GN 01752.310 ZUS or KRUS Agency Requests for Medical Examinations
A. Background – medical examination for U.S. resident
If ZUS or KRUS requests a medical examination for a U.S. resident, SSA will schedule the examination and send the results to ZUS or KRUS.
B. Process – obtaining medical evidence for a Polish claim
The following process is used for obtaining medical examination for ZUS or KRUS (See GN 01704.810 for general information on processing requests for medical examinations.)
1. ZUS or KRUS Requests for Medical Examinations
ZUS or KRUS requests for medical examinations are made in item D. section IV on form PL/USA 3.
2. SSA Schedules Examinations or Forwards Pertinent Medical Evidence
SSA schedules an examination or forwards “pertinent medical evidence” from SSA files. Pertinent medical evidence is evidence that was obtained by SSA in connection with a continuing disability review or a disability claim filed or adjudicated within a year of the date for which ZUS or KRUS has specifically requested medical evidence.
SSA will arrange for the consultative medical examination to be performed if requested to do so by ZUS or KRUS. ZUS or KRUS will bear the costs of this service. If only the consultative medical examination is performed, the liaison/communication form will be forwarded including a statement that SSA arranged for the examination.
SSA’s files include claims folders in DIO or in the caves in Kansas City.
3. SSA Requests Reimbursement for Cost of Medical Examinations
SSA requests reimbursement for the cost of medical examinations obtained for ZUS or KRUS using form SSA-1278-PL (USA/PL-8). Once completed, this form should be scanned into the electronic file.
NOTE: This form may be printed from the SSA Totalization Forms section of the Totalization Resource Kit.
Requests for Medical Examinations/Evidence, GN 01704.810.
D. Exhibit –Form PL/USA8
The form PL/USA 8 may be printed from the SSA Totalization Forms section of the Totalization Resource Kit on the Division of International Operations (DIO) webpage.