If a potential client cannot afford medical care for chronic pain, what is likely to happen to her disability claim?

When a potential client presents a disability claim but lacks sufficient medical care or evidence due to financial constraints, it increases the likelihood of a consultative exam being necessary for the claims process. When medical documentation is lacking, Social Security Administration (SSA) guidelines often dictate that they may call for a consultative examination to gather the necessary medical information needed to assess the claim.

A consultative exam is conducted by a medical professional who can evaluate the claimant and provide the SSA with the relevant medical evidence to support the disability determination. This circumvents the absence of prior medical records stemming from the client’s inability to afford care, thus ensuring that the claim is still thoroughly evaluated based on the best available evidence.

While an automatic approval is not feasible without appropriate documentation, proceeding without medical evidence may not hold up to SSA scrutiny, similar to a direct rejection; thus, a consultative exam becomes a viable solution for processing the claim.