What is a consultative examination?

Shortly after filing a claim for disability benefits, you may receive a message from the Social Security Administration informing you of an examination appointment. This medical exam is known as a “consultative exam.” It is normal to feel nervous upon receiving this notice, and you may very well feel apprehension. Don’t. View this exam as an opportunity to give an independent medical professional more information regarding your symptoms, how your conditions affect you, your day, and your ability to accomplish tasks.

           An employee of Social Security does not perform consultative exams; Social Security hires independent physicians to perform an unbiased, independent exam. While Social Security may schedule many types of exams for you, such as auditory, respiratory, visual, etc., the most commonly scheduled exams are for internal medicine and mental status. 

How do you prepare for the consultative exam? 

If you have any medical records, you should bring them. Remember, this is the first and likely only time this doctor will see you. This doctor doesn’t know you or your medical conditions. The most helpful medical records will be reports and findings from objective studies such as MRIs, EMGs, blood tests (for conditions diagnosed through bloodwork and labs such as rheumatoid arthritis and Lyme’s), and prescriptions. Accurate records and findings carry the most weight with many medical professionals and with Social Security. Of course, for mental health cases, you likely don’t have any medical records besides your prescriptions. This raises my next point. Be prepared to discuss your story with them, such as what caused the impairment and how it affects your current daily living.  

            Provide the physician with your story. Don’t exaggerate, but similarly, don’t minimize. One way to achieve this successfully is to tell the doctor about your typical day and the challenges you may face regularly. Think about the difficulties you encounter daily. Why are they difficult—is it due to physical limitation? Is it due to anxiety? What is it that interferes with your daily functioning? Do you receive any assistance accomplishing your daily tasks or chores? Are you able to perform house chores? Why or why not? 

Tell them about self-care such as bathing and dressing. Tell them about social interactions if your impairments affect or limit them. If you can perform a certain activity, but it is with great difficulty or painful consequences later, let them know about those struggles. Tell them what a good day, a bad day, and a typical day is like for you.

Inform them of your treatment history as well. Who has provided you with treatment in the past? Currently? What specialists have you seen? What procedures have you undergone? Have you been hospitalized? If you have, were they multiple admissions? Do you go to the emergency room frequently due to your conditions? Don’t fret over specific dates—ballpark timeframes serve the purpose of most exams. 

You get the idea; this is about why you might be unable to be reliable or consistent in your abilities to accomplish even menial tasks. It is why you filed for disability in the first place.

           You should be aware that when you arrive at a consultative exam, you might be observed before you even enter the office. Sometimes, the examiner may watch a claimant exit their vehicle in the parking lot, walk to the entrance, etc. Additionally, keep in mind that this is not a feel-good exam. After the exam is completed, you may not feel that the examiner spent enough time with you, learning about your conditions. You may feel that you were hurried. Often, these exams are performed by physicians with many patients and limited time. This is why you should prepare and focus on the issues or impairments that present you with the most limitations. Don’t lose valuable time talking about conditions that are marginal or that don’t limit your ability to function on a day-to-day basis.

           Remember, this is your opportunity to help the examiner understand your conditions and how they affect you. So, tell them.