Some Social Security disability claimants may receive a notice to appear at a Consultative Exam (CE) to help Social Security make a medical determination on a claim, but it is not a given that Social Security will order a CE, typically requested when there is insufficient medical evidence in a file. Below, Social Security sets guidelines in place of when a CE is needed.
After you apply for Social Security or Supplemental Security Income disability benefits, sometimes you need to have special medical examinations or tests before we can decide whether you qualify. The Disability Determination Services (DDS) in your state is currently reviewing your disability claim. The state agency makes the disability decisions for us. The employees there need more information before they can decide if you’re disabled under Social Security law. So, they’re asking you to have a special exam or medical test that we’ll pay for. We’ll also pay for certain related travel expenses. If a doctor who is not your regular doctor performs your exam or test, we can send a copy of the results of the exam or test to your doctor if you ask us.
What should You do?
It’s your responsibility to take the exam or test and cooperate with the doctor examining you. If you can’t keep the appointment we made for you, let the state agency know right away. The contact phone number and address are provided with the letter you receive notifying you about the exam or test. If you don’t let the state agency know that you can’t keep the appointment, DDS will make a decision based solely on the information already available in your case. This may result in a decision that you‘re not disabled.
What will the doctor do?
The doctor (or other medical person) who sees you will only conduct the exam or test and get specific information requested by the state agency. The doctor will not take part in deciding whether you’re disabled, and he or she will not prescribe treatment or medication for you. The doctor will send a report of the exam or test to the state agency.
What will the state agency do?
The state agency will review the doctor’s report, along with all of the other information in your case, and make a disability decision. We’ll send you a letter to tell you about the decision the state agency made on your case.
What if I do not agree with the decision?
If you don’t agree with the decision, you have the right to appeal. Your letter will tell you how to appeal the decision.
Things to remember
- The exam or test requested is intended to provide additional information needed to help the state agency make a decision in your case.
- If you can’t keep the appointment, you must let the state agency know right away. If you don’t, the state agency may decide that you’re not disabled.
