Frequently, in claims for disability benefits, the available medical evidence from
treating sources is not sufficient to make the disability decision. If it is determined
that a consultative examination (CE) is necessary, initiate the CE request by means
of an SSA-423-U6 to the FSP/VARO or SSA-5526-U3 to the Foreign Service Post in Manila,
Philippines if the source is in the Philippines.
Requests to the FSP should clearly and concisely show who is to be contacted and what
evidence is needed (e.g., orthopedic CE, x-rays of lumbar spine, pulmonary function
studies, etc.) Open-ended authorizations should not be used. Guidelines as to what
is needed in a consultative medical report and range of motion charts should be included
with the SSA-423-U6/SSA-5526-U3 request. Background MER should be included for review
by the consulting physician.
When requesting a consultative examination at government expense it is imperative
that the examiner word the request in such a way as to prevent unnecessary examinations
and expenses. Advise the FSP to inform the authorized consulting physician that expenses
for hospitalization are not authorized because we believe that hospitalization is
not necessary for the performance of the requested examination and/or laboratory tests
Also advise the FSP that generally SSA will pay for only the examinations and tests
requested. However, requests by the consulting physician for additional inexpensive
tests necessary for completion of the medical examination may be granted without prior
approval by SSA.
The FSP accepts a copy of the SSA-423-U6/SSA-5526-U3 as INTPSC's intention that the
SSA will pay the cost of getting additional medical and/ or nonmedical evidence.