Occasionally, the AC may discover potential issues regarding the
conduct, qualifications, or performance of an ME, VE, or consultative
examiner during case adjudication.
When a referral for further consideration may be warranted, the
analyst will discuss the situation with an administrative appeals judge
(AAJ). If the AAJ agrees a referral is appropriate, the analyst will
send an email to EDO at ^DCARO OAO with the subject line “Expert
conduct referral.” The content of the email will include the
following information:
•
The claimant's name and Social Security
Number;
•
The name of the ME, VE, or consultative
examiner;
•
A brief description of the conduct or qualification
issue;
•
The exhibit number or location of the relevant information
in the file; and
•
The name of the AAJ agreeing that referral is
appropriate.
If the case is paper, staff will
also forward copies of any relevant documents to EDO via a scanned
attachment or, when more appropriate, forward hard copies of the
documents.
After sending the email, the analyst will add the expert conduct
case characteristic “EXCN”
in the applicable case processing system(s).
If the analyst suspects fraudulent
behavior, the analyst need not consult with an adjudicator
before referring the matter to the Office of the Inspector
General (OIG), as explained in HALLEX HA 01130.009.