Ohio Social Security Disability And SSI Legal Blog

What happens if you refuse to go to a consultative exam?

If you’re applying for Social Security Disability Insurance (SSDI) benefits or Supplemental Security Income (SSI) benefits, you may be asked to undergo one or more consultative examinations as part of your disability process.

The Social Security Administration (SSA) can’t exactly force you to submit to an evaluation by some strange doctor, and they may even make it sound like it’s just a casual request. What if you refuse to go?

You could end up tanking your own claim

SSA has to follow a strict set of rules when determining whether or not someone qualifies as disabled under the agency’s rules. That means reviewing your medical records very carefully. Sometimes, those medical records simply aren’t complete. That can happen because:

  • You haven’t seen a doctor in a long time for a specific condition, either because your condition has been stable or because you lack the means (such as health insurance) to obtain treatment.
  • Some of your medical providers haven’t replied to SSA’s requests for your medical records or more information, so there are gaps in your file that need to be filled in.
  • SSA thinks it is possible that your condition has changed since you filed your claim and wants an analysis.
  • SSA believes that you need a highly technical or specialized type of testing to confirm your diagnosis or the severity of your condition and no such testing exists in your records.

If you refuse to attend a consultative exam, SSA will be obligated to make their decision with the evidence they have in file. Since they don’t ask for a consultative exam unless they’re unsure of how your claim should be decided, that’s unlikely to work in your favor. 

Obtaining SSDI or SSI benefits can be very difficult. Experienced legal guidance can make the process easier.