Physical Exams and Evaluation for Social Security Disability

A disability is a limitation on stamina, mobility, dexterity or an individual’s physical functioning. Physical disabilities include impairments which limit facets. It includes disorders such as blindness, epilepsy and sleep disorders. That’s why we have physical exams.

Social Security Physical Exams are Normally Brief

Although they can last as long as 20 minutes in some cases, they may only take up to five minutes. Most typical physical exams end in about ten minutes.

Does Social Security Send People?

Before an examiner can close a case, they must have recent medical advice regarding your disability (meaning that they must have some medical evidence on record that’s no older than 90 days).

Because of this, if you apply for disability and the disability examiner investigating your case finds that you have never been seen by a medical practitioner within the past months, or you have a condition listed on your application for disability but have not received treatment for it –like depression– you will probably be scheduled an appointment with a physician.

Going to this appointment isn’t optional and your case can be denied if you refuse to go or miss appointments. Social Security will, however, reschedule you in the event you skip one or more appointments but have a justifiable reason, such as a medical emergency, getting lost on the way, or transportation difficulties.

Social Security Medical assessments are appointments that include X-rays performed exams, mental status exams, memory or IQ exams, as well as full evaluations. Such are scheduled and paid for by the Social Security Administration.

The actual process is that a disability examiner will a) determine whether an exam should be done and b) subsequently ask the PRO, or professional relations office section of the DDS, or disability determination services agency, to make the appointment.

The Doctors Who Perform Physical Exams

Doctors who work for the Social Security Administration do not conduct these physical exams. Those who perform these physical exams are contracted, physicians. They submit a report of findings of said examinations.

All types of doctors agree to perform assessments. A lot of the doctors who perform CEs do not have feelings for individuals.

This, not too surprisingly, is shown through the myriad complaints which claimants have regarding the exams they’re sent to, like “the assessment was incredibly short,” or “the doctor was rude,” or “the physician was condescending.”

Sadly, a claimant can disadvantage their situation if they try to appear more physically capable than they actually are, or, when requested by the doctor about their condition, verbally play down the seriousness of their condition (in one sense, it is astonishing that people do so, but the reality is most individuals don’t wish to apply for disability and, under other ideal conditions, would prefer to be working).

Physicians who have a bias against Social Security’s disability programs, or disability claimants themselves will sometimes go so far as to search for signals that the claimant is malingering, such as observing the claimant walking from the workplace back to their car (and then write this monitoring in their CE report, which is submitted to Social Security).

Other valid complaints regarding CE doctors include the fact that claimants with conditions such as degenerative disc disease are sometimes mailed to physicians whose specialty is completely removed from these conditions, like gynecologists (this does happen). Also, the claimant will discover that the DDS examiner did not send the doctor any background info to give them insight.

What Happens at the Assessment?

A consultative exam involves all the elements of a physical examination. For example, weight, heart rate, and blood pressure measurement are all parts of a physical examination will be assessed. The physician will assess the impaired body part and/or perform tests such as an exercise stress test.

What Happens After the Physical Exam?

Following the examination, the physician will complete the report. He will include the person’s principal medical complaint, a thorough synopsis of the person’s major complaint or complaints, a report of the positive and negative findings based on the history, assessment, and laboratory findings which were discovered during the assessment, and a diagnosis and prognosis for the claimant.

The consultative doctor will also make a statement about that which a claimant can do despite the disability — that is, an opinion concerning the claimant’s ability to carry out work-related activities like lifting, carrying, standing, walking, managing things, hearing, talking, etc.

Social Security’s Reality Exams

Disability consultative exams are scheduled not to ascertain the condition of limitations or the claimant’s health, but as a formality that has to be satisfied before the case can be closed by the examiner.

Therefore, if you haven’t seen a doctor lately, or if you haven’t ever been treated for one or more of your medical conditions, your disability examiner will probably schedule a physical or emotional consultative exam (or both if applicable).

The Result of a Social Security Medical Exam

A physical CE exam typically offers little for your case and will be used to support a claimant. Naturally, it’s only logical that there a CE can’t be given the same weight. It provides no insight into your condition and can neither demonstrate your capabilities nor strength. The short nature of the assessment and how the examining physician has never met nor treated you illustrates just how unlikely it is for many consultative exams to help an individual’s situation (nonetheless, if you’re scheduled, you must go or risk being denied for failure to cooperate).

As a disability examiner, I found it uncommon for a CE to have any effect on a claim that it supplied the case and medical documentation that allowed a disability choice to be made.

Is an exam simply a sham? Not always.

A physical consultative exam, or CE, can supply, in certain cases, a disability examiner an up-to-date snapshot of the claimant’s current medical condition that allows the examiner to proceed with an acceptance when the remaining older evidence in the file is powerful and validates the instance.

Additionally, a CR, meaning that a psychiatric or psychological assessment, can be vital to those seeking disability benefits. Many individuals filing on the basis of one or more emotional conditions haven’t received routine (if any) mental health care in the past, and the CE might be the sole medical documentation or service available to the examiner working on their disability application or request for reconsideration.

The most important thing to consider a consultative assessment is that it’s a tool used to further the aims of the social security disability bureau (i.e., closing cases, denying claims) as opposed to those of the claimant (receiving benefits).

The best thing to do is show up (as mentioned, failure to participate in the CE could be grounds for dismissal of the claim), and don’t worry about the results in most instances, they will not carry nearly as much weight as your previous medical history as well as the observations made by your regular treating physician or medical specialist.

Read More: Mental Evaluation for Social Security Disability and SSI