Navigating the complexities of the Social Security disability system can be daunting, especially when understanding the crucial role of Disability Doctors. These medical professionals, often referred to as Consultative Examiners (CEs), are vital to the Disability Determination Services (DDS) process. They provide essential medical evaluations that help determine eligibility for disability benefits. This article sheds light on who disability doctors are, what they do, and how their expertise contributes to fair and accurate disability assessments.
Why Disability Doctors are Essential for Disability Determinations
In a significant number of disability claims, the medical information provided by an individual’s treating physician is sufficient for the DDS to make a decision. However, in approximately 30% of cases, additional medical evidence is required. This is where disability doctors step in. They conduct Consultative Examinations (CEs) to gather further medical documentation. These examinations are crucial for providing a comprehensive understanding of the claimant’s medical condition and its impact on their ability to work.
The DDS relies on a network of around 250 disability doctors across various specialties, including medical, psychiatric, and psychological fields. Their impartial evaluations ensure that disability determinations are based on thorough and objective medical evidence, contributing to the fairness and accuracy of the Social Security disability process.
Becoming a Disability Doctor: Opportunities for Healthcare Professionals
If you are a licensed healthcare professional, you might be eligible to become a disability doctor and perform Consultative Examinations. The DDS is continuously seeking qualified professionals to expand its network of examiners. Professionals who can contribute to this vital role include:
- Licensed Psychologists
- Medical Doctors (MD)
- Doctors of Osteopathy (DO)
- Audiometrists
- Speech & Language Pathologists
- Vocational Specialists
- Occupational Therapists (OT) and Physical Therapists (PT) proficient in cognitive and/or motor testing for young children
To be considered for a contract as a disability doctor, interested examiners must submit a Request for Qualification (RFQ) to the DSHS Procurements website. This RFQ process ensures that all examiners meet the necessary qualifications and understand the examination requirements set by the DDS. Detailed information about RFQs and examination requirements can be found on the DSHS Procurements website.
Areas of Expertise Needed from Disability Doctors
The DDS contracts with disability doctors across a range of specializations to ensure comprehensive evaluations. Current RFQs highlight the need for expertise in the following areas:
- Developmental or Speech-Language Pathology: Professionals with expertise in assessing developmental delays and speech-language disorders. (Developmental or Speech-Language)
- Medical CEs (Physical or Specialty Exams): Physicians with various medical specializations to conduct physical examinations and specialty-specific assessments. (Medical CEs (physical or speciality exams))
- Hearing, Audiology, or Vision: Specialists in audiology and vision care to evaluate hearing and visual impairments. (Hearing, Audiology, or Vision)
- Psychiatric Evaluations: Psychiatrists to conduct mental health evaluations. (Psychiatric )
- Psychological Evaluations: Psychologists to perform psychological assessments. (Psychological)
- Vocational Workshop Evaluations: Professionals to conduct one-day vocational workshop evaluations. (RFQ 1236-429 One-Day Vocational Workshop Evaluation)
Resources and Information for Disability Doctors
For disability doctors and healthcare providers interested in learning more or participating in the DDS program, several resources are available:
- Fee Schedules: Information on compensation for consultative examinations and medical services.
- Fee Schedule
- DDS Schedule of Maximum Allowances for Medical Services effective 1/1/2024 (PDF)
- DDS Schedule of Maximum Allowances for Medical Evidence Requests effective 1/1/2024 (PDF)
- DDS Schedule of Maximum Allowances for Medical Services effective 4/1/2023 (PDF)
- Consultative Examiner Disability Digest: A newsletter providing updates and insights for consultative examiners.
- October 2018 (PDF)
- Medical Criteria (“Blue Book”): The Social Security Administration’s guide to disability evaluation.
Contact Information for Aspiring Disability Doctors
Healthcare professionals interested in becoming Consultative Examiners can reach out to the Professional Relations Department for further information and application guidance:
Professional Relations Department:
Disability Determination Services
P.O Box 9303 MS 45550
Olympia, WA 98507-9303
1-800-562-6074
For specific inquiries, you can also contact the following individuals:
- Medical Relations and Contracts Manager: Jennifer Elsen PH: (360) 664-7356 Fax: 1-833-656-1248 [email protected]
- Consultative Examination Unit Manager: Allie Bailey PH: (509) 724-8187 [email protected], Uyen Kashani PH: (360) 584-6630 Fax: 1-833-656-1248 [email protected], Brianne Leon PH: (360) 584-5674 Fax: 1-833-656-1248 [email protected], Teresa Bracy PH: (360) 584-6416 Fax: 1-833-656-1248 [email protected], Tetyce Capshaw PH: (509) 385-2542 Fax: 1-833-656-1248 [email protected], Rhodesia Mitchell PH (509) 202-5848 FAX 1-833-656-1248 [email protected]
- Consultative Examination Unit Supervisor (Spokane and Federal Way Offices): Toni Damo-Agcaoili PH: (253) 681-5178 [email protected]
- Consultative Examination Unit Supervisor (Olympia Office): Susie Nakamura PH: (360) 664-8031 [email protected]
Streamlining Record Submission with Electronic Records Express
To enhance efficiency and reduce administrative burden, the Social Security Administration (SSA) offers the Electronic Records Express (ERE) initiative. This system allows disability doctors and other healthcare providers to submit medical records to the DDS electronically.
Submit Electronic Records
ERE offers several benefits:
- Faster Decisions: Electronic submission speeds up the delivery of records, contributing to quicker disability claim decisions.
- Increased Provider Satisfaction: Reduces labor and improves reliability in record submission.
- Improved Use of Public Funds: Minimizes costs associated with paper-based record management.
Options for Submitting Records Electronically:
- Secure Web Site: Submit records through the SSA Electronic Services secure website. (Submit Electronic Records)
- Fax: Use your office fax, ensuring the DDDS barcoded cover sheet is the first page.
- OLYMPIA DDS TOLL FREE FAX: 1-866-324-3313
- SEATTLE DDS TOLL FREE FAX: 1-866-625-3815
- SPOKANE DDS TOLL FREE FAX: 1-866-478-0546
For more information about ERE and electronic record submission, contact the DDS Professional Relations Staff.
Support Staff Credentialing and Billing Information
CE Provider Support Staff Credentialing Form: If support staff assists with Consultative Examinations, complete and submit the Support Staff Credentialing Form.
Billing and Payment Questions: Direct billing and payment inquiries to 1-800-562-6074 ext 664-7727 or locally (Olympia) 360-664-7727. Bills can be faxed to 1-800-456-5170 (for bills only, no records).
Conclusion: Partnering with Disability Doctors for a Fair Disability System
Disability doctors play a critical role in the Social Security disability determination process. Their expertise and thorough evaluations are essential for ensuring fair and accurate assessments. By providing crucial medical evidence, these professionals help individuals with disabilities access the benefits they need. For healthcare providers seeking to contribute to this important system, becoming a Consultative Examiner offers a meaningful opportunity to apply their skills and make a difference in the lives of others.
