(a) General. If you are applying for benefits and do not have a good reason for failing or refusing to take part in a consultative examination or test which we arrange for you to get information we need to determine your disability or blindness, we may find that you are not disabled or blind. If you are already receiving benefits and do not have a good reason for failing or refusing to take part in a consultative examination or test which we arranged for you, we may determine that your disability or blindness has stopped because of your failure or refusal. Therefore, if you have any reason why you cannot go for the scheduled appointment, you should tell us about this as soon as possible before the examination date. If you have a good reason, we will schedule another examination. We will consider your physical, mental, educational, and linguistic limitations (including any lack of facility with the English language) when determining if you have a good reason for failing to attend a consultative examination.
(b) Examples of good reasons for failure to appear. Some examples of what we consider good reasons for not going to a scheduled examination include—
(1) Illness on the date of the scheduled examination or test;
(2) Not receiving timely notice of the scheduled examination or test, or receiving no notice at all;
(3) Being furnished incorrect or incomplete information, or being given incorrect information about the physician involved or the time or place of the examination or test, or;
(4) Having had death or serious illness occur in your immediate family.
(c) Objections by your medical source(s). If any of your medical sources tell you that you should not take the examination or test, you should tell us at once. In many cases, we may be able to get the information we need in another way. Your medical source(s) may agree to another type of examination for the same purpose.
[45 FR 55621, Aug. 20, 1980, as amended at 59 FR 1636, Jan. 12, 1994; 82 FR 5877, Jan. 18, 2017]
Notes of Decisions
Cited in
31
cases (
18 in the last 5 years), 1980–2025 · leading case:
Walker v. Comm Soc. Sec., 172 F. App'x 423 (3rd Cir. 2006).
Walker v. Comm Soc. Sec., 172 F. App'x 423 (3rd Cir. 2006).
· cites it 7× “Since Walker proffered no good reason in the ALJ’s judgment for failing to attend as directed, he was ruled not disabled pursuant to 20 C.F.R. § 416.918 . Because we conclude that substantial evidence supports this ruling, we affirm the judgment of the District Court.”
Angelica Rivera v. Patricia Roberts Harris, Sec'y of Health, Educ., & Welfare, 623 F.2d 212 (2d Cir. 1980).
“It does not appear that he relied on 20 C.F.R. § 416.918 which provides, in effect, that an individual, who has a disabling impairment that is amenable to prescribed treatment which could be expected to restore his ability to work, cannot be found “disabled” if he “willfully…”
Schow v. Astrue, 272 F. App'x 647 (9th Cir. 2008).
“An ALJ may consider opinions from sources other than “acceptable medical sources,” like a nurse practitioner, 20 C.F.R. § 416.918 (d)(1), and may discount those opinions by providing reasons that are “germane” to that source.”
Swales v. Berryhill, 245 F. Supp. 3d 290 (D. Mass. 2017).
“See 20 C.F.R. § 416.918 (a) (“If you are applying for benefits and do not have a good reason for failing or refusing to take part in a consultative examination or test which we arrange for you to get information we need to determine your disability or blindness, we may find that…”
Rogers v. Massanari, 226 F. Supp. 2d 1040 (E.D. Mo. 2002).
“" See 20 C.F.R. § 416.918 (a) (2000). However, the administrative record, including the rather contentious hearing before the ALJ, indicates that the cause of plaintiff's "depressive symptoms, labile mood and acting out" may in fact render him disabled under the Act, if the…”
Coty v. Sullivan, 793 F. Supp. 83 (S.D.N.Y. 1992).
· cites it 2× “Finally, plaintiff, relying on a report issued by the Department of Health and Human Services (the “Department”), asserts that even if he did not have “good reason” for not appearing at the consultative examination, pursuant to 20 C.F.R. § 416.918 , 6 the Secretary’s decision…”
Verge v. Comm'r of Soc. Sec. (W.D.N.Y. 2020).
· cites it 4× “20 C.F.R. § 416.918 (a). “Good reasons” for failing to participate in a scheduled examination include (1) illness on the date of the scheduled examination; (2) failing to receive timely notice of the examination; (3) being provided with incorrect or incomplete information about…”
Smith v. Kijakazi (N.D. Cal. 2022).
· cites it 2× “’s claims, citing 20 C.F.R. § 416.918 . That section provides, in 9 relevant part, “[i]f you are applying for benefits and do not have a good reason for failing or 10 refusing to take part in a consultative examination or test which we arrange for you to get 11 information we…”
Brumby v. Saul (S.D. Ind. 2020).
· cites it 2× “See 20 C.F.R. § 416.918 (a) (“If you are applying for benefits and do not have a good reason for failing or refusing to take part in a consultative examination or test which we arrange for you to get information we need to determine your disability or blindness, we may find that…”
Lundie v. Kijakazi (E.D.N.Y 2021).
· cites it 2× “See 20 C.F.R. § 416.918 (a).7 Here, the SSA scheduled two consultative examinations of Plaintiff—he failed to appear for both.”
Penvose v. Comm'r of Soc. Sec. (W.D.N.Y. 2020).
· cites it 2× “See 20 C.F.R. § 416.918 (a); SSA’s Hearing, Appeals, and Litigation Law Manual (“HALLEX”) § I-2-5-24A (Oct.”
Fomby v. Comm'r of Soc. Sec. (W.D.N.Y. 2021).
· cites it 2× “Pursuant to 20 CFR 416.918, if one applying for benefits fails to appear for a consultative examination without good reason, the Administration may find him not disabled.”
— 20 C.F.R. § 416.918(a) — 1 case
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