[Title 20 CFR 404.1519a]
[Code of Federal Regulations (annual edition) - April 1, 1996 Edition]
[Title 20 - EMPLOYEES' BENEFITS]
[Chapter III - SOCIAL SECURITY ADMINISTRATION]
[Part 404 - FEDERAL OLD-AGE, SURVIVORS AND DISABILITY INSURANCE (1950- )]
[Subpart P - Determining Disability and Blindness]
[Sec. 404.1519a - When we will purchase a consultative examination and how we will use it.]
[From the U.S. Government Publishing Office]




  20
  EMPLOYEES' BENEFITS
  2
  1996-04-01
  1996-04-01
  false
  
  404.1519a
  Sec. 404.1519a
  
    EMPLOYEES' BENEFITS
    SOCIAL SECURITY ADMINISTRATION
    FEDERAL OLD-AGE, SURVIVORS AND DISABILITY INSURANCE (1950- )
    Determining Disability and Blindness
  


Sec. 404.1519a  When we will purchase a consultative examination and how we will use it.

    (a)(1) General. The decision to purchase a consultative examination 
for you will be made after we have given full consideration to whether 
the additional information needed (e.g., clinical findings, laboratory 
tests, diagnosis, and prognosis) is readily available from the records 
of your medical sources. See Sec. 404.1512 for the procedures we will 
follow to obtain evidence from your medical sources. Before purchasing a 
consultative examination, we will consider not only existing medical 
reports, but also the disability interview form containing your 
allegations

[[Page 318]]

as well as other pertinent evidence in your file.
    (2) When we purchase a consultative examination, we will use the 
report from the consultative examination to try to resolve a conflict or 
ambiguity if one exists. We will also use a consultative examination to 
secure needed medical evidence the file does not contain such as 
clinical findings, laboratory tests, a diagnosis or prognosis necessary 
for decision.
    (b) Situations requiring a consultative examination. A consultative 
examination may be purchased when the evidence as a whole, both medical 
and nonmedical, is not sufficient to support a decision on your claim. 
Other situations, including but not limited to the situations listed 
below, will normally require a consultative examination:
    (1) The additional evidence needed is not contained in the records 
of your medical sources;
    (2) The evidence that may have been available from your treating or 
other medical sources cannot be obtained for reasons beyond your 
control, such as death or noncooperation of a medical source;
    (3) Highly technical or specialized medical evidence that we need is 
not available from your treating or other medical sources;
    (4) A conflict, inconsistency, ambiguity or insufficiency in the 
evidence must be resolved, and we are unable to do so by recontacting 
your medical source; or
    (5) There is an indication of a change in your condition that is 
likely to affect your ability to work, but the current severity of your 
impairment is not established.

[56 FR 36956, Aug. 1, 1991]