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Is It A Good Sign When Social Security Disability Sends You To A Doctor?
As you anxiously await a decision on your application for benefits through Supplemental Security Income or Social Security Disability Insurance, you receive a notice from the Social Security Administration asking that you go to a doctor for a medical examination or testing. Do not assume that the request means that your claim for benefits is in trouble.
When you file an application for Social Security disability, the claim is referred to the Disability Determination Services located in the state in which you live. As its name implies, the job of the DDS is to determine whether or not you have a qualifying disability.
The claims examiners at the DDS may believe they need more information about your medical condition than they got from your medical records. A request that you undergo a special test or examination to provide them with specific information about your medical condition does not necessarily mean that your claim for benefits is in trouble.
A Social Security disability lawyer at MJ Ellis Disability Law can review the notice and advise you about how it specifically relates to your claim for benefits. In the meantime, the following information about special examinations and their role in the claims process may be useful.
SSD benefits evaluation process
When you apply for disability benefits through SSI or SSDI, it goes through a five-step evaluation process. The following are the five steps in order as used in the evaluation process:
- Step 1: Are you working? The first step evaluates your ability to engage in substantial gainful activity, which is a component of the SSA definition for “disability.” If you work and earn in excess of $1,310 a month, you are capable of engaging in substantial gainful activity. The process ends here with a determination that you are not disabled; otherwise, the process moves on to the second step.
- Step 2: Is your physical or mental impairment severe? The impairment or combination of impairments must be expected to last at least 12 months or result in death to be considered as severe. A finding that the impairment is temporary, the process ends with a determination that you are not disabled.
- Step 3: Does your medical condition meet or equal listed impairments? The SSA maintains a listing of impairments that satisfy the criteria for “disabled” under federal regulations. DDS will determine that you are disabled if the medical condition is on the list or equivalent to a listed condition; otherwise, it will go on to the next step.
- Step 4: Can you engage in work you did in the past? Your application will be denied if you are capable of engaging in work that you did in the past; otherwise, the DDS moves to the next step in the process.
- Step 5: Can you engage in other types of work? The DDS evaluates whether you can do other types of work based on your education, age, medical condition and other factors to determine whether you are disabled.
The DDS claims examiners may ask you to submit to further testing or additional medical examinations to provide them with specific information about your medical condition to aid them in the evaluation process.
What happens during a special examination?
The notice from the DDS asking you to see a doctor or other health care provider will explain the purpose of the examination or testing. The doctor performing the examination or the test is not there to evaluate you for purposes of treating your medical condition.
The doctor prepares a written report with the results of the exam and testing and submits it to the DDS. The report contains the findings and opinion of the doctor, but the determination about whether or not you are disabled is made by the DDS.
A copy of the report of the special examination can be obtained by your SSD lawyer. If you want to talk to your doctor about the results of the special examination and test results, you may ask for a copy of the report to be sent directly to your doctor.
What does it mean when Social Security disability sends you to a doctor?
A request from Social Security disability that you submit to a special examination or additional medical tests may only mean that the DDS needs more information than you or your doctors provided in order to complete the evaluation process. You also may be asked to go for a special examination when the medical information you submitted in support of your application for benefits is old because you have not seen your personal doctors in quite a while.
If you decide not to cooperate by going to the doctor as requested by SSD, the DDS will complete its evaluation of your claim for benefits based on the information already in its possession. This may result in an unfavorable decision because asking you to go to a doctor for an exam or testing indicates that DDS needs more information to determine if you are disabled.
Talk to a disability lawyer
Your best source for trusted advice and skilled representation is a disability lawyer at MJ Ellis Disability Law. Call them today for a free consultation.