Approved for Social Security Disability after the Medical Exam

Here's a question I encountered recently and it went something like this: "What are the odds of being approved after they send me to a social security disability medical exam?

Actually, there is no real correlation between being sent to a CE (CE stands for consultative examination and this is generally what people are referring to when they use the term "social security medical exam") and being approved, or denied, on a disability application or disability appeal.

These types of examinations are usually scheduled by disability examiners (the individuals who work at state agencies and make decisions on claims for the social security administration) and are also scheduled by administrative law judges (the individuals who conduct disability hearings. Why are they scheduled? Usually for two reasons. Either to investigate a claimant's functional capabilities (mental or physical) when no records exist to document this, or to provide recent medical record documentation if a disability claimant has not been seen by a medical provider in quite some time.

By and large, social security medical exams have no bearing on the outcome of a disability case. And they are typically scheduled so the adjudicator can fulfill his or her duty to fully investigate a claimant's allegations (the reasons cited for being disabled) and to satisfy the requirements of "recency" (evaluating a claim on the basis of recent medical evidence). Having said that, though, a couple of things should be pointed out.

1. It is "generally" true that after a CE has been attended, a decision on a social security disability or SSI disability case should be forthcoming (the private doctor who conducts the CE is usually allowed ten days in which to submit his CE report to either the disability examiner or the judge).

2. Failing to go to a CE can have an adverse effect. This can be labeled as a failure to cooperate and a case can actually be denied on this basis.


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