What do social security doctors look for?

Old people in geriatric hospice: Elderly man and woman hugging an african american doctor, showing a friendly relationship between personnel and patients.

 

You should treat a visit to a social security doctor like you would any doctor’s visit. Read below to get thoughts from a social security lawyer on how to approach these appointments.

Separate from the doctors and other professionals who will review your claim for disability benefits from Social Security without ever actually meeting you, some people are sent to be evaluated by a physician or psychologist on behalf of the Social Security Administration.  These appointments, arranged by Disability Determination Services on behalf of Social Security, are called consultative examinations.  Social security disability lawyers in Tallahassee, FL and throughout the U.S. come to know what to expect from the various consultative examiners in the cities in which they represent clients.  Claimants who do not have an attorney to ask often wonder why am I being sent to a social security doctor?  This article may shed some light on the subject.

A consultative examination is a procedure that will be requested when the medical evidence in your case is inconsistent or the evidence presented in your medical records and disability interview form is not sufficient to make a determination on your SSDI or SSI case.  Circumstances warranting a consultative examination necessary to obtain medical evidence to make a determination on your case include, but are not limited to:

  • Necessary evidence is not contained in records of your medical sources
  • 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
  • Highly technical or specialized medical evidence that we need is not available from your treating or other medical sources
  • There is an indication of a change in your condition that is likely to affect your ability to work, but the current severity of your impairment is not established

Usually the preferred source for a consultative examination is the treating source.  However, in most geographic areas, consultative examiners are independent sources who will never provide any treatment for your condition.  These independent examiners are contracted in the following scenarios:

  • When the treating source prefers not to perform the examination
  • When there are conflicts or inconsistencies in the file that cannot be resolved by going back to the treating source
  • The claimant prefers another source and has a good reason for doing so
  • Prior experience indicates that the treating source may not be a productive source

Consultative examination reports include:

  • Evidence that serves as a basis for disability decision-making in terms of the impairment it assesses
  • Internal consistency; meaning, are all the diseases, impairments, and complaints described in the history adequately assessed and reported in the clinical findings?
  • Conclusions relating the medical history, the clinical examination and laboratory tests and explain all abnormalities?
  • Consistency with other information available within the specialty of the examination requested
  • Did the report fail to mention an important or relevant complaint within that specialty that is noted in other evidence in the file (example: blindness in one eye, amputations, pain, alcoholism, depression)?
  • Adequate as compared to the standards set out in the course of a medical education
  • Proper signatures

Thoughts on how to deal with a social security doctor from a Tallahassee social security disability attorney:

You should treat a visit to a consultative examination like you would any doctor’s visit.  Be truthful and open about your medical history.  Ask the doctor what he or she thinks about your chances of improvement.  Ask him or her what type of treatment they have seen be most successful in similar patients.  Thank them for their work on your behalf.  Above all, don’t exaggerate or minimize.  Just like anyone else, if the social security doctor thinks you’re not being truthful in one area, they may start to doubt your credibility in other areas.