Not surprisingly, a lot of weight is given to the evaluations of physicians who perform what are called consultative examinations, or CEs. The reports from these examinations are used by ALJs to determine the extent of a person’s disability and whether or not they’re able to work and make a living, so you would think they’d be pretty thorough and exhaustive.
Unfortunately, that’s not always the case, and disparities between CE reports can mean that two claimants in extremely similar situations have entirely different outcomes, with one getting maximum benefits and the other one being denied.
Not All CE Reports are Created Equal
Why are there such disparities amongst CE reports? Some of the problems are individual, with certain doctors just not being as thorough in their reports as others. The only real way to deal with this problem is to evaluate individual reports with a specific set of standards and weed out those physicians whose evaluations are lacking. But there’s a more systematic issue as well: different regions follow different standards.
How does this impact claimants? Let’s say two people file a claim. One of them gets a CE report where the doctor offers his or her opinion about what kinds of day-to-day activities they can and can’t do at work, while the other excludes that information because the local DDS asked them to do so. Isn’t the question of whether or not a claimant can do their job pretty central to deciding if they should receive disability?
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Some Local Disparities in CE Reports Violate SSA Rules
It’s not just the lack of equality that’s an issue. In some cases, like the one described above about including work-related limitations, there are specific national guidelines saying that CE reports need to include the information. When the DDS specifically tells doctors not to include it, are they acting illegally? Should they face consequences?
Questions like these are why you need to make sure you have someone on your side who has handled a number of Social Security Disability appeals and is well-versed in the complexities of the law. You can help your own understanding by continuing to read our blog and downloading our free Social Security Disability eBook.
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