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Requested Medical Exams and Social Security Disability Claims

Ask just about anyone dealing with a disability what their life is like, and the response is almost guaranteed to include never-ending descriptions of hospital and doctor visits aimed at trying to manage and/or improve their condition. All of this medical treatment is costly, and leads many in this situation to apply for Social Security Disability Insurance (SSDI) if/when working is not possible. The constant rounds of medical appointments quickly becomes overwhelming and exhausting, but the Social Security Administration (SSA) commonly requires SSDI applicants to undergo medical/psychological exams with physicians selected and approved by the Administration.

Many people in these difficult circumstances are invisible to much of the country because they leave the workforce, and then tend to spend most of their time at home due to debilitating ailments. In spite of flying under the radar, the number of people applying for and receiving SSDI benefits has gone up in the past 15 years due to an aging population and the loss of blue collar jobs, according to recent studies by economists. A Congressman from West Virginia wants to make it easier for disabled individuals to work but still retain some SSDI benefits, and plans to introduce a bill to that effect next year.

The reports issued by SSA doctors are crucial to the approval of a claim, so knowing what to expect during the exams and what the doctors are specifically assessing is important information to have.

Purpose of the Exams

The purpose of these medical exams is to obtain additional information related to an SSDI applicant’s debilitating condition so a decision on benefits can be made. Typically, these exams are requested when the applicant has not received medical treatment for the disabling condition within the past 60 days or the application lacks sufficient medical evidence to support the disability claim. These exams are not designed to provide medical treatment, but rather to get a picture of a person’s limitations so the examiners assessing the application can understand how much work the individual can perform. These doctors are independent physicians who contract with the SSA, not SSA employees.

Things to Know Ahead of Time

The exams themselves are typically very brief, lasting only five to ten minutes, and can include physical exams, blood work, X-rays and psychological/mental evaluations. The content of the exams is at the discretion of the SSDI application examiner, and is limited to whatever information is needed to make a decision. The exam is provided at no cost to the applicant, and some travel expenses are reimbursed. The doctor does not have a say in the decision for disability benefits, but merely sends a report to the examiner noting his/her findings and test results. The doctor may also look for signs of malingering, or exaggerating symptoms, in hopes of increasing one’s chances for approval, and may note if he/she believes the symptoms described by the applicant are as serious as claimed. Attending these appointments is extremely important because not showing up gives the examiner grounds to deny the application, and makes getting approval on appeal more difficult.

Talk to a Disability Insurance Attorney

Disability benefits are an essential source of financial support for many people, so do not leave approval of a SSDI application to chance. Contact a disability insurance attorney familiar with the SSDI process to assist you. Farrell Disability Law helps disabled individuals across Florida and South Georgia get the benefits they need, and can help you navigate the complicated application and appeal process. Contact us for a free consultation.


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