Do All CE Exams End in Denial? Everything You Should Know about Your CE Exam

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Do All CE Exams End in Denial? Everything You Should Know about Your CE Exam

When you apply for Social Security disability benefits (SSD), you’re probably expecting a notice telling you either that you’ve been approved or your SSD application has been denied. However, some disability applicants receive something else: a letter from the Social Security Administration (SSA) informing you that you must attend a Consultative Exam (CE exam). 

Being scheduled for a CE exam isn’t necessarily a bad sign. Here’s what you need to know about CEs.

What is a Consultative Exam (CE)?

A CE is a medical examination the SSA schedules to gather additional information about your SSD claim.

For example, a CE exam may be scheduled when:

  • Necessary information from your past medical records is unavailable, such as when your medical provider does not cooperate or has passed away
  • Necessary information is missing because tests haven’t been conducted 
  • Your condition may have changed, and up-to-date information is not available

A CE exam will only be scheduled if the SSA did not obtain sufficient information from your treating physician or physicians, and they are unable to fill that gap by requesting additional information from the medical professionals treating you.

Exactly what the CE exam involves depends on the information the SSA needs to collect. They will pay for the exam, but only for those elements necessary for their record–it isn’t necessarily a full medical examination or even a full assessment of the medical condition that is the basis of your disability claim. 

As you can see, a CE may ultimately be to your benefit. If there’s not sufficient information in your application and supporting evidence to approve your claim, a CE exam may fill that gap. But it’s important to know what to expect and what will be expected of you.   

What to Expect at a Consultative Exam

What Happens at a CE Exam? 

Exactly what happens at your CE exam will depend on your medical condition and on what information the SSA believes is necessary to complete your file. You may be asked to undergo a physical examination, or a mental health examination, or diagnostic testing. The examiner will ask you questions about your condition and your daily life and limitations.

You will be asked for identification. Depending on your condition you may also need to bring medications and/or medical equipment such as a walker. 

Note that the CE report will include more than test results and medical observations. The examiner will also pay attention to things like your mobility when you arrive at the exam, whether someone has accompanied you, and even how you got to the exam. 

During the exam, you’ll want to take notes about the interaction. For example, it’s helpful to note the questions you were asked and how you responded. If you can’t make sufficient notes as the CE proceeds, write down as much as you can remember about how the CE exam went as soon as you leave. You can also bring an observer to act as a witness, and they can take notes as well. 

Who Can Conduct a CE? 

The doctors who perform consultative examinations for SSD claims do not work for the Social Security Administration. They’re independent medical professionals the SSA pays to conduct CE’s and complete reports according to SSA standards. You won’t be asked to make any payment for the exam or testing, and your medical insurance company won’t be billed. In some cases, your own doctor may conduct the CE exam. 

Tips for Your SSDI Consultative Exam

While being scheduled for a CD isn’t necessarily a bad sign, you can hurt your Social Security disability claim

Here’s what you need to do: 

  • Show up for your CE. That may sound obvious, but people do miss scheduled exams. Make sure you’re there and on time. If you’re late to your appointment, the examiner may not see you.  If your disability prevents you from traveling to the examiner’s office, accommodations are available. But, you’ll have to contact the SSA promptly after you’re informed of the CE. 

  • Follow any advance instructions, such as fasting for blood tests or other preparations for testing.

  • Bring everything that’s required with you, including government-issued identification, prescribed medications, and any prosthetics or aids such as a walker or brace. 

  • Take some time before your CE to think and make notes about your condition, including your symptoms and the treatment you’ve had to date–you don’t want to accidentally skip over something important because you weren’t prepared. 

  • Make sure to answer all questions honestly and to cooperate with any testing that is requested. Don’t leave anything out, but don’t exaggerate symptoms or limitations. Remember that the SSA will be considering other evidence, such as the examiner’s report and your medical records. 

  • Keep good notes as described above. 

  • Be prepared to take some time. Depending on the type of exam scheduled, there are minimum required durations. Some of those requirements are short–20 minutes–but others may be an hour or more. 

Talk to an Experienced Disability Benefits Advocate

Securing Social Security disability benefits can be tough, even when you have a serious disability. Most SSD claims are initially denied. Some claims are denied for technical reasons, like insufficient work credits(. But medical decisions are more nuanced. Often, whether or not your SSD claim is approved depends on submitting the right type of evidence in the right form to make it easy for the SSA to see that your condition meets their criteria. 

Working with an experienced disability benefits advocate from the beginning allows you to put together the strongest possible application, and to be well-prepared for a CE, a request for additional information, or anything else that arises. If you’ve already applied and been denied, the same is true for your appeal. You have the opportunity to submit additional supporting documentation, even at the reconsideration stage. 

Our disability advocates have helped thousands of disabled people receive the benefits they deserve. Whether you’re just starting the process or need to appeal a denial, Disability Help Group is here for you. To learn more, call (800) 800-3332 or contact us here now!

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