DDDS General Medical and Psychological Consultative Services

Purpose
The Department of Social and Health Services (DSHS), Division of Disability determination Services (DDDS), administers the Social Security Disability Insurance (SSDI), Supplemental Security Income (SSI), and DSHS Non-Grant Medical Assistance programs. The purpose of this Request for Qualifications (RFQ) is to expand the list of qualified, contracted providers to perform and provide consultative services for DSHS/DDDS staff and others who make disability determinations on behalf of the Social Security Administration/for clients who apply for these benefits.
Contact Name
Jennifer Elsen, Medical Relations Manager
Contact Email and Address
Jennifer.Elsen@ssa.gov
Department of Social and Health Services
Economic Services Administration
Division of Disability Determination Services
P.O. Box 9303
Olympia, WA 98507-9303
Contact Phone and Fax
(360) 664-7356 - Office
(360) 586-0851 - Fax
Submissions
If you are interested in providing consultative services, please submit your application packet to the above address or fax number.
* As of 6/13/19, applications are not being accepted. 
 

Documents

RFQ # 1436-522 ESA Medical and Psychological Services

      DDDS General Medical and Psychological Consultative Services

  • Exhibit A – Application Checklist
  • Exhibit B – Acknowledgement of Professional Qualification and Confidentiality Form
  • Exhibit C – Statement of Agreement
  • Exhibit D – Contractor Intake Form
  • Exhibit E – Applicant Certification and Assurances Form
  • Exhibit F – Federal Background Authorization Forms
  • Exhibit G – Sample Contract – DDDS General Medical and Psychological Consultative Services