benefits. If you do not go to the appointment, your claim will be decided based on the information already in your file, and SSA is already telling you there isn’t enough in there to approve your claim.
  2. The independent medical provider may make a significant portion of their income (or all of it) doing these kinds of exams. If they are perceived as too “applicant-friendly,” they might see their income dry up. That gives them a powerful incentive to be skeptical of your claims. 

With these things in mind, you need to walk into the consultative exam properly prepared. This means being able to clearly and concisely explain your health problems and the limitations you have, having relevant medical records and documentation from other providers on hand and being extremely direct when you answer questions. 

During the exam, make sure that you neither exaggerate nor downplay your symptoms. Offer concrete examples of how your condition affects your daily life. For example, instead of saying, “I can’t stand hardly at all,” say something like, “My back pain is so severe that I’m unable to stand long enough to even cook a hamburger.” 

Ultimately, if the findings of the consultative exam do not accurately represent your condition, you may have to file an SSDI appeal. At that point, it may be wisest to seek focused legal guidance.