DI 43510.015 Obtaining MER
A. Source in foreign country
When additional MER is needed, the examiner will request assistance from the FSP by means of the SSA-423-U6 (SSA-5526-U3 to the Foreign Service Post in Manila, Philippines if the source is in the Philippines). The SSA-423-U6/SSA-5526-U3 should clearly state why the additional medical evidence is needed. Include a statement that the medical sources who provide evidence will be paid a reasonable fee for the costs of preparing their reports. The request should include the full name and address of the source to be contacted.
B. Domestic source
When additional MER is needed from a domestic source, the examiner will request assistance from the resident DO by means of an SSA-5526-U3. Instruct the DO to obtain evidence from the source and to return it to INTPSC, P.O. Box 17769, Baltimore, Maryland 21203. Include an SSA-827 (Authorization for Release of Medical Evidence), signed by or on behalf of the claimant when preparing your request to the DO, provide the DO personnel with the POMS reference DI 43510.075 for obtaining MER. This will alert the DO that special instructions are applicable for payment of MER.
Since foreign disability examiners (FDE) in INTPSC have procurement authority, they have the option of requesting MER directly from domestic sources and offering payment for that evidence in accordance with the fee schedule amounts authorized by the Disability Determination Services (DDS) in the State in which the source is located. This optional procedure, which eliminates the need for an assistance request to the local district office and parallels the procedures used by domestic DDS's, should result in more expeditious processing of selected foreign disability claims in which domestic MER plays a key role.
Examples of such cases would include but not be limited to:
Cases in which the date last insured (DLI) is in the past and the only source of evidence prior to DLI is domestic.
Cases in which insured status is currently met, onset is recent and the SSA-3368-F8, Disability Report, reveals what appears to be a current, thorough physical exam from a domestic source.
Payment for MER in title II cases can be made to non-Federal domestic sources for reproducing or making abstracts from existing records. Payment will not be offered or made for the actual tests or exams upon which the MER is based.
The claimant should not be asked to meet any part of the costs of the purchase of MER since such purchases are mandated by law and considered to be in the interest of the government. In the rare case where the source charges the claimant more than INTPSC can pay, this would be a matter between the source and the claimant, in which INTPSC would not become involved.
If the FDE opts to use this procedure, the following guidelines must be followed:
In requesting MER, the FDE is responsible for (1) advising medical sources that payment may be made in accordance with specified fee schedules, (2) informing the source why the evidence is needed and (3) informing the source of the detailed kind of evidence needed for adjudication.
The letter requesting MER should include the name and phone number of the person in INTPSC to contact if there are any questions as well as the information needed on the invoice. A self-addressed envelope should also be included.
Payment for MER from Federal sources, i.e., Veterans Administration or military hospitals, will not be offered or made.
Payment may be made for unsolicited MER if such evidence is of assistance or if the evidence was submitted in good faith.
Bills should be paid as follows:
General--FDE's should submit bills received as a result of a request for MER to the Division of Administrative Payment Services (DAPS). (See DI 11010.545D.4. for the complete address.).
Documentation--Each invoice (bill) must show:
The complete name and mailing address of the medical source to which payment should be sent.
The name and Social Security number of the claimant.
The amount of the charge.
The employer identification number or Social Security number of the payee.
Certification--The FDE who requests and receives MER must place the following statement on the invoice: “I certify that this medical evidence was authorized and received by me.”
The FDE must sign and date the original invoice below the statement and place the last four digits of his own office common account number as well as the subobject class codes 2528 on the invoice. If the original invoice cannot be sent to the DAPS, include the following signed statement on the copy: “This invoice is being certified in lieu of the original copy. No other invoice will be submitted.”
A copy of the letter requesting the evidence can be attached to the invoice in lieu of an OF-347-OP purchase order.