Can you Refuse to go to a Social Security Medical Examination?

Yes, you can refuse to go to a CE, or consultative examination, commonly known as a “social security medical examination”. However, this would not be a smart move. In fact, a failure to attend a scheduled exam can potentially be grounds for a denial of a claim due to a failure to cooperate. If, of course, you are unable to make your appointment, than make sure to call before the appointment to reschedule. For a claimant who simply has no recent medical record documentation, not going to a consultative exam can only lead down the path to a denial.

You have to consider why a disability examiner wants to schedule a claimant for such an exam in the first place. These exams are not for the purpose of treatment.

a. Usually, its because a claimant does not have enough medical treatment. If you have not seen your doctor for your condition stated on your application in a long time, a consultative examination may be set up.

b. Sometimes a CE is scheduled because a claimant has never been treated for a condition they’ve listed on their disability report. Depression is a good example of this. Many individuals list depression on a disability application without ever having received treatment for depression from a mental health treatment source, or even from their own doctor. Or simply because their family doctor indicated a single word in the treatment notes, “depression”.

c. Some disability exams are not really exams. Sometimes a disability exam is actually testing.

They can include opthalmological exams, bloodwork. In other instances, a claimant will be sent out for a simple X-ray if an imaging report is not available from the claimant’s list of medical treatment sources.

When you goto your appointment it is important to bring with you:

a. Make sure that Social Security has received all of your medical records before the consultative examination. You can bring records with you to the examination.

b. Bring your prescription medication to the examination. The doctor will want to know what medication you are taking. The doctor may check the date of your prescription and count the pills in the bottle to see if you are taking the medication according to your doctor’s instructions.

c. Make sure to tell the doctor about all of the medical problems that you have. Be as specific as possible about your medical problems.

Some claimants are understandably nervous about going to consultative exams, possibly because they fear some level of bias on the part of a “social security doctor”. However, the doctors who perform such exams are not employees of the social security administration. These doctors are independent physicians who perform examinations on a contract basis. Having said that, though, it’s true that, when the topic arises, a large percentage of claimants who have gone to consultative exams will report that the examining physician was rude or seemed to exhibit behavior that indicated a biased stance.

Generally, if a claimant goes to a physical consultative exam for a social security disability or SSI disability case, what they’ll find is that:

a. the exam will be fairly short;
b. the doctor may be somewhat rude;
c. the doctor will ask you very little information; and
d. the doctor will typically know little about their medical condition or history — disability examiners will sometimes send the examining physician excerpts from the medical record to apprise them of the claimant’s medical history, but there’s no guarantee that the examining physician will read the information.

However, what a disability claimant will not be privy to is the fact that, at the initial claim and reconsideration levels, consultative exams are usually scheduled so a disability adjudicator can simply obtain recent documentation for the file.

None of which changes the fact, of course, that if you are scheduled to go to an examination appointment for your disability claim, you really need to go.