Before claimants can receive Social Security Disability benefits, they must go through a disability evaluation during which the Social Security Administration (SSA) will determine if the claimant meets the requirements for obtaining disability benefits.
The evaluation process includes a network of local SSA field offices and state agencies called Disability Determination Offices that review the applicant’s claim. If necessary, the claimant may also need to participate in a consultative exam.
Once the claimant has moved through the evaluation process, the SSA will issue a decision on whether to approve or deny the claim for benefits.
If you have been denied benefits or need help compiling the necessary evidence to support your claim, contact the Phoenix, AZ Social Security Disability attorneys at Dayes Law Firm PC to schedule a free, no-obligation quote.
Disability Determination Services
Once a claimant has submitted an application for disability benefits, it is sent to an SSA field office where Social Security representatives verify non-medical requirements, such as the claimant’s age, marital status, Social Security earnings information and employment history. If all non-medical requirements are met, the claim is forwarded to the DDS.
The DDS develops the medical evidence in a claimant’s case and makes an initial determination about whether or not the claimant meets the SSA’s definition of disabled and should receive disability.
To do this, the DDS will review the medical records and information provided with the application and from the claimant’s current and previous medical providers.
If there is not enough information, it may schedule a consultative exam to get more information about the claimant’s medical condition.
Once the DDS has gathered the necessary evidence, it makes a determination about the claimant’s disability status. The claim is then sent back to the field office to take action based on DDS’ findings by beginning benefit payments or holding the paperwork from a denied claim until an appeal is filed.
Consultative Examination
The SSA may send a claimant to a consultative examination if his or her medical record is not developed enough for a sufficient understanding of the claimant’s impairments and limitations or if the claimant has not recently been evaluated by a medical professional.
These examinations may be conducted by independent physicians contracted on behalf of the SSA or by the claimant’s treating physician if he or she is qualified and familiar with the SSA’s disability programs and evidence requirements.
Consultative examinations are not meant to provide treatment to the patient, but instead are focused on getting a better understanding of the claimant’s current medical condition.
Consultative examinations may include any of the following:
- Physical exam
- Psychiatric exam
- Psychological exam
- Ophthalmological exam
- X-rays
- Taking of blood
If you have received notice that the SSA has requested a consultative examination, make sure to attend the examination, as claims examiners can deny a claim for a failure to cooperate.
Consultative Exam Reports
The physician who performs a consultative exam must follow strict guidelines and complete a thorough report for the SSA. This report usually contains details about the exam, findings and test results. Conclusions should be consistent with objective medical findings based on the claimant’s symptoms, response to treatment, medical history and lab results.
The physician usually includes a diagnosis of the claimant’s medical impairments and a prognosis for each. He or she may also provide an estimate of how the impairments limit the claimant, such as listing how long he or she can stand, walk or sit before requiring a break. He or she may also provide personal opinions about the claimant’s credibility and claims of pain.
The physician sends the report to the DDS to make a decision about the claim. You can also request that the results be sent to your primary physician, which gives him or her the opportunity to refute any inaccurate findings.
Contact a Social Security Disability Attorney Now
Medical evidence of your disability and its impact on your life are vital to receiving the benefits you need. Our Social Security Disability lawyers can help you gather the evidence to support your claim. We can also guide you through the appeals process if your claim is denied.
Contact Dayes Law Firm PC to learn about how we can help develop your medical claim. We work on a contingency fee basis and do not get paid unless you are approved for benefits.
Call us at 1-800-503-2000 to get started.