A Special Examination Is Needed For Your Disability Claim?

A Special Examination Is Needed For Your Disability Claim After you apply for Social Security or Supplemental Security Income disability benefits, sometimes you need to have special medical examinations or tests before SSA can decide whether you qualify.

The Disability Determination Services in your state is currently reviewing your disability claim. The state agency makes the disability decisions for us. The employees there need more information before they can decide if you are disabled under Social Security law. So, they are asking you to have a special exam or medical test that we will pay for. We also will pay for certain related travel expenses.

If a doctor who is not your regular doctor performs your exam or test, we can send a copy of the results of the exam or test to your doctor if you ask us. 3 What should I do? It is your responsibility to take the exam or test and cooperate with the doctor examining you. If you cannot keep the appointment we made for you, let the state agency know right away. (The phone number and address are provided with the letter you receive notifying you about the exam or test.) If you do not let the state agency know that you cannot keep the appointment, it will make a decision based solely on the information already available in your case.

This may result in a decision that you are not disabled. What will the doctor do? The doctor (or other medical people) who see you will only conduct the exam or test and get the specific information requested by the state agency. The doctor will not take part in deciding whether you are disabled, and he or she will not prescribe treatment or medication for you. The doctor will send a report of the exam or test to the state agency. 4 (over) What will the state agency do? The state agency will review the doctor’s report, along with all of the other information in your case, and make a disability decision.

We will send you a letter to tell you about the decision made by the state agency. What if I do not agree with the decision? If you do not agree with the decision, you have the right to appeal. Your letter will tell you how to appeal the decision.

Things to remember, the exam or test requested is intended to provide additional information needed to help the state agency make a decision in your case. If you cannot keep the appointment, you must let the state agency know right away. If you do not, the state agency may decide that you are not disabled. For more information and to find copies of SSA publications, visit the SSA website at www.socialsecurity.gov or call toll-free, 1-800-772-1213 (for the deaf or hard of hearing, call the SSA TTY number, 1-800-325-0778).