Do CE Exams Usually End in Denials?

Applying for Social Security disability requires several steps. For some applicants, the process includes a consultative examination (CE). This medical exam gives the Social Security Administration (SSA) more information about your medical condition to better evaluate your disability case.

While the exam might feel nerve-wracking, it’s not necessarily a good or a bad sign for your application. It’s just another method of providing medical evidence. Read on to learn more about consultative exams and how to prepare for one.

What is a consultative exam?

A consultative exam is a brief general medical evaluation with an SSA-appointed doctor. Sometimes the CE involves a specific test, like an X-ray. You might need a psychological exam if you have a mental health condition.

Not every disability claimant needs a consultative exam, but the SSA might request one for more information to decide your claim. The SSA will cover the costs of the consultative exam, including travel expenses or a translator, if applicable. 

Why did the SSA request a consultative exam?

The SSA might ask you to complete a consultative exam for several reasons. Depending on your situation, you may need a CE because:

• The SSA needs more evidence. The Disability Determination Services (DDS) might need more information about your medical history to decide your case. A consultative exam will give the SSA additional medical treatment details to help reach a conclusion.

• Your medical records aren’t up-to-date. If your records are not recent enough (covering the past 12 months and, ideally, the past 90 days), the SSA may ask for a CE to ensure they have the most updated medical information. 

• Your records are conflicting. In some cases, your medical evidence could contradict itself, especially if you’ve seen several doctors for multiple conditions or impairments. This might create a situation where the SSA wants a consultative doctor to examine you and file a CE report to clarify things.

• The SSA isn’t sure if you can work at the level of SGA. The SSA might ask for a consultative exam to better understand your level of functionality and how much you could theoretically work. If you’re earning more than the Substantial Gainful Activity limit, you won’t qualify for disability.

How long does it take to get a decision after a CE?

After the consultative exam, the disability examiner must submit the CE results to the Disability Determination Services (DDS) within 10 days. The CE is just one step of the process, and getting approved for disability can take two years after the initial application.

Disability application timeline

From initial application to final decision, the disability application process can take up to two years:

• Initial decision: In 2024, the average wait time for an initial application is 7 to 8 months.

• Reconsideration decision: If you file for reconsideration, the SSA typically makes a decision in 6 months.

• Hearing decision: The next stage in the appeals process is a hearing. If you file an appeal, it can take 13 months to get a hearing date and another 1 to 3 months for a decision.

Do CE exams usually end in denial for disability?

Getting a request for a consultative exam is not necessarily a good or bad thing for your disability application. So, if you need one, don’t panic. A consultative exam simply gives the SSA more information about your condition to help make their decision. 

5 Tips for your consultative exam

You can increase your chances of getting approval after your CE by following these tips during the exam:

1. Show up to the exam on time.

2. Be honest about how your condition affects your life.

3. Answer the disability examiner’s questions with specifics.

4. Talk about your worst or your average days.

5. You should see your own doctor around the same time as the CE to better support your case. Your treating physician can also provide a medical source statement.

Get advice for your disability exam

If you have a consultative exam on the calendar, a Social Security disability lawyer can help you prepare. Take our two-minute disability quiz to contact someone at Atticus, a law firm dedicated to helping disability applicants. If you’d like, Atticus can introduce you to a disability lawyer who can help you apply for benefits.

Related resources:

Is a Consultative Exam a Good or Bad Sign for Your Disability Application?

By Jackie Jakab

Ask Atticus: How Do I Know if My Consultative Exam Went Well?

By Sydney Hershenhorn