Social Security recently reported it spent more than $350 million on providing consultative medical examinations to disability claimants in fiscal year 2018. Considering the relatively low value of these types of exams, it seems like a lot of money is being wasted.
Social Security disability examiners order CEs for disability claimants who claim to have physical or mental health impairments, but there is not enough medical evidence in a file to determine whether the person is disabled from these impairments. We have received reports from clients who indicate many of these CE exams they are sent to are not thorough exams and usually last less than 30 minutes. Social Security uses a list of doctors they have contracted with to conduct these exams, so many of these disability claimants are seeing the same doctors who then right a report and send it to Social Security.
Despite the fact that these exams are ordered, the majority of claimants will receive denial notices on the claims they filed, which is really no different from the people who are not ordered for a CE exam. Considering how much money Social Security spends on these exams each year, they may have outgrown their usefulness. Below is an explanation from Social Security of how the sources are chosen for a CE.
Selection of a Consultative Examination Source
The DDS purchases consultative examinations only from qualified medical sources. The medical source may be the individual’s own physician or psychologist, or another source. In the case of a child, the medical source may be a pediatrician.
By “qualified,” we mean that the medical source must be currently licensed in the State and have the training and experience to perform the type of examination or test we request. Also, the medical source must not be barred from participation in our programs. The medical source must also have the equipment required to provide an adequate assessment and record of the existence and level of severity of the individual’s alleged impairments.
Medical sources who perform CEs must have a good understanding of SSA’s disability programs and their evidence requirements. The medical source chosen may use support staff to help perform the consultative examination. Any such support staff (e.g., X-ray technician, nurse, etc.) must meet appropriate licensing or certification requirements of the State.
Generally, medical sources are selected based on appointment availability, distance from a claimant’s home and ability to perform specific examinations and tests.
