BASIC (09-06)

Citations:

20 CFR Sections 404.1519, 404.1519f, 404.1519g, 404.1519k, 404.1519m, 404.1519s, 404.1519t, 404.1624 and 416.919, 416.919f, 416.919g, 416.919k, 416.919m, 416.919s, 416.919t and 416.1024

A. Introduction

This subchapter discusses the SSA Disability Determination Services (DDS) responsibilities for managing and monitoring the consultative examination (CE) process. CEs are purchased when medical evidence of record (MER) does not exist or does not meet the documentation requirements in the “Listing of Impairments.” The following subjects are discussed in this subchapter:

• Managing the CE process

• Sources and types of purchased medical services

• CE/MER evidence

• Authorizing CEs

• Fee schedules

• CE scheduling intervals

• Missed CE appointments

• Claimant evaluation and complaints of CE providers

• CE reports and release of CE reports to claimants by CE providers

• DDS onsite reviews of CE providers

• DDS annual CE oversight reporting