If a Belgian liaison agency requests a medical examination for a U.S. resident, SSA
will schedule the examination and send the results to the Belgian agency.
Medical examinations for Belgium are obtained as follows.
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Belgian agency requests for medical examinations are made on Form BE /USA 3.
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DIO schedules an examination or forwards “pertinent medical evidence” from DIO's files as described in GN 01704.810.
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SSA requests reimbursement for the cost of medical examinations obtained for Belgium
using a reimbursement form. Since Belgium seldom requests a medical examination, a
Belgian reimbursement form has not been printed. If a form is needed, the case should
be routed to DIO program analysts.