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Consultative Examination

How To Protect Yourself Whether You See Your Own Or The Insurance Company's Doctor

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Whether your own doctor or the insurance company's examines you, you can take steps to protect yourself and improve your chances of getting your claim approved.

Keep in mind that your benefits claim may depend on the outcome of this exam.

  • Before the exam, call the doctor's office and ask if you can bring a friend or family member and/or record the exam.  
    • If the doctor permits, ask a friend or family member to with you as a witness. Ask the other person to take notes during the exam about:
      • What was asked and how you responded.
      • What tests were done, and the results.
      • As a back-up, record the entire exam.
    • If the doctor refuses to permit a witness and/or recording, see the next section below.  
  • Prepare for the meeting by reviewing:  
    • The history of your symptoms.  
    • The impact of each symptom on your ability to work and on activities of daily living. Be specific. For example, rather than note that a symptom such as muscle weakness kept you from doing your work, note that the symptom kept you from lifting the boxes that are an integral part of your job. 
    • A good place to look for notes on this subject is your symptoms diary if you have one.

Talk over with a close friend or family member what he or she has noticed about your symptoms and how they have affected your work and/or daily life. Often, in discussing your history with another person, the person or you will think of statements and occurrences you had forgotten about.

  • Don't downplay your symptoms. One person we know of wants to be liked so much that he downplays his symptoms when he speaks with his doctors. This is self-defeating, particularly when it comes to a determination of whether you are entitled to disability benefits.
  • On the other hand, don't exaggerate your symptoms. If you suddenly have unprovable symptoms, it may cast doubt on the reality of statements made when you applied for your disability benefit. 
  • If lab tests are done, insist they be read by the same lab that your doctor used before. Different labs can have different results, even with the same tests.
  • As soon as you can after walking out of the exam room, review the notes and/or tape to make sure they are complete and to add your own observations. If you left something out, or feel you need to clarify something that was said, do so immediately either by returning to the office or calling/faxing/e-mailing.

If The Doctor Refuses To Let You Tape The Exam And Refuses To Permit Anyone Else In The Exam Room With You

Call the DDS. Speak with the person who sent you the notice about the Consultative Exam. Ask if she or he will contact the doctor for you to arrange your being able to record the session and/or to bring a person with you. The request is not only reasonable, but it is becoming more and more common for patients to record and/or bring an advocate to appointments with doctors.

If the company won't speak with the doctor, of if it does, cannot convince him or her to agree to your request, perhaps the insurer would recommend another doctor who is more agreeable to your requests.

If no company approved doctor will allow you to record the appointment or to have another person present, one alternative is to refuse the exam. However, this will likely stop action on your benefits. If you choose this route, consider writing or at least calling the insurance company.

  • Tell the company that you "were willing to take the physical exam" but were refused permission to document the physical. You would like for the insurer to explain why you were refused.
  • Offer to take the exam as long as you can record it or understand why it cannot be recorded.
  • Send the letter to the insurance company by e mail or fax, with a hard copy by mail, preferably return receipt requested. Send a copy to the doctor. Keep copies of the letter and any response.

Another alternative is to take the exam. If you do, follow the guidelines discussed in the above section: What Can I Do To Protect Myself Whether I See My Own or The Insurance Company's Doctor?

In addition:

  • Ask the doctor to write a note confirming that she would not allow you to document it and why. If she is unwilling to put this in writing, it is even more important that you immediately write down all that you remember of the exam including the doctor's refusal.
  • Note how much (or little) observation was made of your symptoms and how much the doctor relied on your own statements. For example, if one of your symptoms was shoulder pain, did the doctor have you lift and stretch and move the shoulder around while watching how you reacted -- or did she just have you lift it once and start writing.
  • Note what the doctor said. For example, if the doctor said "that looks painful" when you lifted your arm - note it.

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