Abromson & Carey, Attorneys at Law
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How does a disability examination work?

Claimants seeking Social Security disability benefits or Supplemental Security Income may have to undergo a special medical examination to determine whether they have a disability. New Jersey's Division of Disability Determination Services reviews claims for SSD benefits and may request this examination to ensure that claimants are disabled.

A claimant is disabled when they cannot work because of a medical condition which is expected to last at least one year or result in death. SSD benefits pay for total disability only, and not for partial or short-term disability.

When DDS needs more information to determine eligibility, it can request a medical examination or test. The Social Security Administration will pay for the exam and test and for certain travel expenses. It will also send the results to a claimant's personal physician if another doctor performs the test or exam.

Under SSA's requirements, the claimant must undergo the examination or test and cooperate with the examining physician. DDS must be informed immediately if an appointment is going to be missed. Otherwise, DDS will decide the claim for benefits on the information it already has. Without the special exam or test results, the DDS may find that the claimant does not the medical requirements for a disability and deny the claim.

The health care practitioner performs this test or examination only to obtain the information for DDS. The doctor or other practitioner will not take part in the disability decision with that agency or prescribe treatment or medication. The examination or test report will be sent to DDS.

After it receives this information, DDS will decide whether the claimant's meets the SSA's definition of a disability. Its decision will be mailed to the claimant.

A claimant may appeal a decision denying this claim. An attorney, in addition to assisting with this appeal, may help with the application and presenting disability evidence.

Source: Social Security Administration, "A Special Examination Is Needed For Your Disability Claim," Accessed May 9, 2017

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