When people in Newark and throughout New Jersey are seeking Social Security disability benefits for injury or illness, they might not realize that every case is different and people might be asked for a variety of evidence as part of meeting the benefits’ requirements to be approved. Not every case is clear based on the evidence as it is initially presented. The Social Security Administration might want the applicant to have a consultative examination before the case can be decided upon. This is not necessarily something for the applicant to be worried about, but it is good to be aware of its details.
The SSA can ask for a consultative examination for many reasons. They include the following: if more evidence is needed because the evidence they have is not sufficient for a determination to be made; to gather more details as to the applicant’s impairments; to gather information that is specialized or technical; to account for differences in the medical findings that are in the evidence the SSA has; and to resolve an issue regarding the applicant’s substantial gainful activity.
The SSA will pay for the consultative examination. When there is a consultative examination, the medical source who was used to provide the initial evidence is preferred. The SSA, however, has the right to have the consultative examination performed by a different source – it will depend on the case. If travel is needed to have the examination, the SSA will pay for that just as it pays for the examination itself.
Some applicants might be under the impression that they can simply refuse to take the consultative examination. No one is forcing them to take it, but if there is a refusal, the SSA will then decide based on the evidence it has. Since the consultative examination was requested, the chances are that there will be a denied claim for refusing to have the exam.
The reason a person is applying for Social Security disability benefits is important. It is also important to remember how the SSA goes about its decision-making process and how critical it is to an approval. If there is a request for a consultative examination, that can be a foundational factor in whether the benefits are granted. Having legal help with a Social Security disability case is vital from the start to prepare for every eventuality.