SSI and SSDI disability benefits require an application process, and the Social Security Administration (SSA) will use the application materials to make a determination about that claim. The application will include medical records, but sometimes those records are not complete enough to make a determination. When the records are outdated or inconsistent, the SSA will usually require more information to make a decision.
The consultative exam process in Kansas City can be used to fill in medical gaps and resolve conflicting information. At BurnettDriskill, Attorneys, we not only guide clients through this process—we have also taken legal action against CE providers and the SSA for fraudulent practices that can harm disability applicants. Contact our qualified legal team at BurnettDriskill, Attorneys, for help preparing for your CE exam.
Under 20 CFR § 404.1519a, the Social Security Administration may order a consultative exam at the SSA’s expense. This examination must be performed by a licensed medical professional who is neutral to the outcome of the application. This means that the examiner cannot have a direct interest in the results of the claim.
The consultative exam can be performed by a range of medical professionals in Kansas City. It may be conducted for general physical impairments, mental health impairments, or specialty areas. The examiner may be a(n):
The exam focuses solely on information gathering and does not result in treatment or prescriptions.
The results of the consultative exam will usually include observations noted by the examiner, diagnostic results, and professional opinions on the applicant’s condition. The report will be used to fill in any gaps in the applicant’s medical history, especially if the application materials are outdated or the applicant has not seen a doctor in a long time.
The results will also help provide necessary context for any conflicting medical records. The report will typically assess the impact of symptoms in the context of the SSA’s definition of “disability” and provide support or challenge to the disability claim. Ultimately, the report will be used to assist in determining the applicant’s ability to work and will be one piece of the evidence used to make a disability claim decision. Unfortunately, our firm has seen this process fail many applicants when inaccurate or even falsified CE reports are submitted.
Oftentimes, the results of consultative exams do not accurately represent the severity of the injury a patient is experiencing. Some examiners even falsify exam results, claiming to have completed exams they did not in order to secure payment from the SSA. In practice, this looks like the practitioner claiming they had a patient complete tests like turning a doorknob or buttoning a shirt. They then report these false exams as being completed successfully, in turn falsifying examination results, and worse, causing a patient’s request for benefits to be denied.
Our firm has taken legal action on behalf of clients affected by such misconduct, and these issues have also been brought to light in news investigations by KSHB and the Kansas City Star, both of which reported on systemic problems in the CE process.
If the results of your consultative exam are not in line with your expectations and experiences, our office can help you object to the report. The process of challenging the results may include providing additional medical documentation, ensuring that the exam was conducted by a properly licensed and neutral professional, and making sure that the exam was thorough and complete.
A seasoned Kansas City lawyer can help with these kinds of challenges to ensure that the legal requirements for the consultative examination were followed and that the applicant’s complete and accurate medical history is presented in the disability claim.
If you are starting the consultative exam process in Kansas City, you should speak with an experienced lawyer. An attorney can represent you as you head into the exam prepared and informed. A lawyer can also help ensure the results of the examination are put into the larger context of your entire application materials.
Getting disability benefits can be a step-by-step process, and a consultative exam may be a necessary step along the way. Call our office to speak with an attorney who will help you understand the details.
(816) 781-4836