Basic (09-06)

DI 39545.350 Claimant Evaluation of Consultative Examination (CE) Providers

Claimant feedback on the quality of CE providers is an important part of CE management and oversight of CE providers. Claimant evaluations reflect a demonstrated interest and concern in the claimant's assessment of CE providers. Knowledge that claimants are surveyed provides an additional incentive to CE providers to maintain the quality of their CEs and the quality of their physical facilities.

A. Procedure

DDSs should consider surveying claimant evaluation of CE providers on a routine basis. This survey is not merely the solicitation of complaints or the gathering of statistics on claimant complaints. The following are suggested guidelines for evaluating CE providers:

1. Survey content

Consider developing survey questions on:

  • convenience of location and physical access to the CE provider's facility;

  • cleanliness of the facility;

  • courtesy and professional conduct of the CE provider and his/her staff;

  • explanation of the examination and its expected duration by the CE provider;

  • timeliness of the examination;

  • duration of the examination;

  • completeness/thoroughness of the examination;

  • privacy of the examination;

  • general comments.

2. Conducting a survey

a. Format

Consider an appropriate survey (questionnaire, telephone, depending on local circumstances).

b. Timing

  • Initiate the survey before a decision is rendered on the claim.

  • Do not wait for a reply to the survey before adjudicating the case.

c. Frequency

  • Begin by surveying claimants scheduled for CEs using a minimum 2 percent random sample.

  • Increase the sample percentage when a problem with a CE provider is identified. A larger survey of claimants who have seen that provider is necessary to assess the severity and scope of the problem and determine appropriate corrective action.

3. Reporting survey results

  • Inform CE provider of general results, positive or negative. Negative results should be reported to the CE provider in writing. Egregious offences should also be reported to RO and Office of Disability Determinations (DCO-ODD).

  • (See DI 39545.375B. for some examples of egregious offences.)

  • If negative, consider training or other means to resolve issues.

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DI 39545.350 - Claimant Evaluation of Consultative Examination (CE) Providers - 04/20/2007
Batch run: 04/04/2013