TN 24 (07-91)
When writing CE reports, the provider must:
Write the history and examination in narrative form and include all specific test results.
Make the reported results of the CE conform to SSA and accepted medical standards and practices.
Include the actual medical facts as well as a statement (based on the physician's findings) which describes the claimant's
ability to function despite impairment.
Make the detail conform to the specifications listed in the Listing of Impairments.
Attach original or legible copies of tracings, xrays, interpretations, lab findings, and graphics to the narrative
report. Include any medical reports or test results brought by the claimant.
Make sure identifying information such as name, SSN or case number appear on the top of the report and on all subsequent pages.
Licensed providers in appropriate specialties will conduct the examinations.
The same providers who conducts the examination will prepare and sign the CE report.
NOTE: CE provider may include license number and/or expiration date on the report.
The medical provider will correct any deficiencies found as a result of an onsite
NOTE: The source may submit photos of the corrections made at the facility to the DDS
as proof of compliance.
Elements of a complete CE, DI 22510.015B.2.
Requirements for each specialty CE, DI 22510.000
Medical source statements, DI 22510.015B.2.
Listing of Impairments, DI 34000.000