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Disability claims and the special medical examination

Once a person completes the initial application for Social Security disability benefits, they are often ready to take a step back and let the process run its course. While it's understandable why a person dealing with a serious medical condition would want a brief respite after this taxing endeavor, this might not be possible.

That's because Colorado Disability Determination Services, the state agency tasked with making disability decisions for the Social Security Administration, may soon make contact requesting what is known as a special medical examination. 

Specifically, the DDS will request and schedule a special medical examination when its examiners conclude that more information is needed to decide whether a particular applicant fits the SSA's definition of disabled.

As for the process, the physician tasked with conducting the special medical examination will only secure the information requested by the DDS, meaning he or she will not provide treatment, prescribe medication or even take part in the ultimate disability determination.

The physician will send a report to DDS, where examiners will render a final disability decision after reviewing the report and all the other information in the file.

It's important to understand that any failure to cooperate with the special medical examination -- i.e., skipping the appointment -- will mean that examiners make their decision based solely on the information available to them, which might be insufficient to support a finding of a disability. As such, applicants should strongly consider contacting DDS to reschedule if the appointment date will not work.

Some other key points that applicants should keep in mind concerning the special medical examination:

  • The cost of the special medical examination will be covered by the SSA.
  • The cost of certain travel-related expenses will be covered by the SSA.
  • The results of the special medical examination can be sent to the applicant's regular treating physician upon request.

If you would like to learn more about filing a claim for disability benefits or your options for pursuing an appeal if your initial claim has been denied, consider speaking with a skilled legal professional.

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