Many people who have applied for Social Security disability and are waiting on a decision receive a notice in the mail that they have been scheduled for a Consultative Exam (CE). Many questions arise when they receive this notice, mainly what is a CE and why has it been scheduled?
A CE exam is an exam the disability determination agency sets up for a Social Security disability claimant when it is determined that there is not enough medical evidence available to determine whether the claimant is disabled. The doctor to perform this exam is chosen by the disability determination agency and the cost for the exam is picked up by Social Security. So, in a sense, the fee for the doctor’s exam is being paid ultimately by the decision maker on disability.
Arguments can be made all day long that this is a conflict of interest, but who else is going to pay for this exam? Disability claimants, most of the time, are financially strapped and lack the resources to pay for this type of exam themselves. Even though there seems to be a bias in place, sometimes the doctor performing the exam writes a report and sends it to the disability determination agency indicating the claimant is clearly disabled and unable to work. You may think this should be the end of the story, but it’s not. Even though one of their own doctors agree that the claimant is disabled, Social Security can and many times does turn around and indicate the claimant is not disabled. When this is the case, the question remains, why would Social Security send a claimant out for a CE if they disagree with the doctor’s assessment?
This is just one of the many reasons Social Security claims are denied at the early phases of this process.
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