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Do you have to go to an SSA consultative exam?

You filed for Social Security Disability Insurance (SSDI) benefits through the Social Security Administration (SSA), and you settled in for a long wait because you know it’s not a quick process.

You didn’t expect, however, to be asked to attend a consultative examination by an unfamiliar physician. Do you have to go? Not exactly, but it’s wise to understand the consequences of your decision.

Why does SSA ask for consultative exams?

Social Security wouldn’t ask for a consultative exam if the decision on your case was clear and easy. Generally speaking, disability examiners want a consultative exam when:

  • There’s not enough information in your file to clearly demonstrate the severity of your condition. This can happen for all kinds of reasons, including poor record-keeping on the part of your doctors.
  • There’s conflicting information in your file. You may have seen multiple physicians and specialists before you got to this point, and some of those doctors may not have agreed with each other.
  • Your primary physician or specialist is uncooperative with requests for information or SSA has found them to be “unproductive.” That can mean either your doctor’s office hasn’t returned information or records SSA has requested or SSA suspects that your doctor is biased and may have exaggerated your condition.

Can SSA force you to go to a consultative exam? No. However, if you refuse to go, they will base their decision entirely on what’s currently in your file. The fact that they have requested a consultative exam tells you that they don’t believe there’s enough there to establish the severity of your condition, so your claim is most likely to be denied.

Dealing with an SSDI claim is already difficult, and going through an appeal is even worse. Don’t hesitate to reach out for experienced assistance with your case.

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