How a consultative examination is conducted

A consultative examination is a physical or mental examination conducted on you for the purpose of helping the Social Security Administration determine whether or not you qualify for disability benefits when it decides that it needs more medical information that is otherwise available.

This examination is done at the request of the Social Security Administration, and is paid for by the Social Security Administration.

Your Florida treating doctor is the preferred source to do a consultative examination

The regulations for the Social Security Administration say that your treating medical source will be the preferred source to do a consultative examination for the Social Security Administration, provided that your treating source satisfies the Social Security requirements.

The requirements of the Social Security Administration for having your source be the person who performs the consultative examination are that this source is:

  • Qualified.
  • Equipped.
  • Willing to perform the additional examination or tests for the fee schedule payment.
  • Generally furnishes complete and timely reports.

When the Social Security Administration will use other sources for a consultative examination

The Social Security Administration will use a medical source other than your treating source for a consultative examination or test when:

  • Your treating source prefers not to perform such an examination or does not have the equipment to provide the specific data needed.
  • There are conflicts or inconsistencies in your file that cannot be resolved by going back to your treating source.
  • You prefer a source other than your treating source and have a good reason for your preference.
  • The Social Security Administration knows from prior experience that your treating source may not be a productive source (for example, he or she has consistently failed to provide complete or timely reports).

Objecting to the medical source designated by the Social Security Administration to perform the consultative examination

Your disability lawyer may object to having you examined by a medical source that the Social Security Administration has designated to perform a consultative examination. If there is a good reason for the objection, the Social Security Administration will schedule the examination with another medical source.

A good reason might be that the medical source designated by the Social Security Administration had previously represented an interest adverse to you. For example, the medical source may have represented your employer in a workers’ compensation case or may have been involved in an insurance claim or legal action adverse to you.

Other things that the Social Security Administration will consider in objections to someone as the medical source to perform a consultative examination include:

  • A language barrier.
  • The medical source’s office location (for example, if the source’s office is on the second floor and there is no elevator).
  • Travel restrictions.
  • Whether the medical source had examined you in connection with a previous disability determination or decision that was unfavorable to you.

If your lawyer’s objection to is a claim that the medical source “lacks objectivity” in general, but not in relation to you personally, then the Social Security Administration will review the allegations. During the review, to avoid a delay in processing your claim, your consultative examination will be changed to another medical source. However, if the Social Security Administration had previously conducted such a review and found that the reports of the medical source in question conformed to its guidelines, then it will not change your examination.

Get help from a Florida disability attorney

Dealing with the Social Security Administration on your disability claim can be confusing and frustrating on your own. Particularly if the Social Security Administration decides that it wants to conduct a consultative examination, you may want an experienced Florida disability lawyer to help you through the process.

If you are not already represented by a Florida Social Security disability lawyer, consider getting an evaluation from me about your claim. Give me a brief description of your claim using the form to the right, or e-mail or call my office at:

Law Offices of Walter Carfora
Florida disability lawyer

111 Second Avenue N.E., Suite 917
St. Petersburg, Florida 33701

Telephone: (727) 823-9780
FAX: (727) 821-6501