Consultative Exams and the Green Book

Social Security Attorneys Protecting the Rights of Claimants in Massachusetts

As most individuals applying for Social Security Disability Insurance (SSDI) know, a condition can arise suddenly through a traumatic injury, or it can develop slowly over time as a result of a chronic illness. When applying for benefits, some applicants will be able to provide the Social Security Administration with a plethora of medical records and background information to support their claim, while others will have less to provide. If an applicant’s medical records are relatively thin, the SSA may request that the individual undergo a consultative exam to better evaluate his or her medical condition. At Kantrovitz & Associates, P.C., our Social Security lawyers can advise people in Massachusetts on the process of receiving an additional examination and guide them through the initial claim as well as any appeals that may be needed.

The Role of Consultative Exams

When an applicant files a claim for SSDI, disability examiners must evaluate the evidence presented by the claimant to determine whether he or she is eligible for benefits. This is typically done through a careful evaluation of medical records, doctor’s reports, and statements about functional limitations and reduced mobility. If an applicant is not able to provide extensive medical documentation to support a claim, a disability examiner will often request that a consultative exam be undertaken.

A consultative exam is not intended to provide treatment to the applicant or even a medical diagnosis. Instead, it is an examination that is conducted in order to give examiners a better sense of an applicant’s current physical health and to evaluate the severity of claimed conditions. During a consultative exam, the examiner will likely focus on gathering information concerning the disabilities or limitations that an applicant claims to have. Thus, for instance, if an applicant says that he or she can no longer use perform any type of lifting activity due to a disability in the arms, the examiner may focus specifically on this area of the body. However, overall physical data may also be obtained through bloodwork, x-rays, and other tests. Additionally, consultative exams are not necessarily purely physical. If an applicant claims a mental disability, the examination may be psychological in nature.

Consultation Examiners and the “Green Book”

The Social Security Administration does not keep doctors on staff to perform consultative exams. Instead, it contracts these exams out to independent physicians who perform the examination and then provide a detailed report to the SSA. Consultation examiners are not necessarily experts in the SSDI process. Instead, they are guided largely by the SSA’s Consultative Examination Guide, also known as the “Green Book.”

The Green Book provides consulting physicians with basic information about the SSDI process, the purpose of consultative examinations, what doctors are supposed to look for, and how to prepare a report after the examination. The guide, while helpful, does not guarantee that a consultative examination will be done correctly and thoroughly. For this reason, SSDI applicants must be their own best advocate in the examination room, providing their examiner with the information that they believe the examiner needs to know about their condition.

Discuss Your SSDI Application with a Massachusetts Lawyer

A consultative examination does not mean that your claim will be denied, only that the SSA needs more medical information in order to accurately evaluate it. You should always attend your exam appointment, and you should be prepared to thoroughly explain to your examiner the symptoms that you are experiencing and how your physical or mental capabilities have been affected. Residents of Massachusetts should know that the SSDI attorneys at Kantrovitz & Associates, P.C., are available to assist them. We represent individuals throughout Plymouth, Norfolk, Middlesex, Essex, and Suffolk Counties, as well as the Merrimack River area. To schedule a free initial consultation, contact us online or call us at (800) 367-0871.