Will Social Security Award Me Disability if I Have Not Been to The Doctor?
If you apply for benefits, Social Security will have to obtain some sort of objective medical evidence in order make a disability determination. If you have never been seen by a doctor for a particular medical condition (or conditions), or you have simply not been seen in the last three months, you can still apply for disability benefits through one or both of the disability programs administered by the Social Security Administration (SSD a.k.a. social security disability and SSI a.k.a. supplemental security income).
Generally, Social Security would like to have a twelve month medical history to evaluate, including medical treatment notes within the last three months in order to make a medical disability determination. If this is not possible, Social Security will obtain the results of a consultative examination (typically referred to by claimants as a "social security medical exam") or examinations to address your alleged disabling condition or conditions. If necessary, Social Security will schedule both medical, mental, and specialty consultative examinations in an effort to obtain objective medical information.
The important thing to remember about these consultative examinations is that they are one time examinations...sometimes performed by physicians who may not specialize in the medical area of your disabling condition.
Additionally, these consultative examinations often do not very last long, and, as a result, many disability applicants feel they are not thorough with regard to addressing the pain and limitations caused by their impairment(s).
However, if you think about it, how could a one-time consultative examination be truly evaluative of the effects of an individual’s condition? Answer: it can't. And this fact is quite plain and obvious to every disability examiner who schedules exams for claimants.
Having said that, though, examiners are nevertheless required to send claimants to exams when sufficient or recent medical evidence is lacking in a a file and more information is needed to get a case ready for a decision to be rendered.
So, will Social Security award you disability if you have not been to a doctor? The simple answer to this question is that, of course, there is a possibility you will be awarded disability benefits if you have not been to a doctor and you are seen by a consultative physician who deems you to be disabled in the examination report they submit.
But, in my experience as a disability examiner, I found that very few disability claims are won based strictly on the findings of a CE (consultative examination). It is possible...just not likely. If you truly want to have a chance of being awarded disability benefits, try to seek some objective treatment for your medical or mental conditions prior to filing for disability. That way even if Social Security chooses to send you to an examination you will at least have some other objective medical evidence in your file.
What will a Social Security Disability Doctor Report to the Social Security Administration?
As I've said several times in this post, "Social Security Doctors" (I put this phrase in parentheses because docs who perform consultative exams do not work for social security---the docs who do work for social security are actually unit medical consultants who work in case processing units with disability examiners in agencies usually referred to as "DDS", or disability determination services) perform "one-off" medical and/or mental evaluations for Social Security.
In my experience as a former disability examiner, I have seen Social Security consultative examination doctors note various things they observed prior to performing their examinations. For instance, in one consultative examination report I received it was noted that the doctor had observed the claimant in the parking lot of the building walking with no limp and without the aid of the cane...that he came limping in on.
In essence, there is no pat answer as to what might be included in a consultative exam report. But what every claimant needs to realize is that the doctor who conducts the exam may be gathering information before a claimant even realizes it.
And, it goes without saying, some of them are biased against the federal disability programs. And this bias really works against claimants who feel feel embarrassed over the fact that they are in the position of filing for disability in the first place, and, thus, tend to minimize their symptoms when being seen by the doctor conducting the consultative exam.
If your disability consultative examination addresses a mental impairment, the doctor may note an individual's mood, eye contact, ability to deal with questions, if the individual was oriented as to time and place, or even the results of mental testing (i.e. intelligence quotient (IQ) or memory testing) when making their report to the Social Security Administration.
Now, beyond this, what information is collected by an individual who conducts a consultative exam for social security?
If you attend a consultative examination to address physical impairments, the Social Security disability doctor will note general findings such as: blood pressure, basic neurological responses, height and weight, heart rate, breathing, physical examination of abdomen, ability to lift legs straight up, etc.
If an individual is alleging some type of joint or back problem, the doctor will most likely perform a range of motion examination in addition to the more basic components of a physical examinations.
Social Security disability doctors make a written report of all that they observe as well as any objective medical information garnered from the consultative examinations. It was my experience that Social Security doctors who evaluated musculoskeletal problems often did not mention how much pain an individual experienced while trying to perform the range of motion evaluation, or just did not mention how much pain an individual experienced during the evaluation at all.
If your examination is a mental evaluation, the Social Security doctor generally includes the results of any objective testing such as IQ or memory testing, along with more subjective observations as to your mental status and mood in their written report.
In addition, the psychiatrist or psychologist generally makes a notation as to whether or not you are capable of completing simple routine repetitive tasks in spite of mental conditions.
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Generally, Social Security would like to have a twelve month medical history to evaluate, including medical treatment notes within the last three months in order to make a medical disability determination. If this is not possible, Social Security will obtain the results of a consultative examination (typically referred to by claimants as a "social security medical exam") or examinations to address your alleged disabling condition or conditions. If necessary, Social Security will schedule both medical, mental, and specialty consultative examinations in an effort to obtain objective medical information.
The important thing to remember about these consultative examinations is that they are one time examinations...sometimes performed by physicians who may not specialize in the medical area of your disabling condition.
Additionally, these consultative examinations often do not very last long, and, as a result, many disability applicants feel they are not thorough with regard to addressing the pain and limitations caused by their impairment(s).
However, if you think about it, how could a one-time consultative examination be truly evaluative of the effects of an individual’s condition? Answer: it can't. And this fact is quite plain and obvious to every disability examiner who schedules exams for claimants.
Having said that, though, examiners are nevertheless required to send claimants to exams when sufficient or recent medical evidence is lacking in a a file and more information is needed to get a case ready for a decision to be rendered.
So, will Social Security award you disability if you have not been to a doctor? The simple answer to this question is that, of course, there is a possibility you will be awarded disability benefits if you have not been to a doctor and you are seen by a consultative physician who deems you to be disabled in the examination report they submit.
But, in my experience as a disability examiner, I found that very few disability claims are won based strictly on the findings of a CE (consultative examination). It is possible...just not likely. If you truly want to have a chance of being awarded disability benefits, try to seek some objective treatment for your medical or mental conditions prior to filing for disability. That way even if Social Security chooses to send you to an examination you will at least have some other objective medical evidence in your file.
What will a Social Security Disability Doctor Report to the Social Security Administration?
As I've said several times in this post, "Social Security Doctors" (I put this phrase in parentheses because docs who perform consultative exams do not work for social security---the docs who do work for social security are actually unit medical consultants who work in case processing units with disability examiners in agencies usually referred to as "DDS", or disability determination services) perform "one-off" medical and/or mental evaluations for Social Security.
In my experience as a former disability examiner, I have seen Social Security consultative examination doctors note various things they observed prior to performing their examinations. For instance, in one consultative examination report I received it was noted that the doctor had observed the claimant in the parking lot of the building walking with no limp and without the aid of the cane...that he came limping in on.
In essence, there is no pat answer as to what might be included in a consultative exam report. But what every claimant needs to realize is that the doctor who conducts the exam may be gathering information before a claimant even realizes it.
And, it goes without saying, some of them are biased against the federal disability programs. And this bias really works against claimants who feel feel embarrassed over the fact that they are in the position of filing for disability in the first place, and, thus, tend to minimize their symptoms when being seen by the doctor conducting the consultative exam.
If your disability consultative examination addresses a mental impairment, the doctor may note an individual's mood, eye contact, ability to deal with questions, if the individual was oriented as to time and place, or even the results of mental testing (i.e. intelligence quotient (IQ) or memory testing) when making their report to the Social Security Administration.
Now, beyond this, what information is collected by an individual who conducts a consultative exam for social security?
If you attend a consultative examination to address physical impairments, the Social Security disability doctor will note general findings such as: blood pressure, basic neurological responses, height and weight, heart rate, breathing, physical examination of abdomen, ability to lift legs straight up, etc.
If an individual is alleging some type of joint or back problem, the doctor will most likely perform a range of motion examination in addition to the more basic components of a physical examinations.
Social Security disability doctors make a written report of all that they observe as well as any objective medical information garnered from the consultative examinations. It was my experience that Social Security doctors who evaluated musculoskeletal problems often did not mention how much pain an individual experienced while trying to perform the range of motion evaluation, or just did not mention how much pain an individual experienced during the evaluation at all.
If your examination is a mental evaluation, the Social Security doctor generally includes the results of any objective testing such as IQ or memory testing, along with more subjective observations as to your mental status and mood in their written report.
In addition, the psychiatrist or psychologist generally makes a notation as to whether or not you are capable of completing simple routine repetitive tasks in spite of mental conditions.
Return to:
Additional Posts
How is SSI different from social security disability?
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How do you qualify medically for social security disability?
Social security disability and melanoma
How to file a social security disability hearing request
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Does my condition qualify for disability?
What medical conditions qualify for social security disability?
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