The Social Security Disability Application: An Introduction
Your initial Social Security Disability application and the first appeal of a denied claim (Request for Reconsideration) are reviewed in Oregon by the Disability Determination Services (also known as "DDS"). If you are filing for Social Security Disability in Washington, it's the Division of Disability Determination Services. The DDS obtains your work history, your medical records, and has physicians review medical records to determine if you meet the definition of a "disability" under the Social Security Act.
Sometimes, the claim analyst asks a physician to examine you and review your records to provide an opinion about your impairment level. A person's impairment level is another way of describing how much a medical condition (physical or mental) interferes with the ability to do work activity. Administrative Law Judge's also sometimes order consultative examination to determine the same issue. These examinations are called "consultative examinations."
Who Are These Examiners?
The physicians that perform consultative examinations are usually doctors in private practice that contract with the DDS. Many, but not all of these doctors are pretty tough on our clients, and rarely find that the people they examine have significant impairments. Quite a few clients tell us that the examinations last less than five minutes.
We also see that DDS will want an orthopedic evaluation, but will end of sending our client to an doctor who is not an orthopedist. If you are dealing with an mental impairment like depression, anxiety or PTSD, you will probably see a psychologist. Although you are seeing the right kind of doctor, the psychologist who examines you may not know a lot about your prior treatment, and has often not reviewed your prior treatment records.
The bottom line is that many consultative examiners have their own bias against disabled people.
So, What Can You Do?
You can, however, do some things to at least minimize the harm a negative consultative report can do to your claim.
Tip No. 1: Be Honest, and Don't Guess
Although we have seen doctors do these examinations without reviewing records, assume the doctor knows about your medical history, and has looked over your records. If you are asked questions, be sure to answer the questions honestly. The biggest mistake somebody can make is to guess an answer. If you "guess" the answer to a question, and you are incorrect, the physician may conclude that you are being less than honest in your response.
Tip No. 2: Give Your Best Effort
Give your best effort. I will say this all the time.
You should also be aware that the physician will observe you walking into the waiting room, walking into the examining room, and getting on and off the examination table. If your physical abilities or symptoms suddenly change after you have entered the examination room, that could be a problem because the physician may doubt the validity of any examination results. This is why it is critical that you give your best effort during the consultative examination.
Another reason you should give your best effort is because the medical doctors have ways of "cross testing." This means that one measurement will be taken during one part of the exam, and then without you knowing it, the same measurement will be taken later on in the examination. If there is a drastic inconsistency between the first and second measurement, the physician will doubt the validity of test results.
Many of the consultative physicians who perform these examinations will almost never find a Social Security disability applicant severely limited. You should assume that this will be the case for you. However, if you give good effort, and an honest history, you are limiting the damaging effect of this consultative examination report.
Psychological consultative examinations usually take quite a bit longer, because the examining psychologist will want to get a history (your story) in order to come up with a diagnosis. Obviously, it is a good idea to show up on time, and again, give your best effort and honest response to all the questions. You should assume that the examiner will have access to other medical records, and if there are any significant inconsistencies, that could spell trouble.
Tip No. 3: If You Will Have Psychological Testing, See Tip No. 2!
In some psychological examinations, you will be asked to perform a battery of tests. This can be tiring, but again, you should do your very best (we cannot say it enough). Although the consultative examiner may interpret test results against you, we will often run those test results by the treating mental health provider to rebut the conclusions of the consultative examiner.
The Good News
The good news is that the consultative examination report is not the only evidence in your file. Judges have disregarded consultative examiner opinions to find our clients disabled several times. This has a lot to do with what all the medical records say, including your own doctor's opinion about impairment.
If you are in the midst of a Social Security Disability appeal, and have questions, contact us. We have handled literally hundreds of claims over the years, and can share our experience so you know where you stand with your claim.