SSA's international agreement requires parties to the agreement to assist each other in obtaining consultative examinations (CEs) and medical evidence of record (MER) when there is a claim under one country's system. These assistance requests differ from regular totalization claims because:

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  no disability determination is required, and

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  the cost of the CE or MER is subject to reimbursement from the requesting foreign country.

The Office of International Operations (OIO) will send a development request (Form SSA-847-U3) to the DDS. The DDS will return the requested evidence to OIO and include a statement of costs paid by the DDS broken down into:

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  CE costs,

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  MER costs,

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  applicant travel expenses,

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  separately billed x-rays or laboratory tests.

If the provider submits the evidence electronically it should be printed and mailed to OIO.