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When might a consultative exam be needed for SSD benefits?

When disabled and seeking Social Security Disability benefits, New Jersey residents might become discouraged when their claim is not immediately approved by the Social Security Administration. They might even be confronted with a denied Social Security Disability claim. However, this is not the end of the case. The SSA might simply need more medical evidence as to the limitations the person suffers from due to the illness, injury or condition.

When the claimant's medical source provides the evidence and it is not sufficient, a consultative examination could help. Knowing when and why to have a CE is key to a case. Claimants should not request a CE until every reasonable attempt has been made to accrue sufficient evidence from the person's medical sources. A CE can be ordered when there is not enough evidence from the medical sources the claimant initially presented. This could be due to a reason that is out of the claimant's control, such as the medical source not cooperating or even dying.

There might be a circumstance in which there is a need for evidence from a medical source for the medical determinable impairment to be established. Some claimants will have an issue that requires a medical source that has specialized or technical expertise. The claimant's own medical source might not have the ability to provide this and a CE will be necessary for a decision. Since the severity of the impairment is so critical, the evidence as to this severity might need a CE. Finally, if there is a conflict in the evidence or if it is inconsistent or ambiguous, the SSA might require other sources to settle the matter.

Regardless of the issues in the Social Security Disability claim, it is important to have a grasp of the nuance that can be part of every individual application. Some cases are easy for the SSA to decide and there is no need for worry. Others are more complicated and there is a need for a CE or other steps to ensure there is a fair decision and the person has the best possible chance to get an approval for Social Security Disability benefits.

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