Consultative Exam
Sometimes your medical records don't say as much about your condition as you might think they should. For instance, your doctor's notes might only say that you complained of low back pain and you were prescribed a pain medication. Limited documentation such as this doesn't give the Disability Office enough information about how your condition limits your ability to function and work.
In other instances, your medical records are hand written and impossible to read. If so, your disability caseworker may send a special form for your doctor to complete, or contact your doctor by phone for more information about how your condition limits you.
If your doctor does not respond, your caseworker can only wait a short time before continuing to process your claim without this information. If your doctor has not responded in two to three weeks, your caseworker will take other steps to get the necessary information, including ordering a Consultative Exam, also known as a "CE."
If information from your medical sources is incomplete, your disability caseworker will likely order a CE. The doctor performing this exam gets paid by the state in which you live, but does not provide medical treatment or make the decision on your claim. This doctor simply performs an exam and gives a report of the findings to the Disability Office. If you don’t remember anything else about a CE, just know that if you are scheduled for one, your disability caseworker was unable to get necessary information from your medical sources and records.
Your disability caseworker will contact you by phone to confirm that you will go to a CE. Your caseworker will notify you in writing of the date and time of the appointment, and of the name and address of the doctor. You can refuse to attend this exam and request that a decision be made on your claim based on the information in your file. But be aware that this request often results in a denial of your disability claim due to lack of information.
Notify your disability caseworker immediately if you have problems that prevent you from attending this exam. If you miss the exam, and it must be rescheduled, this can add weeks to the processing time of your claim. Failure to let your disability caseworker know within twenty four hours of the consultative exam that you can’t keep your appointment may result in a denial of your claim due to lack of information.
The Disability Office pays for the CE and any necessary tests. The exam is scheduled with a doctor closest to your home zip code, so it is important that your caseworker has your correct home address. If you use a post office box or someone else's address to get your mail, make sure your caseworker knows this. When you go to this exam, always bring a picture ID, like a driver’s license; any medications or pill bottles; and any necessary braces, canes, eye glasses, or hearing aids.
Arrive a few minutes early for the exam. If you show up late, the doctor may refuse to see you, and the exam would have to be rescheduled. This can add weeks to the processing time of your claim. If you have children, leave them in the care of a trusted adult during your exam so that you will be able to give this doctor your full attention. Cooperate to the best of your ability during the exam. The doctor may ask you to do something that is uncomfortable, but if possible, please try. Not trying, or refusing to do something the doctor asks, can make a difference in how your disability is viewed. Be honest and don't fake being better or worse than you are. This doctor has access to your medical records and will have reviewed information about your condition.