BASIC (09-06)

Citations:

20 CFR 404.1519n

DDSs will monitor the scheduling of examinations (through normal CE oversight activities) to ensure over scheduling is avoided.

A. Procedure – scheduling intervals

Allow sufficient time to permit the medical source to take a case history and perform the examination, including any needed tests. Use the following minimum scheduling intervals (i.e., time set aside for the individual appointment, not the actual duration of the CE).

• Comprehensive general medical examination (at least 30 minutes).

• Comprehensive musculoskeletal or neurological examination (at least 20 minutes).

• Comprehensive psychiatric examination (at least 40 minutes).

• Psychological examination (at least 60 minutes) (additional time may be required depending on types of psychological tests administered).

• All others (at least 30 minutes or in accordance with accepted medical practice).

Allow additional time for ancillary studies, etc. The purpose of these minimum scheduling timeframes is to ensure that CEs are complete and sufficient time is made available to obtain the information needed to make an accurate determination. Minimum intervals between appointments may need to be adjusted to allow for missed CE appointments.

B. Procedure - monitoring

• Maintain routine CE oversight activities.

• Emphasize to key providers that they should make every effort to schedule CEs at approximately the intervals stated in DI 39545.250A.

• Increase monitoring of a CE provider when there is an indication that scheduling intervals are not being followed (e.g., claimants complain CEs are too short; or routine DDS CE oversight visits uncover instances of overscheduling).

• Follow State procedures to cease using a CE provider if he or she continues to disregard the scheduling interval requirement (e.g., provide due process).

C. Procedure - training

• Explain scheduling interval requirements to all CE providers.

• Explain to CE providers that complaints regarding short-duration examinations can be reduced if they inform the claimant about the nature and expected duration of the procedure before the CE takes place. This information will help improve customer relations and prevent complaints in cases where only partial examinations or ancillary tests are ordered.