The examiner reviewing your disability claim is supposed to make attempts to find all of the recent medical records for your Social Security claim. However, sometimes they are unable to find the records they need.
If the examiner is having a hard time finding recent medical records that show treatment for a condition that you state you suffer from, they may schedule a consultative exam with a doctor to examine you for that particular condition.
Similarly, if an examiner cannot find current medical records (because you are unable to afford current treatment), the examiner will also more likely than not order a consultative exam. In order to make a finding of disability, the Social Security Administration requires that the decision is based on current information (defined as not older than ninety days).
Current medical treatment is also important because to establish disability benefits, a claimant must prove that they currently have limitations that are significant enough to prevent work activity – more than just testimony about day to day limitations.
Unfortunately, If the only evidence available to a disability examiner is the report from a consultative exam, the likelihood of the disability claim being approved is small. The medical exams that are scheduled by Social Security tend to be very brief and simple exams that do not provide much information to the disability examiner.
Additionally, the independent physician who is paid by the Social Security Administration to conduct the exam will probably know next to nothing about your medical history and, therefore, will have nothing to relate their “ten-minute session” with you to. Typically, the only purpose for the consultative exam is so that the disability examiner can state that they have current medical evidence in the file before a decision is made. Usually, when there is little more in the file than the report from the consultative exam, the case will be denied.