What Happens At A Compensation And Pension Exam
A Compensation and Pension exam is a doctor’s appointment where your disabilities get evaluated. Usually this exam is conducted at a VA hospital or clinic. The doctor writes a report, which goes back to the VA Regional Office where you submitted your application for benefits.
When you go to your Compensation and Pension Exam, it will be different from a regular doctor’s visit because you won’t get prescribed any medicine or given any medical treatment.
If you have a mental health disability, the doctor will ask you questions and have you explain your symptoms. You might be asked to complete some psychological tests. Don’t be alarmed by this testing is routine and it’s only one part of the exam.
If you have a physical disability, the doctor will examine you, ask you questions, and, if necessary, perform some medical tests.
Advice For Your Social Security Disability Consultative Examination
Lower your Expectations and Adjust Your Attitude
Social security disability applicants typically have unrealistic expectations of the consultative exam. Many see the CE as an indication that social security is finally taking their complaint seriously and wrongly assume the CE will be thorough and will cover all their disabling impairments both physical and mental.
As noted above, the CE will be very limited in scope and duration, perhaps in a crowded and unattractive office setting. The CE is apt to feel more like a cattle call than a professional medical treatment office.
Presenting to your CE with unrealistic expectations will likely lead to disappointment and frustration. Many disability claimants allow that frustration to show, creating tension between the claimant and the examiner. A claimant that communicates disappointment and anger with the examiner is less likely to find the examiner receptive to their cause.
Many consultative examiners are unwilling to review medical records that claimants bring to the examination. This can be frustrating to claimants, but realize that consultative doctors often see claimants who try to unload stacks of unorganized medical treatment notes on the doctor, or even bring actual radiographic images.
If there are specific objective medical tests such as x-rays or MRI results reports that document the problem for which the consultative doctor is examining you, be prepared with those most recent results at hand.
Make Sure To Have A Good Attitude
It is not uncommon for people to walk away from a Social Security Disability exam feeling frustrated, disheartened or even depressed. Remember to keep your chin up. While the exam does play a role in determining whether or not you are entitled to Social Security Disability benefits, the medical records and professional opinion from your primary physician will play a more important part in that decision.
If, for some reason, you are denied Social Security Disability benefits due to an unfair medical exam you can go on to appeal the decision and may have it overturned so that you can receive the Social Security Disability benefits you are entitled to.
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Going To Your Own Disability Doctor Or To The Ssa Consultative Exam
Whether you are applying for SSDI or SSI, a doctors evaluation is a vital part of your claim for Social Security Disability benefits. You may have been seeing doctors and other medical professionals for your condition, but its often not enough to have them treat you. Their professional opinion, in addition to your medical records, can help support your claim that you have limitations that keep you from working consistently.
Further, the Social Security Administration wants to see recent medical information when deciding on a disability application. If you havent been to the doctor in a while, youll want to make a new visit to obtain an up-to-date assessment of your disabling condition.
If the SSA finds that your application has insufficient or out-of-date medical information, they may require you to undergo a consultative examination .
Here are some tips on preparing for a Social Security Disability doctor evaluation, whether its with your own physician or a doctor at the consultative exam.
How A Disability Lawyer Can Help
At our disability insurance law firm of Dell & Schaefer, we provide you a free consultation to discuss your claim. We start with asking you to send us a copy of your policy. If you have experienced a denied disability claim, we ask you to send a copy of your denial letter. After we review these documents, we let you know how we can help you and what our fees are. Generally, you pay us nothing unless we collect benefits for you.
Our attorneys help people all over the country. A disability insurance lawyer is often able to respond to you on the same day you call. No office visit is necessary.
Another thing you may find helpful is to subscribe to our YouTube channel where you can view regular video updates from us where we discuss disability insurance-related issues. We explain what you can do to improve your chances of having your claim approved the first time it is submitted.
We also provide assistance to those who have had their claim denied and need to appeal. We understand the need you have for your disability benefits and look forward to helping you. We look forward to having the opportunity to speak with you.
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What If I Disagree With My Doctors Opinion That I Am At Mmi For My Workers Comp Injury
Sometimes doctors give up too quickly and state that a patient has reached maximum medical improvement even though there is other treatment, including surgery, that could improve your condition and functional abilities.
If you disagree with your doctors opinion that you are at MMI, then the first thing you should do is ask your doctor for a referral for a second opinion for your work injury. By law the insurance carrier does not have to pay for a second opinion unless the authorized treating doctor refers you for one.
If your treating physician refuses to refer you for a second opinion on whether youve reached MMI, then you have a few options:
- Use your private health insurance to see a specialist for a second opinion, if you have it. If you do this, I recommend asking a workers comp attorney for recommendations on which doctor to see. Its important that you treat with a doctor who is not only good at what they do but also familiar with litigation and comfortable writing a favorable report if a workers comp hearing is necessary. Read my article, Using Private Health Insurance for Your Work Injury, for more information on this topic.
- If you dont have private health insurance coverage, Medicare, or Medicaid, then you can pay for a second opinion out of your own pocket or find a doctor who will treat you on a lien basis. There are many doctors who will perform IMEs at the claimants request, then ask for payment if and when you settle your claim.
Can You Do Any Other Type Of Work
The DDS looks to see if you could do some other type of work, despite your disability. It evaluates your age, education, medical condition , work experience, and any skills you may have that could be used to do some other work. If you cannot, they will determine that you are disabled. But if you can do other work , then you are deemed not disabled and, therefore, ineligible for SSD benefits.
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Will I Be Eligible For Medicare
Medicare eligibility begins after you have received 24 months of Social Security disability benefits. Note that to receive Part B of Medicare , you pay a premium that will be deducted from your Social Security disability monthly check.
Disabled people with relatively low income and assets may be eligible for other programs that pay for medical expenses not covered by Medicare and/or pay the Medicare premium for you. To find out if you are eligible for any such programs, you need to check with your county welfare department.
If you have health insurance coverage already, you need to figure out how Medicare works with your health insurance. Many health insurance policies state that Medicare is to provide the primary coverage with your present health insurance paying only for what Medicare doesnt cover. You need to check with your health insurance company when you get your Medicare card.
The Right Medical Records And Statement From Your Doctor Will Go A Long Way In Getting Approved For Disability Benefits
When applying for disability benefits through the Social Security Administration , you will need to present evidence showing that you have been unable to work for at least a 12-month period. You can help satisfy this burden by having your primary care doctor complete what Social Security calls a “medical source statement.”
Here’s what the doctor should include in a good medical source statement.
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What Happens After The Dds Makes A Disability Determination
After completing its development, the DDS makes the disability determination. An adjudicative team consisting of a medical or psychological consultant and a disability examiner usually makes the determination, explains the SSA.
Once the DDS has made a determination and sent your file back to the SSA, the SSA will send you a decision letter in the mail.
- Approval: If the SSA approves your application for benefits, the letter will tell you how much your benefit will be and when it will commence.
- Denial: If the SSA denies your application for benefits, the letter will tell you why the SSA denied you and how to appeal the decision if you disagree with it.
Contact An Attorney Today
Having an attorney on your side can make this part of the process easier to navigate and may be more likely to result in you getting the benefits that you need. Contact an attorney today to find someone who will advocate on your behalf and give you some peace of mind during this confusing, exhausting time.
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Can I Use My Own Doctor
In some cases, your physician may be able to perform the exam. Your physician must be the correct specialty, however. Its important to speak with your disability examiner and your physician about their credentials as an Acceptable Medical Source. Keep in mind that some physicians may not be comfortable performing the exam, since the results could lead to a denial that may harm your professional relationship.
If your physician is credentialed and willing, you can file a written request with the disability examiner to visit them. In the request, make sure you state that youve already spoken with the physician, they are credentialed, and that they are willing and able to provide the exam. Your examiner will then approve or deny the request.
If L Get Paid First Should I Wait Until I Receive The Notice Of Award Before I Cash The Check Or Spend My Past
There is no problem with cashing the check. But it is best that you deposit your check in an interest bearing savings account and not spend it all until you receive the Notice of Award so that your attorney can make sure that attorneys fees were withheld and that you have not been overpaid. It is also a good idea to make two photocopies of the check before you deposit it. Send one copy of the check to your attorney and keep the other for your records.
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What Will The Amount Of My Monthly Benefits Be
The amount of your first months benefits is shown in your Social Security file. However, the Social Security Administration may recalculate your benefit amount before it pays you. If the Social Security Administration recalculates, it may come up with a higher benefit amount because, for example, all of your earnings might not have been posted when the original calculation was made. Also, there are cost of living increases that are applied every December.
Did Your Doctor Tell You That Youve Reached Mmi For Your Work
As an injured employee going through the workers comp claim process, you know that the weeks, months, and even years after a work accident are filled with stressful situations and strange terms and acronyms. One term youve probably heard from your workers comp claim adjuster, nurse case manager, treating physician or lawyer is MMI. MMI stands for Maximum Medical Improvement.
Reaching MMI is an important milestone in workers compensation. MMI has a role in determining many things, such as:
- Whether you can return to your pre-injury job.
- Whether you have permanent restrictions that limit you to light duty work for the rest of your career.
- Your level of permanent impairment from the work injury.
- The future medical treatment you will need for your work-related injury, including pain management, and how long you will need treatment.
The purpose of this article is to discuss what MMI is and what you can do to protect your legal rights and increase the value of your workers comp case after you reach maximum medical improvement. I hope this information helps guide you during this important time.
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Avoid Exaggerating Your Condition During A Ce Exam
Regardless of why you were scheduled for a CE with a disability doctor, it is important to know that the doctor is not there to treat you or give you any medical advice. So, tell the truth and answer the doctors questions without overstating your symptoms.
For example, if you are being examined for a medical condition, you should not tell a doctor you have pain everywhere, or your level of pain is 10 out of 10 for everything if your daily activities are not consistent with this level of pain.
Or, if your mental health is being examined, do not exaggerate your answers or put little effort into answering any questions. If you have pain or difficulty performing any task the doctor asks you to do, do not be afraid to let them know, but do not try to make your condition look worse than it really is.
Overstating your symptoms or telling exaggerated statements could make a disability doctor believe you are faking and affect your credibility. And, they can report this as suspicious behavior.
Who Completes The Consultative Examination
If you have a treating doctor and he or she has the required skills and equipment to perform the exam, the SSA will issue a request that your doctor complete it. However, your doctor may refuse to do so. If this happens, the DDS will arrange the exam with another doctor. In addition, if the DDS does not have confidence in your doctor or if the agency is attempting to clear up any confusion in the report issued by your treating doctor, or if you simply want to see another doctor for this appointment, you will be assigned another doctor.
Any individual performing the consultative examination must be a licensed physician in private practice, or operating under a licensed doctors supervision.
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Variables Can Delay The Disability Decision
It’s difficult to give a concrete answer on how long it takes to get a disability decision after a consultative exam, because there are a number of variables that will differ from case to case.
How quickly does the doctor submit the report? The first variable is how long does it take the results of the physical or mental exam to get to DDS? The Social Security Administration makes it clear to the consulting doctors who conduct the medical exams for Social Security that the doctor’s examination report should be sent to DDS within 10 business days from the date of the exam. This means basically two weeks. However, not every doctor gets their CE report in by this time. Most, I would say, do, in my experience as a disability examiner for Social Security. But there are cases in which doctors seem to have about as much trouble getting a report submitted as they do having their teeth pulled.In addition, there are often other extenuating factors that can slow down a case, even after a claimant has gone to a Social Security exam. While you could get an answer within a month of your exam if the report is submitted quickly , any of the following could cause delays.
Has the case gone to quality review? The case may be intercepted by external quality control at the Disability Quality Branch, where the decisions of disability examiners are reviewed for their accuracy. When a case is sent to DQB, it can stay there for an untold number of weeks.
When Youre At Mmi An Attorney Can Help You Maximize Your Workers Comp Claims Value
When it comes to workers comp, few milestones are as important as maximum medical improvement.
To protect your legal rights and to give yourself the best chance of getting every benefit and dollar youre owed when you reach MMI, call me for a free consultation: 251-1620 or 810-5614. I help injured employees throughout Virginia, including those in Richmond, Chesterfield, Henrico, Bristol, Abingdon, Roanoke, Harrisonburg, Winchester, Fairfax, Manassas, Fredericksburg, Newport News,Williamsburg, Norfolk, Virginia Beach, and Chesapeake. Lets finish your case together.
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What Is The Disability Claim Continued Eligibility Questionnaire
If your claim is on automatic payment, after 10 weeks of payment, you will receive a Disability Claim Continued Eligibility Questionnaire . Return this questionnaire form to the EDD to certify that your disability continues. If you do not return the DE 2593 to the EDD online or by mail within 20 days after receiving the form, your benefits will stop. If this form is submitted late, you may lose benefits.