After a Social Security Consultative Exam, How Long Does it Take for a Decision?

When you'll get your disability decision depends on how quickly the doctor submits the report and what the results are.

How old are you?

After attending a consultative exam per the request of a disability claims examiner, most disability claimants are eager for an answer on whether they will be granted disability benefits.

What's Left for Social Security to Do?

Generally, if you are sent to a consultative examination (CE), this means that the disability examiner has received and evaluated all of your medical records from the doctors and hospitals you listed at the time of application. Therefore, in most cases, when the consultative examination report comes in from the examining physician or psychologist, there won't be much to do to get a decision made. If you call the DDS (Disability Determination Services) after your exam, you might get the answer that the claims examiner is simply waiting on the results of your consultative examination.

Variables Can Delay the Disability Decision

It's difficult to give a concrete answer on how long it takes to get a disability decision after a consultative exam, because there are a number of variables that will differ from case to case.

How quickly does the doctor submit the report? The first variable is how long does it take the results of the physical or mental exam to get to DDS? The Social Security Administration makes it clear to the consulting doctors who conduct the medical exams for Social Security that the doctor's examination report should be sent to DDS within 10 business days from the date of the exam. This means basically two weeks. However, not every doctor gets their CE report in by this time. Most, I would say, do, in my experience as a disability examiner for Social Security. But there are cases in which doctors seem to have about as much trouble getting a report submitted as they do having their teeth pulled.

In addition, there are often other extenuating factors that can slow down a case, even after a claimant has gone to a Social Security exam. While you could get an answer within a month of your exam if the report is submitted quickly (and most people do), any of the following could cause delays.

Are the results of the exam in question? Another variable is whether the examining physician or psychologist indicates that the results of the exam are in question. This can happen after a physical or mental exam has been conducted. In such instances, an exam may need to be rescheduled. I remember, as an examiner, a rare case of an individual having to be sent to an IQ test on three separate occasions. The individual's scores kept coming out suspiciously low. While it was clear that the claimant had some level of cognitive impairment, it was also apparent that the claimant had attempted to "steer the outcome of the testing" to fraudulently get disability benefits.

Has a new condition or impairment come to light? The disability examiner or the supervisor may discover, late in the process, that the a particular condition was not investigated, because it hadn't been discovered in the previously gathered medical evidence. This can cause delays.

Will the case get a technical review? The case may get "hung up" in technical review before exiting the Disability Determination Services agency.

Has the case gone to quality review? The case may be intercepted by external quality control at the Disability Quality Branch, where the decisions of disability examiners are reviewed for their accuracy. When a case is sent to DQB, it can stay there for an untold number of weeks.

Learn more about Social Security consultative exams.

By: Tim Moore, former Social Security disability claims examiner

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