Identification Number:
DI 22510 TN 21
Intended Audience:See Transmittal Sheet
Originating Office:ORDP ODP
Title:Development of Consultative Examinations (CE)
Type:POMS Transmittals
Program:All Programs
Link To Reference:
 

PROGRAM OPERATIONS MANUAL SYSTEM
Part DI – Disability Insurance
Chapter 225 – Case Development Procedures
Subchapter 10 – Development of Consultative Examinations (CE)
Transmittal No. 21, 04/17/2020

Audience

PSC: DE, DEC;
OCO-OEIO: CR, ERE, FCR, FDE, RECONE;
OCO-ODO: DE, DEC, DS, RECONE;
ODD-DDS: ADJ, DHU;

Originating Component

ODP

Effective Date

Upon Receipt

Background

We clarified the instructions in this section and revised the video consultative examination (VCE) policy to permit scheduling VCEs in areas with a shortage of qualified psychiatric and psychological CE sources and in situations where claimants cannot access an in-person CE due to incarceration or medical concerns. We also revised instructions about performing VCEs across State borders if the relevant State authorities permit such medical practice during exigent situations.

Summary of Changes

DI 22510.012 Use of Video Teleconferencing Technology for Psychiatric and Psychological Consultative Examinations

We clarified the instructions and revised the VCE policy to include claimants in areas with shortages of CE sources and those who cannot access in-person CEs due to incarceration or medical concerns. We added flexibility to use qualified CE sources across State lines consistent with state-permitted licensure leniencies provided during exigent circumstances.

DI 22510.012 Use of Video Teleconferencing Technology for Psychiatric and Psychological Consultative Examinations

CITATIONS:

20 CFR Part 404, Subpart P, Appendix 1, §12.00C

20 CFR 404.1519, 404.1519a, 404.1519g, 416.919, 416.919a, and 416.919g

A. Policy Overview

If we cannot get the evidence we need to evaluate a claimant's medical impairment(s) from the claimant's own medical sources, we may purchase a psychiatric or psychological consultative examination (CE). We may schedule a psychiatric or psychological CE using video technology if the claimant has limited ability to access an in-person CE because:

  • The claimant resides in a rural area,

  • The claimant resides in an area with a shortage of qualified medical sources (see DI 22510.010) to perform the CE, or

  • One of the situations described in DI 22510.016E limits the claimant's ability to access an in-person CE.

If we schedule a video CE (VCE), the claimant has the right to request an in-person CE without penalty. Therefore, we must ensure the claimant is aware that we have scheduled him or her to attend a CE by video prior to the appointment.

B. What types of VCEs can the Disability Determination Services (DDS) schedule?

DDS may only use VCE to conduct:

  • Psychiatric examinations, or

  • Psychological examinations without testing.

For information on CE report content for mental disorders, see DI 22510.021.

C. VCE scheduling criteria

You may schedule a psychiatric or psychological VCE as long as doing so meets all five of the following conditions:

  1. 1. 

    The claimant agrees to attend a VCE as explained in DI 22510.012A,

  2. 2. 

    The type of VCE is consistent with policy in DI 22510.012B,

  3. 3. 

    The available video conferencing technology permits the claimant to adequately see, hear, and understand the CE source throughout the VCE,

  4. 4. 

    The CE source confirms the technology permits proper evaluation of claimants, and

  5. 5. 

    The DDS uses secure broadband connections to maintain the claimant's privacy.

D. Licensure – Can DDSs schedule VCEs across state borders?

In general, a provider may only conduct CEs across State borders if he or she is licensed in multiple states or holds a license that permits him or her to do so. Many State licensing laws and regulations disallow healthcare providers to practice across state borders without appropriate licensing in other state(s). However, some States permit healthcare providers to practice across State borders during exigent circumstances, such as National or State emergencies, to meet healthcare needs. Confirm state licensing requirements prior to scheduling a VCE across state borders (.i.e., before scheduling a VCE with a CE source who is located in a different State than the claimant).

For information on selecting a medical source to perform a CE, see DI 22510.010.


DI 22510 TN 21 - Development of Consultative Examinations (CE) - 4/17/2020