Call Us Today - It's Free!

What is a Consultative Exam (CE) and How Does It Affect Your SSD Benefits?

If you have submitted an application for Social Security Disability Benefits you will likely have to attend a Consultative Examination. The purpose of this exam is not to provide medical treatment; these examinations simply provide an overview of a Disability applicant’s current conditions. A Consultative Examination is scheduled if an applicant’s medical evidence is insufficient to determine whether they have a disability. These examinations can be physical or psychological and oftentimes, diagnostic tests such as X-rays, blood work, and MRIs are performed as part of the examination.

Who Schedules Consultative Examinations?

When you file a Disability application, Disability Determination Services (DDS) is responsible for reviewing and gathering all medical evidence in connection with an applicant’s claim and rendering an initial Decision. If DDS determines that the medical evidence in the file is insufficient to make a determination, they contact the IMA Group.  The IMA Group is a Government Division that is responsible for scheduling CE appointments for the Social Security Administration (SSA).

Who Pays for Consultative Examinations?

Doctors and psychologist are contracted by the Social Security Administration to perform Consultative Examinations. These Physicians are not employees of the Social Security Administration. The DDS office that schedules the CE is responsible for all costs associated with the appointment. This means:

  • You do not use your private insurance
  • There is no co-pay
  • If you have UNUSUAL expenses in travelling you must let IMA Disability Services know so that they can make necessary arrangements BEFORE the examination.

What Should You Bring to an IMA Consultative Exam?

Prior to your appointment, you will receive a Medical History Form. If you have an attorney, you should speak with them about how to complete this form as this information will be permanently entered into your disability case file. In addition to that form, you must also bring a copy of IMA Appointment notice and government-issued ID. You should also bring:

  • All of your current medications or a list of your current medications
  • Any assistive devices including but not limited to: Glasses, cane, hearings aids, braces, or other medical aids
  • Any additional medical evidence that was not already submitted to SSA

Unlike other medical examinations, you are not allowed to record this appointment, but you can bring someone with you. If you need a translator, you should make sure that you bring someone to the appointment or that IMA has already arranged to have a translator present for you.

What Can You Do to Prepare For the Consultative Exam?

The physician that is examining you will need you to answer questions as accurately as possible. It would be best if you are very detailed about your symptoms and current conditions. You need to also mention any hospitalizations or surgeries you have had that are related to your disabilities. You must make every effort to comply with what is asked of you during the exam. Do NOT exaggerate your limitations, as this is not going to help your claim and will call your credibility into question.

What Information Does a Completed CE Report Include?

You can request that a copy of the physician’s medical report be sent to your attorney’s office upon completion. The report will include information such as:

  • The applicant’s Medical Diagnosis
  • A description of the applicant’s physical or mental limitations
  • A statement about the applicant’s ability to work OR a statement about the applicant’s inability to work
  • Recommendations for future treatment

After you attend your examination, you should expect to receive a Decision from DDS within a few months as to whether your Disability application has been approved or denied. It’s important to note that if you are scheduled for an IMA appointment you must attend. Failure to attend could result in delay of processing your claim or a Decision could be rendered in your case without this additional medical evidence. Your application is usually denied if you do not attend the CE.

How Can a Social Security Disability Attorney Assist with Your CE?

As with anything related to Social Security disability insurance and benefits, consultign an attorney is your best course of action. O’Connor Law PLLC is staffed with SSD attorneys in New York City. Our benefits team will review your case and provide a consultation for your next steps for FREE. If you choose to hire an attorney, we will complete any forms necessary, confirm Social Security information is up to date prior to your exam, ensure you have transportation to the exam, obtain a copy of your IMA report after your exam, and monitor your file for approval.

What’s more is that if you are a non-English speaker, we will ensure an interpretor is present for your exam. Our attorneys work with clients who have immigrated over to the United States and speak various languages. Contact our office today at (914) 595-4502 or fill out the form below.

  • bronx
  • larchmont
  • mount vernon
  • ossining
  • port chester
  • westchester
  • white plains
  • yonkers