What Does a Medical Consultant do on a Disability Case?

Parmele Law FirmSocial Security

Not surprisingly, the Social Security Administration (“SSA”), which administers the federal Social Security Disability Insurance (“SSDI” or “disability benefits”) program, employs doctors to assist with disability determinations.

Medical Consultants and Medical Examiners.

When and individual applies for disability benefits, the claim goes to the state Disability Determination Services (“DDS”) to be reviewed and processed by a disability examiners.

The disability examiner is the person who ultimately decides (at the initial level) whether the claim for SSDI should be granted or denied.

To determine whether a claimant is “disabled” or “not disabled,” the disability examiner needs to have objective medical evidence.

But disability examiners are not doctors.

So the SSA employs doctors —officially called “medical consultants” or “medical examiners”—to assist the disability examiners.

These DDS doctors are licensed physicians. They must have an M.D. degree and be licensed. Many of them are retired from active practice.

They are not the same doctors who perform Consultative Examinations (“CE”) for the SSA.

What Medical Consultants Do.

When it comes to processing a disability claim, the disability examiner does basically all the work.

It is the disability examiner (who, remember, is not a doctor) who gathers all of your medical records and reviews them. The disability examiner is the one who conducts the disability interview with you. He or she also reviews your relevant work history. Disability examiners generally write up a factual synopsis of your case for the file.

But probably most important is the fact that it is the disability examiner who fills out the Residual Functional Capacity form (“RFC”). (A physical RFC if your condition(s) are physical, or a mental RFC if your condition(s) are mental in nature.)

In other posts we have stressed the importance of an RFC to your claim and why you should have your treating physician fill one out for you. Briefly, your “residual functional capacity” defines for the SSA what you are capable of doing (lifting, sitting, following directions, etc.) and what you are too limited by your condition(s) to do. Your RFC determines in large part whether you will be awarded disability benefits.

Because there is so much riding on the accuracy of the RFC, the SSA requires disability examiners to have their RFC forms reviewed by a doctor – either a medical consultant or a psychological consultant.

If the medical consultant agrees with the disability examiner’s assessment of your RFC capabilities, he will “sign off” on the RFC.

Think your RFC, filled out by a disability examiner and reviewed by a retired physician who does not know you and has never seen you is as accurate as one filled out by your treating physician?

Neither do we.

That’s why we believe that everyone applying for SSDI benefits should be represented by experienced social security disability counsel.

We FIGHT to Get Our Clients the Benefits They Deserve.  

Disability benefits are subject to a number of complicated and confusing rules. If you need help, contact us. We are experienced disability attorneys. We have helped many people get benefits and we can help you, too. We have offices throughout Missouri. We also have offices in Kansas, Illinois and in Oklahoma City, Oklahoma. We offer FREE consultations and we do not get paid unless you win your case. Call us at 855-727-8625.