The Consultative Examination

Clients often call us with questions concerning a letter they receive indicating that they have been scheduled for a “Consultative Examination”. Most clients want to know what the exam is and if they have to attend. Clients are also curious as to who has scheduled this exam and what doctor they will be seeing. Here is some basic information and insight about Social Security medical exams.

What is the Consultative Examination?

A fairly high percentage of individuals who file for either Social Security Disability benefits or Supplemental Security Income benefits will be required to go to a medical examination by the Social Security Administration. Social Security Disability exams are called Consultative Examinations (“CE exam”). CE exams can be physical in nature, psychological (IQ testing), or psychiatric in nature. They can also include ophthalmological exams, blood work, and the taking of x-rays. The Disability Office that schedules your exam also pays for the CE exam and any necessary tests. The exam is scheduled with a doctor closest to your home zip code, so it is important that you always notify your attorney when you move or change addresses.

Why is a Consultative Examination being scheduled in my case?

Sometimes your medical records don’t say as much about your condition as you might think they should. For example, your doctor’s notes might only say that you complained of low back pain and you were prescribed a pain medication. In other instances, your medical records are hand written and impossible to read, or information from your doctor may be incomplete. In some cases, clients have not been to see a doctor recently. Limited documentation such as this does not give the disability examiner reviewing your case sufficient information about how your condition limits your ability to function and work.

CE exams are requested by disability examiners (examiners handle initial disability applications) and also by Administrative Law Judges at the disability hearing level. The purpose of these exams is to obtain additional medical information and documentation for an adjudicator (a disability examiner or a judge) to arrive at a decision. Disability examinations that are scheduled by a disability examiner or a disability judge are mandatory and failure to attend can result in a decision based on existing evidence, or the closure of a case for failure to comply. However, if you miss a scheduled exam and have a valid reason for this happening, an examiner will usually allow for the examination to be rescheduled.

 Who performs the exam?

CE examinations are performed by independent physicians and psychologists who have contracted to examine disability claimants and provide written reports afterwards. The doctors who perform these exams are not Social Security doctors. They are not employed by the Social Security Administration, rather they are independent contractors who are paid for their services. In addition to performing an examination, physicians and psychologists who perform CE exams are required to submit the written results of an examination. Please keep in mind that Social Security CE exams are not for the purpose of rendering medical treatment or making the decision on your claim. The purpose of these exams is to provide a recent snapshot of your conditions and various limitations.

How long does the exam take?

One of the most common complaints among our clients who have gone to CE examinations is that the duration of the exam was only 5-10 minutes. The length of the exam will vary depending on the type of exam a claimant is sent to. Examinations for physical allegations can be relatively brief (10-15 minutes is not abnormal), while a mental exam can take considerably longer due to the nature of psychological or psychiatric testing.

 What should I do to prepare for the exam?

Being required to go to a medical exam by Social Security is no cause for alarm. Getting an appointment letter for a CE examination means, at the very least, that your claim is actively being worked on.  

 Here are some important tips to keep in mind when attending your CE examination:

1. Arrive a few minutes early for the exam. If you show up late, the doctor may refuse to see you, and the exam would have to be rescheduled. This can add further delay to the processing of your claim.
2. If you have children, leave them with someone during your exam so that you will be able to give the doctor your full attention.
3. When you go to the exam, always bring a government issued picture ID, like a driver’s license.
4. Take any medications or pill bottles with you to the exam, and any necessary braces, canes, eyeglasses, or hearings aids that you use.
5. Have someone go with you to the examination and observe.
6. Takes notes during and after the examination. How long did the doctor see you? What questions were asked? Were any tests performed?
7. Cooperate to the best of your ability during the exam. The doctor may ask you to do something that is uncomfortable. Not trying or refusing to do something the doctor asks, can make a difference in how your disability is viewed.
8. Be honest and don’t pretend to be better or worse than you are.

Got a question that you need answered? Please check out our website at www.westcoastdisability.com . We try to provide you with valuable information on our website that may help you navigate the Social Security Disability process. Also, feel free to shoot us an email at info@westcoastdisability.com or call us at (800) 459-3017.

The Differences Between Social Security Disability ("SSDI") and Supplemental Security Income ("SSI") benefits

If you thought SSDI and SSI were the same Social Security programs, you are not alone. Frequently, our clients use the terms interchangeably, but in fact, each program is quite different. Both programs are administered by the Social Security Administration. They also both require that an individual prove that he/she is unable to work due to a physical or mental impairment(s), or a combination of impairments, for 365 days or more to establish entitlement. If you are granted either one of these benefits, you receive health insurance and cash benefits. However, that is where the similarities end between these two programs. Below is a description of each program and its unique features to help you understand the fundamental differences between the two entitlement packages.

Social Security Disability benefits

Often referred to as SSDI or Title II benefits, Social Security Disability benefits are calculated based on what you have paid into the Social Security system. You must have worked a sufficient amount of “quarters” to be entitled to these benefits. There is a 5 month waiting period from the onset date of disability that must toll before you are entitled to these benefits. After you have been found disabled for a full 24 months on a Title II application, you will also receive Medicare benefits. The maximum amount of retroactive benefits you can receive in regards to a Title II claim, is one year prior to the initial application date.

 Supplemental Security Income                        

Often referred to as  SSI or Title XVI benefits, the Supplemental Security Income program is designed to operate as a “needs based” program. To qualify, your countable resources cannot exceed more than $2000 as an individual and $3000 as a couple. Owning one automobile, one house, and one wedding ring will not disqualify you from this program. The Federal payment amount is $710 for an eligible individual and $ 1066 for an eligible couple for the year 2013. There is no waiting period for Supplemental Security Income as is required for Social Security Disability benefits. Supplemental Security Income eligibility also entitles you to Medi-Cal in the state of California, sometimes referred to as Medicaid in other states. The earliest benefits can begin in a Title XVI case is from the date of application.

For more information on SSDI and SSI benefits, visit our webpage at http://www.westcoastdisability.com/Practice-Areas/

Got a question that you need answered? Please check out our website at www.westcoastdisability.com . We try to provide you with valuable information on our website that may help you navigate the Social Security Disability process. Also, feel free to shoot us an email at info@westcoastdisability.com or call us at (800) 459-3017.

Parkinson's Disease - Not a Joking Matter

When Cari and I started our Social Security Disability blog, I doubt either one of us would have thought we would ever mention the name of Kanye West in it. Unfortunately, we are mentioning it now and not in connection with a positive story.

Kanye West is no stranger to controversy. At a minimum, he is known for being brash, outspoken, and arrogant , though I am sure some of you reading this could substitute some better adjectives that may more accurately describe this man. In fact, I think President Obama’s remark that Kanye West is a “jackass” is likely appropriate. However, I understand that in the entertainment world shock value sells and that there is often the perception that there is no such thing as “bad publicity.” As long as it is harmless, I have no problem with it. I usually can just ignore it.

Occasionally, however, a celebrity or public figure does something that is so offensive that it warrants discussion and while I am hesitant to call further attention to this (ummm…let me choose my word carefully) “jackass,” I am going to do so to address a larger issue – the insensitivity  that certain people have to those with profound disabilities.

Kanye West recently released a new album called “Yeezus.” In the song entitled “On Sight,” West describes how he gets a woman “shaking like Parkinson’s.” Full disclosure… I am editing the exact phrase he uses because this blog is G-rated, but let’s just say he uses a more offensive term than the feminine noun “woman” but that would require a whole other blog to address this lyrical choice.

What I want to address in this blog is his insensitivity towards the Parkinson’s Disease community by making a casual and distasteful reference to getting a woman trembling like she has Parkinson’s Disease.  It makes me wonder if West is just grossly insensitive to those who suffer from this progressive and debilitating disease OR is he just completely ignorant to all the trials and tribulations that people with Parkinson’s Disease go through on a daily basis?

I prefer to think of people as being ignorant opposed to apathetic. Stupidity breeds confusion, while apathy to others in dire situations is an indication (to me at least) that you are devolving as a human. Thus, I am just going to hope that Kanye West simply doesn’t understand how serious and devastating Parkinson’s Disease can be.

For our clients who deal with it every day, you know exactly what I am talking about. For those of you out there who have never known someone with Parkinson’s, let me tell you that experiencing tremors is just one of the many symptoms that people with Parkinson’s must deal with. While tremors are often a hallmark of Parkinson’s Disease, other physical symptoms include rigidity, bradykinesia, balance issues, and gait immobilization. People with Parkinson’s Disease can have difficulty with communications and suffer from word-finding and aphrasia.  A host of cognitive and mental health issues can accompany a diagnosis of Parkinson’s Disease, including depression, concentration and memory issues, and in its advanced stages, dementia. Parkinson’s Disease is incurable, and while there are medications out there to manage the symptoms, Parkinson’s is progressive in nature.  For more information on Parkinson’s Disease, please visit our website at:

http://www.westcoastdisability.com/The-Social-Security-Disability-Claims-Process/Impairments-Physical/Parkinson-s-Disease.shtml

Additionally, the America Parkinson’s Disease Association (“APDA”) has a wealth of information and support for the Parkinson’s Disease community. Here is a link to their website:

http://www.apdaparkinson.org/

I happen to think it would be beneficial for Kanye West to visit with one of the local APDA chapters, so he can understand why the Parkinson’s Disease community was outraged by his poor choice in lyrics.   As a disability advocate, I can’t help but take offense when a life altering disease is discussed glibly and in what appears to be a poor attempt at a comedic lyric. It isn’t creative. It isn’t shocking. It just makes you a bigger jackass.

Got a question that you need answered? Please check out our website at www.westcoastdisability.com . We try to provide you with valuable information on our website that may help you navigate the Social Security Disability process. Also, feel free to shoot us an email at info@westcoastdisability.com or call us at (800) 459-3017.