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.
Belgian agency requests for medical examinations are made on Form BE /USA 3.
DIO schedules an examination or forwards “pertinent medical evidence” from DIO's files as described in GN 01704.810.
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.