[Title 20 CFR 404.1519p]
[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. 404.1519p - Reviewing reports of consultative examinations.]
[From the U.S. Government Publishing Office]




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


Sec. 404.1519p  Reviewing reports of consultative examinations.

    (a) We will review the report of the consultative examination to 
determine whether the specific information requested has been furnished. 
We will consider the following factors in reviewing the report:
    (1) Whether the report provides evidence which serves as an adequate 
basis for decisionmaking in terms of the impairment it assesses;
    (2) Whether the report is internally consistent; Whether all the 
diseases, impairments and complaints described in the history are 
adequately assessed and reported in the clinical findings; Whether the 
conclusions correlate the findings from your medical history,

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clinical examination and laboratory tests and explain all abnormalities;
    (3) Whether the report is consistent with the other information 
available to us within the specialty of the examination requested; 
Whether the report fails to mention an important or relevant complaint 
within that specialty that is noted in other evidence in the file (e.g., 
your blindness in one eye, amputations, pain, alcoholism, depression);
    (4) Whether this is an adequate report of examination as compared to 
standards set out in the course of a medical education; and
    (5) Whether the report is properly signed.
    (b) If the report is inadequate or incomplete, we will contact the 
examining consultative physician or psychologist, give an explanation of 
our evidentiary needs, and ask that the physician or psychologist 
furnish the missing information or prepare a revised report.
    (c) With your permission, or where the examination discloses new 
diagnostic information or test results that reveal potentially life-
threatening situations, we will refer the consultative examination 
report to your treating physician or psychologist. When we refer the 
consultative examination report to your treating physician or 
psychologist without your permission, we will notify you that we have 
done so.
    (d) We will perform ongoing special management studies on the 
quality of consultative examinations purchased from major medical 
sources and the appropriateness of the examinations authorized.
    (e) We will take steps to ensure that consultative examinations are 
scheduled only with medical sources who have access to the equipment 
required to provide an adequate assessment and record of the existence 
and level of severity of your alleged impairments.

[56 FR 36959, Aug. 1, 1991]