When you apply for Social Security Disability Insurance benefits (SSDI), the Social Security Administration (SSA) will decide whether you qualify for benefits. They could schedule a cumulative medical exam to help them make a decision on your claim. This is a physical or mental examination that they will use when deciding whether you are unable to work due to your medical condition.
When Could You Be Required to Attend a Cumulative Medical Exam?
Whether the SSA will schedule a cumulative medical exam will depend on your disability and the evidence you submit to support your application. Examples of when this exam may be required include:
- Additional medical information is needed that is not included in your medical records.
- There are gaps in your medical treatment, or you have not been treated by a doctor for a while.
- The SSA cannot obtain your medical records from your doctor for a reason beyond your control, such as your physician’s death or refusal to supply them.
- There are inconsistencies in your medical records.
- The SSA needs specialized medical evidence to decide your claim.
- You could experience a change in your medical condition in the future that may affect your ability to work.
Who Performs a Cumulative Medical Exam?
Your treating physician can conduct a cumulative medical exam. Often it is performed by an independent doctor hired by the SSA. These doctors do not work for the SSA.
What Happens at a Cumulative Medical Exam?
The purpose of your exam is not to treat you. It is to determine how serious your disability is.
The extent of your cumulative medical exam will depend on your disability and the questions that the SSA has about how it affects your ability to work.
However, there are specific rules on how long your exam should last. Here are some requirements that should be followed:
- A general physical exam should be for at least 30 minutes.
- A musculoskeletal or neurological examination should take at least 20 minutes to perform.
- A psychological exam should last at least 60 minutes and a psychiatric exam should last for at least 40 minutes.
- Other types of examinations are required to be for at least 30 minutes.
Once the exam is completed, the physician would submit a written report to the SSA.
Who Pays for a Cumulative Medical Exam?
The SSA will pay for a cumulative medical exam and any diagnostic tests associated with it. You should not be charged for these services.
Are you considering filing for SSDI? Does the SSA require you to attend a cumulative medical exam? Call our Roswell office to schedule a free consultation with our experienced Social Security disability lawyers who can help you obtain the SSDI benefits you are entitled to.