Social Security disability denial after ALJ hearing - now being sent for consultative exam - what to expect?

This is actually pretty unusual at the Appeals Council level. Typically, the AC just reviews the evidence that was already in the record during the ALJ hearing. A consultative exam (CE) at this stage likely means one of two things: 1) The AC is considering remanding the case back to the ALJ but wants updated medical evidence, or 2) They found some technical issue with the ALJ's decision and need more information before making their decision.As for what to expect, it depends on what type of CE they ordered. It could be a physical exam, mental exam, or both. The exam is usually brief (15-30 minutes) and focused on specific issues related to your brother's claimed disabilities. Make sure he brings a list of all medications and can clearly explain how his conditions limit him on a daily basis.

Thank you so much for this information! His letter mentions a \

When I went for mine last year it took like 20 mins tops. Dr barely looked at me. Asked me to bend over (couldnt) and touch my toes and stuff. Be honest abt the pain dont try to push through it. Doc will write down everything

That's good to know. Did they ask a lot of questions about daily activities? My brother struggles with basic things like putting on socks, but has good and bad days.

The fact that they're sending him for a CE at the Appeals Council level might actually be a positive sign. It suggests they're giving his case serious consideration rather than just rubber-stamping the ALJ's denial. When I was going through the process (took me 3 years to get approved), I had two CEs - one after initial denial and one during reconsideration.For the physical exam, they'll likely test range of motion, strength, reflexes, and observe things like how he sits, stands, walks, and transitions between positions. They'll ask about daily activities, pain levels, medication effectiveness, and side effects. The doctor will complete a form indicating what they believe your brother can do (lift, carry, stand, walk, sit, etc.).My advice:1. Be completely honest about limitations - don't exaggerate, but don't minimize2. If something hurts during the exam, say so immediately3. Explain how symptoms vary day to day if that's the case4. Mention any side effects from medications that impact functioning5. Briefly describe a typical day including any assistance neededThe CE doctor doesn't make the disability decision - they just provide medical findings that become part of the file. Good luck to your brother!

This is incredibly helpful, thank you! He's so worn down from this process. It's been almost 2 years of fighting while barely being able to function. I'll make sure he knows all these points before the exam.

tell him be careful!!!! these doctors work FOR SSA not for him. they are looking for reasons to deny him. my cousin pretended she could do more than she could cause she was embarrassed and they used it against her. tell him DON'T DO ANYTHING that hurts!!!!

While it's true the consultative exam doctors are paid by SSA, they're actually independent physicians who are supposed to provide objective medical findings. They don't

I've helped many clients through this process, and a CE at the Appeals Council level could indicate they're considering a remand (sending the case back to the ALJ for a new hearing). This is generally better than an outright denial.One thing your brother should do: keep a journal for the next week documenting his daily limitations in detail. How long can he sit before needing to change positions? How much can he lift without pain? Does he need to lie down during the day? How do his medications affect him? This will help him accurately describe his limitations during the exam.Regarding getting through to SSA if you have questions about the appointment: many people waste hours on hold or getting disconnected. I've had clients use Claimyr (claimyr.com) to get through to SSA quickly. They have a video showing how it works: https://youtu.be/Z-BRbJw3puU - might save some frustration if you need to call about appointment details or requirements.

I'll tell him to start keeping that journal right away. Great idea! And thanks for the tip about Claimyr - we've been hung up on multiple times trying to get clarification about this exam. I'll check out that video.

Just to add some context: The consultative exam is designed to provide an independent medical assessment. The doctor will complete a form called an RFC (Residual Functional Capacity) that rates your brother's ability to perform various work-related activities. This becomes part of his file but isn't the sole determining factor.The Appeals Council is more concerned with whether the ALJ made a legal or procedural error or if the decision was supported by substantial evidence. The CE suggests they may have found an issue with how the ALJ handled the medical evidence.One recommendation: After the exam, have your brother write down everything that happened while it's fresh in his mind - what tests were done, what questions were asked, what he told the doctor, etc. This can be helpful information for his attorney.

YA BUT those drs spend like 15min with you and think they know everything!!! my dr whose been treating me for YEARS says im disabled but SSA ignored him and listened to their dr who saw me once. the whole system is rigged!!!

i had 2 go to 3 of these exams b4 i got approved. just b honest. if u cant bend dont bend. if it hurts say it hurts. dont let them push u. and dont try 2 be tough/brave. took me 31 months 2 get my ssdi approved. hang in there.

31 months, wow. Did you have a lawyer? My brother's attorney hasn't been very communicative about what this exam means.

ya i had lawyer. they take 25% of backpay up to $7500. most lawyers dont talk much till theres actual news. they handle 100s of cases. def keep the lawyer cuz appeals council is complicated. btw my CE dr was actually nice but exam was really basic