Gade & Parekh, LLP formerly the Law Office of Elizabeth Gade, Inc. Gade & Parekh, LLP formerly the Law Office of Elizabeth Gade, Inc.

The role of the CE in disability claims

California residents and others who are seeking disability benefits don't need to see a doctor before filing for them. However, it is generally a good idea to do so. Those who can't afford to see a doctor may still benefit from going to an emergency room or a free local clinic. If an applicant lacks medical records that are less than 90 days old, he or she will need to have a consultative examination (CE).

A mental and physical exam may be necessary for those claiming both mental and physical impairments and lack medical records. In addition to taking up a person's time, consultative examinations are rarely used to approve a benefits application. In fact, they are generally seen as a way to justify denying a claim. Exceptions to the rule include conditions like mental retardation or anything else that can be established through objective measures.

In many cases, doctors who don't specialize in an applicant's condition do the exam. For instance, an allergist may examine someone who claims to have a back ailment. Therefore, it may not be possible to truly determine the extent to which an applicant is impaired by a mental or physical condition. Since it can be difficult to prove that a condition results in an inability to work, it is unlikely that a claim can be approved.

Those who are applying for SSD may want to do so with the help of a legal representative. He or she may advise an individual to obtain medical records prior to applying for disability benefits. In the event that an application is denied, a representative may help someone file an appeal. If that is denied, an applicant may rely on an attorney to help prepare for a formal hearing in front of a judge.

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