TN 1 (07-11)
DI 23007.009 Refusal to Attend a Consultative Examination (CE) Appointment
20 CFR 404.1512 through 20 CFR 404.1519t , and 20 CFR 416.912 through 20 CFR 416.919t
A. Exceptions to instructions in this section
Claimant refuses to cooperate with a request for evidence or action.
Claimant fails to cooperate with a request for evidence or action.
Claimant fails to attend a consultative examination (CE) appointment
Applicant requests withdrawal of the application.
Claimant does not wish to pursue the claim
Claimant fails or refuses to cooperate with a request for work history evidence
B. Refusal to attend a CE appointment defined
Refusal to attend a CE appointment means the claimant states orally or in writing that he or she WILL NOT attend a CE appointment, and does not provide a good reason why he or she will not attend the CE appointment. If the claimant provides a good reason why he or she will not cooperate with a scheduled CE appointment, reschedule it. For examples of good reasons for not attending a CE appointment, see DI 23007.009C.
NOTE: If the claimant’s treating source advised the claimant not to attend the CE appointment due to a health reason or health risk, do not persist in attempting to have the CE performed.
C. Good reasons for refusal to attend a CE appointment
Examples of good reasons include:
NOTE: The items in this list are only examples. You must exercise judgment and take into account the facts of each claim.
D. Special efforts required for title XVI childhood disability claims
For instructions on Failure Issues for title XVI childhood disability cases, see DI 25205.020.
E. Review and documentation of the claim
Regardless of the nature of the claimant’s impairment(s), if the claimant refuses to attend a CE appointment, you may discontinue development that requires evidence from or action by the claimant (e.g., consultative examinations and claimant forms completion).
review the file again to determine if you need the requested evidence;
develop medical evidence of record (MER) from other medical sources;
make every reasonable effort as explained in DI 22505.001A.2;
complete development of functional evidence indicated by the facts of the case, if the available MER substantiates mental impairment; and
DI 22511.007, Sources of Evidence
DI 22511.009, Sufficiency of Evidence
DI 22511.011, Contacting Claimants and Collateral Sources
document the case development summary worksheet with the details of the development undertaken; see case development summary instructions in DI 20503.001E. If the claimant explained why he or she would not attend the CE appointment, include the reason.
NOTE: Review by a Medical consultant or psychological consultant is not necessary if there is no medical evidence.
F. Procedure for refusal to attend a CE appointment determination
After you review and document the claim:
make a disability determination based on the evidence in file; and
if you cannot make a fully favorable determination, send a personalized disability notice (PDN). NOTE: The PDN must include an explanation that the adjudicator requested the claimant attend a CE appointment, but the claimant refused, and we made a determination based on the evidence in file.