Why do I have to go see a Social Security doctor to get disability benefits? (Part 1)

April 18, 2011

641572_taking_a_bite.jpgAfter an individual files an application for Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI), the Social Security Administration typically sets an appointment for a medical examination to be done by a doctor paid by the Social Security Administration. These appointments are set by state agencies called either Disability Determination Services (DDS) or Disability Adjudication Services (DAS), depending on the state in which you reside (i.e. the state agency in Georgia is DAS). The appointments themselves are referred to as consultative examinations. Many people question the reason for the examination and the need to go to see a Social Security doctor.

For a claim for Social Security Disability or Supplemental Security Income benefits to be successful, the claimant has the burden to prove that he/she is disabled and, in general, is unable to perform substantial gainful activity (work). The Social Security Administration has a duty to develop a claim for benefits by obtaining medical records and other evidence. While it seems that the Administration often falls short in their duty to develop the evidence, the Administration does routinely set up medical evaluations in order to assist in their determination of disability.

When a disability medical exam has been scheduled, it is usually important that the individual attend the exam and do their best during the exam. If an individual fails to go to a scheduled medical exam, Social Security will typically deny the claim for disability benefits. However, there are certain situations where an individual may not need to go to a disability medical exam.

As noted earlier, the person claiming that he/she is disabled has to prove it. Therefore, if the disabled individual receives regular medical treatment and the records of their treating doctors support a finding of disability, there is no need to waist the taxpayers' money for an unnecessary medical exam. Further, there are some instances where the state agency will schedule an appointment with a doctor who does not specialize in the alleged disability or with a doctor known to be biased against the disabled individuals.

We will continue this discussion in Part 2 in order to provide insight into the medical examinations themselves and what can be done to help your claim for disability benefits.

It is important to get advice specific to your disabilities, situation and evidence before you go to a disability medical exam.