When additional MER is needed from a domestic source, the examiner will request assistance
from the resident DO by means of an SSA-5526-U3. Instruct the DO to obtain evidence
from the source and to return it to INTPSC, P.O. Box 17769, Baltimore, Maryland 21203.
Include an SSA-827 (Authorization for Release of Medical Evidence), signed by or on
behalf of the claimant when preparing your request to the DO, provide the DO personnel
with the POMS reference DI 43510.075 for obtaining MER. This will alert the DO that special instructions are applicable
for payment of MER.
Since foreign disability examiners (FDE) in INTPSC have procurement authority, they
have the option of requesting MER directly from domestic sources and offering payment
for that evidence in accordance with the fee schedule amounts authorized by the Disability
Determination Services (DDS) in the State in which the source is located. This optional
procedure, which eliminates the need for an assistance request to the local district
office and parallels the procedures used by domestic DDS's, should result in more
expeditious processing of selected foreign disability claims in which domestic MER
plays a key role.
Examples of such cases would include but not be limited to:
-
1.
Cases in which the date last insured (DLI) is in the past and the only source of evidence
prior to DLI is domestic.
-
2.
Cases in which insured status is currently met, onset is recent and the SSA-3368-F8,
Disability Report, reveals what appears to be a current, thorough physical exam from
a domestic source.
Payment for MER in title II cases can be made to non-Federal domestic sources for
reproducing or making abstracts from existing records. Payment will not be offered
or made for the actual tests or exams upon which the MER is based.
The claimant should not be asked to meet any part of the costs of the purchase of
MER since such purchases are mandated by law and considered to be in the interest
of the government. In the rare case where the source charges the claimant more than
INTPSC can pay, this would be a matter between the source and the claimant, in which
INTPSC would not become involved.
If the FDE opts to use this procedure, the following guidelines must be followed:
-
a.
In requesting MER, the FDE is responsible for (1) advising medical sources that payment
may be made in accordance with specified fee schedules, (2) informing the source why
the evidence is needed and (3) informing the source of the detailed kind of evidence
needed for adjudication.
-
b.
The letter requesting MER should include the name and phone number of the person in
INTPSC to contact if there are any questions as well as the information needed on
the invoice. A self-addressed envelope should also be included.
-
c.
Payment for MER from Federal sources, i.e., Veterans Administration or military hospitals,
will not be offered or made.
-
d.
Payment may be made for unsolicited MER if such evidence is of assistance or if the
evidence was submitted in good faith.
Bills should be paid as follows:
-
1.
General--FDE's should submit bills received as a result of a request for MER to the
Division of Administrative Payment Services (DAPS). (See DI 11010.545D.4. for the complete address.).
-
2.
Documentation--Each invoice (bill) must show:
-
a.
The complete name and mailing address of the medical source to which payment should
be sent.
-
b.
The name and Social Security number of the claimant.
-
c.
The amount of the charge.
-
d.
The employer identification number or Social Security number of the payee.
-
3.
Certification--The FDE who requests and receives MER must place the following statement
on the invoice: “I certify that this medical evidence was authorized and received by me.”
The FDE must sign and date the original invoice below the statement and place the
last four digits of his own office common account number as well as the subobject
class codes 2528 on the invoice. If the original invoice cannot be sent to the DAPS,
include the following signed statement on the copy: “This invoice is being certified in lieu of the original copy. No other invoice will
be submitted.”
A copy of the letter requesting the evidence can be attached to the invoice in lieu
of an OF-347-OP purchase order.