In many cases, Social Security will send you to one or more consultative medical evaluations. In a typical case, they will send you to a general medical examination with an internist, and they will send you to a mental health consultative evaluation with a psychologist.
Understand that consultative evaluations are one time visits intended to provide Social Security with some insight about your capacity for work. The doctors you see will not provide on-going treatment, and you may be asked to sign a release specifically stating that the Social Security doctor is seeing you solely for the purpose of a disability evaluation.
To put this another way, Social Security will not pay for your on-going medical treatment and if you have little or no other treatment in your file other than one or two consultative evaluation reports, you are probably going to lose.
Can Physical Medicine Consultative Evaluations Help Me or Will They Hurt My Case?
My experience has been that physical medicine consultative evaluations are unlikely to help your case. The doctors SSA uses are typically industrial clinic doctors or doctors that earn most of their money seeing patients on referral from insurance companies.
About half the time, reports from physical medicine doctors say little or nothing relevant to your work capacity, which is the main issue in your disability case. I get the sense that no one told some of the doctors on SSA’s consultative panel about the purpose of these exams – I regularly read reports that repeat a claimant’s allegations of pain, discomfort and symptoms but draw no conclusions about that person’s capacity for work.
Rarely do physical medicine reports help your case. Industrial clinic doctors and insurance company review doctors usually have a built in bias against injured or sick patients. Many of the reports I see from these doctors will assume that you are exaggerating your symptoms and they almost always find that you have some capacity for work.
Will Mental Health Consultative Evaluations Help or Hurt my Case?
Surprisingly, my experience has been that mental health consultative evaluations can often help your case, and rarely will they cause any major damage.
Psychologists on the SSA referral panel are almost always legitimate, practicing psychologists who accept consultative evaluation work in order to make extra money. Since these mental health providers see real patients with real problems, they tend to approach Social Security consultative evaluations with more of an open mind.
I have won cases primarily on the strength of Social Security paid mental health consultative evaluations.
How You Can Improve Your Chances for a Positive Result from a Consultative Evaluation
Whether you are sent to a physical medicine doctor or to a psychologist, you can improve your chances at getting a favorable report by bringing copies of existing medical records to the evaluating doctor. Specifically if you have objective test reports from MRIs or CT scans, bring those to the physical medicine doctor. If you have operative reports or functional capacity evaluations bring those.
If you have been hospitalized at a psychiatric facility, bring those records to the consulting psychologist. Also bring any treatment records or psychiatric or psychological summaries.
Understand that medical professionals are trained to approach the conclusions of a fellow medical professionals with an open mind. This is especially true if the one-time consultative doctor is reading reports and viewing test results from long time treating doctors that span years.
Secondly, be aware that consultative doctors and their staff may very well be observing your behavior from the time of your entrance to the time of your departure, looking for inconsistencies. I regularly read reports that say things like “I observed the claimant walking without difficult into the waiting area, where he got in and out of his chair without difficulty. However, when the claimant entered my office, he did so with an exaggerated limp and groans of pain, and claimed that he could not get on the examining table without assistance.”
Again, consultative evaluation doctors are looking for signs of exaggeration and malingering. They are also trained to spot deliberate poor performance on medical or psychological testing.
You are not going to outsmart an experienced doctor, nor should you try to do so. Tell the truth and do your best on whatever tests the doctor gives you. My experience has been that long time treatment records are still better evidence than a single report or two from a one-time consultative visit.
If you are not currently represented and have been scheduled for one or more consultative evaluations and you have questions, please reach out to me by email or phone – I’m happy to help.
