Social Security Disability Consultative Exam: What is it?

Some Social Security Disability applicants are sent for a consultative examination while others are not.  What is a consultative examination?

SSD Benefits
Mooney & Associates representing social security clients – 717-200-HELP –


Essentially, it is a medical examination scheduled by Social Security with a physician they choose.  It can range from a general internal medicine (family) doctor, to a specialist, such as an Orthopedic, to a pain management doctor to a Psychiatrist.  It really depends on the medical conditions you are alleging to cause you to be disabled.  If Social Security feels the need for a consultative examination for determination of your application, you will receive written notification from social security.

So why do some get sent for an examination, while others do not?   The following could be  reasons you may have a consultative examination scheduled in your claim.

  1.  Despite sending health release authorizations, perhaps your medical provider simply has not responded or cooperated  with Social Security in request for medical records.
  2.  Social Security may schedule an examination when they feel that an applicant has very little medical evidence, meaning medical records.  Perhaps you did not have for health insurance so you did not treat that much.  Perhaps you have treated, but not recently due to financial problems.  Regardless, an examination is scheduled because that additional information is needed before a determination can be made on your application.  Simply put, Social Security may just believe it does not have enough medical information to make a determination.
  3. Specialization.  Perhaps you have primarily treated with your Family Doctor for all your medical issues, but one or more medical issues are complex.  They may send you for a consultative examination with a specialist in that particular medical condition.
  4. You could even be sent for a consultative examination by the Administrative Law Judge in your case at the actual hearing.  I just had that for one of my clients, where the ALJ decided to stop the hearing, and then refer the case our for a consultative examination.  It happens.

These are just a few reasons.  They key thing to remember is, you MUST attend the examination.  The claims examiner can certainly deny your application for your failure to cooperate if you do not attend an examination.

There is no ‘script’ or ‘method’ to ‘pass’ these examinations.  Cooperate with the doctor and be honest about your symptoms and limitations.  The examination should not take more than 10 to 15 minutes.

Mooney & Associates aggressively represents individuals that have applied for Social Security Disability and have been denied.  We represent disabled individuals throughout Pennsylvania and Maryland.    Not only do we handle denials, but if you have not applied for benefits yet, call us, we can take and file the disability application for you.  Call us today at 717-200-HELP or 1-877-632-4656 to schedule your FREE Consultation.


Mark Buterbaugh

Attorney representing injured workers and Social Security Disability clients in Pennsylvania and Maryland.