Why Is a Consultative Exam Requested?

A consultative exam is typically requested by North Carolina Disability Determination Services (DDS) when:

• Your current medical records are incomplete, outdated, or unavailable
• There are conflicting opinions in your documentation
• You have not received regular medical treatment
• The SSA needs more information to assess the severity or limitations caused by your condition

It is not a routine step for every applicant—only those whose evidence needs further clarification.

Who Performs the Consultative Exam?

The exam is conducted by a licensed physician or psychologist approved by the SSA. While the exam may not be performed by your treating doctor, the provider must meet SSA’s professional standards and guidelines.

You do not pay for the exam—SSA covers the full cost.

What Happens During the Exam?

The contents of the exam depend on the condition(s) you’re claiming. Some examples:

• Physical exam: Includes strength tests, range of motion, reflexes, and physical limitations
• Mental exam: Involves memory, mood, comprehension, and cognitive function
• Specialized testing: Vision, hearing, IQ tests, or X-rays, depending on what is needed

The exam is brief—usually lasting 20–60 minutes—and is not meant to diagnose new conditions or provide treatment. It exists solely to give SSA the evidence needed to rule on your claim.

What Happens After the Exam?

The examining provider sends a report back to DDS summarizing their observations, test results, and professional assessment. DDS will:

• Use the report to help decide whether your condition meets SSA disability criteria
• Combine the CE findings with your existing records
• Determine your residual functional capacity (RFC)—what kind of work, if any, you can still perform

This report can strongly influence the outcome of your claim, especially if other documentation is lacking.

Can You Be Denied Based on a CE?

Yes. If the CE provider’s findings do not support your claim, it could result in a denial. However, if your own medical records are strong and consistent, a CE report is usually just one part of the bigger picture.

Tips for a Successful Consultative Exam

• Show up on time and be cooperative—missing a CE can result in denial
• Be honest about your symptoms and limitations, but avoid exaggeration
• Bring a list of medications, diagnoses, and recent treatments
• Do not expect treatment or medical advice—this is purely an evaluation