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What happens when the SSA requests a special medical examination?

As we've made clear in previous posts, anyone seeking to secure Social Security disability benefits should know from the outset that they could be in for a long wait, as the process can take months or even years.

Given this reality, it's understandable how an applicant who recently completed the lengthy -- and arduous -- process of filing their initial application for disability benefits could find it frustrating to receive a letter asking for a special medical examination. Indeed, this may very well seem like yet another hurdle to overcome during already trying times.

What exactly is a special medical examination?

If the state agency tasked with making disability decisions on behalf of the SSA -- for us, the Tennessee Disability Determination Services -- determines that further medical information is needed to decide if you fit the agency's definition of disabled, a special medical examination will be requested.

Who performs the special medical examination?

There is no definitive answer to this question, as the Tennessee Disability Determination Services could have either your regular treating physician or another physician with whom you are unfamiliar perform the special medical examination.

Can my treating physician see the test results even if they don't perform the special medical examination?

Yes, a copy of the exam notes and/or test results can be sent to your treating physician upon request.

Who pays for the special medical examination?

The costs of the special medical examination are borne entirely by the SSA. In addition, the agency might cover certain travel expenses necessitated by the request for the exam.

We'll continue this discussion in our next post, focusing on the responsibilities of the applicant and what the Tennessee Disability Determination Services will do after receiving the results of the special medical examination.

If you have questions about this issue, the initial application process or a claim denial, consider speaking with a skilled legal professional.

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Mr. McKellar was voted by his peers as a “Top Attorney” by Knoxville’s CityView Magazine in its 2010, 2011, 2012, 2013, 2014, 2015, 2016, and 2017 editions. In 2014, 2015, and 2016, Mr. McKellar was selected as a member of the “Top 100 Trial Lawyers” by the National Trial Lawyers.

Ms. Easter was voted by her peers as a “Top Attorney” in Cityview Magazine for Family Law / Divorce / Child Support in 2012, 2013, 2014, 2015, 2016, and 2017.

Mr. Devore was voted by his peers as a "Top Attorney" by Knoxville’s CityView Magazine for Social Security Disability in 2017. "

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