TN 41 (01-02)

A. Background

Many FOs have worked out special arrangements with institutions and government agencies for requesting medical reports. Notify the medical sources to forward the medical reports directly to the DDS, or OCO/ODO, as appropriate. In the rare instance where medical development is initiated by the FO and the FO is notified by the source that the evidence will not be available for some time, prepare a status report and forward it to the DDS or OCO/ODO. (If the SSA-3367-F4 is available, annotate the appropriate items to indicate that medical development was undertaken.)

If the FO has made special arrangements with medical sources to photocopy medical records, continue this practice. Forward photocopied records to the DDS promptly. When, by special arrangement, the FO representative personally secures medical reports from hospitals, or from an institution official, but the records are not immediately available, give the source a stamped preaddressed envelope to mail the medical report directly to the DDS.

In some cases, institutions, hospitals, or agencies may be unable or unwilling to comply with requests for medical evidence. When this occurs, attempt to make special arrangements with the source(s) (e.g., arrange to make photocopies of reports on file). Keep in mind, however, that the ARC for Management Operations Support must approve all special arrangements. FOs should contact the regional Center for Disability for assistance.

B. Procedure - developing special arrangements

The FO must be sensitive to the needs of medical sources that wish to see the claimant before furnishing a report and should explain this to the claimant. Inform the claimant that SSA will pay a reasonable charge for existing medical records from his/her non-Federal sources, but not for the cost of the examination or test on which the report is based. Also, tell the claimant that where a special examination or test is needed, the DDS will contact the claimant and arrange for such examination or test at Federal government expense.

There will also be local and regional circumstances where the DDS will not be able to develop for medical evidence (e.g., some hospitals may have made all initial contacts through local FOs over a period of years or special arrangements may have been worked out with FO assistance and the hospital staffs.) In these cases, the best method of handling the medical development might be through FO initiation. Each situation, however, must be evaluated separately to determine the best way to continue the established relationship.

New situations will arise which will require other activities or development. This could involve a hospital or institution that must have photocopying assistance to provide the evidence. The FO has a continuing responsibility to be sensitive to the specific needs and concerns of medical sources. The FO will advise the ARC for Management Operations Support of any special arrangement that should be modified or instituted. The ARC for Programs in coordination with the ARC for Field Operations is responsible for keeping on top of problems in this area, ensuring continuing sensitivity to medical community relationships and in implementing local and regional arrangements responsive to the needs of the medical sources.