DDDS Consultative Medical Examinations

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 physicians to perform medical examinations for clients who apply for these benefits.
Contact Name
Uyen Kashani, Professional Relations Specialist
Contact Email and Address
Uyen.Kashani@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) 664-7437 - Office
(360) 586-3578 - Fax
Submissions
If you are interested in becoming a Consultative Examiner, please submit your application packet to the above address or fax number, Attn: Matthew Delozier.

As of 10/30/2017, applications are not being accepted.

Documents

RFQ # 1436-522 ESA Medical and Psychological Services
       DDDS Consultative Medical Examinations

  • Exhibit A – Application Checklist
  • Exhibit B – Acknowledgement of Professional Qualification and Confidentiality Form
  • Exhibit C – Statement of Agreement for Medical Providers
  • Exhibit D – Applicant Certification and Assurances Form
  • Exhibit E – Contractor Intake Form
  • Exhibit F – Sample Contract – DDDS Consultative Medical Examinations
  • Exhibit G – Cardiac Specialty Examination
  • Exhibit H – Neurological Specialty Examination
  • Exhibit I – Orthopedic Specialty Examination
  • Exhibit J – Respiratory Specialty Examination
  • Exhibit K – Rheumatology Specialty Examination
  • Exhibit L – Medical Source Statement of Ability to do Work-Related Activities