Social Security disability examiners are required to address any claims or indications of mental health problems contained within your disability file (your application and related forms and your medical records). If your medical records don't contain sufficient information about your mental state, the Social Security Administration (SSA) will send you to an independent doctor for a mental consultative exam (CE).
Consultative exams are usually ordered because there is no recent medical information in a patient's file. Both Social Security disability insurance (SSDI) and Supplemental Security Income (SSI) programs require that recent medical information for the applicant be on file before the SSA can make a disability decision.
Quite often, disability applicants will list ongoing mental symptoms such as depression, anxiety, memory loss, or chronic insomnia on their application. But many applicants either have not received medical treatment for their mental symptoms within the past 60 days or have never received medical treatment for their symptoms. Either way, without a recent medical evaluation to tell Social Security about your current mental state, disability examiners can't rule on your case, so they will schedule you for a psychological consultative exam to get some up-to-date information about your mental condition.
Social Security might require you to attend a mental exam even if you've recently seen a psychiatrist or psychologist. It just depends on a particular case—that is, what information your disability examiner believes should be in your file. Some disability examiners (or their unit supervisors) just prefer to have the input of a doctor who consults for Social Security before making a decision.
If you didn't claim a mental impairment on your application, Social Security could have obtained information from another source that you may have a mental impairment of some kind. Social Security may also have found the mention of depression or some other mental impairment in your medical records. Sometimes, this information might be added to the questionnaires they send to you and your third-party contact (the person you named on your disability application).
Lastly, if you apply for disability for a physical medical condition, such as joint problems, but the doctor can't find physical evidence to support your claim, you may be sent for mental testing.
The consulting doctor will perform one of the following mental exams during a CE.
Psychiatric exam. These exams are performed by a psychiatrist (MD) rather than a psychologist. Psychiatric exams are generally used to evaluate those with psychosis or affective or mood disorders (such as anxiety or bipolar depression).
Psychological exam. Psychological exams are used to evaluate symptoms that point to reduced cognitive function (low IQ) and for claimants with little education or a history of enrollment in special needs courses in public school.
Mental status exam (MSE). An MSE is a common exam used to evaluate one's current mental state. The MSE will test memory, language skills, awareness, and mood (such as depression or agitation). During a mental status exam, you may be asked to recall items on a list after reading it, count by fives, name the current U.S. president, tell the examiner about your childhood, interpret what is going on in a picture, and so on.
Memory scale exam. This exam is used specifically for those who report short-term memory loss. Examples of applicants who may be asked to participate in this exam are stroke victims, people with traumatic brain injury, Alzheimer's, and so on, although just about anyone could be sent for a memory scale if they listed short-term memory loss on their disability application.
Consultative examinations are a one-time visit with a psychologist or psychiatrist, paid by Social Security to perform an examination that contains the fundamentals of a standard mental evaluation. If you have alleged learning disabilities, the inability to read or write, a decline in mental functioning due to stroke, neurocognitive disorder, or accident, or you suffer from intellectual disorder (formally known as mental retardation), you may be sent to a psychological consultative examination that involves intelligence quotient (IQ) testing and/or memory testing.
If you have alleged that you have a serious personality or mood disorder such as bipolar disorder, or schizophrenia, most likely you will be sent to a psychiatric evaluation.
If there is an indication that you may have a situational problem with depression, anxiety, or panic attacks, you may just be sent to a mental status examination. This examination is to evaluate your current mental condition.
The physician or psychologist who performs a mental examination for disability is required to send a written report to your state Disability Determination Services (DDS) agency (where Social Security disability decisions are made) within 10 days, so that the disability examiner has a medical opinion of your current state of health on file before making a decision.
The report will contain an opinion about:
Unlike some consultative exams for physical conditions, mental CEs are more than mere formalities, as disability examiners tend to strongly consider evidence gained from a mental consultative examination when deciding a claim for disability.