DDDS Consultative Psychological 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 Qualification (RFQ) is to expand the list of qualified, contracted physicians to perform psychological examinations and psychometric testing for DDDS clients who apply for these benefits.  

* As of 5/10/18, we are only accepting new applications in E WA.

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.

Documents

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

  • Exhibit A – Application Checklist
  • Exhibit B – Acknowledgement of Professional Qualification and Confidentiality Form
  • Exhibit C – Statement of Agreement for Health Professionals
  • Exhibit D – Applicant Certification and Assurances Form
  • Exhibit E – Social Security Disability List of Preferred Psychological Tests
  • Exhibit F – Contractor Intake Form
  • Exhibit G – Sample Contract – DDDS Consultative Psychological Examinations
  • Exhibit H – Medical Source Statement of Ability to do Work-Related Activities