Basic (09-06)
DI 39545.175 Authorizing Consultative Examinations (CEs)
DDS examiners, supervisors, medical consultants (MCs) and psychological consultants
(PCs) will ensure that only necessary and appropriate CEs are purchased.
A. Policy – DDS Responsibilities
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Ensure CEs are purchased from qualified medical sources. To be qualified, the medical
source must be licensed or certified in the State in which the CE is performed and
have the training and experience to perform the type of examination or test requested.
(See Ensuring Proper Licensure of CE Providers, DI 39569.300.)
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Confirm licensing status and sanction status before using any medical sources to perform
CEs
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Ensure CE volume providers or clinics that employ CE panelists to perform CEs require
each CE panelist to sign a License/Credentials Certification Statement (see exhibit,
DI 39569.400).
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Purchase only the specific examinations and tests needed to make a disability determination.
B. Policy – Diagnostic Tests and Procedures
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MCs must approve the ordering of any diagnostic test or procedure when there is a
chance it may involve significant risk.
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Diagnostic tests or procedures that are invasive and involve significant risks, such
as myelograms, arteriograms, or cardiac catheterizations should not be ordered (see
DI 22510.006, When Not to Purchase a CE).
C. Policy – Administrative Law Judge (ALJ) CE Requests
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MCs must approve ALJ CE requests for diagnostic tests or procedures that involve significant
risk to a claimant.
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ALJ CE requests that appear to be inappropriate are referred to the DDS CE Coordinator
to discuss with their ODAR counterpart. Alternative means of obtaining the information
may be suggested for the ALJ’s consideration. ALJs should not request CE assistance
when invasive procedures are involved.