Purpose
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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. |
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Contact Name
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Jennifer Elsen, Medical Relations Manager |
Contact Email and Address
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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
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(360) 664-7356 - Office (360) 586-0851 - Fax |
Submissions
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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