VDDS orders at least one CE in a large percentage of all disability claims.   The purpose of the CE varies depending on what information your DDS specialist thinks he or she needs to make a decision on your case.  You could be asked to see a general doctor or nurse practitioner for an overall physical.  You might be asked to attend a mental CE with a psychologist for an evaluation of any limitations caused by mental problems such as anxiety or depression.  They might set up an x-ray, breathing test, or heart test for you.  The results of the doctor’s report from these CE’s will often make or break your disability application.  Below are the most important facts and tips you should know prior to your CE:


If you are applying for disability benefits then you are not working (or not working very much), may not have health insurance, and are likely feeling great financial pressure.  With this in mind, the SSA covers the cost of any requested CE’s.  The fees that Social Security pays for these exams are regulated by the State you live in and are typically very low—around $200.

DDS also tries to schedule the exam with a doctor that is close to your house so that you won’t be inconvenienced by having to travel too far.  In rare cases, an exam gets scheduled with a doctor that is located an hour or so away from a person’s home.  If the doctor is too far away for you or something comes up and you can’t make it to the appointment, it is crucial to let your DDS specialist and/or your attorney know that ASAP so they can make arrangements to reschedule.  Failure to show up for a scheduled CE without telling anyone is grounds for DDS to deny your application for lack of cooperation.


The old saying “you get what you pay for” applies here.  Often these exams last five or ten minutes and are not thorough at all.  And 99 times out of 100, the doctor that is performing the exam is someone you have never even met before.  Social Security regulations encourage DDS to ask your regular treating doctor to perform the exam (if you have one and they are willing to do it), but this rarely happens in reality.

Given that the exams are often very brief and usually performed by a doctor that isn’t familiar with you, the doctor’s opinion ends up being super wrong in many cases.  As an example, I once had a female client who was 60 when she stopped working.  Her regular doctor had told her she needed double hip replacements and she needed a cane to walk.  She was about 5’1 and weighed about 110 lbs.  DDS sent her out for a CE to assess her physical abilities.  The doctor issued a report stating that my client should be able to perform a job that required her to lift up to 100 lbs throughout the workday—almost her entire body weight!  Luckily, I was able to convince the judge that the opinion was whack and we won the case anyway, but it’s a cautionary tale about what types of huge errors these doctors are capable of.

In order to protect yourself against a possibly whack CE opinion from a doctor you barely met, here are a few tips:

  • Take a notepad to the examination with you or make notes in your phone.  Note the time the doctor began examining you and the time the exam ended.  Make note of any tests or range of motion exercises the doctor asks you to perform.  The doctors often report that a person had a normal range of motion without actually checking the range of motion.  If there is anything unusual about the doctor’s office or the visit in general, make note of that too.  I once had a client that was sent out for a mental CE.  The doctor conducted the exam in the back of an insurance office (not joking) and there was no privacy whatsoever.  The client could hear the employees of the insurance office through the wall talking on the phone and selling insurance and was sure those employees had heard her evaluation as well.  The doctor gave an opinion that was not helpful to our case.  The client made notes about this and we were able to use that to discredit the opinion in court.
  • Also make note of the name and appearance of the doctor who performed the exam.  Social Security regulations require that the doctor who examined you must sign the report in order for it to be valid.  I’ve had at least two cases where the client and I later figured out that another doctor or someone in that doctor’s practice (like a nurse practitioner) actually performed the exam and the doctor who signed the report wasn’t even present.  I have successfully used this information in court to discredit bogus findings that are not helpful to a case.
  • Ask the doctor which of your medical records that they have reviewed.  The doctor is supposed to mention in the report which medical records (sent to them by your DDS specialist) he or she reviewed before examining you, but sometimes they fail to do that.  Establishing an inconsistency on that part of the report is another way to discredit the exam findings if they are harmful to your case.  If a doctor made assumptions about your abilities without reviewing all of the important medical records first, you or your attorney can make the argument in court that the opinion is not credible.  If there is some particularly important medical information you believe the doctor must see, you can take a copy of that with you and ask them to review it before they issue the report.
  • Be thorough.  Don’t assume the doctor knows about all of your health problems—take your time and tell them about each one.  Don’t leave anything out.  If the doctor is trying to rush you through the interview portion of the exam or won’t listen to you, make note of that as well.
  • Be polite.  If you make the doctor angry for some reason, they might write something nasty about you in the report, which is obviously bad for the case.  I’ve seen it happen before.
  • Don’t overexaggerate your problems by taking a cane with you if you don’t actually need the cane or pretending to be in more pain than you actually are in.  These doctors can smell BS a mile away. And don’t assume that no one is watching you in the parking lot.  I’ve seen countless CE reports where the doctor noted that the client was walking fine in the parking lot and lobby and then took out a cane and started hobbling around once the exam started. If the doctor thinks you are overexaggerating your problems, they might put on their report that you were “malingering”—aka faking it, which is bad for your case.


CE reports where the doctor overstates your disability can be just as harmful as ones where the doctor understates them.  Your DDS specialist has the power to discredit a CE report if they don’t think it’s consistent with the other evidence they have.  They might decide that the doctor was just going along with whatever you told them during the visit and the report is therefore not an objective assessment of your abilities.  They might decide that the doctor’s report doesn’t jive with the rest of the medical records they received.  There are certain doctors here in Alabama that are notorious among my colleagues and I for issuing totally disabling CE reports to people that have no basis in fact or reality.  We frequently see cases in our office where the CE doctor concludes that a person is very limited and should be awarded benefits, but DDS denied the person’s application anyway because the report was just too over the top.  In these cases, it’s up to you or your lawyer to convince a judge that the doctor was actually correct.


If DDS does not ask for a CE during the application process, the judge who hears your appeal has the authority to order one later if they think the information is necessary before making a decision on your case.  Some judges are more agreeable about doing this than others.  Certain judges do not like to delay making decisions on their cases and are hesitant to do anything to hold the case up after a court hearing.  Having a good attorney who can make the argument as to why a post-hearing CE is needed can go a long way.  And if a CE is genuinely needed in order to paint a clear picture of your case and the judge refuses to request one, it can be grounds for an appeal to the next level if the judge goes on to deny your case.

After your DDS specialist receives and reviews all of your medical records, paperwork, and consultative examination report (if applicable), then he or she is usually ready to issue a decision.  Even if you are one of the lucky few who gets approved on initial application, there are still many complicated variables to keep in mind.